Dr MS Kanwar, senior consultant, respiratory medicine at Indraprastha Apollo Hospitals, joined IBNLive readers for an interaction on why India is not being able to curb the incidence of TB cases.
Q. How bad is the situation MDR-TB and is there any possible cure coming in the near future? Asked by: ketan72
A. MDR-TB situation is getting worse in India. It is difficult to treat because of increased number of drugs and the relatively high toxicity of those combinations. We still cure them with fairly good success if the patient is able to tolerate the drugs for long enough time.
Q. Olden days sanatoriums were established in Major towns and TB patients Quarantined. Is that still needed to eliminate incidence of TB? Asked by: sundar1950in
A. No, not at all. That happened only in the pre-treatment era.
Q. Is it that in the rural areas the Zoonotic factor of transmission of TB from cattle to human being and vice versa is leading to continued presence of tuberculosis? Asked by: sundar1950in
A. No, Bovine TB is only of negligible importance in the current scenario of TB in India.
Q. Not only TB, many other infectious diseases and the doctors attending on it will thrive for years to come. Ironically, it is due to our leaders who sit in public offices not being worried on a clean village, town, panchayat or city. If a minister makes a remark for right purposes, it is twisted and he is blamed. Hygiene & health of the state is under attack. Your take? Asked by: sundar1950in
A. TB will get largely eliminated if the hygienic conditions, standard of living and overcrowding of living space improve. These things along with the improved nutrition was largely responsible for self elimination of the disease in the developed world.
Q. Has the bacteria gone drug resistant leading to difficulty of elimination of the disease? Asked by: sundar1950in
A. Yes, the prevalence of drug resistance in TB has increased over the last quarter of a century in India. It has led to many failures to standard anti-TB Chemotherapy. Once the MDR treatment is started the response rate is variable and also dependent on the fact that the drugs have to be tolerated for much longer, usually about 18 months. The results are still not comparable with those of standard first line treatment.
Q. Bacillus tuberculosis - is more virulent now? Asked by: sundar1950in
A. No, it is not more virulent but the risk of primary or initial drug resistance is getting higher than before.