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KARACHI, March 22: Multiple drug resistant tuberculosis (MDR-TB), which is very difficult to treat, may be on the rise in the country, said chest physicians on Saturday.
Pakistan is actually situated inside the ‘hot zone’ for this type of TB, said one of them at a seminar organized jointly by the JPMC and Pakistan Chest Society, Sindh, in connection with the World TB Day.
Dr Ghazala Ansari pointed out that the best management of MDR-TB is actually its prevention through adequate treatment of all people diagnosed as potential TB patients.
The other speakers at the seminar pointed out that more people died of TB than any other infectious disease. The national TB Control Programme was in its infancy.
Dr Jawaid Khan of the Aga Khan University, in his presentation, said the key factor in the management of tuberculosis was the correct diagnosis and prescription, besides total compliance of the guidelines by the patient.
He was of the view that since TB was a high prevalence disease every doctor should familiarize himself or herself with new approaches for its treatment.
Dr Amanullah Ansari, Sindh’s TB Control Programme manager, said community-based DOTS programme was an internationally established and cost effective strategy to control the spread of tuberculosis.
This programme, he said, was being implemented in the province step-wise. He was of the view that one agency alone couldn’t control the spread of the said disease.
Dr Ansari called for collaboration among all the agencies and bodies that are active in this area.
Tuberculosis had considerable socio-economic burden, said Dr Shahina Qayyum of the JPMC. “It is not only that poor people become TB patients but that tuberculosis makes people poor.”
Quoting her own study, she claimed that 26 per cent of the TB patients ultimately became jobless. And more than 31 per cent of the patients borrowed money to support their family and themselves.
Kazi Abdus Shakoor, Dr Nadeem Rizvi and Dr Masroor Ali Khan Afridi also spoke on the occasion.
OJHA INSTITUTE: The director of the Ojha Institute of Chest Diseases told Dawn that it costs between Rs200,000 and Rs250,000 to treat MDR-TB.
The main factor behind the spread of the disease is the failure on the part of a normal TB patient to take standard combination of required drugs for the requisite duration, said Dr M. Ashraf Sadique.
Comparing the drug resistant type of tuberculosis with the normal type, he said hospitalization of all TB patients wasn’t necessary. “But people suffering from the MDR type must be admitted as soon as possible,” he said.
Ordinary tuberculosis costs between Rs1,800 and Rs2,000 to treat, said the director of the Ojha Institute of Chest Diseases. “The MDR type, on the other hand, costs at least ten times that amount.”
Dr Tehzeeb Anwer of the same institute was of the view that misdiagnosis and wrong medication was an important underlying reason for the rapid spread of MDR-TB.
The Ojha Institute’s doctors told Dawn during a visit to their institution that 4,680 TB patients were registered with them. “1,800 of these people come to us daily for medication under the Daily Observed Treatment programme,” said Dr Sadique.
Showing Dawn around his hospital, he said philanthropists and NGOs had always donated generously for the welfare of patients. “Most of the donors are so selfless and dedicated that they don’t want any kind of publicity.”
Both he and Dr Tehzeeb Anwer claimed that their hospital was the only one in the public sector which didn’t charge a single penny from the patients.
