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Incidence of Multidrug-Resistant (MDR) and Extensively drug Resistant (XDR) Tuberculosis among Different age Groups in Tertiary Care Hospitals of Chandigarh, India
Authors: Phageshwar*, Imtiyaz Wani** and Jagdish Chander*

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ABSTRACT: Chandigarh has been adjudged among the top five performing states and union territories in
the country by TB India-2008 RNTCP (Revised National Tuberculosis Control Programme) status report,
brought out by the Union Health Ministry. In controlling TB, Chandigarh is now at par with Delhi,
Rajasthan, Gujarat and Arunachal Pradesh. According to National Rural Health Mission, in 2008, 13,937
patients were examined for sputum diagnosis, out of which 1,793 were found positive and 837 new smear
positive patients were put on treatment. The other smear positive patients were either referred to other states
or were treated under other categories of treatment. The new sputum positive detection rate is 84 per lakh of
population in Chandigarh. Up to December, 2008, 15,123 patients were put on treatment. In calendar year
2008, the total annual detection rate was 243 per lakh. There were only two per cent death among 2400-odd
patients put on treatment in one year, two per cent failure rate and three per cent defaulter rate, the lowest in
the country. A total of 910 cases of pulmonary tuberculosis were enrolled over four years (2008-2012). Among
these, cases of MDR-TB and XDR-TB were meticulously studied for drug susceptibility, treatment, adverse
effects profile and overall survival. Fifty-two (5.7%) cases of MDR-TB were identified, among which eight
(15.3%) were diagnosed as XDR-TB on the basis of drug susceptibility testing, using the prescribed
definition. The cases were sensitive to 2, 3, 4, 5 and more than 5 drugs in almost equal proportions. Thirtyseven
(71.1%) cases were successfully cured; eleven (21.1%) patients died; and only four (7.6%) cases
defaulted, indicating overall satisfactory adherence to treatment. For effective treatment of MDR-TB and
XDR-TB, early case detection, improved laboratory facilities, availability of appropriate treatment regimens,
and financial assistance in resource-limited settings through effective political intervention are necessary for
better patient adherence and overall cure.