Move to decentralise Government Hospital for Thoracic Medicine, Tambaram: Minister
Health Minister V.S. Vijay inaugurated a Drug Resistant Tuberculosis (DR TB) ward at the Government Vellore Medical College Hospital (GVMCH) in Adukkamparai near here on Saturday. The Minister lit a lamp and administered drugs to a patient.
Dr. Vijay told reporters that the opening of the ward follows the decision to decentralise the Government Hospital for Thoracic Medicine, Tambaram, Chennai, which hitherto housed all DR TB patients from the State. The DR TB ward in GVMCH is the second such ward to be opened in Tamil Nadu, next to the one opened recently in Madurai.
The ward in Vellore would cater to patients in Vellore district and the neighbouring districts of Krishnagiri, Dharmapuri, Namakkal and Salem. Similar wards would be opened in Coimbatore, Tirunelveli and Thanjavur to cater to patients, including those from neighbouring districts.
Dr. Vijay said the DR TB ward was meant for multi-drug resistant (MDR) patients, and they would be administered second line drugs which are more potent than the first line drugs administered to patients who are under DOTS (Directly Observed Treatment Short course) in their homes. DR TB wards would function as short stay homes where patients would be monitored. If they withstand treatment for 15 days, they would be discharged and sent home to continue the drugs under DOTS Plus. Three per cent of the new TB cases in Vellore district were multi drug resistant (MDR), while 12 % of those TB patients on re-treatment were MDR.
The State government was spending Rs. 15 lakh to Rs. 20 lakh each on the DR TB wards, while the drugs are supplied under the Revised National TB Control Programme (RNTCP).
Dr. Raja Sivanandam, Deputy Director of Medical Services (TB), said MDR TB was the result of either patients directly contracting infection from other patients or poor drug adherence by normal type TB patients getting first line drugs through DOTS. Drugs under DOTS Plus have to be administered to the MDR patients on a daily basis for a period of 24 to 27 months, as against the first line drugs which are given to normal type TB patients under the direct supervision of a health worker for a period of 6 to 8 months.
The Tamil Nadu Health Society-RNTCP has entered into a Memorandum of Understanding with the Department of Microbiology of the Christian Medical College and Hospital for diagnosis of MDR TB through culture and DST (drug susceptibility testing). A state-of-the-art technology called CBNAAT (cartridge-based nucleic acid amplification test) is employed to diagnose a patient suspected to be suffering from MDR TB and the results are available in 2 to 3 hours. This method obviates the necessity of employing the hitherto practised culture test of ascertaining the growth of Mycobacterium Tuberculosis (m-tb) - causative organism of TB - in LJ medium, in which it takes 2 to 3 months to obtain the results.
Thanks to the MoU with the CMC, sputum samples of suspected MDR TB patients from the above-mentioned five districts are tested for resistance to first line drugs at the CMC’s microbiology lab. If MDR TB is confirmed, the patients are sent to the DR TB ward in GVMCH for administration of DOTS Plus drugs. If they test negative, they would be continued on first line drugs under DOTS.
P. Sankar, Collector of Vellore, Ravishankar, Dean, GVMCH, R. Arunan, Resident Medical Officer, GVMCH, and P. Karthiyayini, Mayor of Vellore, were present.