New Delhi: More than a quarter of Tuberculosis (TB) patients in India have drug resistance to one or the other anti-TB drug, revealed the national anti TB drug resistant survey report released on Saturday.
The first national survey done between 2014 and 2016 by ministry of health and family welfare found that the Fluoroquinolone (first line anti TB drug) resistance among Multi Drug Resistance (MDR)-TB patients is high and is similar to resistance rates reported by the Revised National Tuberculosis Control Programme (RNTCP).
The results of the survey released on the World TB day showed that MDR-TB is 6.19% among all TB patients with 2.84% among new and 11.60% among previously treated TB patients. Among MDR-TB patients, additional resistance to any fluoroquinolones was 21.82% and 3.58% to any second-line injectable drugs.
“Among MDR-TB patients, additional resistance to at least one drug from each of the two classes, i.e. fluoroquinolone and second-line injectable drugs for Extensively Drug Resistance (XDR-TB) was 1.3%. Any first- or second line drug resistance among all TB patients is 28.0% with 22.54% among new and 36.82% among previously treated TB patients," the report said.
Any isoniazid (another first line anti TB drug) resistance was found to be 11.06% and 25.09% among new and previously treated TB patients, respectively. Any pyrazinamide (first line anti TB drug) resistance is 6.95% and 8.77% among new and previously treated TB patients, respectively.
Around 54% patients resistant to these drugs do not successfully complete treatment and death rates stand at 20%, according to the report. “High rates of treatment failure and deaths are associated with fluoroquinolone resistance in the Indian cohort of MDR-TB patients," stated the report.
“The survey results clearly indicate that drug resistance is present in all settings (in hospitals or communities), and the wide range of resistance patterns from any isoniazid (first line TB drug) resistance to (XDR)-TB needs to be addressed with strengthening of drug resistance surveillance, universal DST and appropriate DST guided treatment strategies," the report said.
The health ministry has claimed that this is the largest ever national drug resistance survey conducted by any country in the world and the first ever survey having Drug Susceptibility Testing (DST) for 13 anti-TB drugs using the automated liquid culture system, mycobacteria (causing TB) growth indicator tube (MGIT) 960® . A total of 5280 sputum smear-positive pulmonary TB patients (3240 new and 2040 previously treated) diagnosed at the designated microscopy centres (DMCs) of RNTCP were enrolled in the survey.
Union health ministry of Saturday also launched the Nikshay Aushadi Portal and shorter regimen for Drug Resistant TB. “We are already aligned with world TB treatment protocols. It has to a mission to End TB by 2025, through community participation, involving civil societies and other stakeholders," said Preeti Sudan, Secretary, union health ministry.
The Global TB Report 2017 published by World Health Organization (WHO) estimates that India contributes 27% (2.79 million) and 25% (147 000) of the global burden of TB and MDR-TB, respectively. About 2.79 million TB patients are estimated to be added annually. The RNTCP has notified 1.94 million patients in 2016. India has been locating and treating MDR-TB patients since 2007 and achieved complete geographical coverage of programmatic management of drug-resistant TB (PMDT) services in 2013.