Single Channel Treatment Useful to Tackle TB: Study
By Express News Service | Published: 20th February 2014 09:36 AM |
Early detection of tuberculosis (TB) and a coordinated mechanism to channelise treatment through a single line of treatment like DOTS programme can show the way-ahead for tackling drug resistance as multi-drug resistant (MDR) TB poses a major medical challenge in the country, a study has revealed.
Taking the tribal dominated district of Rayagada to assess resistance pattern to anti-TB drugs, the cross-sectional study conducted by the Regional Medical Research Centre (RMRC), Bhubaneswar, under ICMR has made significant revelations.
The study demonstrated a low level of overall resistance to first line of anti-tuberculosis drugs and also a significantly lower rate of MDR TB both in new and re-treatment cases. In newly diagnosed cases, resistance to the first line of drugs like isonazid or streptomycin was observed to be 2.7 per cent while there was absolutely no resistance to rifampicin or ethambutol.
What has come as a more heartening finding for experts is that MDR-TB was not found in a single person among newly diagnosed patients while it was as low as 8.1 per cent in previously treated patients who sought re-treatment.
MDR-TB prevalence in India varies from 0.5 to 5.7 per cent in newly diagnosed and 11.8 to as high as 47.1 per cent in re-treatment cases. The disease, which has developed resistance to a large number of drugs, has posed a serious challenge to TB control activities in the world. Emergence of MDR and extensively drug resistant strains of TB are, in fact, threatening to run out of control with disastrous consequences.
The WHO estimates that there were about 450,000 new (incident) MDR-TB cases in the world in 2012 with India accounting for a major share. In 2015, it is estimated that about 20 per cent of the USD 8 billion that low- and middle-income countries require for TB care and control will be needed for the treatment of MDR-TB.
The study conducted by Director of RMRC SK Kar, D Das and B Dwibedi has brought to light factors behind the low prevalence of drug resistant TB strains in such a backward district of the country. Some of the reasons as put forth are high treatment success rate of 85 per cent notwithstanding majority over 55.6 per cent being indigenous tribal population. The backwardness of the region could also have had a positive effect in a way that anti-TB drugs were scarcely available outside the RNTCP system. The working of LEPRA society for improved case detection, treatment and awareness among TB patients also had its impact.
The experts have concluded that more attention to early detection and treatment through a single channel system like DOTS can sustain this low level of resistance to anti-TB drugs for a longer period. The study has been published in Science Direct journal.