Multidrug-resistant TB on the rise in India

Rise of multidrug-resistant tuberculosis threatens to derail the progress made by nations, including India which was among the three countries that accounted for half of over 4 lakh such cases globally in 2015.
India is also among the six countries that account for 60 per cent of the total TB cases globally, a study published in The Lancet Respiratory Medicine said.
In 2015, there were an estimated 4.8 lakh cases of multidrug-resistant tuberculosis (MDR-TB) globally, with approximately half of these cases being in India, China, and Russia, the study said.
"But, migration and travel mean that drug-resistant TB strains have emerged in almost every parts of the world," it said, adding, "New antibiotics are becoming available for the first time. But without accurate diagnostics, clear treatment guidelines and improved control efforts, their effectiveness could be rapidly lost."

"The rise of multidrug-resistant and extensively drug-resistant (XDR) tuberculosis threatens to derail decades of progress in controlling the disease," the new study said.
The study comes ahead of World TB day on March 24.

Tuberculosis kills more people each year than any other infectious disease, including HIV/AIDS.
In 2015, TB was estimated to have killed 1.8 million people and six countries -- India, Indonesia, China, Nigeria, Pakistan and South Africa -- account for 60 per cent of the total number of cases of tuberculosis worldwide, the study said.
"Approximately 1 in 5 cases of TB are now resistant to at least one major anti-TB drug and approximately 5 per cent of all cases of TB are classed as MDR (resistant to two essential first-line TB drugs, isoniazid and rifampicin) or XDR (also resistant to fluoroquinolones and second-line injectable drugs)," the study said.

It said a small number of repurposed and new medicines have recently become available to treat drug-resistant TB including bedaquiline, delamanid, and linezolid.
However, the study warned that without accurate diagnosis, clear prescription on appropriate use and improved control efforts to prevent transmission and well-functioning healthcare systems, the effectiveness of the new drugs could be "rapidly lost".
"Tuberculosis exists on an epic scale in India and cases of multidrug-resistant TB are an increasing concern. Access to drugs to treat tuberculosis, including drug resistant TB is a major concern," co-author of the study, Zarir Udwadia from Hinduja Hospital and Research Center in Mumbai, said.

"Despite some small scale programmes for compassionate use of new life-saving drugs, such as bedaquiline and delamanid, there is no widespread access of drugs to fight MDR-TB in India, meaning these drugs remain unavailable to patients who need them most," Udwadia said.