Multidrug-resistant TB will rise in India

• Lancet Infectious Disease journal has forecast an increase in drug-resistant tuberculosis cases in the four high-burden countries, including India, and suggested that person-to-person transmission will become the engine that drives drug-resistant tuberculosis in these countries.

Highlights of the study:

• By 2040, 12.4 per cent, or an eighth, of TB cases in India will be multi-drug-resistant, up from 7.9 per cent in 2000
• In the other three high-burden countries, multi-drug resistance will rise to 32.5 per cent of all cases in Russia, 8.9 per cent in the Philippines and 5.7 per cent in South Africa, respectively up from 24.8, 6 and 2.5 per cent in 2000.
• Nearly 40 per cent of all drug-resistant TB cases occur in these four countries, accounting for more than 2, 30,000 cases in 2015.
• Globally, an estimated 10.4 million new cases of tuberculosis and 1.8 million deaths related to tuberculosis disease occurred that year.
• Multi-drug-resistant TB accounted for 480,000 cases, and 9.5% of these cases were estimated to be extremely drug resistant.
• Of the multi-drug-resistant cases, one in 10 are expected to be extensively drug-resistant by 2040 — 9% in Russia and the Philippines, 8.9% in India, and 8.5% in South Africa — according to the study, based on a mathematical model using WHO data.
• According to health ministry figures, India has 2.8 million cases of TB every year. Of these, 2.8 per cent are new cases of multi-drug resistance while another 11.2 are acquired cases of multi-drug resistance.

What is multidrug-resistant tuberculosis?

• The bacteria that cause tuberculosis (TB) can develop resistance to the antimicrobial drugs used to cure the disease.
• Multidrug-resistant TB (MDR-TB) is TB that does not respond to at least isoniazid and rifampicin, the 2 most powerful anti-TB drugs.
• Most people with TB are cured by a strictly followed, 6-month drug regimen that is provided to patients with support and supervision. Inappropriate or incorrect use of antimicrobial drugs, or use of ineffective formulations of drugs (such as use of single drugs, poor quality medicines or bad storage conditions), and premature treatment interruption can cause drug resistance, which can then be transmitted, especially in crowded settings such as prisons and hospitals.
• In some countries, it is becoming increasingly difficult to treat MDR-TB. Treatment options are limited and expensive, recommended medicines are not always available, and patients experience many adverse effects from the drugs. In some cases even more severe drug-resistant TB may develop. Extensively drug-resistant TB, XDR-TB, is a form of multidrug-resistant TB with additional resistance to more anti-TB drugs that therefore responds to even fewer available medicines. It has been reported in 117 countries worldwide.

By: Vishal