Health

KEY POINTS

MDR & RR TB

·         MDR TB is the most basic form of drug-resistant TB, defined as an infection that does not respond to isoniazid and rifampicin, the two most powerful anti-TB drugs.

·         RR TB is resistant only to rifampicin.

Drug becomes resistant

·         Typically this happens when the patient does not complete the full course of medication.

·         Depending on the drug and severity of the infection, TB medication may have to be taken for up to 9 months.

·         If a patient drops out along the way, the bacteria is exposed to the drug, but is not killed.

·         The organism in this case often mutates in such a way that the drug no longer remains effective.

·         This patient, whose symptoms may be in remission (the reason why he or she stopped taking the medication), remains capable of infecting others with the mutated bacteria, and new patients who catch the disease will report drug resistance.

GOI steps to curtail Drug resistance

·         Notification - Recording and notifying the WHO about every diagnosed patient is an important first step.

·         The government has launched a web-based application called Nikshay to enable health functionaries at various levels across the country to monitor TB cases in their areas.

·         Patients receive daily SMSes to ensure they continue their medication.

·         The medicines come with a toll free number that is visible only after the medicine has been taken out of the foil pack; patients are required to give the number a missed call.

·         Every missed call is tracked, and when there are too many gaps, the patient is traced, often by treatment supervisors who travel to remote areas on bikes that the programme pays for.

·         The TB elimination plan also has incentives for patients and private practitioners.