New Delhi: India, which bears the highest burden of tuberculosis (TB) - around 25 percent of global cases - may see an alarming spike in drug-resistant TB in the next two decades, warns a new study.


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The study has set alarm bells ringing for the country which aims to end tuberculosis by 2025 as targeted by the government.


It said that drug-resistant TB could make up one in ten cases of the disease in the country by 2040.


Between 2000 and 2040, cases of drug-resistant TB are expected to rise in four high burden countries of India, the Philippines, Russia, and South Africa between 2000 and 2040, said the study.


"By 2040, a third of tuberculosis cases in Russia are predicted to be drug-resistant, compared with one in ten in India and the Philippines, and one in 20 in South Africa," the study said.


This compares to almost a quarter of cases (24.8 per cent) in Russia, 7.9 per cent in India, 6 per cent in the Philippines, and 2.5 per cent in South Africa in 2000, the study said.


Tuberculosis is a bacterial disease that can be treated with a combination of antibiotic drugs.


However, the "use and misuse" of antibiotics - such as using the wrong drug, or not completing the full course of treatment - may result in bacteria developing drug resistance, known as acquired drug resistance.


The upturn is likely because of increased transmission of drug-resistant tuberculosis between people, rather than by strains acquiring resistance to drugs, it said.


While better access to treatment programmes will reduce rates of drug-resistant TB in the aforementioned countries, they alone will not eradicate the problem as current efforts may not be enough to reverse the spike.


The study also called for research into additional control measures to prevent the spread of the drug-resistant disease.


These measures include early detection, reducing the number of patients who do not complete treatment, and providing tailored treatment depending on which drugs the strain is susceptible to.


"We cannot focus solely on curing people with TB or drug-resistant TB if we want to halt the epidemic. Even if we prevent new drug-resistant infections, there are enough current cases to keep the epidemic going. Drug-resistant TB will continue to be an increasingly dangerous threat so long as resistant strains spread through the air from one person to another," said Aditya Sharma of the US Centers for Disease Control and Prevention.


He said there is a need to dramatically step up efforts to break the cycle of transmission, while also maintaining efforts to rapidly find and treat all people with tuberculosis.


"We must strengthen infection control measures, focus on households, health centres, and communities to prevent tuberculosis spreading from person to person, and develop more effective diagnostic tests to rapidly and accurately detect drug resistance," he said.


Earlier, a study by the Centre for Disease Dynamics, Economics and Policy (CDDEP) revealed that TB is estimated to kill 4,80,000 Indians every year although it is now believed that these numbers are under-represented and the mortality could be 5,00,000 a year.


Latest figures estimate that each year there are 10.4 million new cases of tuberculosis, leading to 1.8 million deaths globally.


Nearly 40 per cent of all drug-resistant TB cases occur in Russia, India, the Philippines, and South Africa - accounting for more than 2,30,000 cases in 2015.


The study has been published in the prestigious Lancet medical journal.


(With PTI inputs)