Even as the number of cases of multidrug-resistant tuberculosis (MDR-TB) in the State are on the rise, for the last six months, patients with its symptoms are forced to spend thousands of rupees on private labs for diagnosis.

This is because the State Government has stopped sending sputum samples to the National Tuberculosis Institute (NTI) in the city, the only government institute where the tests are done for free.

MDR-TB can brush aside at least two of the best first-line anti-TB drugs (rifampicin and isoniazid).

The NTI has been conducting MDR-TB culture tests for patients from across the country with no access to the specialised Intermediate Reference Laboratory (IRL).

‘Stop sending samples'

Karnataka has yet to get its own IRL and it is the NTI which does the tests. However, State Joint Director (TB) Kumaraswamy Lal S. wrote to Shahsidhar Buggi, Director of SDS TB and Rajiv Gandhi Institute of Chest Diseases (RGICD), on October 26, 2010 to stop sending samples to NTI for culture tests.

Though the Central TB Division of the Union Ministry three years ago had identified RGICD to set up an IRL, the project is in cold storage.

No permission

Admitting that the free test facility had been stopped, Dr. Kumaraswamy told The Hindu on Wednesday it was because these tests were being done without the Central Government's permission so far. “NTI is an institute for training and research. So the Central Government has asked us to stop sending samples there and start our own IRL instead,” he said.

Asked how patients who could ill afford such costs were expected to manage till then, he said he had written to the Central Government to allow them to use the NTI facility till the IRL starts functioning. For the record, a patient has to spend nearly Rs. 4,000 on a culture test in a private lab.

NTI is ready

NTI Director Prahalad Kumar said his institute was ready to do any number of tests. “There was a memorandum of understanding between NTI and State Government and it is still on. We don't know why they have stopped sending us the samples,” he said.

Dr. Shashidhar Buggi said diagnosis of MDR-TB has been hit following the Government's October 26 letter. “While we have 400 registered cases of MDR in our institute, there could be many more across the State. Nearly 3 per cent of newly diagnosed sputum positive cases in the country are found to have developed MDR-TB. One patient can directly spread the disease to at least 10 patients if it is not checked at the initial stage.”


In Karnataka, the infection rate is compounded by lack of awareness and patients discontinuing treatment. “Although TB patients are provided free medicines, people in rural areas don't have food to eat as they are poor. They discontinue (medication) because taking the medicine without proper food causes acidity,” Dr. Buggi explained.

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