Doctors’ Perception On Multi-Drug Resistant Tuberculosis (MDR-TB) Diagnosis And Treatment

Every year around 2 million people develop TB in India and 300,000 die due to TB. The emergence of drug-resistant TB (DR-TB) has become a major public health concern in India. Not only MDR-TB is a potential threat in controlling TB but it is also full of challenges starting from diagnosis to treatment and drug delivery.

Health care providers can help prevent MDR-TB by early diagnosis, following recommended treatment guidelines, monitoring patients’ response to treatment, and making sure therapy is completed.

Objective: Determining doctors’ perception on Multi-drug Resistant Tuberculosis (MDR-TB) diagnosis and treatment

A total of 114 doctors participated in the survey – General practitioners (69%), Pulmonologist (14%), Others (17%)

• When asked about the first-line therapy prescribed for tuberculosis, 49% of the doctors stated rifampicin, followed by isoniazid (34%)
• The majority of the doctors stated that the most important factor while prescribing the drugs is the patient’s resistance profile (48%), while 26% stated rationale to introduce a given drug
• When doctors were asked why does multidrug-resistant tuberculosis continues to emerge and spread, 31% stated due to non-adherence to the treatment, followed by inappropriate or incorrect use of antimicrobial drugs (30%) and poor compliance (22%)
• 32% of the doctors stated that prolonged treatment time, followed by adverse effects of the treatment (26%), expensive treatment options (20%) and limited treatment options (17%) are the factors that make it difficult to treat MDR-TB
• When asked how the government can take steps to control MDR-TB, 30% of the doctors stated by developing and promoting national standards for TB, by strengthening TB awareness initiatives (28%), creating awareness (19%), improving access to drugs (17%)
• In our survey, most of the doctors stated they prescribe rifampicin as a first-line of therapy and the patient’s resistance profile is the most important factor while prescribing the drugs. Concerns such as prolonged treatment time, expensive and limited treatment options make it difficult to treat MDR-TB

Early MDR-TB detection and prompt initiation of effective treatment are important factors by which doctors can obtain successful outcomes. To control the primary transmission of MDR-TB in India, developing and promoting national standards for TB, strengthening TB awareness initiatives, and improving the medical security of each patient should become a priority.

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