Gaurav Saigal
UTTAR PRADESH would be third state in India to provide treatment to Multi Drug Resistant-TB (MDR-TB) patients, after Gujarat and Maharastra.
MDR-TB drugs or second line TB drugs are given from Directly Observed Treatment shortcourse-Plus (DOTs-P) centres to those TB patients who have developed resistance to first line TB drugs.
Until now the State was providing only the first line TB drugs under DOTs programme.
Initially DOTs-plus centres would come up in Lucknow and Agra, the cities that have Intermediate Referral Laboratory (IRL), said the State Tuberculosis Officer, DK Jain.
The IRL are specialised labs for sputum culture test that can confirm a patient is resistant to first line of drug - Floroquinalone - and that the patient require second line or MDR-TB drugs.
“MDR-TB drugs are toxic and costly too thus we need to confirm a patient's resistance to first line of TB drug before starting the MDR-TB drug. This confirmation needs IRL support,” said Dr Rajendra Prasad, chairman of State Task Force on Revised National TB Control Programme.
First line treatment of TB takes a minimum 9 months while the treatment for MDR-TB takes at least 2 years. The approximate cost of treating MR-TB patients is Rs one lakh per patient.
“The lab in Lucknow is at Chhatrapati Shahuji Maharaj Medical University and the one at Agra is at State TB Demonstration Centre. These two labs would be linked to the National Referral Lab at Chennai,” said Jagdish Rai former State TB officer, who was working on DOTs-Plus project for last two years.
DOTs-Plus, according to experts, should have been started earlier but main hurdle was a clearance from World Health Organisation (WHO). It demands that unless a state has covered the entire population with the DOTs programme it can not start DOTs-Plus.
Training of doctors from Lucknow and Agra for running the lab has been completed, said Rai.
The next step would be to identify patients of MDR-TB and initiate the treatment so that the patients of MDR-TB do not convert in to Extreme Drug Resistant-TB (XDR-TB) that is considered fatal. This process could take another two month before MDR-TB patients would start getting medicine.
Category-wise TB treatment
TB patients are divided in to three category. Category-I is for those patients who test sputum positive for TB for the first time. The category-III is for those who are confirmed TB patient but the level of bacteria in them is such that their sputum test result comes negative. Patients in both these category get first line of drugs.
Those patients in whom treatment at category I and III fails, come under category II for a revised treatment. They too get first line of TB medicine but with few additional drugs.
Such patients in whom treatment fails even in category two are declared as category-IV patients ie. MDR-TB.
Friday, May 15, 2009
Women in Baghpat subjected to Polyandry
Gaurav Saigal
WOMEN IN western parts of Uttar Pradesh are suffering with a novel phenomenon. They are subjected to polyandry and the reason is strange.
Marginal farmers marry single woman so that their families do not get separated and the piece of land is not divided among brothers.
Baghpat the district that has worst sex ratio 847 against the overall sex ratio in the state 927, has a dubious identity of being the first district in Uttar Pradesh where Polyandry is practiced due to poverty among farmers' community.
“Those farmers who do not hold large piece of land and are dependant upon favourable climatic conditions for crops, opt Polyandry,” said Dhama, a social activist working in the region.
These farmers can neither afford several marriages in the family as this would increase number of family members to be fed and the land they have would be divided among brother, as they believe women would divide brothers.
Many famers here hold very small piece of land while some have already taken loan against the land.
“Poverty has added to decline in sex ratio. As a result some parts of India are facing shortage of girls for marriage and this particular problem in Uttar Pradesh has just begun,” said Dr Neelam Singh, member of the State Advisory Committee.
Like Baghpat other districts of the region too fall in the same category where poor sex ratio and poverty is a bane for women. Muzaffarnagar (857), Meerut (854), Gaziabad (851), Gautam Buddha Nagar (851) are places where sex ratio is poor. Courtesy the hate for girl child and ultrasonology techniques that helps to materialise the hate by determining the sex of the foetus, she said.
The problem is not in the eastern parts of the state as the sex ratio is comparatively better. Districts like Varanasi, Sultanpur, Sonebhadra, Siddarthnagar, Shrawasti, Sant Ravidas Nagar and Kushinagar saw decline in sex ratio but the ratio in all these states is still over 930.
WOMEN IN western parts of Uttar Pradesh are suffering with a novel phenomenon. They are subjected to polyandry and the reason is strange.
Marginal farmers marry single woman so that their families do not get separated and the piece of land is not divided among brothers.
Baghpat the district that has worst sex ratio 847 against the overall sex ratio in the state 927, has a dubious identity of being the first district in Uttar Pradesh where Polyandry is practiced due to poverty among farmers' community.
“Those farmers who do not hold large piece of land and are dependant upon favourable climatic conditions for crops, opt Polyandry,” said Dhama, a social activist working in the region.
These farmers can neither afford several marriages in the family as this would increase number of family members to be fed and the land they have would be divided among brother, as they believe women would divide brothers.
