KARACHI, Oct 18: The health department of the city government has taken serious note of the supply of drugs in abnormal combination by the Sindh government to different towns for tuberculosis patients under the DOTS programme, as these medicines can be dangerous in prolonged use.

A letter issued by EDO (health) to the director TB control, government of Sindh, says that medicines supplied for tuberculosis patients are in an abnormal combination for the continuation phase, as Rifampcin and Ethambutol both 100mg of INH are in combination.

The letter adds that a patient will receive 600mg of INH, which is against all standards, because this high dose can have serious toxic abnormal health effects.

According to a chest specialist, INH is the short form of a compound isoniazid, the maximum dose of which for a TB patient is 300mg and the prolonged use of its excessive dosage can damage liver of the patient, while other two compounds administered to TB patients are Rifampcin and Ethambutol, which are administered according to a calculated formula.

The daily dose of Ethambutol is 25mg per kilogram body weight of a patient, while the same for Rifampcin is 450mg if a patient’s weight is less than 50kg and it is 600mg if the body weight is more.

However, under the medicines procured by Sindh health department’s committee headed by additional-secretary procurement, Dr Majid, the compound INH has been included in both Ethambutol and Rifampcin, making its dose as high as 600mg to be consumed daily.

These medicines have been procured under the anti-TB DOTS programme for the province and incidentally the technical expert of this procurement was Director Ojha Institute of Chest Disease, Dr Ashraf Sadiq, who is not even a chest specialist and the Ethambutol has been procured by an unknown firm without any record of supplying sensitive medicines.

These medicines, worth millions of rupees, are being distributed in different districts, besides a number of towns in Karachi.

The towns which have received these medicines are: Shah Faisal - for 500 patients; Gadap - for 600 patients; New Karachi - for 500 patients; Orangi - 600 patients; Keamari - 350 patients; Gulshan-i-Iqbal - 300 patients; Korangi - 300 patients; Gulberg - 200 patients; Malir - 100 patients; Saddar - 200 patients, and Lyari Town for 100 patients.

It is interesting to note that neither the health department of the city government nor the focal person for DOTS in the city was taken into confidence or informed about the distribution of medicines in the towns by the provincial health department, although the functional responsibility of successful implementation of DOTS lies with the concerned district governments and officials of the TB control programme.

The issue came into limelight when doctors in some of the towns expressed concern over the combination of medicines supplied to them.

DOTS is the most modern measure to counter threats of lung TB - the most common form of tuberculosis - whereas it can occur in any part of the body, including intestines, nervous system and even bones.

This disease has re-emerged around the world in the recent past and its prevalence rate in Pakistan in pulmonary and extra- pulmonary cases is 178 patients in a population of one hundred thousand.—PPI