Worried over the increasing number of multi-drug resistant (MDR) cases of tuberculosis (TB) in the State, the Department of Health and Family Welfare has directed all private practitioners and hospitals to report TB cases to the health authority.

The directive comes in the wake of the Union Health Ministry’s notification that makes it mandatory for all private doctors and clinics treating a TB patient to report the case to the government.

While the notification was sent to all States in May, Karnataka has intensified moves to prevent TB and check cases of drug resistance to the disease.

“This is because the number of MDR-TB cases is on the rise. Of the 4,000 suspected cases, we have 130 confirmed cases of MDR-TB enrolled under the Programmatic Management of Drug Resistant TB (PMDR-TB), which was earlier known as Directly Observed Treatment Short Course (DOTS)-Plus,” sources in the State TB Cell told The Hindu here.

The programme was started in September 2011 in eight districts under the first phase, and 108 cases were reported till September 2012. “Now it has been extended to all districts, and 500 more cases are likely by September 2013,” the sources said.

According to doctors, the best first-line anti-TB drugs (rifampicin and isoniazid) are not effective against MDR-TB cases.

TB cases are also on the rise. While more than 68,000 cases (including 42,000 new cases) were reported in the State in 2011, nearly 70,000 (including 43,000 new cases) have been reported this year.

Caused by Mycobacterium, tuberculosis is an infectious disease that primarily affects the lungs. TB symptoms include uncontrolled cough and expectoration for over three weeks, weight and appetite loss and fever during evenings, sometimes even coughing blood.

“Till now there was no compulsion on private doctors to keep a record of TB cases. But to ensure proper TB diagnosis and case management, reduce TB transmission and fight emergence of drug resistant TB, it is essential to have complete information of all cases,” said M.D. Suryakanth, State Joint Director for Tuberculosis Control Programme.

He said that the officials had met most of the private hospitals and doctors in the State in this connection. “We will repeatedly remind them about the need for reporting TB cases,” Dr. Suryakanth said.

He said that the Union Health Ministry had a prescribed format for private doctors to file a monthly report on TB cases. The doctors can report to the district health officer/chief medical officer of a district and municipal health officer of a municipal corporation, every month, he said.

New cases

Shashidhar Buggi, Director of Rajiv Gandhi Institute of Chest Diseases (RGICD), said that nearly three per cent of the newly diagnosed sputum positive cases in the country are found to develop MDR-TB.

“Unless the private practitioners, who are the first point of contact for more than 60 per cent of the population, report all TB cases to the health authorities, it will be difficult to check the spread of MDR-TB,” he said.

He pointed out that most patients go to private practitioners to begin with. “While some doctors use irrational combinations of medicines, most patients discontinue treatment mid-way, making them drug resistant. Such patients need to be monitored and counselled,” he said.

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