TODAY -

Challenges of Multidrug-Resistant Tuberculosis

Sh Nilica Devi *



Global tuberculosis control is facing major challenges today. In general, much effort is still required to make quality care accessible without barriers of gender, age, type of disease, social setting, and ability to pay. Co-infection with Mycobacterium tuberculosis and HIV (TB/HIV), and multidrug-resistant (MDR) and extensively drug-resistant (XDR) tuberculosis in all regions, make control activities more complex and demanding.

Tuberculosis (TB) is a disease caused by bacterium Mycobacterium tuberculosis that are spread from person to person through the air. The general symptoms of TB disease include feelings of sickness or weakness, weight loss, fever, and night sweats. The symptoms of TB disease of the lungs may also include coughing, chest pain, and coughing up blood. Symptoms of TB disease in other parts of the body depend on the area affected.

What id Multi Drug-Resistant Tuberculosis (MDR TB)?

Multidrug-resistant TB is TB resistant to at least Isoniazid and Rifampicin, the two most potent and commonly used drugs in the current four-drug (or first-line) regimen. WHO treatment standards requires at least four drugs be used to treat TB in order to avoid the development of further resistance.

Isoniazid (H); Rifampicin (R); Ethambutol (E); Pyrazinamide (Z) and Streptomycin (S) are the first- line drugs. The stories of those living with drug-resistant TB are harrowing. Novel regimens are needed to treat MDR-TB on a global scale.

What is Extensively Drug-Resistant Tuberculosis (XDR TB)?

Extensively drug resistant TB is TB resistant to Isoniazid and Rifampicin, plus any Fluoroquinoloneand at least one of three injectable second-line drugs (i.e., Amikacin, Kanamycin, or Capreomycin). XDR TB is emerging as an even more ominous threat as it is resistant to the most potent TB drugs and patients are left with treatment options that are much less effective.

XDR TB is of special concern for persons with HIV infection or other conditions that can weaken the immune system. They are more likely to develop TB disease once infected.

Drug-susceptible TB and drug-resistant TB are spread the same way. TB bacteria propel into the air when a person with TB disease of the lungs or throat coughs, sneezes, talk or spits and very less bacilli are enough to cause infection when inhaled.

Causes of Drug-Resistant Tuberculosis

Drug-resistant TB has microbial, clinical, and programmatic causes. From a microbiological perspective, the resistance is caused by genetic mutation that makes drug ineffective against the mutant bacilli. An inadequate or poorly administered treatment regimen allows drug-resistant mutants to become the dominant strain in a patient infected with TB.

However, it should be stressed that MDR-TB is a man-made phenomenon – inadequate treatment, inadequate drug supply or poor drug quality and inadequate drug intake leads to the development of MDR-TB.

Risks for getting MDR TB

Drug resistance is common in people who:
o Do not take their TB medicine regularly and as prescribed by the doctor.
o Develop TB disease again, after having taken TB medicine in the past.
o Come from areas where drug-resistant TB is common.
o Spent time with someone known to have drug-resistant TB disease.

Prevention of MDR TB

Good treatment is a pre-requisite to the prevention of emergence of resistance. Revised National TB Control Programme (RNTCP) recognises that implementation of a good quality Directly Observed Treatment, Short Course (DOTS) programme is the first priority for TB control in the country. Prevention of emergence of MDR-TB in the community is more imperative rather than its treatment.

The most important thing a person can do to prevent the spread of MDR TB is to take medications exactly as prescribed. No doses should be missed and treatment should not be stopped early. Patients should tell their health care provider if they are having trouble taking the medications.

Health care providers can help prevent MDR TB by quickly diagnosing cases, following recommended treatment guidelines, monitoring patients’ response to treatment, and making sure therapy is completed. Another way to prevent getting MDR TB is to avoid exposure to known MDR TB patients in closed or crowded places such as hospitals, prisons, or other such places.

The fight continues

Today, drug-resistant TB is quite common in India and China, as the two countries combined account for more than half of the global MDR-TB burden. Drug-resistant TB is often “found” by determining a patient’s reaction to first-line treatment, which means that by the time they are identified as having drug-resistant TB, patients have become even more resistant than they were prior to their latest therapy. Treatment for MDR-TB is commonly administered for 2 years or longer and involves daily injections.

