(a) whether the Multi Drug Resistant TB and XDR-TB are spreading in
the country ;
(b) if so, the details thereof;
(c) whether XDR-TB strain, mixing with the HIV/ AIDS, is causing high
percentage of mortality ;
(d) if so, the steps taken to cure and check the spread of the disease;
(e) whether the Government proposes to set up Advanced Reference Test Labs
exclusively to detect Drug Resistant TB; and
(f) if so, the number of Test Labs setup or likely to be set up in the country,
State-wise ?
THE MINISTER OF STATE IN THE MINISTRY OF HEALTH & FAMILY WELFARE (SMT. PANABAKA LAKSHMI)
(a)&(b) There is no evidence to suggest that Multi Drug Resistant TB (MDR-TB)
and/or Extensively Drug Resistance TB (XDR-TB) is spreading in the country.
Results from Drug Resistance Surveys conducted since 1997 in Tamil Nadu,
Gujarat and Maharashtra indicate that there has been no increase in the level of
MDR-TB, which continues to be about 3% in new TB cases and 10-20% in
retreatment cases. As of now, there is no documented case of XDR-TB in the
country.
(c) TB disease caused by XDR-TB strain is virtually incurable in any patient, with
or without HIV infection. People infected with HIV are more vulnerable to all forms
of TB, including XDR-TB, and are more likely to die from TB. This was recently
reported in a hospital-based outbreak in South Africa. However, till date there has
been no such case reported in India.
(d) MDR-TB and XDR-TB develop when TB patients are incompletely or inadequately
treated. Therefore the first priority is prevention of the development of drug resistance
by detection of TB patients and effective treatment as per RNTCP guidelines.The
Phase-II Project Implementation Plan of the Revised National TB Control Programme
(RNTCP) has the full range of activities as recommended by the 2006 WHO Stop TB
Strategy, which are needed to prevent the development of drug resistance. These
activities first include the maintenance of good quality DOTS services for early
detection and curing of drug susceptible TB cases. RNTCP has a system for making
patients adhere to treatment and the cure rates within RNTCP have been in excess of
the global benchmark of 85%. Furthermore, RNTCP has developed a system in
accordance with international guidelines for the effective treatment of MDR-TB, which
is currently being pilot tested in Gujarat and Maharashtra. To ensure that TB patients
get standard diagnostic and treatment services as per RNTCP, special emphasis is laid
on the IEC activities, involvement of NGOs, private sector and medical colleges in the
revised strategy.
(e)&(f)Yes. Currently TRC, Chennai, National TB Institute, Bangalore, and LRS Institute,
Delhi have the capacity for conducting quality assured culture and drug susceptibility
testing to detect MDR-TB. Under Phase-II of the RNTCP two laboratories one each
in the State of Gujarat and Maharashtra have also been established.