Multi-drug resistant TB cases surge in Bihar

PATNA: Bihar can benefit from Union finance minister Arun Jaitley’s emphasis during his budget speech on eliminating five chronic diseases that afflict India. While tuberculosis (TB) is one of them, the others are kala azar, filariasis, leprosy and measles.

The state has seen an upsurge in the number of TB patients in the last three years. It had 217 cases per lakh population in November 2016 against 203 in 2014 and there are indications to suggest that the number of patients is increasing with each passing day.

To eliminate TB by 2025 — the deadline — the number of cases has to fall to 10 per one lakh population in the next nine years.

Experts believe it is an uphill task for Bihar as it has missed many such targets in the past because of poor implementation of TB eradication programmes.

The most alarming aspect of the story is that the number of multiple drug resistant (MDR) TB is also on the increase. As per official records, 2091 MDR-TB patients were diagnosed in Bihar last year, whereas 2056 such cases were detected in 2015. Despite their condition, a majority of patients drop off the radar without adherng to the full regimen, a sure recipe for extremely drug resistant (XDR) TB.

Notably, MDR -TB is resistant to the two best known first line drugs: isoniazid and rifampicin. XDR is resistant also to the best second line medicines.

Dr Rajiv Ranjan, a physician, said while the recovery rate of MDR cases was about 60%, it was abysmally low in XDR cases. He said both the conditions could be prevented provided all cases of tuberculosis were treated properly with full regimen.

“MDR and XDR are caused by poor quality of health system, substandard drugs, lack of accessibility to treatment and failure to complete the therapy,” he added.

However, state TB officer Dr KN Sahay told HT that the situation of TB in Bihar was “not alarming”. “Because of the increased surveillance, more and more cases are diagnosed,” he claimed.

To ensure uninterrupted administration of anti-tubercular drugs, the government would provide medicines to patients on a daily basis from February 15, 2017, he said. As per existing provisions, patients are given drugs thrice a week.

Notwithstanding the claim made by Sahay, in Bihar TB continues to affect the lives of thousands of people with 64078 patients officially registered for anti-TB therapy in 2016, which is almost 5% of the total cases registered in the country. Bihar ranks 8th among the states in terms of number of patients registered for treatment

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