Multi-Drug Resistant (MDR) tuberculosis in India? Do
members agree that XDR-TB is a reality? Yes or no.?
The bacterium
has mutated -- India is already grappling with the disease burden of Multi-Drug
Resistant (MDR) tuberculosis, which manifests when a patient fails to take all
the TB medicines exactly as prescribed and misses out some doses. The TB
bacterium, which remains in the patient, mutates and cannot be treated with the
first and second line of treatment.
The bacterium has mutated even more as Extensively
Drug Resistant TB (XDR-TB) that is resistant to normal drugs. Doctors are now
trying combination drugs to treat it.
According to the World Health Organization
(WHO), India is home to 73,000 patients with MDR-TB. The figure for XDR-TB is
not yet known."XDR-TB is a reality.
"XDR-TB develops a couple of years after MDR-TB
if it is not treated properly.
Many are of opinion that, "unless XDR-TB is realized
as a danger, the situation cannot be controlled".
The prevalence ratio of TB in India is about 1:32,
according to the Tuberculosis Association of India. India's directly Observed Treatment Short
course (DOTS) strategy, which is implemented through the Revised National
Tuberculosis Control Programme (RNTCP), is aimed at achieving an at least 85
percent cure rate amongst new patients.
XDR-TB is not absolute as of now, it can very soon
assume dangerous proportions if preventive measures are not taken quickly.
Doctors also said that XDR-TB raises concerns of a
future TB epidemic with restricted treatment options, jeopardizing the major
gains made in TB control and progress on reducing TB deaths among people living
with HIV/AIDS.
It is, therefore, vital that TB control is managed
properly and new tools are developed to prevent, treat and diagnose the
disease, they said.
The true scale of XDR-TB is not known as many
countries lack the necessary equipment and capacity to accurately diagnose it.
It is, however, estimated that there are around 40,000 cases per year globally.
As of June 2008, 49 countries have confirmed XDR-TB
cases. By 2010, that number had risen to 58.
Like other forms of TB, XDR-TB is spread through the
air. When a person with infectious TB coughs, sneezes, talks or spits, TB
germs, known as bacilli, are propelled into the air. Inhaling even a small
number of these leads to an infection.
: "The Indian TB treatment is not working as our
population is larger...over population is adding to the problem."
"The population needs to be tracked. Family members and
contacts of patients need to be tracked. In India there is no accountability,
no surveillance. Patients need to be put on a data base," he said, adding,
MDR-TB doesn't need long to turn into the extreme form.
One in three people in the world is infected with the
TB bacteria. Only when the bacteria become active do people contract the
disease. Bacteria become active as a result of anything that can reduce the
person's immunity, such as HIV, advancing age or medical conditions.
Significantly, fewer people are dying of tuberculosis
in Southeast Asia today compared to 1990, according to the World Health
Organization. The death rate due to the disease has decreased by more than 40
percent in the past 13 years.
As access to TB care has expanded substantially, the
number of people with TB, or the TB prevalence rate, has also declined by a
fourth in the region compared with 1990.
All the 11 member-countries of the WHO in South
Asia have adopted the WHO Stop TB Strategy. More than 88 percent known TB
patients have been successfully treated.
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