Patients, who have had a previous episode of tuberculosis (TB), delay treatment by about 25 days when the infection relapses thus spreading it to healthy people, revealed a study by the Foundation of Medical Research (FMR).
Researchers looked at the medical history of 83 randomly-selected patients living in localities in the city with a higher incidence of the infection and found that the delay is similar to that among first-time TB patients. The study has been published in the international scientific journal, PLOS ONE, on March 28.
The findings are alarming because patients who have a relapse are most likely to harbour the multiple-drug resistant TB (MDR) and extensively drug resistant TB (XDR TB) which are difficult to treat, said doctors.
“If a patient has suffered from TB in the past, it is likely that they have been given multiple drugs in various dosages and combinations to treat the disease. A reinfected patient is the most likely candidate of having the drug resistant forms of the infection,” said Dr Vikas Oswal, consultant chest physician attached to a municipal hospital in Govandi, one of the areas which was covered under the study.
“If there is a delay in reinfected patients seeking help and getting screened , they spreading the drug resistant TB infection to more and more people in the community, which is very dangerous,” he added.
According to the authors of the paper, denial of the infection recurring and the misguided belief that TB can strike only once in a lifetime are the main reasons behind relapsed patients not becoming aware of the symptoms earlier than new patients
“The data clearly points at the significant gap in the health literacy of the TB patients. Patients who have had TB in the past have clearly not been counselled about the disease, which is taking them so long to seek help” said Dr Nerges Mistry, director, FMR and one of the authors of the study.
Interestingly, the study also found that out of the 70% patients who initially sought help in the private sector, 64% shifted to public hospitals for treatment. “The cost of consultations and medicines in private sectors is high. In the public sector, the medicines and follow ups are free of cost. That is why there is a switch from the private to the public sector,” said Mumbai’s municipal TB officer, Dr Daksha Shah.