Premature discontinuation of treatment by patients contributes to rise in MDR TB

Gurgaon: Rani (41), a resident of Nuh in Haryana, was diagnosed with Tuberculosis 2 years back and prescribed medication for nine months. However, on misguided advice of a local alternative health practitioner, she discontinued her medication mid-way. One year later, the disease turned into a more vicious avatar, with her TB developing resistance to drugs.
In recent years, multi drug resistant tuberculosis has emerged as a major threat to India’s fight against the disease, and threatens to take our anti-Tb campaign back by several years.
Doctors at Columbia Asia Hospitals, Gurgaon say lack of awareness and widespread practice of discontinuation of treatment mid-way by patients, as in the aforementioned case, contributes hugely to the rise in MDR Tb.
“TB is a curable disease. A combination of drugs is given to the patient that must be taken for at least 6 months. This treatment is only successful when patients complete this course of treatment. Failure to complete the medication can have serious consequences including the bacteria developing resistance to the drug. This has been a major concern in India’s fight against Tuberculosis. A large number of patients discontinue medication mid-way due to a number of factors. While some people find it difficult to cope with the side effects of the medication and stop taking it, others experience an improvement in their condition and start believing they don’t need it anymore. Often, people belonging to economically poor sections of society are unable to afford this treatment and discontinue taking medication mid-way. This has disastrous consequences and can make a treatable disease lethal,” says Dr Piyush Goel, Consultant, Pulmonologist at Columbia Asia Hospitals, Gurgaon.
Multidrug-resistant TB (MDR-TB) is TB that does not respond to at least isoniazid and rifampicin, the 2 most powerful anti-TB drugs. The bacteria that cause tuberculosis (TB) can develop resistance to the antimicrobial drugs used to cure the disease in a number of cases. When treatment is discontinued prematurely, the TB bacteria gets immune to the drugs and stops reacting to it when treatment is repeated.
Apart from premature treatment interruption, inappropriate or incorrect use of antimicrobial drugs or transmission of MDR Tb from person to person are other factors responsible for the spread of drug resistant Tb.
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. According to WHO, such strain has been reported in 117 countries worldwide.
India bears the world’s largest TB burden with over 30 lakh cases recorded in recent years. Tuberculosis is a contagious infection caused by a bacterium called Mycobacterium tuberculosis. This usually attacks the lungs, but can also spread to other parts of the body like brain and spine.
“For our Tuberculosis fight to be successful, we have to ensure that treatment reaches the last patient, and all patients complete their treatment so that they do not develop resistant. At the same time, patients have to be identified and treated early so that they do not transmit the disease to others. There is an urgent need for new TB drugs to be developed and research is on to find new anti-biotics,” adds Dr Goel.
Things to do to keep TB at bay:
? Eat a health and nutritious diet rich in fruits and vegetables to ensure your immunity levels are good. Tb bacteria is highly prevalent in India, and healthy immunity is important to fight it off

? Report any cough lasting more than three weeks to a doctor

? See a doctor if you experience recurrent fever, fatigue or weight loss

? Make sure you complete your treatment and follow the prescription religiously, if your doctor prescribes Tb medication