The tuberculosis scourge in Mumbai shows no sign of respite with number of multi-drug resistant cases rising across the city. Of 16,825 suspected patients tested for TB with a diagnostics tool, GeneXpert, 5,994 patients were detected with TB from January 2013 till January 27 this year. Latest data from Brihanmumbai Municipal Corporation states that 2,310 cases – 38 per cent of ailing population – are multi-drug resistant.
A senior civic TB officer said this means that patients don’t respond to first-line drugs of isoniazid and rifampicin. “Many patients turn multi-drug resistant after seeking faulty treatment from private practioners over which we have little control. When they approach civic set-ups for help, their condition worsens considerably,” said the officer.
Further, Mumbai has upto 122 extensively resistant TB (XDR-TB). XDR-TB patients are resistant to MDR-TB drugs.
A central government team including Health Secretary Kesav Desiraju and principal secretary Anshu Prakash were on a visit to Mumbai to discuss TB-related issues this week. Under the Revised National TB Control Programme (RNTCP), patients who had gone beyond MDR-TB resistance and were possibly tackling XDR-TB had to wait for up to nine months before getting treatment.
Additional civic health commissioner Manisha Mhaiskar said this will change by the end of the year. “With laboratories like Hinduja, JJ and Sewri TB Hospital being accredited to carry out second-line liquid culture tests,” said Mhaiskar.
A change in RNTCP strategy indicates that newly diagnosed MDR-TB patients will be simultaneously tested for XDR-TB. “The strategy should have been changed long ago instead of making patients wait... Yet, the renewed strategy will save on crucial months for which a patient had to wait before getting right treatment. This will bring the patient respite,” said a senior BMC TB official.
The central government is envisaging providing free nutritional supplements for MDR-TB patients. “However, the city currently houses 4,500 MDR-TB patients on treatment and chalking out the feasibility of catching hold of each patient to provide them meals is an uphill task,” said the official.