Extensively drug-resistant tuberculosis in India: a review

Abstract

Background & objectives: Extensively drug resistant tuberculosis (XDR-TB) has become a new threat for the control of TB in many countries including India. Its prevalence is not known in India as there is no nation-wide surveillance. However, there have been some reports from various hospitals in the country.

Methods: We have reviewed the studies/information available in the public domain and found data from 10 tertiary care centres in 9 cities in India.

Results: A total of 598 isolates of XDR Mycobacterium tuberculosis have been reported in the studies included. However, the reliability of microbiological methods used in these studies was not checked and thus the XDR-TB data remained invalidated in reference laboratories.

Interpretation & conclusions: Systematic surveillance and containment interventions are urgently needed.

Fig. 1

The years during which M. tuberculosis isolates were screened for drug sensitivity and MDR and XDR isolates were detected. Information on the exact year(s) in which XDR isolates were identified was not available in the papers from most centres. The numbers indicate the reported XDR M. tuberculosis isolates.

Fig. 2

Map of India showing the location of nine cities from where the publications on XDR-TB have emerged. The circles are placed at approximate geographic locations. Except in Delhi with two centres, every other city had only one centre reporting XDR-TB. In Tamil Nadu State there are two centres, Chennai and Vellore.