Rise of tuberculosis in Mumbai youth discussed at med meet – Times of India

MUMBAI: The rising incidence of difficult-to-treat tuberculosis (TB) among Mumbai’s youth found a mention at the recently held national conference on TB and Chest Diseases in Ambala.
A research paper presented by Dr Homa Mansoor of international NGO Medecins Sans Frontieres (Doctors Without Borders) highlighted the plight of 34 youngsters treated at MSF’s salvage treatment centre in Govandi between October 2017 and October 2020. The youngsters were diagnosed as extensively drug-resistant TB (XDR) or pre-XDR.
She said the right medicine in the right dosage should be readily available for patients with such extensive disease.
“It is sad to note that the average age of this group was 23 years,” she said. Around 60% were females.
When these 34 patients came to the Govandi centre, most of them had previously been given bedaquiline, the newer anti-TB drug available in India only through a government programme, for a period of six months.
Each was treated with the salvage regimen, including bedaquiline, delamanid and imipenem. “Around 56% of these 34 patients (19) had an unsuccessful outcome such as death, no change in condition or they were lost to follow,” said the doctor.
Around 32%, or 11 patients, had successful outcomes and four patients are still on treatment.
Unfortunately, said Dr Mansoor, 88% of this group had severe lung damage that would affect their quality of life. “Even if they were cured of TB, some of them cannot walk for a short distance,” she said.
Dr Mansoor said effective rollout of the programme guidelines are needed to ensure the right treatment at the right time. “We should upfront give concurrent regimens of bedaquiline and delamanid , with an extension of bedaquiline beyond six months for pre-XDR & XDR cases,” she added.
Incidentally, the new treatment guidelines of the central government allow for bedaquiline to be given for periods more than six months. “We can give the new drugs for a longer period, but each case has been evaluated before the approval is given,” said pulmonologist Dr Vikas Oswal, who is associated with the TB centre at the BMC-run Shatabadi Hospital in Chembur.