Drug-resistant TB high in India, 5 lakh deaths a year

Hyderabad: The incidences of multi-drug resistant tuberculosis, already a high in India by global standards, is increasing, as over five lakh new cases are identified each year. Inadequate and incomplete treatment of tuberculosis is the main reason for the increasing incidences of drug resistance. Experts say that to control multi-drug resistant tuberculosis (MDRT) double the efforts are required to control TB.

The controlling of MDRT is a challenge as its treatment plan requires a heavy dose of drugs and medicines for 24 months. It also requires intervention from specialists of the kidney, brain and digestive tracks, besides a lung specialist, which increases the cost of the treatment and requires frequent trips to the hospital.

The lapses in treatment during the first stage of TB are due to stigma, lack of financial resources or knowledge of the disease in the general public.

Experts say that TB patients take medicines for three months, during which time cough and body pains subside. But the complete treatment course is of nine months to kill the bacteria in the body, which several patients ignore. This half-treatment regime leads to the re-emergence of the disease. The re-emergence is deadly and proves fatal in many cases. There were five lakh TB deaths recor-ded in India by the World Health Organisation (WHO) in 2018.

A vicious cycle of TB, MDRT and HIV infection has also been noted in significant numbers by medical practitioners. These combinations are elongating the treatment period, besides making them expensive and increasing fatality rates.

Dr Mehboob Khan, superintendent, Chest Hospital, said, “There are more inpatients of MDRT now than there used to be five years ago in the hospital. Nearly 40 per cent of in-patients belong to this category. Telangana has 50,000 new cases of MDRT TB every year.”

The ground reality is that 80 per cent of patients do not understand the concept of having to complete the TB treatment course.

The other problem observed in big numbers is that TB patients do not get enough cooperation and support from family members. There is often worry about loss of pay if the patients do not report to work.

Due to these factors, nutritional and medication regimes are compromised.

These compromised patients, who have taken only half-treatment, are not only at a high risk of a relapse but also become an un-quarantined health hazard, as each uncured TB patient out in the open can spread the disease to nearly another thousand people, experts argue.

Dr C Vijay Kumar, senior pulmonologist, Apollo Hospitals, said, “Following a good cough etiquette is important to control the  spread of the disease. This is such a simple yet effective preventive measure. The spread of TB is very high in high-density zones of cities, since most all our metro cities are over-crowded.”

India contributes to 27 per cent of TB cases worldwide. To eradicate TB globally, controlling its spread in India is very important and the stated target is to eradicate it by 2025.

Experts, however, concede that it is a herculean task for India, despite a robust surveillance and control programme.