67 cases of multi-drug resistant cases of TB in Ernakulam alone

: Even as the World Health Organisation’s call is to find the missing 3 million tuberculosis patients who are not getting treated and cured, one of the major concerns of TB treatment remains increasing drug resistance cases.

The multi-drug resistant cases of TB (MDR TB) are reported when either there is a break in the initial treatment regime or in patients who have been exposed to second line of drugs for TB earlier for other diseases. People working in the healthcare sector are also exposed to MDR TB during their work schedule.

In the district alone, there were 67 cases of MDR TB against the 2,500 TB cases reported in a year from government institutions. Drug-resistant TB cases take a longer duration of treatment — that could be over two years — compared to the six- or nine-month treatment course for TB. The whole gamut of medicines is different and stronger. There are also cases which are termed extensively drug resistant when even the second line of medicine seems ineffective.

“The government institutions never prescribe the second line of TB medicines for other complications because of these considerations,” said Suma. C, District TB Officer. There are other antibiotics available for treating severe chest infections, she said.

The State had reported 24,204 TB cases in 2013. The reporting from private institutions need to be consolidated better as not all institutions report TB to the government. It became a disease to be notified only in 2012. The State is seeking support from the State branch of Indian Medical Association to get all private practitioners and institutions to report TB. Only when details from private institutions were culled, the State could assess the real spread of the disease, said Dr. Suma.

TB bacteria latch on to persons with low immunity and the disease, which, predominantly affects the lungs, spreads by regular close contact with the affected person. People with diabetes are at high risk as TB could exist as co-morbid condition. Migrant workers are a risk group because if there is one infected person, the crowded living conditions and low sanitation expose others in the group to the disease.

“Though awareness programmes are held for the migrant workers, language seems to be a major barrier,” said Dr. Suma. Even when literature on disease was printed in their language, quite a few had turned out to be illiterate, she added. Sometimes a worker who had been detected with TB might leaves without informing the healthcare institution that provided treatment, she said.

So far the State had a target of 70 per cent detection and to cure 85 per cent of those detected. Since the State has achieved its target, the new target is to go for 90 per cent detection and cure for 90 per cent. On World TB Day on Monday (March 24), the district TB Centre is organising an awareness rally and public function at E. K. Narayanan Memorial Hall, Opposite Palluruthy Block Panchayat at 11 a.m. District Collector M.G. Rajamanickam and District Medical Officer Dr. Haseena Mohammed will participate.

The State had reported 24,204 TB cases in 2013. The reporting from private institutions need to be consolidated better as not all institutions report TB to the government.

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