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Category: Volume 07 Issue 02 February 2019
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Title: MDR-TB- Clinical Profile of MDR-TB Cases at DR-TB Centre

Authors: Dr SM Khan, Dr B.O. Tayade , Dr Sonal S. Arsude

 DOI: https://dx.doi.org/10.18535/jmscr/v7i2.112

Abstract

The present study was carried at NKPSIMS , RC & LMH on patients admitted in one year from Dec 2012 to Nov 2013 after confirmation of being a Multidrug resistant tuberculosis (MDR-TB) case (i.e. resistant to Rifampicin or to both Isoniazid & Rifampicin).96 patients (69 males & 27 females) were registered, admitted and treated for MDR-TB/ XDR-TB and were thoroughly reviewed regarding age, sex, residence, socio-economic status, symptomatology, duration of illness, prior regularity or irregularity in respect of treatment received, prior receipt of number of anti-TB regimens and comorbid  illnesses and adverse drug reactions.

Males outnumbered the females, residents of Nagpur district (urban and rural areas) were found to be more than other districts of Vidarbha region.

One patient of Extra Pulmonary MDR-TB was registered and initiated on CAT- IV regimen and there was one confirmed case of XDR-TB who was admitted and investigated for auxilliary investigations and initiated on CAT-V regimen.

This study reflects the case of "NKPS Nagpur Model" a PPP model which delivers to TB & MDR-TB patients and nutritional supplements as well. The unique feature of this model is that Public sector role is to provide human resources and free investigations with free drug delivery and the private sector provides specialist care to DR-TB patients along with infrastructure support. This approach has become known as the "NKPS Nagpur Model ".

Early diagnosis, registration and initiation of Anti MDR-TB and XDR-TB regimens can prevent the dissemination and transmission of the deadly and dreadful resistant bacilli.

Keywords: Multi Drug Resistant TB, Extremely Drug Resistant TB, Extended framework of DOTS package, DOTS Plus regimens (Cat 4 and Cat 5), Public Private Partner-ship NKPS Nagpur Model

References

  1. WHO Global Tuberculosis Control Report 2010:Summary;Cent Eur J Public Health 2010;18:237
  2. Chakraborty AK. Epidemiology of Tuberculosis: Current status in India. Indian J Med Res 2004:120:248-276
  3. The World Health Organization/ International Union Against Tuberculosis and Lung Disease, Global Project on Surveillance for anti-Tuberculosis Drug Resistance: A model for other Infectioius Diseases: Mohammed Abdul Aziz and Abigail Wright; Stop TB Department.World Health Organization, Geneva, Switzerland; download from http://eid.oxfordjournals.org:Global Anti-TB Drug Resistance*EID 2005;41 (Supplement)*S259
  4. Revised National Tuberculosis Control Programme, DOTS Plus Guidelines, January 2010, Central TB Division, Dictorate General of Health Services, Ministry of Health and Family Welfare, Nirman Bhavan, New Delhi.
  5. Multidrug and Extensively Drug Resistant TB (M/XDR TB 2010). Global report on surveillance and response.
  6. TB India 2012 ; Annual Status Report
  7. Guidelines on programmatic management of Drug Resistant TB (PMDT) in India, December 2011.
  8. Chauhan LS. Drug Resistant TB RNTCP Response. Indian J Tuberc 2008;55:5-8
  9. Frieden TR, Manseff SS. The DOTS strategy for controlling the global Tuberculosis epidemic. Cli Chest Med 2005;26:197-205
  10. Stop TB working group on DOTS plus for MDR-TB(2003).As prioritised research agenda for DOTS Plus for Multi Drug Resistant Tuberculosis(MDR-TB).Int J TUberc Lung Dis 7:410-414
  11. Chaudhary RR, Thatte U.Beyond DOTS: avenues beyond ahead in the management of Tuberculosis. Nat Med J India.2003;16:321-327.
  12. Mukherjee JS, Rich ML, Socci AR, Joseph JK, Viru FA, Shin SS, et al. Program and principles in treatment of multi drug resistant tuberculosis.Lancet2004;363:471-478.
  13. Dreniewski F, Ettrionagahni I, Graham C, Magee J g, Smith E G, Watt B. A national study of clinical and laboratory factors affecting the survival of patients with multiple drug resistant tuberculosis in the UK. Thorax.2002;57:810-816.
  14. Surendra K Sharma, Sanjeev Kumar, P K Saha, Ninoo George, S K Arora Deepak Gupta, Urvashi Singh, et al. Prevelence of multi- drug resistant tuberculosis among Cat II pulmonary tuberculosis patients.Indian J Med Res 133; March 2011:312-315
  15. Paulin Joseph, Vijaya Bhaskarrao Desai, Nalini Sunder Mohan, Jemima Sheela Frederick, Rajeshwari Ramchandran, Balambal Raman, et al. Outcome of standardized treatment for patients with MDR-TB from Tamil Nadu, Indian J Med Res 133; May 2011:529-534.
  16. Bikram Singh Datta , Ghulam Hassan, Syed ManzoorKadri, Waseem Qureshi, Mustadiq Ahmad Kamili, Hardeep Singh, et al. Multidrug Resistant and Extensively Drug Resistant Tuberculosis in Kashmir. Indian J Infect DevCtries 2010;4(1):019-023.
  17. Issakidis P, Verghese B, Mansoor H, Cox H s, Ladomirska J, Saranchukt P et al. Adverse events among HIV/MDR-TB co-infected patients receiving antiretroviral and second line Anti-TB treatment in Mumbai, India. PloS One2012;7:e40781.
  18. R Singla, R Sarin, U K Khalid, K Mathuria, N Singla, A Jaiswal, et al.Seven year DOTS-Plus experience in India.Results, constraints and issues. Int J Tuberc Lung Dis 2009;13(8):976-981.

Corresponding Author

Dr SM Khan

Department of Respiratory Medicine, NKP Salve Institute of Medical Sciences & RC

Lata Mangeshkar Hospital, Nagpur, Maharashtra, India