Drug-resistant TB: A growing problem


Despite advances in the field of medicine, tuberculosis remains a major killer worldwide. One reason is because of the increasing number of drug-resistant strains of the bacterium that causes TB.

“About 450,000 people developed multi-drug resistant TB (MDR-TB) in 2012. More than half of these cases were in India, China and the Russian Federation. It is estimated that about 9.6 percent of MDR-TB cases had extensively drug resistant TB (XDR-TB),” the World Health Organization (WHO) said, adding that 170,000 have died of the disease.

What’s distressing is that many cases of MDR-TB are found in children. In a recent study published in The Lancet, Ted Cohen of the Harvard School of Public Health said in 2010 that 32,000 children under 15 had MDR-TB and could not be treated with the powerful drugs isoniazid and rifampicin.

He added that many cases of MDR-TB in this age group are undetected. Cohen’s research is the first to study the extent of MDR-TB in kids.

Drug-resistant TB occurs when antibiotics somehow fail to kill all of the bacteria that are responsible for the disease. Bacteria that survive the onslaught of a certain antibiotic become stronger and pass on this trait to other bacteria.

Eventually, surviving bacteria will not be affected by a single anti-TB drug and this immunity may extend to other antibiotics as well. For this reason, patients with active tuberculosis are required to take a lot of medications for a long time to treat the disease and prevent antibiotic resistance.

When TB does not respond to the standard drugs isoniazid and rifampicin, this is called MDR-TB. This type of TB is usually caused by the inappropriate or incorrect use of anti-TB drugs and bad or poor medicines.

While a patient with MDR-TB can still be cured using other drugs, his treatment options are limited and the remaining medicines will not work as well as the first-line of drugs against TB. The patient is also at risk for XDR-TB.

Moreover, these secondary medicines are not always available and have to be taken for a longer period of time (up to two years). Treatment is more costly and there is a bigger chance that the patient may experience side effects. These include nausea and vomiting, loss of appetite, dark urine, fever, and yellow skin.

To prevent drug-resistant TB, patients must follow their doctors’ instructions and complete their medicines. Skipping medicines or suddenly stopping treatment allows TB bacteria to become more powerful, making the disease difficult and more costly to treat.

After only a few weeks of treatment, TB becomes no longer contagious and the patient should start feeling better.

A program called directly observed treatment, short-course (DOTS) can help patients remember when to take their medicines. In the Philippines, this began in 1997 and now covers the entire nation. The National TB Control Program of the Department of Health has been implementing this program in various municipalities and barangays for years, with hopes that it will help prevent needless deaths from TB.


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