According to a joint report released by WHO and the International Union Against Tuberculosis, medicines and strategies currently available to fight TB do not work against XDR and the only result for the patients is death. [break]
“People with XDR have a high probability of dying in about two years,” said Dr Bhawana Shrestha, director of the German Nepal Tuberculosis Project (GENETUP) lab at Kalimati.
Dr Shrestha is in contact with two XDR patients, who she says are being given medicine designed to cure Multi Drug Resistant (MDR) TB because proper treatment for XDR doesn’t exist at present.
“It isn’t unlikely that XDR patients will transmit the disease to others,” she added.
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Dr Shrestha says XDR patients need to be kept in a quarantined area but such facilities don’t currently exist in Nepal.
“There isn’t even a proper chest hospital in the country, so a quarantine facility for XDR cases is a far cry,” said Dr Pushpa Malla, director of the National Centre for Tuberculosis.
According to Dr Malla, another reason why the government isn’t considering a quarantine facility is because it would be against the basic human rights of the patients.
“I was at a quarantine station in Latvia, where patients were kept in isolation chambers and they are not allowed to come in contact even with their own family members. It felt absolutely inhuman,” said Dr Malla.
“Even if we are to create a quarantine facility, we will need to build a special negative pressure room, which is very costly and unlikely in the current context; but we could use wards created for bird flu patients,” she added.
Dr Malla feels that it is necessary to enquire further about new drugs that might be useful for treating XDR. She is meeting an international consultant next week to enquire about this.
While WHO statistics indicate that the number of deaths from TB worldwide has increased from 1.6 million in 2005 to 1.7 million in 2006, patients with the incurable strain of the disease, which is transmitted through respiration, are in contact with the public. Although WHO has lauded Nepal’s TB program as the best in South Asia, the existence of XDR poses a new challenge to the national TB program.
kushal@myrepublica.com
