TB is a major worldwide disease with new cases arising at an

TB is a major worldwide disease with new cases arising at an alarming rate, What factors can account for this and what lays behind the trend of multidrug resistant strains of mycobacterium? please cite reference.

Solution

Tuberculosis is caused by mycobacteriam tuberculosis. TB is one of the most common cause of death due to infection of the mycobacteriam species.various factor have been found to develop resistance against M. tuberculosis. resistance means simply afterwards that drug potency in terms of pharmacological response will be decresed gradually and at certain level it will not active against the strain. There are two types of resistance 1. natural resistance and second is aquired resistance. natural resistance is found on wild strain. multidrug resistance is the phase in which strain is not responsive against primary line therapy of disease.

factor which induced resistance

gene factor

In a recent year study suggest that the patient who shows the presence of HLA -DRB1 13 and HLA-DRB 1 14 has two fold risk to develop resistance against strain.(Park et al.)

Incomplete and inadequate mangment  Review of literature suggests that the most powerful factor of MDR-TB is a history of treatment of tuberculosis(diagnosis). TB patients get treated with DOTS regimens not only through the Revised National Tuberculosis Control Programme (RNTCP), but also receive treatment from private medical doctors. Irregular, incomplete, inadequate treatment is the commonest mean of acquiring drug resistant due to improper mangment of drug mostly organism develop the resistnacce against drug eg. use of single drug to treat tb is the fetal cause to develope resistance against organisms.it may be due to ignorance. anothe common error in prescription error it may like additions syndromes.

Inadequate treatment compliance : the change over form has complied a significant effece in development of drug resistance it was observed that only 44 per cent of the patients receiving short-course treatment (n=2300) and 36 per cent of those receiving standard chemotherapy (n=1000) completed 81 per cent or more of their treatment.

Noncompliance with prescribed treatment is often underestimated by the physician and is difficult to predict. On the other hand, certain factors such as psychiatric illness, alcoholism, drug addiction and homelessness do predict noncompliance .The drug defaulter, just like placebo reactor is not a consistent or readily identified person demographic factors such as ,sex, age, marital status,socio-economic status and education levelhave not been found to correlate with the degree of compliance.