A study published online in the Lancet Infectious Disease journal has yet again highlighted the need to bring down person-to-person transmission of drug-resistant tuberculosis in India.
The Lancet study has predicted an increase in drug-resistant TB cases in four high-burden countries, including India.
According to the study report conducted by an international team of scientists, by 2040, one in every eight TB cases in India will be multidrug-resistant (MDR) TB.
Nearly 40 per cent of all drug-resistant TB cases occur in four countries (South Africa, Russia, Phillipines and India), which accounted for over 2,30,000 cases in 2015.
Dr Vikas Oswal, chest physician and TB expert in Mumbai, said, “The worrying factor is primary MDR-TB is on rise. Earlier, it used to be 10% and now, it is around 12% to 15%. Lack of awareness among people and physicians, and poor private sectors’ engagement are a few reasons.”
He said many TB patients default on their treatment due to financial constraints and long-term medication course.
“We need to counsel patients on importance of completing the treatment. We also need to sensitise physicians on TB treatment guidelines as many physicians still give second line drugs to first line patients without knowing the fact that this is increasing the drug resistant TB cases. We need robust public-private engagement by directing TB patients to public sector for free medication and treatment,” said Oswal.
In 2015, globally, an estimated 10.4 million new cases of TB and 1.8 million deaths related to TB disease occurred. There were an estimated 4,80,000 cases MDR-TB cases, of which 9.5% were accounted to be extremely drug resistant.
Dr Daksha Shah, Mumbai TB officer, Brihanmumbai Municipal Corporation (BMC), said, “As our diagnostic faculty is upgraded, we are seeing more number of MDR-TB patients and every year these numbers are increasing.”
Shah said doctors should suspect MDR-TB in a patient who has been treated in past for TB.
“Doctor should confirm MDR-TB in such patients and accordingly give medicines. As an authority, we are taking all precautionary steps by providing free treatment, medicines, but for early detection, knowledge of doctors and awareness among public and TB patients is also important,” said Shah.
According to health ministry figures, India has 2.8 million cases of TB every year. Of these, 2.8% are new cases of multidrug resistance while another 11.2 are acquired cases of multi-drug resistance.
Dr Rajendra Nanavare, TB expert and ex-medical superintendent at Sewri TB Hospital, said, “In India, 17% of drug resistant cases are because of defaulting TB treatment by not taking proper treatment or not given proper treatment. It is seen that in India, less than 3% are primary infections of drug resistant TB. We need to ensure that each and every TB patients get proper treatment and complete the course so that this primary infection percentage does not rise.”