A Study of Drug Resistance TB among Patients with New Sputum Smear Positive Pulmonary Tuberculosis

Abstract

Multidrug-resistant tuberculosis (MDR-TB) has emerged as a significant global health concern. Especially in india, Emergence of drug resistant tuberculosis (TB), particularly multidrug resistant TB (MDR-TB) and extensively drug resistant TB (XDR-TB) is a major concern. India is the country having second highest burden of MDR-TB cases following China. Although progress has been made to reduce global incidence of drugsusceptible tuberculosis, the emergence of multidrug-resistant (MDR) and extensively drug-resistant (XDR) tuberculosis during the past decade threatens to undermine these advances. Reported that india has approximately 66,000 MDR- TB cases among notified pulmonary TB cases in 2011 (new cases - 21,000 with a range of 15,000-27,000 and retreatment cases - 45,000 with a range of 40,000-50,000). Various survey done in India by well-qualified and accredited laboratories revealed that MDR-TB in new cases is about2.1% (1.5-2.7) and is about 15% in retreatment cases. In globally, about 9% of all MDR cases are XDR-TB. Even though patients are previously treated for TB is the most important risk factor for development of MDR-TB. New sputum smear positive tuberculosis patients having the risk of either one of spontaneousmutations or transmission of drug-resistant strains for developing single or multi drug resistance. Andunfortunately we did not have any studies about the prevalence of MDR-TB among new cases of sputum-positive pulmonary TB. Category II pulmonary TB are including those who treatment failure, relapse aftertreatment, or default. Newer diagnostic tests like Cartridge Based Nucleic Acid Amplification Test(CB-NAAT) [GeneXpert] and / or Line Probe Assay (LPA) are the novel integrated tests for the diagnosis of tuberculosis and rapid detection of RIF and INH resistance in pulmonary and extra pulmonary specimens obtained from possible tuberculosis patients. If we finds earlier whether they have drug resistance, we can start the treatment for MDR-TB as soon as possible. Starting treatment for drug resistance earlier, we can save the money for the nation and improves the mortality and morbidity of TB patients.