Overcoming the health system barriers to early diagnosis and management of multidrug-resistant tuberculosis in a rural setting in North India. Issue 1 (21st January 2020)

• Record Type: Journal Article
• Authors: Bashar, Mohammad Abu; Aggarwal, Arun; Bhattacharya, Sudip
• Is Part Of: BMJ case reports. Volume 13:Issue 1(2020)
• Publication Date: 2020-01-21
• Subjects: global health -- tuberculosis; Medicine -- Case studies -- Periodicals; 610.5
• DOI: 10.1136/bcr-2019-231009
• Languages: English
• ISSNs: 1757-790X

Abstract

Abstract : India contributes a quarter of the global burden of multidrug-resistant tuberculosis (MDR-TB) and has inadequate diagnostic infrastructure and institutional capacities for drug susceptibility testing. Subsequently, this leads to a large number of undetected and untreated cases of MDR-TB. In this report, we describe a case of a 55-year-old man from rural North India presenting with complaints of continued symptoms of chronic cough, fever and dyspnoea despite being recently diagnosed with recurrent tuberculosis and receiving treatment from the local community health centre. MDR-TB was suspected, but confirmatory diagnostic capabilities were not available in the local setting. The patient was finally diagnosed with MDR-TB. Treatment was coordinated by the district tuberculosis programme officer. Through this case, we describe the various barriers to detecting MDR-TB in the rural regions of India. Prompt identification of patients with presumptive MDR-TB, diagnosis of the disease and initiation of treatment are crucial to preventing disease transmission and reducing morbidity and mortality.