Retrospective Study of Profile of Patients of MDR and XDR TB Attending the Tertiary Care Hospital in Mumbai Under Nonprogammatic Condition

Abstract

PURPOSE: Tuberculosis is widely spread in developing countries and is higher in prevalence in India. DOTS strategy has been covered in all the states of India along with this there is an involvement of medical colleges in Revised National Tuberculosis Control Programme of India. In spite of this a large number of the patients are still being treated by private practioners. Due to the lack of knowledge, ignorance and poverty on the part of patients and inadequate experience of the basic doctors, treatment of TB still not adequate. It is also a common observation that in patients who do not show remission of symptoms in short time, Quinolones are added to the first line regimes by the treating physician. This may lead to failure of the treatment of TB with resultant Mono-, Poly-, Multi-, Extensive Drug Resistant TB. The study was conducted to note the demographic profile, the drug resistant pattern & sputum conversion on the treatment of drug resistant TB. METHODS: Out of 222 patients [ MDR suspect ] of pulmonary & extra pulmonary TB having treatment failure, relapse and defaults, 197 were subjected to culture and sensitivity by BACTEC method. RESULTS: 110 are males & 112 are females, majority [183] are young age group between 10-40, majority [141] are unskilled labourer, students & housewives.183 Pulmonary, 45 Extrapulmonary, 6 Both. Commonest EPTB site lymphnode [29]. 79% took CAT I regimen one time & 78% took CAT II one time. 154 sputum positive at start. Of these, 154 were having MDR, 1 mono and 2 poly- resistance. Resistance to any three second line drugs were found in 9 patients and 11 had XDR TB. On treatment with second line drugs sputum was positive at end of 3 months in 37, > 3 to 6 months in 17, & > 6-9 months in 10 & > 9 to 14 months in 6patients. CONCLUSIONS: MDR TB has high prevalence in the young economically productive population of poor economic status. Maximum number of sputum smear converted was between 3 to 6 months.