Many famers here hold very small piece of land while some have already taken loan against the land.
“Poverty has added to decline in sex ratio. As a result some parts of India are facing shortage of girls for marriage and this particular problem in Uttar Pradesh has just begun,” said Dr Neelam Singh, member of the State Advisory Committee.
Like Baghpat other districts of the region too fall in the same category where poor sex ratio and poverty is a bane for women. Muzaffarnagar (857), Meerut (854), Gaziabad (851), Gautam Buddha Nagar (851) are places where sex ratio is poor. Courtesy the hate for girl child and ultrasonology techniques that helps to materialise the hate by determining the sex of the foetus, she said.
The problem is not in the eastern parts of the state as the sex ratio is comparatively better. Districts like Varanasi, Sultanpur, Sonebhadra, Siddarthnagar, Shrawasti, Sant Ravidas Nagar and Kushinagar saw decline in sex ratio but the ratio in all these states is still over 930.
TB catching the young lot in UP
Gaurav Saigal
TUBERCULOSIS IS catching people in their most productive age (15-34 years) in Uttar Pradesh.
Majority cases registered for treatment in past one year fall in this age group even as the state has total coverage of TB treatment under the Revised National Tuberculosis Control Programme (RNTCP).
The total number of new patients registered in one past year after sputum test was 1,19,944. Majority, 53,871 cases were in the 15-34 year age bracket.
Males have outnumbered females in the tally of patients for UP prepared under RNTCP.
In the 15-24 year age group there were 26,724 new cases while 27,147 cases were in the 25-34 years age group. Experts say this has a direct link with the poor immunity levels among youths.
Chairman of the State Task Force on RNTCP Dr Rajendra Prasad said, “More youths in the list of new cases means youths in the state are not strong enough to combat TB bacteria. It is unfortunate as youth who develop TB suffer socio-economic loss in most productive span of life, especially if left untreated.”
Alarmingly 3,296 new patients registered across the state were below 14 years of age group.
TB bacteria are normally present in human body but the strong immunity levels keeps the bacteria suppressed. Whenever immunity gets low TB bacteria overpowers weak immune and thereby develops the disease in the body, Dr Prasad said.
As far as the target for detection of new cases and maintaining cue rate is concerned UP is ahead of the target. The target is to maintain cure rate of 85 per cent in new patients and UP's performance is above the given target, said State TB Officer (STO) DK Jain.
India is the highest TB burden country, globally accounting for one fifth of bacteriologically proven TB incidence.
TB is an infectious disease caused by a bacterium, Mycobacterium tuberculosis and it spreads through the air by an infected TB patient. TB is treatable but if patient is left untreated, a single patient can infect more than 10 people in a year by coughing.
gauravsaigal1@rediffmail.com
TB cases (new) in age group in last one year
0-14 - 3296
15-24 - 26724
25-34 - 27147
35-44 - 23772
45-54 - 17659
55-64 - 13997
above 65 - 7349
TUBERCULOSIS IS catching people in their most productive age (15-34 years) in Uttar Pradesh.
Majority cases registered for treatment in past one year fall in this age group even as the state has total coverage of TB treatment under the Revised National Tuberculosis Control Programme (RNTCP).
The total number of new patients registered in one past year after sputum test was 1,19,944. Majority, 53,871 cases were in the 15-34 year age bracket.
Males have outnumbered females in the tally of patients for UP prepared under RNTCP.
In the 15-24 year age group there were 26,724 new cases while 27,147 cases were in the 25-34 years age group. Experts say this has a direct link with the poor immunity levels among youths.
Chairman of the State Task Force on RNTCP Dr Rajendra Prasad said, “More youths in the list of new cases means youths in the state are not strong enough to combat TB bacteria. It is unfortunate as youth who develop TB suffer socio-economic loss in most productive span of life, especially if left untreated.”
Alarmingly 3,296 new patients registered across the state were below 14 years of age group.
TB bacteria are normally present in human body but the strong immunity levels keeps the bacteria suppressed. Whenever immunity gets low TB bacteria overpowers weak immune and thereby develops the disease in the body, Dr Prasad said.
As far as the target for detection of new cases and maintaining cue rate is concerned UP is ahead of the target. The target is to maintain cure rate of 85 per cent in new patients and UP's performance is above the given target, said State TB Officer (STO) DK Jain.
India is the highest TB burden country, globally accounting for one fifth of bacteriologically proven TB incidence.
TB is an infectious disease caused by a bacterium, Mycobacterium tuberculosis and it spreads through the air by an infected TB patient. TB is treatable but if patient is left untreated, a single patient can infect more than 10 people in a year by coughing.
gauravsaigal1@rediffmail.com
TB cases (new) in age group in last one year
0-14 - 3296
15-24 - 26724
25-34 - 27147
35-44 - 23772
45-54 - 17659
55-64 - 13997
above 65 - 7349
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