Many second-line drugs are toxic and have severe side effects. The World Health Organization has issued a target of treating 80% of MDR-TB cases by 2015. Without new, simple, and affordable treatments for MDR-TB, this is not realistically possible.

It is estimated that 70% XDR-TB patients die within a month of diagnosis. The most recent drug-resistance surveillance data issued by the WHO estimates that an average of 5% MDR-TB cases are XDR-TB.

TB anywhere is TB everywhere. As an airborne disease that can be spread through the simple act of coughing, our decision makers have an obligation to heed to the evidence and speed up our fight against this ancient disease, before its control spins out of our grasp.


* Sh Nilica Devi wrote this article for The Sangai Express
The writer is Junior Microbiologist, BABINA Diagnostics, Imphal
This article was webcasted on October 20, 2018.



* Comments posted by users in this discussion thread and other parts of this site are opinions of the individuals posting them (whose user ID is displayed alongside) and not the views of e-pao.net. We strongly recommend that users exercise responsibility, sensitivity and caution over language while writing your opinions which will be seen and read by other users. Please read a complete Guideline on using comments on this website.




LATEST IN E-PAO.NET
  • Scientist of Manipur: Amom Ruhikanta
  • Violence in Manipur 2023-2024 : Timeline
  • Conspiracy, thy name is Kuki !
  • "ST status for Meetei" at Thounaojam
  • Ket Meth New Album "Ghost Stories"
  • World Hypertension Day
  • International Day of Families
  • Let the rule of law prevail
  • When donation becomes obligatory demand
  • Tourism of Manipur through Gastronomy
  • Beyond Eternity :: Poem
  • Patriarch subjugation on women
  • Celebrate Manipuri Cinema shine at Cannes
  • Training on cultivation of various mushroom
  • Transformative impact of Ayurveda & Yoga
  • War for over a year : Delhi is answerable
  • The logic behind illogical chargesheet
  • Preserving Thang-Ta :: Rare Photos
  • Regarding Human Rights Situation in Manipur
  • World Hypertension Day 2024
  • Article 355 of Constitution of India #3
  • Disinformation campaign touba thengnarey
  • Deeply mourn the demise of Oja Biren Lamba
  • Water Mimosa for sustainable development
  • Publicity drives of educational institutions
  • ED's revolutionary move!!!
  • Malemnganbi Laishram : Science Topper
  • Featured Front Page Photo 2024 #2: Gallery
  • Thokchom Sheityajit : Arts Topper
  • Aiena Naorem : Commerce Topper
  • AISSE 2024 Exam Result- RKM Imphal
  • Gold, new world currency !
  • Milk for hair and skin
  • Of illegal immigrants & the larger picture
  • The missive from Kamjong
  • Hr Secondary Exam 2024 : Science Topper
  • HSE 2024 : Subject Pass Percentage
  • HSE 2024 : District Pass Percentage
  • HSE 2024 : Candidates with Highest Marks
  • Hr Secondary Exam 2024: Science Full Result
  • Hr Secondary Exam 2024: Arts Full Result
  • Hr Secondary Exam 2024: Commerce Result
  • Hr Secondary Exam 2024 : Arts Topper
  • Hr Secondary Exam 2024 : Commerce Topper
  • Sezo Ringa- Debut Music Video "Revival"
  • Journalism - A thrilling career #2
  • After Class XII where? The eternal question
  • Entry of Arvind Kejriwal
  • Birth Centenary of Jananeta Irabat, 1996 : #1
  • Our nurses, our future: Power of care
  • Screenplay Writing course concluded
  • Workshop on IP & Patent Filing held
  • Let there be less Politics in Sports
  • Sam Pitroda is absolutely white
  • Motherhood: Soul & spirit of family & society
  • Time has come to criminalise ecocide
