‘Totally drug-resistant is misleading term’

The Union ministry of health and family welfare on Tuesday objected to the use of term totally drug-resistant tuberculosis (TDR-TB) stating that it was “misleading” and not recognised by the World Health Organisation (WHO) and the Revised National Tuberculosis Control Programme (RNTCP) of the Indian government.

The Union ministry of health and family welfare on Tuesday objected to the use of term totally drug-resistant tuberculosis (TDR-TB) stating that it was “misleading” and not recognised by the World Health Organisation (WHO) and the Revised National Tuberculosis Control Programme (RNTCP) of the Indian government.

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The statement was issued in response to the recent announcement made by Hinduja hospital in Mahim that it had detected 12 patients with TDR-TB, an incurable form of TB.

The government’s press release stated that the cases should be referred to as extensively drug-resistant-TB (XDR-TB) as per the WHO norms.

Three of the 12 patients detected with TDR-TB by Hinduja hospital died in the past two months. This was the first time that TDR-TB patients were detected in India.

However, the ministry said the hospital laboratory was not accredited by the RNTCP to test for XDR/ TDR cases. The government statement added that the hospital had recently sent a proposal for accreditation to conduct the Line Probe Assay (LPA) test, which detects drug resistant TB, and that is under process.

The ministry further said that testing for resistance beyond XDR-TB was not advocated by WHO and that poor clinical response to the treatment had not yet been correlated with diagnosis of drug-resistant TB without laboratory confirmation from accredited laboratories. “Any type of drug-resistant TB can only be diagnosed by laboratory test and not by clinical examination alone,” the release said.

The statement added that drug-resistance surveys from Gujarat and Maharashtra show that there was no XDR-TB among new cases and approximately 0.5% among re-treatment cases.