Acta Scientific Clinical Case Reports

Case Report Volume 1 Issue 9

Health System Obstacles and their Overcoming for Early Detection and Management of Multi- Drug Resistant (MDR) Tuberculosis in a Rural Setting of Haryana, North India

MD Abu Bashar*

Department of Community Medicine, MM Institute of Medical Sciences and Research, MM Deemed to be University, Mullana, India

*Corresponding Author: MD Abu Bashar, Assistant Professor, Department of Community Medicine, MM Institute of Medical Sciences and Research, MM Deemed to be University, Mullana, India.

Received: September 16, 2020; Published: September 30, 2020

×

Abstract

  India contributes one fourth of the global burden of multi-drug resistant tuberculosis (MDR-TB) and has inadequate diagnostic infrastructure and institutional capacities for drug susceptibility testing (DST). Subsequently, this leads to a large number of undetected and untreated cases of MDR-TB. In this report, we describe a case of 55 years old man from rural north India presenting with complaints of continued symptoms of chronic cough, fever, and dyspnea despite being diagnosed with recurrent TB recently and receiving treatment from local Community Health Centre (CHC). MDR-TB was suspected, but confirmatory diagnosis capabilities were not available in the local setting. The patient was finally diagnosed with MDR-TB. Treatment was coordinated by the district TB program officer. Through this case, we describe the various barriers of detecting MDR-TB in the rural regions of India. Prompt identification of patients with presumptive MDR-TB, diagnosis of the disease, and initiation of treatment are crucial in preventing the transmission of disease and reduce morbidity and mortality.

Keywords: Community Health Centre (CHC); Multi-drug Resistant Tuberculosis (MDR-TB); India

×

References

  1. World Health Organization. Global Tuberculosis Report 2014. Geneva (2014).
  2. Mukherjee JS., et al. “Programmes and principles in treatment of multidrug-resistant tuberculosis”. The Lancet 9407 (2004): 474-481.
  3. World Health Organization. Multidrug and extensively drug-resistant TB (M/XDR-TB), 2010. Global Report on Surveillance and Response. Geneva (2010).
  4. World Health Organization. Global tuberculosis control (2016).
  5. Rifat M., et al. “Why are tuberculosis patients not treated earlier? A study of informal health practitioners in Bangladesh”. International Journal of Tuberculosis and Lung Disease 5 (2011): 647-651.
  6. World Health Organization. Global tuberculosis report (2017).
  7. Institute of Medicine (US). Facing the Reality of Drug-Resistant Tuberculosis in India: Challenges and Potential Solutions: Summary of a Joint Workshop by the Institute of Medicine, the Indian National Science Academy, and the Indian Council of Medical Research. Washington (DC): National Academies Press (US); 2012. 2, Drug-Resistant TB in India (2012).
  8. Revised National Tuberculosis Control Programme. Central TB Division. Directorate General of Health Services. Ministry of Health and Family Welfare. Government of India: Guidelines on Programmatic Management of Drug Resistant TB (PMDT) in India. New Delhi, India (2012).
  9. World Health Organization (WHO). The stop TB strategy: Building on and enhancing DOTS to meet the TB-related Millennium Development Goals. Geneva (2006).
  10. Revised National Tuberculosis Control Programme. Central TB Division. Directorate General of Health Services. Ministry of Health and Family Welfare. Government of India. TB India 2016. Annual Status Report. New Delhi India (2016).
  11. Abeygunawardena S C., et al. “Management of previously treated tuberculosis patients in Kalutara district, Sri Lanka: how are we faring?” Public Health Action 4 (2014): 105-109.
  12. Chadha S S., et al. “Operational challenges in diagnosing multi- drug resistant TB and initiating treatment in Andhra Pradesh, India”. PLOS ONE 6 (2014): e26659.
  13. Harries A D., et al. “Using a bus service for transporting sputum specimens to the Central Reference Laboratory: effect on the routine TB culture service in Malawi”. International Journal of Tuberculosis and Lung Disease 8 (2004): 204-210.
  14. Khann S., et al. “Linkage of presumptive multidrug resistant tuberculosis (MDR-TB) patients to diagnostic and treatment services in Cambodia”. PLOS ONE 8 (2013): e59903.
  15. Kilale A M., et al. “Are sputum samples of retreatment tuberculosis reaching the reference laboratories? A 9-year audit in Tanzania”. Public Health Action 3 (2013): 156-159.
  16. Li Y., et al. “Are we doing enough to stem the tide of acquired MDR- TB in countries with high TB burden? Results of a mixed method study in Chongqing, China”. PLOS ONE 9 (2014): e88330.
  17. Qi W., et al. “Performance of culture and drug susceptibility testing in pulmonary tuberculosis patients in northern China”. International Journal of Tuberculosis and Lung Disease 15 (2011): 137-139.
  18. Shewade H D., et al. “Low pre-diagnosis attrition but high pre- treatment attrition among patients with MDR-TB: an operational research from Chennai, India”. Journal of Epidemiology and Global Health 7 (2017): 227-233.
  19. Shewade H D., et al. “High pre-diagnosis attrition among patients with presumptive MDR-TB: an operational research from Bhopal district, India”. BMC Health Service Research 17 (2017): 249.
  20. Shewade H D., et al. “MDR-TB screening in a setting with molecular diagnostic techniques: who got tested, who didn't and why?” Public Health Action 5 (2015): 132-139.
  21. Shewade H D., et al. “MDR-TB in Puducherry, India: reduction in attrition and turnaround time in the diagnosis and treatment pathway”. Public Health Action 6 (2016): 242-246.
  22. Boyd R., et al. “Time to treatment for rifampicin-resistant tuberculosis: systematic review and meta-analysis”. International Journal of Tuberculosis and Lung Disease 21 (2017): 1173- 1180.
  23. Lawn SD., et al. “Advances in tuberculosis diagnostics: the Xpert MTB/RIF assay and future prospects for a point of care test”. Lancet Infection Disease 13 (2013): 349-361.
  24. Revised National Tuberculosis Control Programme (RNTCP); Central TB Division. National strategic plan for TB elimination 2017-25. New Delhi, India (2017).
  25. Revised National Tuberculosis Control Programme (RNTCP). TB India 2017. Annual status report. New Delhi India (2017).
  26. United Nations Development Programme. Sustainable Development Goals.
  27. World Health Organization. The End TB Strategy.
×

Citation

Citation: MD Abu Bashar. “Health System Obstacles and their Overcoming for Early Detection and Management of Multi- Drug Resistant (MDR) Tuberculosis in a Rural Setting of Haryana, North India". Acta Scientific Clinical Case Reports 1.9 (2020): 32-35.




Metrics

Acceptance rate30%
Acceptance to publication20-30 days
Impact Factor1.278

Indexed In





News and Events


  • Certification for Review
    Acta Scientific certifies the Editors/reviewers for their review done towards the assigned articles of the respective journals.
  • Submission Timeline for Upcoming Issue
    The last date for submission of articles for regular Issues is May 25, 2022.
  • Publication Certificate
    Authors will be issued a "Publication Certificate" as a mark of appreciation for publishing their work.
  • Best Article of the Issue
    The Editors will elect one Best Article after each issue release. The authors of this article will be provided with a certificate of “Best Article of the Issue”.
  • Welcoming Article Submission
    Acta Scientific delightfully welcomes active researchers for submission of articles towards the upcoming issue of respective journals.
  • Contact US