  • Meiteis, a disappearing community in Manipur
  • World Bamboo Congress @Taiwan : Gallery
  • Ima Manipur should smile more
  • 2nd National Lok Adalat at High Court
  • The Power of Poppy - 30 :: Poem
  • Army impact on Tamphasana Wushu odyssey
  • Aftermath of ferocious hailstorm #1 : Gallery
  • "Dynamic library service" :: Book Rvw
  • Radio E-pao: Manipuri Film OST (130+ song)
  • Artificial Intelligence & Environment
  • Article 355 of Constitution of India #2
  • Integrated Farming Systems for farmers #4
  • Delhi's stand after 1 year of clash
  • A new type of terrorism
  • Scientist of Manipur: Waikhom Vishwanath
  • SRF, JRF, RA @ Assam University
  • The Bleeding River :: Poem
  • Executive Meeting of WMC Assam Unit
  • Journalism - A thrilling career #1
  • Raising the call to replace Minister
  • A storm in a political teacup
  • Cheirao-chingkaba @ Chinga : Gallery
  • Happy Mother's Day
  • Empowering hill communities via U-Mangra
  • African Swine Fever
  • Free Training on Mushroom at Nagamapal
  • Harshit Dhingaun recieves award from Korea
  • Look for ways to restore normalcy
  • The danger of last kicks of a dying horse
  • Preserving Thang-Ta traditions
  • Resolving ST issue by democratic process
  • Top 5 songs to awaken your inner patriot
  • Project Assistant @ Manipur University
  • Leishemba Sanajaoba conferred Doctorate
  • Double tragedy: No time for red-tapism
  • A Youtuber called Dhruv
  • Nupi Landa Thaunaphabishing : Full Book
  • 174th Anniv Maharaj Narasingh #2 : Gallery
  • Challenges in Healthcare in rural Manipur
  • A salute to leadership quality of PM Modi
  • Career in press for freedom of expression
  • One day after devastating hailstorm
  • Understanding the suffering of others
  • A ferocious hailstorm @Imphal : Gallery
  • Article 355 of Constitution of India #1
  • Integrated Farming Systems for farmers #3
  • Election gossip & rumours
  • 'Melodic Minds' Tour in Guwahati
  • Leaving a trail of destruction
  • Political see-saw
  • A brand-new Scientific discovery
  • In memoriam of the happiness we shared !
  • Crop/animal for higher productivity in NE #5
  • "ST status for Meetei" at Sekmaijin
  • Oh Motherland :: Poem
  • Animal life should be treated with dignity
  • '365 Days of Chin-Kuki Aggression' : Gallery
  • Renaissance of politics in our youth
  • TB & tobacco co-epidemics in Indonesia
  • The Power of Poppy - 29 :: Poem
  • Advanced Charging Infrastructure in NE
  • Lessons learnt in the last one year
  • True colour of politics
  • World Heritage Day @ MU : Gallery
  • "ST status for Meetei" at Kakwa
  • Joint Combing Operations in Jiribam
  • Reboot PSUs for jobs: Task for new Govt
  • Ayurvedic remedies to keep healthy eyes
  • May 3, 2023 to May 3, 2024
  • One year of crisis, and what next ?
  • Scientist of Manipur: Nongmaithem Rajmuhon
  • Whither social justice & work for women?
  • Taiwan to enhancing economic ties with India
  • Integrated Farming Systems for farmers #2
  • Athoubasingi Numit #2 : Gallery
  • Privilege trap of While Male Meitei
  • Crop/animal for higher productivity in NE #4
  • 'Chizami Model' working in Gujarat ?
  • Racing towards the one year mark
  • On misattribution & falsifying history
  • Nupi Landa Thaunaphabishing #15 :: Book
  • May Calendar for Year 2024 : Tools
  • 12th World Bamboo Congress at Taiwan
  • Complex dance of democracy in Manipur
  • "ST status for Meetei" at Pangaltabi
  • Integrated Farming Systems for farmers #1
  • Showing ugly face of muscle power
  • Spare the rod, spoil the monster
  • Descent of Radha-Krishna #31: Download
