Saturday, January 7, 2012

New, deadlier form of TB hits India

THE TIMES OF INDIA - 07-01-2012


Tuberculosis, which kills around 1,000 people a day in India, has acquired a deadlier edge. A new entity—ominously called Totally Drug-Resistant TB (TDR-TB)—has been isolated in the fluid samples of 12 TB patients in the past three months alone at Hinduja Hospital at Mahim. The hospital’s laboratory has been certified by the World Health Organization
(WHO) to test TB patients for drug resistance.

While Iran first reported TDRTB cases three years ago, India seems to be only the second country to report this deadly form of the disease. TDR-TB is the result of the latest mutation of the bacilli after Multi-Drug-Resistant TB (MDR-TB) and Extremely Drug-Resistant TB (XDR-TB) were diagnozed earlier.

Even more worryingly for Mumbai, 10 of the 12 TDR-TB cases are from the city, while the other two are patients from Ratnagiri and UP. One of the 12 patients has since died. India sees around 3- 4 lakh deaths for all forms of TB each year, while the world saw 1.7 million deaths in 2009.

As the full form of TDR-TB suggests, none of the known TB combination drugs work on the patient. All 12 showed resistance to 12 drugs. “The TB bacilli have obviously mutated. The emergence of TDR-TB has grave implications for public health,’’ said Hinduja Hospital’s Dr Zarir Udwadia, whose observations have been published in the latest issue of the US-based Clinical Infectious Diseases (CID) peer review journal. His team started isolating TDR-TB cases among patients with pulmonary TB in October 2011.

Dr Amita Athawale, who heads KEM Hospital’s chest department, said TDR-TB was a reality in India. “The cases we clinically isolate are just the tip of the iceberg,’’ she said. TB is one of the biggest killers in India, along with heart attack.

Among tuberculosis patients, drug resistance develops mainly because patients fail to complete the 6- to 9-month first treatment phase. “They feel better within a couple of months of taking the drugs and so they stop taking them. However, the TB germs in the body are not completely vanquished and they again multiply,’’ said a senior BMC public health official.


Tuberculosis is one of the most fatal diseases in Mumbai, accounting for nearly 15% (8,953) of the deaths in 2010

• Left untreated, each person with active TB can infect 10 to 15 people a year

• TB is a contagious disease. Like the common cold, it spreads through the air

• Patients resistant to all first-line and second-line drugs are classified as having Totally Drug-Resistant TB (TDR-TB)

An estimated 1.7 million people died from TB worldwide in 2009

• About 3 lakh to 4 lakh die of TB each year in India

• It is believed that more than half the city’s TB patients seek treatment in the private sector
‘Deadlier strain arose due to health system’s failure’ AVERAGE AGE OF PATIENTS WHO DIDN’T RESPOND TO TUBERCULOSIS DRUGS IS 32 YEARS

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