MdR-TB emerges as new challenge in Kashmir

Raihana Maqbool
Posted June 23, 2016

14 deaths have taken place due to MdR-Tb in Kashmir so far

Raihana Maqbool

Srinagar: Two months ago, Shaikh, who wishes to be identified by his last name, was diagnosed as suffering Multi Drug Resistant Tuberculosis.

Shaikh, who works as a mason, hails from a small village in Anantnag and was suffering from tuberculosis. He was put on DOTS (a treatment regimen) some nine years ago.

Since he did not follow the treatment as was required and would take medicines irregularly, two months back when he was tested at the Chest Diseases Hospital, he was found suffering Multi Drug Resistant Tuberculosis (MdR-TB).

Even though Tb is on a steady decline in Jammu and Kashmir, but MdR-TB is posing a new challenge with its increased incidence here.

MdR-TB is a more difficult disease to treat and usually requires stronger drugs and longer treatment.

MdR–TB is a form of TB infection caused by bacteria that are resistant with two of the most powerful anti-TB drugs -- Isoniazid (NH) and Rifampicin (RMP). It is usually caused by lapses in following treatment course, leaving the treatment incomplete, or could also be acquired from other person with MdR-TB.

Dr Naveed Nazir Shah, at CD Hospital says that the symptoms of MdR patients are same as that of other TB patients.

Talking about two types of MdR patients, he said “one set is of those resistant patients who have never taken any medicines -- these are called primary resistance cases. Another type is of the secondary resistance patients -- those patients who have already taken one course of medicine but due to some reasons have developed resistance to medicines.”

Confirming that incidence of MdR-TB is on increase here, Dr Shah says “We are detecting more cases which include both males and females, but the ratio of females is comparatively lesser.

“As MdR-TB is an airborne pathogen, persons with active pulmonary tuberculosis caused by a multidrug-resistant strain can transmit the disease if they are alive and coughing,” the doctor says.

He says when a TB patient is suspected with MdR, his/her samples are sent for MdR-TB testing.

“If a tuberculosis patient has already taken the prescribed course of medicines and shows no improvement, his/her sputum is sent for culture sensitivity to find out whether the patient has develop MdR or not.”

Doctors say that most cases of MdR-TB have been reported from far-flung areas of Kashmir which include Anantnag and Kupwara.

“In Anatnag 29 cases were detected, in Srinagar 19, Budgam 10, Pulwama 7, Baramulla 15, and 18 cases have been detected from Kupwara. Seven patients from Jammu also have been registered with MDR-TB here,” says Dr Shah.

A total number of 14 deaths have taken place due to MdR-Tb in Kashmir so far.

Dr Shah says precautions have to be taken both for the patients as well as the attendants.

“The challenge is that the treatment needs patience as the course lasts for two years. We have to convince the patient to take treatment for a long period of time,” Dr Shah says.

As per experts for effective treatment of MdR-TB and XDR-TB, early case detection, improved laboratory facilities, availability of appropriate treatment regimens are necessary for better patient-care and overall cure.

As per the records available with the Government Chest Diseases Hospital, Srinagar, a total number of 105 MdR-TB cases have been registered in the hospital till May 2016 end.

Six patients with Extensively Drug Resistant TB (XDR-Tb) have also been registered. XDR-TB is a form of multidrug-resistant TB with additional resistance to more anti-TB drugs that therefore responds to even fewer available medicines.

State TB Cell has revealed that 23,392 patients have been registered for TB treatment in the past five years. 3500 people have died due to TB in past 10 years in J&K.

India is one of the countries with the highest burden of multidrug-resistant tuberculosis (MdR-TB). As per the WHO Global Report on Tuberculosis 2013, India accounts for 64,000 MdR-TB cases out of 300,000 cases estimated globally to occur among the notified pulmonary TB cases annually.

As per WHO, in 2014, an estimated 480,000 people worldwide developed MdR-TB. It is estimated that about 9.7 percent of these cases were of XDR-TB.


Comments 1

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Jamie Ross
Jun 23, 2016
Jun 23, 2016

This information is vital in order to help people to understand why it is important to stay with a medicine protocol. It is always difficult to understand this when while taking the medicine, the patient feels better and begins to think they do not need to finish the regime. Thank you for making us all aware of the statistics to help us understand.