Gujarat has recorded the second highest number ofextreme drug-resistant TB since the discovery of the disease in India threeyears ago; the state has recorded the third highest number of deaths afterMaharashtra and Delhi
Thirty-four-year-old Anita Agarwal (name changed) was admitted to TB Hospital on the Civil campus in Ahmedabad. When she did not recover after six months of treatment, worried doctors tested her sputum, only to discover that she had developed third-line drug-resistant TB.
Though extreme drug resistant TB (XDR-TB) is just two-year-old in Gujarat, it has already become a subject of concern among medical experts. According to data provided by the Directorate General of Health Services under RTI, between 2012 and 2014, Gujarat has registered the second highest number of patients with XDR-TB in the country.
The state-wise average of patients diagnosed with XDR-TB is 33 whereas Gujarat accounts for 222 of the 768 cases reported in the same period. Maharashtra with 316 cases tops the chart.
According to medical experts, XDR-TB is man-made, caused due to irregular intake of medicines during the course of DOTS. “When patients with first and second line infection follow irregular medication and stop treatment abruptly, the bacteria become resistant to the drugs. Later when medicines are given, they don’t react to them and the condition of patients deteriorates,” said Dr Rajesh Solanki, TB specialist at Ahmedabad Civil Hospital.
Third in mortality rate
The response to RTI plea also shows that in just 20 months, ended September 2013, Gujarat has recorded the third highest number of deaths in XDR-TB in the country after Maharashtra and Delhi.
The data collected between January 2012 and September 2013, show 29 patients with the infection have died.
However, as WHO has stated, the treatment options in this infection are seriously limited. It is therefore vital that TB control is managed properly.
“If not taken care of properly, it can infect other people as it is an air-borne disease. When TB at the third stage passes on to another person, he/she also gets the infection of the third stage,” said Dr Vidyut Desai, former president of Ahmedabad Medical Association.
‘Wrong misrepresentation of facts’
When Mirror contacted medical experts, they said that the number provided under RTI is a misrepresentation of facts.
“Gujarat has extremely efficient data collection teams which visit the remotest areas just to register people living with TB so that we can keep a track of them. Hence, the high number of TB patients in Gujarat. But it doesn’t prove that incidence of XDR-TB in the state is the second highest in the country. It reflects efficient data collection procedure which other states lack,” said a TB specialist on request of anonymity.
How XDR-TB develops
TB patients need to follow the medical guideline mentioned in DOTS but when the TB bacteria become resistant to the anti-TB drugs provided to patients at first and second line treatment, they develop XDR-TB.
XDR-TB is the third-line multi-drug resistant TB which is resistant to any fluoroquinolone, and at least one of the three injectable second-line drugs (capreomycin, kanamycin and amikacin), in addition to isoniazid and rifampin. This makes XDR-TB treatment extremely complicated in resource-limited settings. According to World Health Organisation, currently no medical treatment is available for XDR-TB.
There are two phases of XDR-TB treatment:
* The Intensive Phase (6-12 months) will consist of seven drugs: capreomycin, PAS, moxifloxacin, high dose-INH, clofazimine, linezolid and amoxyclav.
* The Continuation Phase (18 months) will consist of six drugs: PAS, moxifloxacin, high-dose-INH, clofazimine, linezolid and amoxyclav.
Thirty-four-year-old Anita Agarwal (name changed) was admitted to TB Hospital on the Civil campus in Ahmedabad. When she did not recover after six months of treatment, worried doctors tested her sputum, only to discover that she had developed third-line drug-resistant TB.
Though extreme drug resistant TB (XDR-TB) is just two-year-old in Gujarat, it has already become a subject of concern among medical experts. According to data provided by the Directorate General of Health Services under RTI, between 2012 and 2014, Gujarat has registered the second highest number of patients with XDR-TB in the country.
The state-wise average of patients diagnosed with XDR-TB is 33 whereas Gujarat accounts for 222 of the 768 cases reported in the same period. Maharashtra with 316 cases tops the chart.
According to medical experts, XDR-TB is man-made, caused due to irregular intake of medicines during the course of DOTS. “When patients with first and second line infection follow irregular medication and stop treatment abruptly, the bacteria become resistant to the drugs. Later when medicines are given, they don’t react to them and the condition of patients deteriorates,” said Dr Rajesh Solanki, TB specialist at Ahmedabad Civil Hospital.
Third in mortality rate
The response to RTI plea also shows that in just 20 months, ended September 2013, Gujarat has recorded the third highest number of deaths in XDR-TB in the country after Maharashtra and Delhi.
The data collected between January 2012 and September 2013, show 29 patients with the infection have died.
However, as WHO has stated, the treatment options in this infection are seriously limited. It is therefore vital that TB control is managed properly.
“If not taken care of properly, it can infect other people as it is an air-borne disease. When TB at the third stage passes on to another person, he/she also gets the infection of the third stage,” said Dr Vidyut Desai, former president of Ahmedabad Medical Association.
‘Wrong misrepresentation of facts’
When Mirror contacted medical experts, they said that the number provided under RTI is a misrepresentation of facts.
“Gujarat has extremely efficient data collection teams which visit the remotest areas just to register people living with TB so that we can keep a track of them. Hence, the high number of TB patients in Gujarat. But it doesn’t prove that incidence of XDR-TB in the state is the second highest in the country. It reflects efficient data collection procedure which other states lack,” said a TB specialist on request of anonymity.
How XDR-TB develops
TB patients need to follow the medical guideline mentioned in DOTS but when the TB bacteria become resistant to the anti-TB drugs provided to patients at first and second line treatment, they develop XDR-TB.
XDR-TB is the third-line multi-drug resistant TB which is resistant to any fluoroquinolone, and at least one of the three injectable second-line drugs (capreomycin, kanamycin and amikacin), in addition to isoniazid and rifampin. This makes XDR-TB treatment extremely complicated in resource-limited settings. According to World Health Organisation, currently no medical treatment is available for XDR-TB.
There are two phases of XDR-TB treatment:
* The Intensive Phase (6-12 months) will consist of seven drugs: capreomycin, PAS, moxifloxacin, high dose-INH, clofazimine, linezolid and amoxyclav.
* The Continuation Phase (18 months) will consist of six drugs: PAS, moxifloxacin, high-dose-INH, clofazimine, linezolid and amoxyclav.
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