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India reports first cases of ' total drug - resistant tuberculosis " - -

India reports first cases of 'total drug-resistant tuberculosis'

India has reported its first cases of "total drug-resistant tuberculosis", a long-feared and virtually untreatable form of the killer lung disease.

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Mohammed Shamim Sheikh, who suffers from 'total drug-resistant tuberculosis' at his home on the outskirts of Mumbai, India Photo: AP Photo/Rafiq Maqbool

Since 2003, highly resistant cases have been documented in Italy and Iran, mostly limited to impoverished areas and it has not spread widely.

The airborne disease is mainly transmitted through close personal contact and is not nearly as contagious as the flu.

The Indian hospital that saw the initial cases tested a dozen medicines and none of them worked, a pretty comprehensive assessment. A TB expert at the US Centres for Disease Control and Prevention said they do appear to be totally resistant to available drugs.

Ordinary TB is easily cured by taking antibiotics for six to nine months. However, if that treatment is interrupted or the dose is cut down, the stubborn bacteria battle back and mutate into a tougher strain that can no longer be killed by standard drugs. The disease becomes harder and more expensive to treat.

In India, doctors in Mumbai have reported a total of 12 patients, all poor slum dwellers, who failed initial treatment and also did not respond to the medicines tried next over an average of two to three years. Three have died. None of the others have been successfully treated.

The doctors detailed the first four cases in a letter to a US medical journal last month, blaming private doctors for prescribing inappropriate drug plans that sparked greater resistance in three of those four patients.

"These three patients had received erratic, unsupervised second-line drugs, added individually and often in incorrect doses, from multiple private practitioners," wrote the doctors from P.D. Hinduja National Hospital and Medical Research Center in the journal Clinical Infectious Diseases.

There is also a debate within the public health community about whether to even label the infections "total drug resistant". The World Health Organisation has yet to accept the term.

However, Dr Paul Nunn, a coordinator at the WHO's Stop TB Department in Geneva, said there is ample proof that these virtually untreatable cases do exist.



    
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