- Hello Jeff - I have heard of MRD TB and XDR TB and even
XXDR TB but now TDR TB? Totally Drug Resistant TB evidently was first
diagnosed in Iran in a set of patients three years ago. Now, India has
discovered and diagnosed TDR TB in a set of patients in Mumbai hospital.
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- As I stated many times on the program, we are entering
a stage where TB, like 60 years ago, is going to be incurable. We have
arrived now with TDR TB.
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- The best method of protection is PREVENTION. We must
be very very careful not to get exposed to TB. This will mean that healthcare
workers will have to take infection control very seriously.
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- I remember going to a clinic and being on of three patients
treated by one doctor. One of the patients had TB and I noticed the doctor
going back and forth between myself, the TB patient and another patient
and noticed the doctor did not wash his hands. This is unacceptable behavior.
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- Detection of TDR TB will be of utmost importance and
people with resistant TB will have to abide by public health guide lines
for the sake of themselves, their families and friends and the greater
community.
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- TB has now become one of our worst nightmares.
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- Patty
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- Mumbai hospital reports first set of 'total' drug-resistant
TB cases
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- Almost three years after the first set of patients were
diagnosed with Totally Drug-Resistant Tuberculosis (TDR-TB) in Iran, researchers
at the P D Hinduja National Hospital and Medical Research Centre here said
today they have detected India's first set of TDR-TB patients - 12 over
the past two months.
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- In a paper published in the international journal Clinical
Infection Diseases, Zarir Udwadia and his team have described how they
detected the first four TDR-TB patients.
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- "Prior to TDR, XDR or extensively drug-resistant
TB was the furthest stage patients had been diagnosed with in India. After
drug susceptibility testing was performed on four TB patients present at
the hospital, it was seen that all four patients were resistant to both
first line as well as second line treatment," said Udwadia, adding
that there was no treatment for them.
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- According to Udwadia, the drug-resistant nature of the
TB-causing mycobacterium tuberculosis increases with mutations of the strain
often catalysed by incorrect and erratic administration of second-line
drugs. "An audit of the patients' prescriptions showed that three
of the first four patients received unsupervised second-line drugs often
in incorrect dosages by private practitioners in an attempt to treat their
multi-drug resistant TB (MDR-TB). By the time they were referred to us,
they had moved from the MDR stage and the XDR stage to TDR-TB," he
said.
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- In a study a few years ago, it was seen that only five
of 106 private practitioners in Dharavi could prescribe a correct prescription
for a hypothetical patient with MDR tuberculosis. The majority of prescriptions
were inappropriate and amplified resistance, converting MDR-TB to XDR-TB
and finally TDR-TB.
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- WHO estimates that India accounts for 20% of the world's
total load of MDR-TB.
-
- "The Revised National TB Control program (RNTCP)
might have been a success but only a very small percentage of MDR patients
actually have access to Directly Observed Treatment Short-course (DOTS,
the globally standardised short-course chemotherapy cure for TB). It's
probably time we rethink our TB control policies" said Udwadia.
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- "I don't know the details of the report but a few
new cases doesn't mean that the success of DOTS can be disregarded. The
nature of the TB bacterium is such that rapid mutation takes place making
it drug-resistant. It is premature to say that the report is an indicator
of TB spread in the community," said A Thomas, Director of the National
Institute for Research in Tuberculosis, Chennai.
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- http://www.indianexpress.com/news/mumbai-hospital-reports-1st-set-of-total-drug.../896826/
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-
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- Patricia A. Doyle DVM, PhD Bus Admin, Tropical Agricultural
Economics Univ of West Indies Please visit my "Emerging Diseases"
message board at:http://www.emergingdisease.org/phpbb/index.php Also
my new website: http://drpdoyle.tripod.com/ Zhan le Devlesa tai
sastimasa Go with God and in Good Health
-
- Benjamin Franklin said, "They that can give
up essential liberty to obtain a little temporary safety deserve neither
liberty nor safety."
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