MDR – TB HI ENGNGE NI ?

Dr. Harvey Vanlalpeka,

MO - STCS

TB enkawlna dan thar Revised National TB Control Programme (RNTCP) ah hian TB damdawi hi a tlangpuiin chi 5 hman thin ani a, chungte chu  Isoniazid, Rifampicin, Pyrazinamide, Ethambutol leh Streptomycin te an ni. TB vei ten heng damdawi pangnga zinga Isoniazid leh Rifampicin an ei a, an taksaa a TB hrik awm a tihhlum theih loh hian Multi Drug Resistant TB (MDR-TB) vei kan tih te chu an ni a. A dang damdawi pathum te pawh hian TB hrik chungah hna thawk mahse, an hnathawh tur angin an thawk thei lova, chuvang chuan MDR-TB anga ngaih tho an ni.

Multi Drug Resistant TB (MDR-TB) awm theihna chhan te chu -

1.      Damlovin damdawi a ei tur ang a ei that loh avanga insiam thei a ni.

2.      TB Damdawi dik lo (wrong categorization) an eiin

3.      TB damdawi petu mithmuh laia an ei loh avangin

4.      Damlovin damdawi course ei kim a pawimawhna a hriat chian loh avangin.

MDR – TB Vei hlauhawm zia –

Miin MDR TB a vei tawh chuan TB damdawi pangngai ei pawhin a dam thei tawh lova, damdawi sang zawk leh chak zawk an ei a ngai tawh thin. Damdawi man ringawt pawh Rs. 67,000/- vel mi pakhatin a sen a ngai a, a ei chhung pawh kum 1 ½ atanga kum 2 chhung a ni. TB hrik hi boruak a leng kan hip luh ani a, MDR-TB vei sa chuan  MDR-TB hrik bawk midang a kaichhawng thei a, chubakah chuan MDR- TB vei hian damdawi an ei that loh chuan X-DR (Extensive Drug Resistant TB) an vei mai dawn a ni. X-DR hi MDR aiin a la hlauhawm a, damdawi ngeih loh an ngah tawh avangin enkawl ngaihna an vang hle. Chubakah, damdawi ei pawh nise, an dampui ngei dawn ani tih a sawi theih tawh loh. Mizo te hi awmkhawm tel tel nuam ti mi kan ni a, chuvang chuan natna hrik inkaichhawn te hi a awlsam bik em em a ni.

Khawvela  MDR- TB dinhmun –

WHO in a tarlan danin khawvelah China ramah leh India ramah MDR-TB vei an tam ber. China hi pakhatna niin TB vei zinga  9 % velin an vei a, India ram hi pahnihna kan ni a, TB vei zawng zawng zinga  4%  vel hi MDR-TB vei ang an ni. Pathumna chu Russia a ni a, palina chu South Africa an ni. Khawvel pumpuiah hian mi 4,40,000 velin MDR-TB an vei a, an zinga mi 1,50,000 chu kum 2008 khan an lo thi tawh a ni.

Mizoram dinhmun –

Mizorama district hrang hrang report-a a landanin MDR-TB vei nia rinhlelh mi 200 aia tam fe an awm tawh a ngaih a ni.

MDR TB vei hmuhchhuahna hmun te –

India ramah hian National level-a hmuhchhuahna hmun thumah a awm a, chungte chu – National Reference Laboratory kan tih te an ni a, heng -

1.      Tuberculosis Research Centre, Chennai

2.      The National Laboratories Institute, Bangalore leh

3.      LRS Institute of TB & Respiratory Diseases, New Delhi te an ni.

State level-ah chuan State TB Demonstration Centre (STDC) emaw IRL (Intermediate Reference Laboratory) tia vuah ani a. STDC, Manipur hi North East-ah chuan a awmchhun ala ni rih. Heng National level-a NRL awm hovah hian Mizoram atang pawhin khak culture tura thawn thin a ni a,  kum 2012 ral hma chuan Mizoramah pawh IRL hi nei ve thei tura ngaih kan ni.

A inven dan –

1.      TB vei reng rengin damdawi an ei hun chhung tura ruat thla (6-8) an eizawh loh chuan MDR-TB ah achang thei a, chuvang chuan damdawi an ei tur zawng zawng tha taka  an ei a pawimawh.

2.      TB damdawi dik lo ei hian MDR-TB a thlen theih avangin, an TB damdawi dik tak an ei theih nan thawktuten fimkhur takin an history te la in an damdawi ei tur an bithliah tur a ni.

3.      Kan khuh emaw kan hahchhiau in kan hmui romol-in emaw kut talin emaw  hup thin a tha.

           

A enkawl dan –

1.      RNTCP ah chuan TB vei ten damdawi an ei hun chhung hi thla (6-8) ani a. Thla 6 ei ho chu TB vei hmuhchhuah thar an niin, Category- I leh Category –III ah an natdan azirin dah thin an ni. TB vei nawn tawh ho chu Category-II ah dah an ni a, an damdawi ei hun chhung pawh thla 8 a ni thin. TB veiin Cat-II damdawi thla 4 a ei hnua a khaka TB hrik hmuh ala nih chuan MDR-TB ani thei a, an khak chu culture & sensitivity test tura thawn thin a ni. Chuta an thawn hnua MDR-TB vei an ni tih hmuhchhuah anih chuan MDR-TB vei tana damdawi eitur bik ruahman sak an ni thin a, chu chu kum 1 ½ atanga kum 2 chhung an  ei a ngai  a ni.

2.      MDR–TB damdawi hi DOTS Plus site atanga pekchhuah thin ani a, amaherawhchu, mizoramah  DOTS Plus site kan la neih loh avangin mahni sum senga heng damdawi te hi lei ala ngai a. A man ringawt pawh Rs. 67,000/- vel mi pakhatin a sen a ngai a ni. Kum 2012 hma chuan Mizoramah pawh DOTS Plus site neih theih beisei a ni a, tunah hian hma lak chhoh mek a ni.