Drug resistance in tuberculosis- resurvey in Wardha district, India after implementation of revised national TB control program

Abstract

Level of drug resistance among new TB patients indicates the efficacy of any control programme. A drug resistance survey, as a part of global study in new pulmonary tuberculosis (NPTB) patients, was conducted in Wardha district, India under WHO /IUTLD in 2001, before the implementation of the Revised National Tuberculosis Control Programme (RNTCP) which was implemented in the district in 2002. The present study was conducted in Wardha district in 2014-2015, thirteen years after the implementation of RNTCP, and the drug resistance in isolates from NPTB patients was compared to the results of 2001 survey. The methodology used was same in both the surveys. : In addition to 132 isolates from Wardha, the study also included 112 isolates from adjoining city, Nagpur and total of 244 sputum isolates were subjected to drug sensitivity by standard 1% proportion method on Lowenstein Jensen’s medium. In addition molecular typing of resistant strains was done.: In Wardha, compared to 2001 survey, overall susceptibility to first line drugs washigher (94.7% vs 80.2%); and resistance to streptomycin (3% vs 7.6%) and isoniazid (2.2% vs 15.2%) were significantly lower (p≤ 0.05). MDR was 0.75% against 0.50% in the earlier study but the difference was statistically not significant. Only two MDR isolate were recovered, of which only one was from Wardha.After the implementation of RNTCP in Wardha District, drug resistancein new PTB patients has shown a decline and MDR continues to be low reflecting upon the efficiency of the program.