Over 25 pc of TB patients in India have resistance to anti-TB drugs: Survey

More than a quarter of tuberculosis patients in the country have resistance to anti-TB drugs, a new government survey has revealed.

On World TB Day today, the health ministry released two reports -- TB India 2018 Report and National Drug Resistance Survey Report.

According to the first national anti-TB drug resistance survey 2014-16, India records more new tuberculosis (TB) patients annually than any other country, contributing to 27 per cent of the world's TB burden.

About 2.79 million TB patients are estimated to be added annually and the Revised National Tuberculosis Control Programme (RNTCP) notified around 1.94 million TB patients in 2016.

"MDR-TB rates at the national level are still within the range of previous state-level surveys conducted in India. However, more than a quarter of TB patients in India have drug resistance to one or the other anti-TB drug.

"Fluoroquinolone resistance among MDR-TB patients is high and is similar to resistance rates reported by the RNTCP," the survey said.

It said that India initiated the programmatic management of drug resistant TB (PMDT) in 2007 to address the emerging problem of drug resistant-TB (DR-TB), and the national PMDT scale-up was achieved by March 2013.

"The treatment success rate among MDR-TB patients in India is consistently about 46 per cent and the death rate is around 20 per cent as against the global level of treatment success rate of 52 per cent and death rate of 17 per cent.

"High rates of treatment failure and deaths are associated with fluoroquinolone resistance in the Indian cohort of MDR-TB patients," it said.

It said that MDR-TB is 6.19 per cent among all TB patients with 2.84 per cent among new and 11.60 per cent among previously treated TB patients.

"Among MDR-TB patients, additional resistance to any fluoroquinolones was 21.82 per cent and 3.58 per cent to any second-line injectable drugs. Among MDR-TB patients, additional resistance to at least one drug from each of the two classes, i.e. fluoroquinolone and second-line injectable drugs (XDR-TB) was 1.3 per cent," it said.

It advocated for setting up and strengthening drug resistance surveillance including using state-of-the-art next generation sequencing.

"This will provide the programme with the trends of drug resistance, transmission patterns and mapping of hot spots in different states for better understanding of molecular epidemiology for TB surveillance.

"Rapidly scaling up universal DST and appropriate DST guided treatment. Strengthening epidemiologic intelligence for specific interventions based on local epidemiological profile," it said.

Union Health Secretary Preeti Sudan, while releasing the reports, said that India is already aligned with world TB treatment protocols.

"It has launched a mission to end TB by 2025, through community participation, involving civil societies and other stakeholders. The global target to end TB is 2030 but we will end it by 2025.

"This is a tall order but I am confident that if we all work together, if all the partners combine together and we ensure full treatment is given on regular basis we can show the world this can be achieved. I am confident of this and my confidence is backed by our success in eradicating Polio," she said.

Addressing the participants, the health secretary further stated that the prime minister has given a call for TB Mukth Bharat' which can only be possible "if we ensure our panchayat and blocks are declared TB free". For that the government has adequately provisioned drugs and diagnostic in every part of the country, she added.

Prime Minister Narendra Modi recently launched a campaign to eradicate tuberculosis (TB) from India by 2025, five years ahead of a globally-set deadline.

Meanwhile, the India TB report 2018 said that Since 2007-08, annually, RNTCP screens approximately 20 million symptomatic persons by microscopy for TB and initiates about 1.5 million persons on TB treatment.

"In 2017, 7,32,449 patients have been tested using these methods and 38,854 Rifampicin resistant/MDR-TB patients have been diagnosed," it said.