MDRTB . . . Our first patient on DOTS Plus . . .

Last week, I had to do the fortnightly supervisory visit of our Tuberculosis Unit. In between the visits to the different PHCs,  we stopped to visit AD - supposedly the first MDRTB patient to be put on DOT Plus in the district as well as under our Tuberculosis Unit.

The drive . . . Desolate and dusty roads . . .

A young man, unmarried, looking emaciated but quite high on enthusiasm met us as we reached the village. He had been on Anti-tuberculosis medicines for quite some time. Unlike many of our regular tuberculosis patients, AD came from a high caste family. And we found something which we find in many of the upper caste tuberculosis patients - an aversion to free medicines available from the government. 

The street where AD lives . . . AD can be seen sitting in front of his home . . .

On detailed question, it was very obvious that this aversion to free medicines is what gave him away. AD, who was a very outgoing and fun-loving guy just did not have the discipline to stick to medications which he was supposed to take on a regular basis and his upper caste status discouraged him from getting himself free medicines for treatment. He had felt better many a time and had stopped treatment himself . . . 

Which ultimately landed him in this state of affairs . . .What surprised me was that he was still a bit careless. He was not very careful with what he ate and he loved roaming the village roads on his bike. 

Later we went to visit his DOTS provider. A quack who is very much sought out - I thought I should pay a visit to him and give him some encouragement for the work he was doing. The village was so remote and he was an obvious messiah to all those who fell sick in the villages near by. 

RS, the quack who's DOTS provider to AD . . .

He was quite proud of his clinical achievements and the succor he has been to the multitude of poor and sick villagers who were very much dependent on his skills. . . We did not have much of a time, but it was quite an entertainment listening to him. 

After, seeing AD one more time and reiterating about the need to stick on to his medications, we were on our way to the PHC.


As I drove, it was very obvious that there were many like AD in the villages I was whizzing through - it would take a herculean effort to treatment them and more so to detect as well as prevent such cases . . . Sometime during the next week, I would post on my visit . . . and you would realize a major reason TB is going to stay on with us . . .


Well, I almost forgot, AD's brother is also a defaulter who's sick with persistent cough and fever for almost a year and is awaiting his culture . . . He was away visiting when we met AD . . .