'TB patient with unfinished treatment can infect 10 others'

Trying times for chest diseases institute as many patients run away

Authorities at the Rajiv Gandhi Institute of Chest Diseases (RGICD) here face a tough problem, as at least three tuberculosis (TB) patients run away from the hospital, on an average every month, without paying the bills mostly because they cannot afford the cost.  

The hospital is an open area without a gate at the main entrance. There are no guards at the other gates in the 470-bed hospital. The fact that patients are not given uniforms makes it difficult to identify them, say hospital sources.

Dr Shashidhar Buggi, RGICD director, said that in most cases, the patients were traced either with the help of their addresses, mobile phone numbers or with the help of the police. While many of those fleeing are from a poor background, there are also instances of ignorant patients discontinuing treatment. 

‘Treated as outcasts’

“TB patients are usually hospitalised for quite a long time if their condition is serious,” the director said. The urge to return home drives them to take such steps. While most patients come to take treatment from far-off places and feel homesick, there are also a handful who are treated as outcast by their families. The greater risk is that one patient who has not completed treatment can infect 10 others within a year. 

  Buggi said two rare cases of extremely multi-drug-resistant tuberculosis (XMDR-TB) have been identified in the State. While one of them died due to complications associated with the disease, the other is recovering in her hometown. 

Buggi, also the secretary of the Karnataka State Tuberculosis Association, said that when a patient suffering from multi-drug resistant TB (MDR-TB) discontinues medication, he develops XMDR-TB as the bacteria finds an alternative method to counteract. 

Supervision necessary

“In such cases, supervision becomes a must. First, to ensure that they take medicines and also to keep track of their varying health condition,” he said. 

A patient who discontinues medication in the initial stages of TB has a chance of developing MDR-TB, for which the treatment may last as long as 20 months. 

The treatment will be for an even longer duration for an XMDR-TB patient and drugs are administered under constant supervision. 

“Not only are the second line of drugs prescribed for them expensive, but are also more toxic,” said Buggi. It can also lead to psychological problems, liver toxicity and thyroid complications. 

Currently, 550 patients with MDR-TB have been identified in the State by the TB Association and RGICD. Of these, 387 are men and 162 women. 

Buggi told Deccan Herald that the Revised National Tuberculosis Control Programme was well implemented and that the number of patients who had availed of the benefits was significant. However, it is mostly the ignorant people from rural backgrounds or city residents who do not bother taking treatment at an early stage who face problems.