TB cases outside of lungs rise in India

Tuberculosis bacteria--Courtesy of Janice Carr/CDC

India physicians report an uptick in the number of tuberculosis cases occurring not in the lungs, but elsewhere in the body even as they criticize the government for failing to see that patients have access to the drugs they need to treat the disease.

Doctors who specialize on parts of the body other than the lung are seeing more cases of TB in the abdomen, bones, genitals, joints and lymph nodes, for an overall 15% increase in cases occurring "extra pulmonary."

India and its neighbors also face an increase in drug-resistant types of TB, creating a situation in which the disease not only is harder to diagnose, but also harder to treat.

One pulmonary doctor complained that drugs to treat the resistant form tend to be available only in public hospitals and other institutions and that the government has made no plans to make them available in the private sector that treats half the nation's 3 million cases.

Bedaquiline, considered a major treatment for patients with an extremely resistant form of TB and who do not respond to other drugs, has been approved by the government for only 500 patients so far in its national TB control program, the doctor said. He said the government is only now ready to do a pilot study.

The head of the Indian National Institute for Research in Tuberculosis said the government's reluctance to make the drug available in the private sector has to do with concerns of mismanagement of it, leading to an increase in the disease instead of stemming it.

- here are stories from Reuters and Times of India