New Delhi, Jan 24

Even as the health ministry continues to be in a denial mode over cases of totally-drug resistant tuberculosis (TB) surfacing in Mumbai, a non-governmental organisation (NGO) Tuesday urged stakeholders working on the deadly disease to scale up services.

"There is an urgent and critical need to scale up services, by stakeholders working for TB care. TB needs to be actively identified through approved, early, accurate and high quality diagnosis,” a spokesperson from the Partnership for TB Care and Control in India said. “Proper completion of treatment needs to be ensured for all TB patients.”

India has been relying on the Directly Observed Treatment Short course (DOTS) chemotherapy under the Revised National Tuberculosis Control Programme (RNTCP) (1997) for TB control, a disease that kills two people every three minutes, and accounts for over 3 million (3 lakh) deaths every year. DOTS has been effective in controlling Multi-drug resistant (MDR) TB.

However, a team of doctors from Mumbai's Hinduja hospital recently found cases of totally-drug resistant (TDR) TB resistant to all drugs used to treat the disease.

The health ministry, after its report by experts, stated the cases to be falling within the category of Extensively Drug Resistant TB (XDR TB). The ministry shrugged off the term 'TDR' saying it is not recognised by the World Health Organisation (WHO).

While XDR-TB cases are resistant to any of the three second-line drugs, the multi-drug resistant TB (MDR-TB) cases do not respond to at least two of the most potent first-line anti-TB drugs.

"The reasons for drug resistance in TB are a combination of poor programme reach, inaccurate diagnosis methodologies, improper treatment as well as non adherence to it and indiscriminate drug prescription,” the spokesperson added.

Interestingly, India is not the only country that has report cases of TDR-TB, Italy reported the first TDR-TB cases in 2007, followed by Iran in 2009.

The airborne disease is caused by the bacterium Mycobacterium tuberculosis that affects the lungs. Symptoms include severe cough which lasts for three weeks or longer, producing bloody or discoloured sputum, night sweats, fever, fatigue and weakness, pain in the chest, loss of appetite, and pain in breathing or coughing.

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