Drug-resistant TB cases expected to rise in state

Although a government survey last year claimed that Karnataka had only a 1.23% incidence of drug-resistant tuberculosis, a state health official revealed that the new case notification rate is now over 3%, with over a thousand people having been afflicted with mutated strains of tuberculosis, which are impervious to most drugs.

Dr Manjula M, joint director (TB programme), Department of Health and Family Welfare told DH that said that out of the estimated 83,000 people suffering from tuberculosis in the state, 1,696 cases were registered as being of the multi-drug resistant (MDR) variety, as of December 2018.

According to a World Health organisation (WHO) official, the incidence of MDR tuberculosis first appeared in the state in 2012. Quashing contradictory statements that the incidence rate of the disease was declining, the WHO official said that 540 cases had been registered in the last three months alone.

“By this, we can expect the rate to climb to 2,000 cases by the end of the year,” the official said.

Dr Manjula added that the fatality rate is nearly 20% but stressed the fact that the state was tackling the problem with a rigorous treatment programme, involving a battery of drugs.

“Those patients who do not respond to the usual 18-24 month treatment regimen, are placed on tier 2 drugs at an accelerated treatment period of 9-11 months. Those cases, which do not respond to even this, are treated using two new drugs, Bedaquiline and Delamanid, which while effective, come with severe toxic side-effects,” she said.

Most of the people suffering from the disease are from the lower middle-class or the working class. Wherever there is overcrowding, there is tuberculosis, she said.

Dr Nagaraj C of the Rajiv Gandhi Institute of Chest Diseases said that the hospital was receiving nearly 300 to 350 cases per month until January 2019 because health centres in rural districts were not geared up to tackle the disease.

“Now, since January, we have had a total of 60 cases of multi-drug-resistant TB and four cases of the XDR variety, which stands for extreme drug resistance,” he said.

According to Dr Manjula, nearly all TB cases are being treated at government hospitals with just one or two cases in private hospitals.