Monitoring helps MDR, pre-XDR TB patients

Hinduja doctors say individual treatment improves outcome

Updated - March 23, 2018 08:15 am IST - Mumbai

Lung and Bronchi Illustration.

Lung and Bronchi Illustration.

Patients with drug-resistant tuberculosis (TB) who get individual treatment and are monitored closely at every step — from medication and nutritional supplements to tackling of side effects of the drugs — see a substantially better outcome.

Doctors at Hinduja Hospital have seen this difference in Multi Drug Resistant (MDR) and Pre-Extensively Drug Resistant (pre-XDR) TB patients treated as part of the hospital’s ‘Treat to Cure’ programme. The programme started in August 2015 with 50 patients, of whom 30 have completed the treatment and are currently TB-free. It lost three patients as they shifted base, while four patients passed away. The other 13 are still undergoing treatment.

Doctors said 84% of the patients had a positive outcome within six months of treatment. “We are doing an overall follow-up of the patients from the time of starting the treatment to ensuring that they are taking the medication regularly. Often side effects are the reason why patients drop out mid way. We are ensuring that patients are followed up on every day and the adverse effects are taken care of promptly,” said consultant microbiologist Dr. Camilla Rodrigues.

She said the patients, all from financially disadvantaged backgrounds, are getting holistic treatment free of cost under the programme. ‘Treat to Cure’ is funded through CSR. The cost of the overall treatment of an MDR patient goes up to ₹2 lakh.

Chest physician Dr. Zarir Udwadia said patients usually do not get this level of supervision, where each person is followed up on personally. “But it tells us that individual treatment and good follow-up gives good results,” he said.

Onus on private sector

Dr. Rodrigues said private sector hospitals should shoulder some responsibility to offer free TB treatment.

It is estimated that an MDR patient spends nearly ₹3.60 lakh on treatment, travel loss of wages and other factors. An XDR patient spends nearly ₹5.40 lakh. The World Health Organization terms this a catastrophic health cost. This is also the reason why many patients don’t complete treatment.

But doctors at Hinduja Hospital said if every private hospital takes the responsibility of some patients, it will go a long way.

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