Andhra Pradesh, which is believed to have the highest number of tuberculosis (TB) cases in the country, is not able to treat TB patients due to non-availability of essential drugs.
There is acute shortage of streptomycin injection, which is used for patients who are not responding to the primary drug regimen, in government hospitals in the state. Even the government chest hospital situated in the state capital does not have streptomycin. As per a rough estimate, more than 50,000 patients require streptomycin injection every month in the state. According to sources, there is shortage of streptomycin for the last one year. When contacted, health officials said the injection is in short supply not only in Andhra Pradesh but in the entire country and it will take some time to resume supply.
While the Central government claims there is no dearth of funds for TB, in reality, there is shortage of essential drugs in almost all the government hospitals. What is worrying the doctors is that with the non-availability of streptomycin, the patients who have undergone the primary drug regimen can infect others and this can lead to a serious problem.
The multi-drug resistant TB cases in Andhra Pradesh are about 12-17 percent of the total cases registered. This makes it more important that the state-run hospitals are supplied with enough stocks of streptomycin injections.
According to deputy superintendent of Government Chest Hospital and state task force RNTCP chairman Dr K Subhakar, TB prevalence in the state is 258 per 1 lakh population and annually 1.2 lakh new cases are being added. In India, even today, two deaths occur every three minutes due to TB. Every year, 1.8 million contact the disease, of which about 8 lakh are infectious. Until recently, 3,70,000 died of TB annually at the rate of 1,000 per day. Globally, there are around 9.4 million TB cases and 1.3 million TB deaths. Africa reports the highest incidence, prevalence and mortality rates, although South East Asia has the highest number of absolute figures, contributing 35 percent to global TB incidence.
Dr Subhakar said TB is the most common opportunistic infection in people living with HIV virus. As HIV breaks down the immune system, HIV-infected people are at a greatly increased risk of contacting TB. HIV is also the most powerful risk factor for progression from TB infection to TB disease. TB in turn accelerates the progression of HIV to AIDS and shortens the survival span of patients with HIV infection. Thus, TB and HIV are closely interlinked.
In India, there are an estimated over 5 million HIV-infected persons. With such a large number of HIV-positive individuals, it is likely that HIV may worsen the TB epidemic in the absence of a robust TB control programme. However, even among HIV-infected people, TB can be cured. Directly Observed Treatment, Short-course (DOTS) is as effective among HIV-infected TB patients as among others.