Rise in the number of patients suffering from multiple-drug resistant (MDR) tuberculosis in Punjab is costing the state government exchequer dear, with the cost of free drugs being distributed at local directly observed treatment short-course (DOTS) centres is 100 times the cost of treating normal TB.
The prevalence of MDR-TB is more among factory workers and migrants belonging to weaker economic sections. Factory workers in the city who live in cramped houses and work under extreme conditions are more prone to contracting the disease. Same is the case with migrant labourers who throng the city to get jobs at various industrial units here.
District TB officer Dr Rajeev Sharma said, “The treatment of TB that completes in six months costs around Rs 2,000 for one patient, but MDR-TB treatment costs around Rs 2 lakh extending over a period of 24 months. The rate of patients who discontinue during the course of treatment in Jalandhar is around 15-17%, which needs to be brought down by proper intervention.”
“We receive two new cases of MDR-TB every month at the civil hospital, which are confirmed after diagnosis at our centres. There are several cases which go undiagnosed and general trend in the past suggests of misdiagnosis of MDR-TB by many private hospitals,” Dr Sharma further said.
MDR-TB has been for long time in India but due to a sudden increase in the number of patients it has now become a major threat. The increasing trend of MDR-TB was more likely in pulmonary TB when compared with extra-pulmonary TB, say experts at the civil hospital.
However, very few diagnostic laboratories in the city are well-equipped to test drug sensitivity. There are just 3% chances that a patient without any previous TB history can acquire MDR-TB and it goes up to 17% for patients who have not completed their DOTS course or have skipped the medicine course, the TB officer informed.
Civil surgeon, Jalandhar, Dr RL Bassan said, “Prevalence of TB is high among people belonging to the economically weaker sections as they do high endurance work and don’t consume necessary proteins which can keep diseases like TB at bay. At times, patients who suffer from TB miss their course or skip the medicines due to lack of knowledge which exposes them to MDR-TB.”
Rano Devi (25), who hails from Saharsa in Bihar, is undergoing treatment for drug-resistant tuberculosis (TB) at a local DOTS centre. Little did she know that discontinuing her treatment and hiding the disease for getting married would make her resistant to TB drugs.
The migrants tend to hide their ailment to get jobs, thus aggravating the problem. “Most of the times, migrants just vanish after one or two courses of DOTS after they feel better. At times, they keep changing cities. The government has connected all DOTS centres in the country. If someone is undergoing treatment in a particular state he can go and contact a centre in another state to seek treatment. But lack of awareness exposes them to MDR-TB,” Dr Bassan said.
Official data suggest that the prevalence rate of MDR-TB against overall TB cases is 38.8% in Punjab, while in North India it increased from 36.4% in 2010 to 40.8% in 2013.