Treatment default hits fight against TB

COIMBATORE: The problem of patients who default from TB treatment continues to be a serious public health issue despite the best efforts of officials. Coimbatore district records about 1,300 new cases of tuberculosis annually and in the past three years, 1380, 1285 and 1303 new cases have been identified. "It is very essential that TB patients should complete the full course of treatment.Educating and creating awareness among them in this regard is one of the objectives this World Tuberculosis Day," said Dr M Sakthivel, deputy director, medical services (TB).
Dr Sakthivel said there are many instances when the TB patients and their families have refused to cooperate with direct observed treatment (DOT) volunteers. "After taking treatment for a short period they believe it is unnecessary to continue. This is wrong," he said. According to him, in some cases DOT volunteers have even been chased away by patients.
Apart from voluntary refusal to continue treatment, factors like migration, alcoholism, drug and work related reasons too result in default from TB treatment. Health officials say defaulters are putting the entire community at risk by not continuing treatment and advise patients to avail the free, universal access to TB treatment. "In Coimbatore district, the cure rate of TB patients is around 85% and mortality rate is close to 5%. The default rate in the district is roughly estimated to be about 6%," said Dr Sakthivel.
Studies say default from TB treatment could culminate in multi-drug resistant tuberculosis (MDR TB). While normal TB patients have to undergo treatment for a period between 6 months and 8 months, treatment for MDR TB can extend even up to two years.
On Saturday, a state-of-the-art laboratory for follow up tests in MDR TB was inaugurated at a private hospital in Coimbatore. "It is a boost to MDR TB healthcare and the government will pay the hospital for tests carried out in this laboratory apart from their own services," said Dr M Sakthivel. According to him, now samples are being sent to Chennai for follow up tests, which causes unnecessary delays, increases risk of contamination. This is the third centre in Tamil Nadu next only to Intermediate Reference Laboratory in Chennai and Christian Medical College in Vellore.
Sakthivel added that the Coimbatore Medical College Hospital will also soon get a modern facility to diagnose MDR TB. "The facility inaugurated at PSG Hospitals is for follow up tests for MDR TB, while the proposed facility at CMCH is for diagnosing MDR TB," said Dr Sakthivel. Presently diagnosis of MDR TB is done at Intermediate Reference Laboratory and National Institute for Research in Tuberculosis in Chennai, Christian Medical College, Vellore and Medical College, Madurai.