  • Socio-Historical analysis on Ethnic Conflict
  • "ST status for Meetei" at Langmeidong
  • Ngangbam Dipapati- Gold @European Cup
  • Crop/animal for higher productivity in NE #3
  • Fresh surge in violence
  • The real culprit
  • National Science Teacher workshop
  • Livelihood Disaster in Mapithel Region
  • Condemns Killing of CRPF Personnel
  • "ST status for Meetei" at Manipur College
  • Huidrom Oliviya: Silver @Cadet European Cup
  • Election: Runner-up may spoil the joy
  • Scientists of Manipur : Laishram Ladu Singh
  • Imphal Ring Road Project to Transform
  • Crop/animal for higher productivity in NE #2
  • The Power of Poppy - 28 :: Poem
  • Condemned unabated illegal taxation
  • Watermelon : Super nutritious summer fruit
  • People have spoken, Manipur has voted
  • Skirting around core issues
  • Lok Sabha polls in Manipur #2 : Gallery
  • The Taj Mahal that bans Lovers !
  • Importance of bees !
  • Massive hailstorm in Jiribam
  • The messiah of hapless children
  • Attack on fuel tankers & blasting bridge
  • Blame it on Meetei
  • The Happiness Code : Download
  • NH-2 Bridge bombed @Sapermeina : Gallery
  • Crop/animal for higher productivity in NE #1
  • Training Programme under SPARK concluded
  • Why environment control is so difficult
  • 4th Foundation Day- Young Minds Collective
  • All set for second phase poll
  • The Nongsaba phenomenon
  • Khongjom Day @Khebaching #1 : Gallery
  • India's responsibility to end Manipur violence
  • Migrant worker could access TB services only
  • Importance of reading magazines as student
  • SHG pioneering agricultural innovation
  • Nearing the one year mark
  • The enemy within
  • Id-ul-Fitr @Hatta #2 : Gallery
  • Workshop @ NSU Manipur : Gallery
  • 15th Manipur State Film Awards 2023
  • "ST status for Meetei" at Panthoibi Shanglen
  • GSDP doubles, health shines
  • Vote has been cast, repoll held
  • Two faces of democracy
  • Laurels for Scientist Ngangkham Nimai
  • Crime against women in Manipur
  • "ST status for Meetei" at Sugnu
  • Creativity & innovation for vibrant career
  • 4th Foundation Day of YMC
  • Racing towards one year mark
  • Prophetic words, indeed
  • Nupi Landa Thaunaphabishing #14 :: Book
  • 174th Anniv Maharaj Narasingh #1 : Gallery
  • Ensuring Fair Voting in Hills of Manipur
  • Dr Irengbam Mohendra's latest book :: Rvw
  • NDA has the advantage in both
  • Lok Sabha polls in Manipur #1 : Gallery
  • L Rup's Robot 'Kangleinganbi' in Manipuri
  • Art- means of connecting hearts in Manipur
  • Is it Living Alive or Living Death ? :: Poem
  • Rabies - A preventable zoonotic disease
  • April 19, 2024: The blackest day of all
  • Ugly turns on voting day
  • Children Camp @JNMDA Imphal #2 : Gallery
  • The chasm between TB & HIV continues
  • Parliament and its Members
  • Kimchi for health and glowing skin
  • LS election with a difference
  • To vote, or not to vote ?
  • Sajibu Cheiraoba Chak Katpa #2 : Gallery
  • Scientists of Manipur : Laitonjam Warjeet
  • Community seed bank @Umathel : Gallery
  • Saving Manipur
  • Sajibu Cheiraoba: 1 occasion, 2 narratives #2
  • Athoubasingi Numit #1 : Gallery
  • Id-ul-Fitr @Hatta #1 : Gallery
  • 80th Anniv- Battle of Kanglatongbi @UK
  • Hun - Thadou Cultural Festival : Gallery
  • Scientists of Manipur : Ngangkham Nimai
  • Sajibu Cheiraoba Chak Katpa #1 : Gallery
  • Beating of the Retreat #1 : Gallery
  • Kenedy Khuman (Singer) : Gallery
  • Students @ Class X Exam : Gallery
  • Save Manipur : Protest [Feb 15] #3 : Gallery
  • GHOST of PEACE :: Download Booklet
  • List of Kings of Manipur: 33 - 1984 AD