Mahim tailor’s battle against TDR-TB ends, declared cured

The 30-year-old road-side tailor, who is also HIV positive, had to take over 20 drugs on a daily basis. In 2012, following a culture test, doctors at Hinduja found that his body had stopped responding to the first and second line of TB regime, along with 11 other patients.

[related-post]

The 12 patients were labeled as TDR-TB cases, now also referred as extremely drug resistant (XXDR) cases.

“Of the first 12 cases from 2012, over 50 per cent did not survive. His condition was critical because he also had HIV.

A major surgery was done to remove one lung,” said Dr Zarir Udwadia, chest physician. Through the Médecins Sans Frontières programme, the tailor was one of the first Indian patients for whom a Bedaquiline drug request was sent- it is a relatively new drug active against drug-resistant forms of bacteria, allotted on a case-by-case basis by a global committee.

“Back then, Bedaquiline was relatively new and there were not many takers. We sent his documents to procure the drug,” Dr Udwadia said. In Mumbai, only 15 other patients have been administered Bedaquiline so far.

The tailor tested smear negative for the TB bacteria few days ago. While his life could be saved using the drug, another 19-year-old, diagnosed with a resistant form of  TB meningitis, was denied Bedaquiline.

“The committee claimed that administering her Bedaquiline will not make any sense as she will not get cured at this stage,” a doctor treating her said. The girl, referred from Kokilaben Dhirubhai Ambani hospital to Hinduja hospital, lost her eyesight due to TB and has stopped responding to all lines of TB drugs.

Udwadia admitted that 50 percent request for the drug are rejected owing to its judicious use and fear of resistance.
Dr Lalitkumar Anande, senior medical officer at Sewri TB hospital, said, “There are already reports of Bedaquiline resistance. In India, it has still not been approved and clinical trials are underway. However, we cannot solely depend on one drug as bacteria will soon develop resistance.”

Under the Revised National Tuberculosis Control Programme in Mumbai there are over 400 extensively drug resistant patients while 371 multi-drug resistant patients have been cured of TB.