Deadliest TB Form: Totally Drug-Resistant Tuberculosis (TDR-TB) Facts, Causes, Medicines Remedies
Tuberculosis kills around 1,000 people a day in India. But now it has acquired an even more deadlier form called Totally Drug-Resistant TB (TDR-TB )
Spread of Totally Drug-Resistant TB (TDR-TB )
- TDR-TB was reported three years ago in Teheran, the Iranian capital, when 15 patients were found to have bacilli resistant to all first- and second-line drugs.
- India seems to be only the second country to report Totally Drug-Resistant TB (TDR-TB) .
- Totally Drug-Resistant TB (TDR-TB )-has been isolated in the fluid samples of 12 TB patients in the past three months alone at Hinduja Hospital at Mahim .
- 10 of the 12 TDR-TB cases are from the Mumbai, other two are patients from Ratnagiri and UP.
- One of the 12 patients has since died.
What is Totally Drug-Resistant TB (TDR-TB): Totally Drug-Resistant TB (TDR-TB) Characteristics
- Totally Drug-Resistant TB (TDR-TB) is the result of the latest mutation of the bacilli after Multi-Drug-Resistant TB (MDR-TB ) and Extremely Drug-Resistant TB (XDR-TB ) were diagnozed earlier.
- Among tuberculosis patients, drug resistance develops mainly because patients fail to complete the 6- to 9-month first treatment phase. They feel better within a couple of months of taking the drugs and so they stop taking them. However, the TB germs in the body are not completely vanquished and they again multiply," said a senior BMC public health official.
- Left untreated, each person with active TB can infect 10 to 15 people a year since TB is a contagious disease.
- Like the common cold, TB spreads through the air
- Patients resistant to all first-line and second-line drugs are classified as having Totally Drug-Resistant TB (TDR-TB )
- None of the known TB combination drugs work on the patient of Totally Drug-Resistant TB (TDR-TB).
- The average age of the 12 patients - six men and six women - is just 32.3 years.
- Minimum period of suffering has been two years although one patient is ill for over five years.
- Each of the 12 patients was resistant to all first-line drugs (isoniazid, rifampicin , ethambutol, pyrazinamide and streptomycin) and second-line drugs (ofloxacin, moxifloxacin, kanamycin, amikacin, capreomycin, paraaminosalicylic acid and ethionamide ) that were tested.
Multi-Drug-Resistant TB (MDR-TB ) Facts
- A particularly dangerous form of drug-resistant TB is Multi-Drug-Resistant TB (MDR-TB ).
- Multi-Drug-Resistant TB (MDR-TB ) is caused by bacilli resistant to at least isoniazid and rifampicin, the two most powerful anti-TB drugs
- India reportedly has the highest burden of MDRTB , with some estimates pegging it at 3 lakh.
- Barely 1% are covered by the govt's free drug plan
- Drug-resistant TB requires chemotherapy with second-line anti-TB drugs that are costlier than first-line drugs, and which produce reactions that are more severe, though manageable
- MDR-TB treatment continues for 24 to 27 months and could cost up to Rs 2 lakh
Extremely Drug-Resistant TB (XDR-TB ) & Totally Drug-Resistant TB (TDR-TB ) Facts
- The emergence of Extremely Drug-Resistant TB (XDR-TB ), particularly in settings where many TB patients are also infected with HIV, poses a serious threat to TB control.
- The patient is resistant to one more drug Patients resistant to all 1st-line and 2nd-line drugs are classified as having Totally Drug-Resistant TB (TDR-TB )
TB Spread & Causes
- Tuberculosis (TB) is a contagious disease.
- Like the common cold, it spreads through the air. It can affect any part of the body, but only people with TB in their lungs are infectious
- When infectious people cough, sneeze, talk or spit, they spread TB germs, known as bacilli, into the air.
- A person needs only to inhale a small number of these to be infected
- People infected with TB bacilli will not necessarily become sick. The immune system 'walls off' TB bacilli, which, protected by a thick waxy coat, can lie dormant for years. When the immune system is weakened, the chances of becoming sick are greater
- Left untreated, a person with active TB can infect 10 to 15 people a year
- Overall, a third of the world is infected with the TB bacillus, but not all are sick 5 to 10% of people infected with the TB bacilli (but who are not infected with HIV) become sick or infectious at some time in their life.
- People with HIV and TB infections are more likely to develop TB
Forms & Evolution of tuberculosis (TB)
- Multi-Drug-Resistant tuberculosis (MDR-TB ) emerged in 1992
- Extremely Drug-Resistant TB (XDR-TB ) arrived a few years ago
- The new, deadlier form is Totally Drug-Resistant TB (TDR-TB ).
Totally Drug-Resistant TB (TDR-TB) Causes
Drug-resistant TB can be caused by:
- inconsistent or partial treatment
- when patients do not take all medicines regularly for the required period because they start to feel better
- because doctors and health workers prescribe the wrong treatment regimens
- because the drug supply is unreliable
World & India TB deaths & statistics
- An estimated 1.7 million people died from TB worldwide in 2009
- India sees around 3- 4 lakh deaths for all forms of TB each year, while the world saw 1.7 million deaths in 2009.
- TB is one of the biggest killers in India, along with heart attack.
- Tuberculosis is one of the most fatal diseases in Mumbai, accounting for nearly 15% (8,953) of the deaths in 2010
- It is believed that more than half the city's TB patients seek treatment in the private sector