It was in the last week of December 2011 when Ashwin Mishra’s (name changed), 24, doctor told him that he had tested positive for multi drug resistant tuberculosis (one of the world’s largest killer disease that’s resistant to first line of drugs). Doctors treating him say Mishra, who started treatment from July 2011, took the news with a smile.
Fourteen months later, Mishra’s smile and patience with the lengthy TB treatment has helped him beat the disease which kills about two people every three minutes in India. He has become a role model for other TB patients.
Mishra’s treatment for MDR TB began around the same time the drug resistant controversy broke in Mumbai on January 6, 2012. Doctors from PD Hinduja Hospital, Mahim, presented a scientific paper published by them in a journal confirming that they had cases of patients totally drug resistant (TDR) TB who were not responding to any available drugs.
While the World Health Organisation, government and the corporation’s machinery swung into action, the BMC, apart from rolling down and stringently implementing the TB programme in the city, also involved patients like Mishra to encourage others. The corporation’s doctors said such patients strengthen their belief that Mumbai will succeed in controlling the spread of the disease.
Dr Mini Khetrapal, TB officer, Mumbai, told DNA: “Patients like Mishra inspire others to successfully complete the TB course and reinforce their belief that TB is curable.” Khetrapal said treatment default is a serious problem in controlling TB.
The long duration of treatment and side effects, many a times, compel the patient to become a defaulter. “TB treatment is long but works. It starts with an intensive phase (normally, three months) where the patient has to visit the directly observed treatment short-course strategy (DOTS) centre every alternate day for medicine. Sputum test is done at the end of the phase and, depending on the result, we decide whether to start the continuation phase,” said Khetrapal.
Defaulting on treatment may lead to persistence of infectious source, increased mortality, increased relapse rates, and facilitate the development of resistant strains. BMC health officials said the non-compliance rate in Mumbai is just 3% and only 300 defaulters. “We regularly organise patient meets where they share their experiences. It helps us boost their self-confidence,” said Khetrapal.
At such meets, the local TB officers have introduced prizes for patients who have been regular in their treatment. “More the awareness among the patients, less will be cases of drug-resistant TB in our city,” said Khetrapal.