Uttar Pradesh TB Cases Decline, But Drug-Resistant Strains Rise Alarmingly
Even as Uttar Pradesh records a significant decline in overall tuberculosis (TB) cases, medical experts have raised serious concerns over a steady and alarming rise in more severe lung forms—specifically multidrug-resistant (MDR) and extensively drug-resistant (XDR) TB. This critical issue was highlighted during a recent training program held at the Ram Manohar Lohia Institute of Medical Sciences (RMLIMS) in Lucknow on Thursday.
Expert Insights on the Growing Threat
Prof Ajay Kumar Verma, head of the pulmonary medicine department at RMLIMS, emphasized that drug-resistant pulmonary TB is increasing, which makes treatment longer, more complex, and significantly more challenging for healthcare systems. "While overall TB cases have reduced by about 21% since 2015, MDR and XDR TB are rising and remain a serious concern," he stated, pointing out that referral centers like RMLIMS are witnessing a higher burden of such severe cases.
He provided a stark comparison: "In peripheral areas, around three out of 10 TB patients may be drug-resistant, but at tertiary centers like ours, nearly five out of 10 patients have MDR or XDR TB." This indicates a concentration of more complex cases in advanced medical facilities, straining resources and expertise.
Understanding Drug-Resistant TB
Prof Verma explained the mechanisms behind these resistant forms. MDR-TB occurs when TB bacteria become resistant to key first-line drugs such as rifampicin and isoniazid, while XDR-TB shows resistance to advanced second-line medicines as well. He identified incomplete treatment as a major cause of drug resistance, underscoring the importance of adherence to prescribed regimens.
To combat this, he highlighted the role of modern diagnostic tools. Molecular tests such as CBNAAT and Line Probe Assay can detect TB and drug resistance within hours to a couple of days, enabling quicker and more targeted interventions.
Broader Context and Challenges
Former head of the pulmonary medicine department, Prof Rajendra Prasad, acknowledged that India has made significant progress in reducing the overall TB burden. However, he cautioned that the rising trend of drug resistance shows the challenge is far from over, requiring sustained efforts and innovative strategies.
Prof Richa Mishra from SGPGIMS reinforced this view, emphasizing that early detection and complete treatment are crucial not only for reducing TB-related deaths but also for preventing the spread of drug-resistant forms. Her comments highlight the need for integrated public health approaches to tackle this evolving threat effectively.
The situation in Uttar Pradesh serves as a microcosm of a larger global health issue, where gains in controlling infectious diseases can be undermined by emerging resistant strains. Continued vigilance, research, and resource allocation are essential to address this dual challenge of declining overall cases but rising severe forms.
