Discovery of Drug-resistant TB in India Causes Concern

A completely drug-resistant strain of tuberculosis has surfaced in the Indian city of Mumbai.

The discovery of a completely drug-resistant strain of tuberculosis in the Indian city of Mumbai has rung alarm bells among medical practitioners and authorities worldwide, especially those working in TB prevention.

The World Health Organisation itself is known to be organizing a meeting to assess the evidence and decide what to do next.

Tuberculosis - Spread - Symptoms - Diagnosis - Treatment - FAQs
Tuberculosis, caused by Mycobacterium tuberculosis, primarily affects the lung. It may spread to other organs.

This strain of TB, called Multidrug-resistant (MDR) TB, is resistant to all of the main TB drugs and may raise a situation where patients have nothing but their immune system to help fight off the disease.

It was first seen in the early 90's and later extensively drug-resistant (XDR) TB emerged in 2006. Now, the focus may switch to totally drug-resistant (TDR) tuberculosis.

Although Indian cases have been reported for the first time, it was reported in Italy in 2007, where it affected two patients. Then in 2009, 15 patients were reported in Iran.

Screening Tests for Tuberculosis
Tuberculin skin test and Interferon – Release Assays are tests used to screen for tuberculosis.

"We currently have 12 confirmed cases, of which three are dead," New Scientist quoted Zarir Udwadia of the Hinduja National Hospital and Medical Research Centre in Mumbai, as saying.

What compounds the problem for India is that the strain has been found in a congested city like Mumbai, where it could spread very quickly.

Drug Resistance – Antibiotic or Antimicrobial Resistance
Drug resistance is often a problem in malaria, tuberculosis, HIV, sexually transmitted diseases and hospital acquired diseases. Judicious use of antibiotics can control the problem.

"It's estimated that on average, a tuberculosis patient infects 10 to 20 contacts in a year, and there's no reason to suspect that this strain is any less transmissible," Udwadia said.

According to him, the only thing that can be done is to keep the patients in isolated wards in hospitals so that they don't infect anyone else, but that is an impractical solution.

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Udwadia blames poor management of MDR over the years for the current situation.

While the usual strain of TB has been covered very well in India's national programme, the same level of support and treatment was not provided to MDR-TB patients, with cost being a major factor for this.

"Years of mismanagement of MDR-TB at government and private care levels resulted in amplification of the level of resistance till we finally ended up with this untreatable strain," Udwadia said.

Paul Nunn, coordinator of the STOP TB department of the WHO in Geneva, agrees with the assessment and calls on governments to provide better support, regardless of the cost.

"It's a wake-up call for countries to accelerate provision of proper care, particularly for multidrug-resistant patients," he said.

Source-ANI