A Retrospective Analysis of Multi-Drug Resistant Tuberculosis among Presumptive Pulmonary Drug-Resistant Tuberculosis Patients in Andaman & Nicobar Islands

Abstract

Tuberculosis is a contagious bacterial infection affecting more than 10 million people worldwide. It is a major public health concern in India especially with the increasing numbers of drug-resistant cases of tuberculosis. Lack of early diagnosis, inadequate and inappropriate treatment are the major contributors to the development of drug resistance. PMDT strategy strives for early diagnosis and appropriate treatment of drug-resistant TB. This study was undertaken to estimate the rate of occurrence of MDR-TB among presumptive DR-TB patients in Andaman & Nicobar Islands. Materials and Methods: A retrospective data based study for the calendar year 2018 was done by the state TB centre of the Union Territory of Andaman and Nicobar Islands. All patients with presumptive pulmonary DR-TB (as defined by the PMDT guidelines 2017) were included in the study. The drug resistance was confirmed by phenotypic and genotypic methods. Result: The total number of presumptive DR-TB cases during the calendar year 2018 was 235. Forty eight of the cases were confirmed to be MDR-TB cases. Additional drug resistance to Second Line Injectable aminoglycosides (SLI) and Fluoroquinolones (FQ) was found in 2 and 6 of the cases respectively. Two cases of extreme drug resistant tuberculosis were also found (MDR+SLI+FQ resistance). Conclusion: The best strategy for the control of drug resistant tuberculosis is prevention, which can only be achieved by timely diagnosis and early initiation of appropriate treatment of drug resistant TB cases as per drug susceptibility results, thereby preventing their further transmission.