Union health ministry has expedited its efforts for setting up a specialized Intermediate Reference Laboratory (IRL) in Karnataka to diagnose multi drug resistant tuberculosis (MDR TB) cases. Two years ago, the government had identified SDS TB Sanatorium which is located in the Rajiv Gandhi Institute of Chest Diseases to establish the lab. But the project did not take off. Now efforts are being made to revive the same.

The lab test instruments have arrived and the building infrastructure works are on. The Intermediate Reference Laboratory is expected to be functional by November this year, stated HR Raveendra Reddy, World Health Organization consultant for Revised National Tuberculosis Control Project (RNTCP) in Karnataka.. The lab would provide the much-needed relief to speed up the reports, he added.

In Karnataka, nearly 3 per cent of the sputum positive cases were found to be multi drug resistant and the same scenario prevailed in the rest of the country.

The DOTS-Plus Directly Observed Treatment, (Short course) is the current comprehensive management strategy control of TB. The strategy takes into account the specific issues like second line of antibiotics TB drugs that need to be addressed in areas where there is high prevalence of MDR-TB. The model works as a supplement to the standard DOTS strategy.

The new Intermediate Reference Laboratory would be of great help as the Multi Drug Resistant TB cases are on the rise in the country and could be diagnosed at a faster pace, Dr. Shashidhar Buggi, director, Rajiv Gandhi Institute of Chest Diseases, told Pharmabiz.

However, despite the lack of a lab for testing MDR TB, the samples of patients suspected of the same were tested at the National Tuberculosis Institute in Bangalore to confirm the diagnosis.

The RNTCP under the City Corporation, Bruhat Bangalore Mahanagar Palike (BBMP), indicated that there was a depiction of poor coordination and feedback from the districts on the patients initiated for treatment.

Out of the 7,000 new cases that the RNTCP received, 900 cases are transferred and nearly 4,500 cases are referred to other districts from Bangalore annually in Karnataka.

According to BBMP RNTCP records, while 255 cases were transferred initially for treatment and transferred to their residences in the districts only 144 cases returned for treatment. These included patients from the districts of Raichur, Bellary, Gulbarga, Bidar, Kodagu, Haveri, Koppal, Bijapur and Gadag. The patients not given any feedback to the TB unit in Bangalore on the recovery and details of their treatment continuation efforts are not made available. Of the 630 TB cases transferred outside Karnataka, feedback from only 31 cases were received.