India houses one-fifth of global drug-resistant TB cases

India houses one-fifth of the world’s drug-resistant tuberculosis cases. TB has emerged as one of the most serious public health threats.

With an estimated number of 66,000 multi-drug resistant TB (MDR-TB) cases in 2011, India tops the chart in South-East Asia. The actual number of MDR-TB cases, which are extremely difficult to treat, could range from 55,000 to 77,000 though the overall prevalence is just above two per cent.

The South-East Asia region harbours 89,000 estimated MDR-TB cases (72,000–1,08,000) accounting for more than one fourth of the world’s estimated MDR-TB cases in 2011. India ranks second after China,” says the World Health Organisation’s latest report. India is miles ahead of others in the region. The two worst figures after India comes from Indonesia (6,620) and Myanmar (5,500). “We are not tackling MDR cases with seriousness, which is a mistake. Treating each MDR cases is 100 times more expensive than a regular TB case. The government needs to find out MDR cases and treat them as quickly as possible,” R Lakshminarayan, vice president (research) in Public Health Foundation of India, who is not associated with the WHO report, told Deccan Herald.

Extensively drug-resistant TB (XDR-TB) has been reported from five countries – Bangladesh, India, Indonesia, Nepal and Thailand – in the region. In December 2011, so called cases of “totally drug-resistant TB” that posed a big challenge to clinicians and public health authorities were reported in Mumbai.

As per the WHO estimates, prevalence and incidence rates of all forms of tuberculosis in India were respectively 249 and 181 per 1,00,000 population in 2011. As many as 24 persons (range is from a low of 15 to a high of 35) per 1,00,000 are killed by the bug. The spread and virulence of tuberculosis, particularly the resistant variety, compelled the Central government to make TB a notifiable disease, which ensures reporting of TB cases from the private sector to the government programme and compulsory treatment.  Patients jumping from one private doctor to another without completing the drug regimen contributes to sharp increase in resistant TB cases.