The stock-out of Delamanid drug, administered to extensively drug-resistant tuberculosis patients, has severely impacted the treatment of patients, especially those suffering from paediatric TB, in Mumbai.
The city has the highest concentration of drug-resistant patients. In 2017, Mumbai recorded 5,560 such cases followed by 5,495 in 2018. Of them, about 25 to 30 per cent patients, who have stopped responding to multiple first and second line drugs, will require Delamanid. Data from the Mumbai TB office shows that so far 110 patients have been administered the life-saving drug for a six-month course.
“For the past three months, we have received no supply of the drug,” said a doctor attached with government-run Group of TB Hospitals in Sewri. The doctor said the delay in supply had affected paediatric TB cases, in the age group of 11 to 18, who rely on this drug for fighting the drug-resistant bacteria strain.
The doctor added that adult patients could still rely on Bedaquiline, another TB drug for drug-resistant patients, which was also limited in supply.
Delamanid is manufactured by Otsuka Pharmaceutical, a Japanese firm. The government approved the drug in 2017 and 400 courses were procured. In January 2019, the drug was rolled out for patients. Maharashtra has received maximum number of courses to date.
In Govandi Shatabdi hospital, where several children were given the drug, Dr Aparna Iyer from Medecins Sans Frontieres (MSF) said in the absence of Delamanid, a cocktail of other TB drugs was being administered to patients.
“They are not as effective as Delamanid, but it is the only alternative. Based on each patient’s resistance to drugs, we create a regimen,” she said. According to Dr Pranita Tipre, in-charge of Mumbai TB office under Revised National Tuberculosis Control Programme (RNTCP), for 110 patients, a full six-month course was taken from the central government.
“Because of that, no patient’s regimen is left midway. All these patients will be able to complete their six-month course,” she said. But the RNTCP has not put new patients under treatment until fresh supplies come, she added.
When contacted, K S Sachdeva, deputy director general of Central TB Division, said a fresh order was placed last month for Delamanid. “We are waiting for the company to supply. It can take until April,” he said.
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