AN EPIDEMIOLOGICAL STUDY IN XDR-TB PATIENTS IN A TERTIARY CARE HOSPITAL

BACKGROUND:

India with a major burden of multidrug-resistant tuberculosis (MDR-TB) does not have national level data on this hazardous disease. Since 2006, emergence of extensively drug-resistant TB (XDR-TB) is considered a serious threat to global TB control. This study highlights the demographic and other epidemiological factors associated with XDR-TB in Lucknow.

METHODS:

The study was conducted for a period of one year. Sputum samples were cultured using rapid, automated liquid culture system (MGIT 960). Drug susceptibility testing (DST) for Rifampicin (RIF) and Isoniazid (INH) was performed for all positive M. tuberculosis (M.tb) cultures. All MDR-TB isolates were tested for sensitivity to second-line drugs.

RESULTS/FINDINGS:

In the present study it was found that the patients were mainly males who were suffering from XDR-TB visiting our tertiary center. The age group ranged from 17-52 years and was not seen in the pediatric age group. The patients mainly had pulmonary form of tuberculosis as none of the patients had extra-pulmonary tuberculosis. Most of the patients who had XDR were malnourished and had the weight between 26-45 kilograms. In the study majority of patients were on standard treatment for XDR patients as per RNTCP guidelines. One patient was defaulter and two mortalities were seen in our study. Majority of patients were from the Lucknow district.

CONCLUSIONS:

The actual incidence and prevalence rate of XDR-TB in India is not available, although some scattered data is available. This study raises a concern about existence of XDR-TB in India, though small, signaling a need to strengthen the TB control program for early diagnosis of both tuberculosis and drug resistance in order to eak the chains of transmission