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CDC HIV/AIDS/Viral Hepatitis/STD/TB Prevention News Update

INDIA: India Faces New Front in Battle Against TB


Wall Street Journal (01.19.12) - Tuesday, January 24, 2012

With the recent report of 12 TB cases in Mumbai resistant to all current treatments, India is confronting weaknesses in its national TB program. The cases were diagnosed in patients at Hinduja National Hospital and Medical Research Center and reported by Zarir Udwadia, one of Mumbai's leading private pulmonologists, and colleagues.

"While this handful of cases is worrying, it's just the tip of the iceberg," said Dr. Soumya Swaminathan, senior deputy director of the National Institute for Research in Tuberculosis. "The bottom line is we need to take TB much more seriously." Indian health officials on Jan. 18 visited Mumbai to meet with Udwadia and other pulmonologists to develop a course of action. Since the 1997 launch of the current program of free TB testing and treatment, India has cut TB mortality from 500,000 annually to 280,000 in 2010. About 1.5 million of its 2 million TB patients are treated by the program, according to a 2011 government report.

To ensure treatment adherence, the national program requires patients to take their medication in front of a nurse or designated supervisor. However, the program needs more funding, more local-level accountability and more labs that can perform resistance testing, Swaminathan said.

In a survey conducted last year by Udwadia among doctors treating TB in the Dharavi slum in Mumbai, 103 of 106 prescribed the wrong medications for the disease, he said. "Two or three treatment errors is all it takes to create multidrug-resistance," he said.


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