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Tuberculosis (TB) remains a formidable global health challenge, with over 2.95 million active cases reported in India alone in 2020.
Among these cases, 135,000 were classified as multidrug-resistant TB (MDR-TB), posing a significant threat to treatment efficacy and control efforts. HaystackAnalytics, partnered with Dr DY Patil Medical College, Pune, conducted a study shedding new light on TB dynamics in India. Released on Tuesday, the study is based on real-world data from the drug-resistance profile of 600 clinical TB samples in India, using whole-genome sequencing (WGS) technology. WGS plays a pivotal role in identifying drug resistance mutations, facilitating targeted treatment strategies and TB surveillance. In presumptive MDR-TB cases, WGS revealed pre-extensively drug-resistant TB (pre-XDR-TB) in 50.83 per cent of cases, with MDR-TB found in 15.5 per cent, showing nearly equal proportions among men and women. The study highlighted resistance not only to rifampicin and isoniazid, first-line drugs for TB treatment but also to fluoroquinolones, commonly used for respiratory and urinary tract infections. The predominant TB lineages identified were the Beijing genotype (39.5 per cent), followed by Delhi-CAS (36.66 per cent) and EAI (14.50 per cent). Furthermore, 55 per cent of cases in the age group from 15-35 years and 67 per cent in the age group up to 14 years had pre-XDR TB, indicating the vulnerability of younger populations to drug-resistant TB strains. Dr Anirvan Chatterjee, CEO and Co-founder at HaystackAnalytics and a contributor to the study, emphasized the need for tailored TB management strategies, "India bears 27 per cent of the total TB cases in the world, according to the Global TB Report 2023 by WHO. Our study underscores the urgency of revisiting the conventional 'one size fits all' approach to TB management." Dr Chatterjee continued, "Furthermore, understanding the genetic lineages, particularly the predominance of the Beijing genotype, followed by Delhi-CAS and EAI, is crucial for developing targeted interventions and treatment strategies. When anti-TB therapy is given in the absence of a complete drug resistance profile, such a therapy may contain one or more drugs to which the patient is resistant to, and could compromise the outcome of the therapy." The study also highlighted the increasing utilization of WGS by clinicians for accurate diagnostics and personalized treatment approaches. This emphasizes the need for policy interventions to promote the rational use of advanced technologies and appropriate TB treatment practices. Dr Chatterjee further stressed the importance of educating healthcare professionals and patients on the use of diagnostic technologies like whole-genome sequencing (WGS) and Cartridge-Based Nucleic Acid Amplification Test (CBNAAT), especially amidst emerging resistance to newer drugs like bedaquiline. (ANI)
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