The Brihanmumbai Municipal Corporation (BMC) will soon introduce a shorter regimen of medication for multidrug-resistant tuberculosis (MDR-TB) patients.
The standard treatment regimen goes up to nearly two years, often forcing patients to default due to to restlessness caused by the duration and severe side effects of the drugs. A short course of nine to 11 months would motivate patients to complete the treatment, civic officials said.
Mumbai’s TB officer Dr. Daksha Shah said patients will be carefully selected for the regimen. “Only those who are not showing signs of being extensively drug-resistant (XDR) or pre-XDR will be chosen based on their drug susceptibility pattern. Besides the doctor, a committee will decide if the patient is suitable for the short course,” Dr. Shah said. She said the training of doctors and staff for the short course will conclude soon.
The short regimen is popularly known as the Bangladesh regimen as it was implemented in the country and has shown good results. The nine-month-long Bangladesh regimen also selected only uncomplicated multidrug-resistant patients who have shown resistance to the two first line drugs: rifampicin and isoniazid.
But any non-compliance in the treatment can increase risk. Many experts think the regimen may not work widely in India, and only about 3% of the patients here may be eligible for it. They say the pattern of resistance is dire, and drugs have been in use and misused for long. But Dr. Shah said choosing patients carefully will help. A few patients have already been shortlisted and will start the regimen from Thursday at a civic hospital in Govandi.
On Wednesday, the BMC felicitated counsellors, treatment organisers, data entry operators and other staff of the TB department. Dr. Padmaja Keskar, the BMC’s executive health officer, said, “A key problem we face with TB treatment is defaulters. All the staff should bring at least five defaulters back on treatment.”
