All those patients who are residing in Kumaon division of the State have solid reason to smile as the State Health Department is planning to introduce facilities of Intermediate Reference laboratory (IRl) in the division. Department officials told that the IRl will play significant role in determining the extent of drug resistance by conducting representative surveys in broad regions and further assessing the quality of TB cases across the State.
Medicos lamented that the patients who earlier were on DOTS (Directly Observed Treatment, Short-Course) that was introduced to reduce the number of tuberculosis (TB) cases fail to complete the full term course and contribute to the spread of drug-resistant tuberculosis. Since drug-resistant TB is more fatal than normal TB, the department has introduced DOTS-Plus for curbing TB cases in the State.
It is noteworthy that Multi-drug-resistant tuberculosis (MDR-TB) is defined as tuberculosis that is resistant to at least two most powerful first-line treatment anti-TB drugs. Under Revised National Tuberculosis Control Programme (RNTCP), the life saving drugs have been administered free of cost to those patients, who have become resistant to the first line TB treatment. Department figures clearly highlighted that 829 victims were tested so far for MDR and out that, nearly 29 per cent (239) of patients have been conferred with the MDR.
Shockingly, the maximum number of MDR patients (55) has been reported from Haridwar district followed by Dehradun (51) district. Apart from establishing MDR ward (DRTB Centre) for Kumaon region at Sushila Tiwari Medical College, Haldwani and plans to start Intermediate Reference laboratory are also on full swing to redress the grievance of drug resistant TB patients.
In an exclusive interaction with The Pioneer, Dr RP Badoni, State TB Officer said that the department has been focusing to cover all MDR patients in order to recuperate completely from the deadly clutches of TB in the State. He said that special focus has been laid down to impart training to health workers, ASHAs and ANMs in order to target villagers living in the higher areas of the State. He said that it is has made mandatory to reach at grass root level to curtail TB cases in Uttarakhand.
“Drug resistance is manifested when there is a selective growth of resistant mutants among the actively multiplying bacillary population in the presence of drugs. The emergence of drug resistance depends upon the frequency of drug resistant mutants in the susceptible bacillary population, the size of the actively multiplying bacillary population in the lesions, and the anti-microbial quality of the drugs used,” Dr Badoni reiterated, adding that drug resistance of the mycobacterium tuberculosis isolated from patients who have been treated for one month or more is defined as “acquired drug resistance”, while that of patients who have never been treated previously or treated for less than one month is called “Primary Drug Resistance.” He further told that resistance to a single drug is defined as “Mono Resistance” and resistance to two or more drugs is defined as “Poly Resistance.” whereas resistance to at least Isoniazid and Rifampicin is termed as “MDR”.