TDR – TB in India
JATB has obtained the original article on TDR – TB in India which was published in Clinical Infectious Diseases – 21st December 2011. It is featured as a link with this post. An excerpt from the article is pasted below. This particular portion of the article has been chosen so we can think about whether this is the root cause for the vexing situation of DR TB, whatever alphabet one prefixes it with. A point to note is the recommendation the article makes for treatment for MDR-TB within the confines of government-sanctioned DOTS-Plus programmes, which is a great testimonial for India’s TB control programme. Let’s not get complacent, and recognize that all might not be well after all and get corrective action into place – urgently.
Excerpt from the original article.
Although India’s RNTCP has been a tremendous success, patients with MDR tuberculosis currently are not covered, with only 1% having access to Directly Observed Treatment, Short-course (DOTS)–Plus initiatives. The vast majority of these unfortunate patients seek care from private physicians in a desperate attempt to ﬁnd a cure for their tuberculosis. This sector of private-sector physicians in India is among the largest in the world and these physicians are unregulated both in terms of pre-scribing practice and qualiﬁcations.
A study that we conducted in Mumbai showed that only 5 of 106 private practitioners practicing in a crowded area called Dharavi could prescribe a correct prescription for a hypothetical patient with MDR tuberculosis. The majority of prescriptions were inappropriate and would only have served to further amplify resistance, converting MDR tuberculosis to XDR tuberculosis and TDR tuberculosis. We would urge that patients with MDR tuberculosis only be treated within the conﬁnes of government-sanctioned DOTS-Plus programs to prevent the emergence and spread of this untreatable form of tuberculosis.