Prevalence of Primary Resistance against Isoniazid and Rifampicin in Newly Diagnosed Sputum Positive Cases of Pulmonary Koch's using Line Probe Assay

MDR-TB is an emerging problem of great importance to public health, with higher mortality rates than drug-sensitive TB. MDR-TB patients require treatment with more-toxic second-line drugs and remain infectious for longer than patients infected with drug-sensitive strains, incurring higher costs due to prolonged hospitalization. In a clinical trial, we studied 50 newly diagnosed sputum positive cases of pulmonary koch's, in a hospital in Meerut between 2011 and 2013. Eligible patients were men and women, who were above 18 years of age, newly diagnosed sputum positive cases with no previous history of ATT. Patients were subjected to undergo HAINES TEST, a molecular assay. It identifies the M. tuberculosis complex and simultaneously detects genetic mutations related to resistance. Primary drug resistance was found (USING RATIO METHOD) to be significantly high, i.e. 14% for isoniazid and 24% for rifampicin, MDR-TB cases were reported to be 12%. Significance was ESTIMATED BY Z-TEST FOR SINGLE SAMPLE-PROPORTION AT 5% LEVEL OF SIGNIFICANCE. LINE PROBE assays demonstrate excellent accuracy for isoniazid and rifampicin resistance, even when used on clinical specimens. More aggressive treatment with second line drugs in MDR-TB cases on time is a blessing for the patient and reduces mortality rate significantly. Together with data from demonstration projects, the meta-analysis provides evidence for policy making and clinical practice.