Surveillance of drug resistance to anti-tuberculosis drugs in districts of Hoogli in West Bengal and Mayurbhanj in Orissa.

ABSTRACT

The Central TB Division (CTD), Government of India, initiated a systematic drug resistance surveillance (DRS), as per the global guidelines, among new TB patients reporting to health facilities under RNTCP. The data obtained from two districts of the eastern part of the country conducted by National TB Institute (NTI) are presented in this study. Objective: To measure the levels and pattern of resistance to anti-tuberculosis drugs among “newly diagnosed” sputum smear positive pulmonary tuberculosis cases in two identified districts, namely, Hoogli of West Bengal and Mayurbhanj of Orissa. Results: Of the total 693 smear positive specimens subjected for culture from both the districts, 545 (78.6%) were culture positive for M. tuberculosis, 62 (8.9%) were culture negative and 86 (12.4%) were contaminated. Culture negativity and contamination rates were 7.9% & 9.9% from Mayurbhanj district and 10% and 14.9% respectively from Hoogli district. The resistance to any drug was 5.4% in Mayurbhanj and 16.7% in Hoogli district. The resistance level to all the four primary drugs ranged from 0.4% to 3.9% in Mayurbhanj and 1.9% to 13.7% in Hoogli district. MDR was 0.7% (95% CI 0.0% - 1.7%) and 3.0% (95% CI 1 % - 5.1 %) in Mayurbhanj and Hoogli districts respectively. Conclusion: The study demonstrates that the levels of H, R and MDR in these two districts are within the expected levels, when compared with other studies conducted in India as per global DRS guidelines. However, in order to document success of RNTCP in reducing the levels of MDR TB, particularly in younger population, it is now necessary to conduct DRS in much larger population.