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'For TB, one prescription does not fit all patients'

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'For TB, one prescription does not fit all patients' MUMBAI: When it is tuberculosis, one prescription doesn’t fit all patients. Government-run programmes offer the same medicines to all patients with drug-resistant TB, but an intervention by Hinduja Hospital, which was the first to detect totally drug resistant cases in the city, shows that this does not always work.

The hospital, which adopted the cost of treatment and care of 50 drug-resistant TB patients over the last three years, found that when poor patients with drug-resistant TB got access to free medicines and were assured medical care in case they suffered side-effects, they were more likely to complete the two-year treatment. Hinduja Hospital raised funds through corporate social responsibility programmes, spending around Rs 2 lakh on each patient.

“It is not enough to give prescriptions to patients with multi- or extensively drug-resistant TB. Almost half of them suffer some side-effects due to the medications,” said Dr Camilla Rodrigues from Hinduja Hospital who is associated with the intervention. The hospital began the intervention to offer not only free diagnostics, but even medicines, follow-up visits, multivitamins and supplements on August 15, 2015. Of the 50 enrolled patients, 30 completed the treatment and are disease-free. “Another 13 have completed 18 months’ treatment,” said Dr Rodrigues. Three patients dropped out as they left Mumbai, while four died.

The programme’s main success is that patients have been cured using the drugs available widely in India; no new imported drugs had to be used. Dr Zarir Udwadia, in-charge of all patients’ treatment, said, “This proves that patients need individualized regimen and there cannot be an one-size-fits-all regimen.” Government-run programmes offer the same medicines to all patients, thereby delaying cure in some patients who may be resistant to all existing drugs distributed in the programme. “Our counsellors found that these patients get immediate attention if they have some problems like a side-effect to a drug,” she added. Second-line anti-TB medicines could affect functioning of the kidneys, cause pain in extremities and hearing loss, among others.

Every year, the city has roughly 40,000 TB cases, with a tenth of them having the more serious multi- or extensively drug-resistant forms of the bacterial infection.



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