Of Drug Resistant Tuberculosis

Talking of places to go in health care, and of the Totally Drug Resistant (TDR) strain of Tuberculosis, it turns out that the drug resistance appears mostly because of the simplest reason: incomplete dosages of medicines. Instead of killing the virus, incomplete doses actually help to make the virus immune to the medication!

[…] At the best of times, TB treatment is difficult, requiring at least 6 months of pill combinations that have unpleasant side effects and must be taken long after the patient begins to feel well.

Because of the mismatch between treatment and symptoms, people often don’t take their full course of drugs — and from that (and some other factors I’ll talk about in a minute) we get multi-drug resistant and extensively drug-resistant, MDR and XDR, TB.

[…] WHO predicted there would be 2 million MDR or XDR cases in the word by 2012.

That was before TDR-TB.

How does this happen? It’s complex, of course, with no single simplistic answer. Often patients will stop taking their medicines when they start feeling better. But the condition of health care professionals is pretty bleak:

A study that we conducted in Mumbai showed that only 5 of 106 private practitioners practicing in a crowded area called Dharavi could prescribe a correct prescription for a hypothetical patient with MDR tuberculosis. The majority of prescriptions were inappropriate and would only have served to further amplify resistance, converting MDR tuberculosis to XDR tuberculosis and TDR tuberculosis.

This needs some serious attention. Tuberculosis is dangerous in India without having the TDR strain over our heads. As I said in my last post—there’re still places to go.

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