Lancet study sees a spike in drug-resistant TB cases in India

India may not be able to eliminate tuberculosis by 2025 as targeted by the government as cases of drug resistant TB are expected to rise in four high burden countries of India, the Philippines, Russia, and South Africa between 2000 and 2040, a Lancet study shows.

According to the study drug-resistant TB spreads from person to person and one out of eight cases in India will be multi-drug-resistant by 2040, according to the Lancet paper on high-burden countries.

By 2040, 12.4 per cent, or an eighth, of TB cases in India will be multi-drug-resistant, up from 7.9 per cent in 2000, says the study, by an international team of scientists. In the other three high-burden countries, multi-drug resistance will rise to 32.5 per cent of all cases in Russia, 8.9 per cent in the Philippines and 5.7 per cent in South Africa, respectively up from 24.8, 6 and 2.5 per cent in 2000.

Nearly 40 per cent of all drug-resistant TB cases occur in these four countries, accounting for more than 2,30,000 cases in 2015.

Globally, an estimated 10.4 million new cases of tuberculosis and 1.8 million deaths related to tuberculosis disease occurred that year. Multi-drug-resistant TB accounted for 480,000 cases, and 9.5 per cent of these cases were estimated to be extremely drug resistant.

Of the multi-drug-resistant cases, one in 10 are expected to be extensively drug-resistant by 2040 - 9 per cent in Russia and the Philippines, 8.9 per cent in India, and 8.5 per cent in South Africa - according to the study, which used a mathematical model based on WHO data.

The study also estimates how many of these drug-resistant cases would be a result of non-resistant strains acquiring resistance during treatment. It predicts that fewer such cases will be caused by strains acquiring resistance - reducing from around 30 per cent of cases of multi-drug-resistant tuberculosis in 2000 to 20-25 per cent in 2040, and 80 per cent of cases of extensively drug-resistant disease in 2000, to 50 per cent in 2040.

Aditya Sharma of the US Centers for Disease Control and Prevention, said it isn't enough to focus on curing people with TB or drug-resistant TB.

''Even if we prevent new drug-resistant infections, there are enough current cases to keep the epidemic going. Drug-resistant TB will continue to be an increasingly dangerous threat so long as resistant strains spread through the air from one person to another,'' PTI quoted Sharma as saying.

''We must strengthen infection control measures, focus on households, health centres, and communities to prevent tuberculosis spreading from person to person, and develop more effective diagnostic tests to rapidly and accurately detect drug resistance.''

According to health ministry figures, India has 2.8 million cases of TB every year. Of these, 2.8 per cent are new cases of multi-drug resistance while another 11.2 are acquired cases of multi-drug resistance.

"While better access to treatment programmes will reduce rates of drug-resistant tuberculosis in countries with a high burden, they will not eradicate the problem alone, and current efforts may not be enough to reverse the epidemic," the report said.