Popular test likely behind drug resistance of TB bacterium

Earlier too,quoting a WHO alert in July this year,the TB control division had written to the states that these tests not be encouraged and hospitals should instead rely on microscopic examination of sputum.

Serological tests like Elisa and Serum IgG test for TB work on the principle of detection of antibodies to a particular organism in the blood. Dr Ashok Kumar,deputy director general of the TB division,said: “Private practitioners widely use these tests for convenience purposes but they are unreliable. There is overdiagnosis or underdiagnosis. If a person without the disease is given antibiotics,the bacterium is exposed to antibiotics and may lead to resistance. On the other hand,if it is not diagnosed,not only does the person suffer,he spreads the disease as well.”

DGCI Dr V G Somani,who took charge very recently,did not want to speak about the ban request by the TB division.

According to Dr Kumar,the danger of an unreliable TB test is more severe in a country like India where,because of the high prevalence rate of the disease,the TB bacteria is endemic. So every time a person who is not a TB patient is exposed to antibiotics,there is a fleeting exposure of the bacterium to the medicine which may lead to the organism developing ways to protect itself from any future onslaught.

India is estimated to have 75 new cases of TB (sputum positive) every year,of which,an estimated 2 per cent are of the drug-resistant variety.

Kumar said the kits were popular because no expertise was needed to run them. “For a microscopic examination of sputum,you need a trained person. Private practitioners tend to take shortcuts and the expensive ones happen to be the most popular,” he noted.

The health ministry had drawn up a plan to have DOTS+ sites (one for every 10 million population) for the treatment of patients with drug-resistant TB,but not all of them are in place yet. Of the 43 search laboratories that were to be set up in the country,however,31 are functioning.

Fineprint

* If a person without disease is given antibiotics,the bacterium may develop resistance

* If not diagnosed,not only does the person suffer,he spreads the disease as well

* India is estimated to have 75 new cases of TB (sputum positive) every year

* Of this,an estimated 2 per cent are of the drug-resistant variety