Multi-drug resistant tuberculosis (MDR-TB) - a grave threat to children!

Tuberculosis The WHO Global Tuberculosis Report 2013 noted the dangers that MDR-TB posed to children. 'A child with TB [is] as likely as an adult with TB to have MDR-TB [multi-drug resistant TB]. It is therefore essential that the identification of MDR-TB in children be strengthened. Efforts should be made to systematically conduct household contact investigation of all patients with MDR-TB, including children,' it underlined.

An earlier paper from 2002 published in the Pediatrics journal suggested that every adult who has MDR-TB was likely to pass on the ailment to at least two children. 'As many as a million children could be exposed to MDR tuberculosis globally each year, many of whom, in the absence of effective preventive therapy, will go on to develop MDR-TB disease,' the 2002 paper notes.

Another recent study conducted by Kokilaben Hospital in Andheri, has shown that 72% of the 21 children with tuberculosis and admitted in the hospital contracted the disease from their community and not their immediate family. Also, these children had contracted the dreaded TB strain MDR-TB which is resistant to multiple drugs, and thus treating them is all the more difficult for the doctors. Out of these, a teenager tested positive for XXDR TB, which is resistant to all drugs.

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What is MDR-TB?

MDR-TB refers to Multi-Drug-Resistant Tuberculosis. It is a type of tuberculosis that is resistant to the first line anti-TB drugs. It is often caused because people stopping their medication midway instead of following the complete regimen as prescribed by the physician. It is spread in the same manner as tuberculosis.

What are its symptoms?

Symptoms are same as regular TB and include severe cough which lasts for three weeks or longer, producing bloody or discoloured sputum, night sweats, fever, fatigue and weakness, pain in the chest, loss of appetite, and pain in breathing or coughing. However, in these cases, the symptoms progressively get worse and may cause complications and death since the patient does not respond to most anti TB drugs. (Read: How India's faring in the battle against TB)

So what is XXDR TB?

Earlier termed totally drug resistant TB (TDR TB) but later renamed XXDR TB, the term refers to an extremely drug resistant TB strain that is impervious to all the first and second line drugs used in tuberculosis treatment. This resilience makes it very hard to treat and contain it.

How TB is caused?

TB is caused by the bacteria Mycobacterium tuberculosis. It is an aerobic (requires high levels of oxygen to survive), non-motile bacterium and transmitted primarily through the air. You can get TB from an infected person when he coughs, sneezes or spits. This bacterium is known to be highly stable and can survive in a dry atmosphere for weeks. A test known as 'drug sensitivity' is performed on a TB strain to determine which drug will eradicate the bacterium most effectively.

How did the bacteria develop to become drug resistant?

When the disease first emerged it was treated with a combination of drugs. With time, the bacterium started to develop immunity to the drugs being used. As the bacterium mutated, medical science started to use more potent drugs for its treatment. This cycle resulted in the formation of a strain that is so evolved that it is immune to all medications known to treat the disease. (Read more: Drug-resistant tuberculosis why you should be worried)

How can you prevent tuberculosis?

  • Avoid close contact with people affected with TB. If you cannot avoid contact with them, wear protective masks and gloves.If you work at a hospital, wear good-quality microfilteration masks. Wash your hands with a disinfectant cleanser after contact with the patient.
  • Avoid crowded, stuffy and unhygienic places.
  • Work on improving your immunity by including diet rich in antioxidants. Have atleast 4-5 servings of fresh vegetables and fruits everyday. If you cannot have it due to certain practical constraints, make sure you take your daily dose of antioxidants/multivitamins after consulting your doctor. Anti-oxidants help fight free radicals produced in the body due to any kind of disease/stress and help in cell repair.
  • Include atleast 2 good servings of protein in your daily diet. They are the building blocks of all our cells and help in cell repair too. (Read more: How you can prevent tuberculosis)

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