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TDR-TB threat: Ramdas says RGICD is ‘guessing’

Three-member committee formed to study TB status in state; health minister Ramdas demands biological tests.

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The revelation of two confirmed Total Drug Resistant-Tuberculosis (TDR-TB) at Rajiv Gandhi Institute of Chest Diseases (RGICD) has shaken the health ministry and officials who had instantly gone into a denial mode, even as they blame the RGICD for not bringing the cases to their notice.

However, minister for medical education, health and family welfare, SA Ramdas, following a DNA report on Wednesday, has decided to constitute a three-man committee to submit a detailed report on the status of tuberculosis in the state to the government.
He also conducted a ‘surprise visit’ to RGICD and declared that he is not convinced that the two were TDR-TB cases because “the two cases were only confirmed by clinical tests,  and biological tests have not been done while confirming them.”

He alleged that RGICD has only conducted a clinical analysis of the two patients wherein sputum (phlegm) culturing was not conducted. He blamed RGICD for ‘guessing’ that since the patients have not responded to the medication since two years, it must be TDR.

Biological tests (also called culture and sensitivity test) include culture of the sputum being subjected to multiples tests during which the DNA strands are isolated.

The tests involve allowing the bacteria — Mycobacterium tuberculosis — to grow and various drugs are used on it to indicate whether the samples are TDR-TB-positive or not.
These tests are conducted only in Chennai and New Delhi’s National Institute of Tuberculosis.

Ramesh, joint director, Lady Willingdon State Tuberculosis Centre’s Revised National Tuberculosis Control Programme, which is a state government-administered organisation, said: “We have not received TDR cases so far and if Rajiv Gandhi Institute for Chest Diseases has them, then they should have informed us.”

Despite that, RGICD authorities stand by their version that two patients are indeed confirmed as TDR-TB cases, one of which— a 56-year-old man—is absconding.

Ramdas, however, does admit that there are 56 cases of major Multi Drug Resistant Tuberculosis (MDR-TB), and six cases of Extreme Drug Resistant Tuberculosis (XDR-TB).

“We have sent 4.8 lakh sputum samples from the state to Chennai’s Intermediate Reference Lab and received 68,000 TB-positive cases, of which 56 are MDR positive and six have extreme drug resistance. If there are other cases, we will trace the patients and give them appropriate treatment,” he said.

There is no denying that the state ministry is concerned despite its initial reaction. Therefore, the constitution of the three-member committee, which in all likelihood, comprises Dr Suryakanth, officer in-charge at Lady Willingdon State Tuberculosis Centre’s Revised National Tuberculosis Control Programme; Dr Sathya Prakash, senior scientist, National Tuberculosis Institute; and Dr Raghupathi, resident medical officer, state health department.

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