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‘Strong’ XDR-TB put DOTS Plus programme at risk
In view of non-adherence to antibiotic policy, Extensive Drug Resistance (XDR)-TB is becoming a serious challenge in the country. A study has now found 20.17 per cent of XDR-TB strains amongst a total of 223 MDR (Multi-drug resistance)-TB strains. The trend is disturbing considering that world’s prevalence of XDR-TB cases amongst the MDR-TB varies from 5 per cent - 15per cent.
XDR-TB leaves patients (including many people living with HIV) virtually untreatable using currently available anti-TB drugs.
The increasing XDR-TB threatens the DOTS Plus programme, say the researchers in the study published in the latest issue of Indian Journal of Tuberculosis. The researchers picked 223 samples of the MDR-TB strains from Delhi-based Lala Ram Swarup Institute of TB and Respiratory Diseases.
The identified Mycobacterium tuberculosis complex was subjected to drug sensitivity testing by first line and second line drugs by proportion method and absolute concentration method as per standard procedure.
Most of these strains showed resistance to as many as four drug combinations. In the second line drug resistant pattern also, more than four drugs resistance pattern was observed, noted D Bahera, Director of the Institute.
Calling for more such studies, the researchers felt that identification and observation of resistance patterns of XDR-TB strains may help clinicians manage MDR-TB cases, the treatment line of which is expensive, time-taking and involves intake of toxic drugs with many side-effects.
This is due to failure of experts to adhere to the antibiotics policy and rampantly using second line drug treatment even in the absence of sensitivity reports, said Bahera, one of the researchers.
Every year, 1.9 million new cases are reported in the country, of which 0.8 millions are ‘infectious smear positive TB cases’. Every year, 28 of 1000 persons die due to TB in India.
