Multiple drug resistant tuberculosis cases are rising in the City Beautiful, according to a study done by Dr Sunil Sethi from Deptt of Medical Microbiology in collaboration with Dr Dheeraj Gupta from Pulmonary Medicine Deptt of the Post Graduate Institute of Medical Education and Research.
The study shows that the prevalence of MDRTB was found to be very high in newly diagnosed cases, 9 percent as compared WHO reported figures which are 3-5 percent which is a real cause of concern say experts.
This ICMR funded study included 2100 patients from 2006-2010 from whom sputum and blood was collected for tests. The test results show that the prevalence was even higher in previously treated patients as these patients stop taking drugs in-between and bacteria becomes resistant to available drugs. Overall MDRTB was observed in 17 percent cases, whereas it was as high as 27 percent in previously treated patients.
Dr Sethi said that, “Tuberculosis is one of the earliest opportunistic diseases to develop amongst persons infected with HIV, and HIV infection is the most powerful risk factor of progression of TB from infection to disease, with 21-34 times more chances to develop the disease as compared to those who are HIV – negative.”
The study shows that out of the total number of patients diagnosed with multiple drug resistant TB, 20 percent were found to be HIV positive. Tuberculosis is one of the earliest opportunistic diseases to develop amongst persons infected with HIV.
Dr Dheeraj Gupta said, “TB which was curable earlier will soon become untreatable if MDRTB continue to increase and proper interventions are not taken. So it is very important not to stop the treatment in between and patients can get free treatments at DOTS centre located in different parts of country.”
If person is diagnosed with MDRTB he has to be treated with ten drugs per day for at-least 2 years and chances of cure is less and cost of medicine is around a lakh, added Gupta.
However what came as good news for the medical experts after conducting the study is that Extreme Drug resistance (XDRTB) which is reported worldwide and prevalence in different parts of our country is 2-8 percent was not found in Chandigarh.
“If person is diagnosed with XDRB, mortality is very high as high as 80 percent. Fortunately we did not get any XDRTB. However, there is need to monitor the trends of drug resistance in TB in various populations in order to timely implement appropriate interventions to curb the menace of MDRTB,” said Dr Sunil Sethi.
MDRTB is very difficult to diagnose as all labs in India don’t have culture facilities. Even if they have, MDRTB can be diagnosed in around 3-4 months. But the first molecular diagnostic lab in department of Microbiology which is named as line probe assay lab which can diagnose TB in 48 hrs is a good news for the denizens of the city.
“This is real advancement in field of TB diagnostics. The lab has just started functioning and first Molecular lab to be accredited in PGI. We soon would be getting BSl 3 lab in a month time after investing around 50 lakhs. This will be boon for the patients of Chandigarh, Punjab, Haryana, and Kashmir. All the patients with MDTRB will be diagnosed within 48 hours and will be put on treatment. This will definitely reduce the transmission of MDRTB. All the patients will be diagnosed free of cost under the RNTCP program otherwise the test cost will be around Rs1200,” added Sethi.