The curious case of TB patient resistant to 12 of 13 anti-TB drugs
A girl from Govandi in Mumbai is resistant to 12 of the 13 anti-TB drugs which are available. As per doctors, this makes her a public hazard since she could spread the disease to others.
However, though she has TB, she lives at home and uses the public transport frequently.
Dr Oswal who thinks that the girl could be quarantined to limit the chances of her spreading the infection says, “She travels in buses and local trains, just like most of us. Knowing that she possibly harbours a bacterial strain that is resistant to all other drugs, including Bedaquiline, she could be spreading the infection.”
But the catch is that it’s not stated anywhere in the national TB policy that severe drug resistant patients have to be isolated. “Doctors have to be cautious and make patients aware about spreading the infection in the community. We can’t stop patients from travelling,” said Dr Sunil Khaparde, deputy director general of the TB control programme.
Delamanid is the drug which works in the girl’s case. However, it may not be of help. As Dr Oswal says, “Delamanid is a highly advanced anti-TB drug, but its efficiency is questionable in her case as it has to be given in combination with other drugs, which she has already developed a resistance to. If she doesn’t respond to it, there is nothing else that we can try”
The girl’s aunt takes care of her. She has never been screened for the infection.
Moreover, the aunt works as a helper at a local school where she has to take care of kids as young as four years old. She said that even though the doctors have asked her to get tested, she never seem to be able to find the time. Also, she said that both her parents had contracted and succumbed to TB.
Her mother died when she was just nine and eight years later her father too bid the world good bye.
Bedaquiline not miracle drug, says doctors
The girl’s case comes on the heels of the recent case in which an 18 year old from Patna was refused Bedaquiline at a Delhi hospital, saying she was not a resident of the city.
The Delhi high court eventually ruled that the patient’s domicile isn’t an eligibility criterion for Bedaquiline.
The decision means that more number of TB patients could take Bedaquiline. However, doctors did say that the screening of the patients should be done very carefully.
Another concern which doctors have expressed is about calling Bedaquiline a ‘miracle drug.’ “When treating TB, there cannot be a single ‘miracle drug’. Any drug has to be given in combination with other drugs that are known to work,” said Dr Yatin Dholakia, technical advisor to Maharashtra State Anti-TB Association.
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