Abstract
Introduction: Multidrug-resistant tuberculosis (MDR-TB) is an emerging public health problem. The study was done to evaluate the clinical profile of MDR TB patients and to study the diagnostic parameters in a cohort. Materials and Methods: All MDR-PTB patients admitted in a tertiary level TB institute for initiation of treatment for study period were enrolled. Various clinical parameters such as symptomatology profile, past treatment details, details of diagnosis, and methods of diagnosis were studied retrospectively in these patients. Results: A total of 125 patients were enrolled. An average age was 29.5 ± 12.2 years. The average duration of chest symptoms was 2.4 ± 0.6 years; cough and expectoration were the most common symptoms present in all (100%) the patients. Two patients were treatment naοve, and 123 were retreatment cases, in which, 63 were relapse, 42 were treatment after default, and 18 were failure cases, just prior to being diagnosed as MDR-TB. Forty-three patients have received at least one of the reserve line drugs as part of anti-TB treatment in past. The average courses of treatment taken prior to been labeled as MDR-TB were 3.15 times. Majority of patients (99) had been diagnosed by using molecular-based tests. Conclusion: Use of reserve line drugs is common for treatment of TB, even without being diagnosed as MDR-TB. Both physicians- and patient-related factors responsible for the development of MDR-TB may be prevented by improving understanding of the disease and by early and proper treatment of both drugs susceptible and drug resistant TB.
Highlights
Multidrug‐resistant tuberculosis (MDR‐TB) is becoming a major public health problem
The Revised National Tuberculosis Control Program (RNTCP) under Programmatic Management of Drug Resistant Tuberculosis (PMDT) is in the phase of expansion and is making fast progress in terms of expanding the diagnostic facilities, as well as the treatment sites for such patients of MDR TB[2] but still a large proportion of TB patients in their early phase of illness are managed by the private health care sector by either the physician, small private hospitals and nursing homes, or corporate hospitals
Every patient of pulmonary MDR TB who is admitted in the MDR‐TB ward of the institute for initiation of Category IV treatment is first evaluated by the resident doctors of the ward, in which a detailed clinical history and examination is recorded, the past treatment records are reviewed, and the reports supporting the diagnosis of MDR‐TB are attached in the case file
Summary
Multidrug‐resistant tuberculosis (MDR‐TB) is becoming a major public health problem. This form of TB is difficult and costly to diagnose, and tough to treat with increased morbidity and mortality as compared to the drug‐susceptible TB. Multidrug and poly‐drug resistant strains have been increasing around the world.[1] There are 64,000 MDR‐TB cases per year in India, out of which only a few are able to reach to the proper healthcare facilities to get treated.[2] The Revised National Tuberculosis Control Program (RNTCP) under Programmatic Management of Drug Resistant Tuberculosis (PMDT) is in the phase of expansion and is making fast progress in terms of expanding the diagnostic facilities, as well as the treatment sites for such patients of MDR TB[2] but still a large proportion of TB patients in their early phase of illness are managed by the private health care sector by either the physician, small private hospitals and nursing homes, or corporate hospitals
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