Tuberculosis Research Centre , Chennai
(2003)
Trends in initial drug resistance over three decades in a rural community in south India.
Indian Journal of Tuberculosis, 50 (2).
pp. 75-86.
ISSN 0019-5705
Abstract
programme.
Aims: To study trend of initial drug resistance over a period of three decades in a rural community in five
panchayat unions in Chingleput district in south India.
Methods: A total population survey of tuberculosis in the area was undertaken in 1968-70, comprising
radiographic examination of all individuals aged 10 years or more and sputum examination of those with
abnormal shadows. Subsequently, the total population survey was repeated on 6 occasions at intervals of 2.5
years along with new entrants found at each survey, and on two more occasions (1991-92, 1994-96) in a subset
of two panchayat unions. Prevalence cases and (new) incidence cases of culture-positive tuberculosis were
identified in each survey, and their susceptibility to Isoniazid and Streptomycin was determined.
Results: Between 1968 and 1986, initial drug resistance to Isoniazid increased from 12.5% to 20.7% in
prevalence cases, at an average annual rate of 3.1%. For Streptomycin, the increase was from 6.4% to 12.1%,
at the rate of 4.9% per annum. In incidence cases, the corresponding annual rate of increase was 3.8% for
Isoniazid and 7.4% for Streptomycin. In the subset of the population, that was surveyed in 1991-92 and 1994-
96, there was some evidence of a decline in the proportion of resistant cases after 1984-86.
Conclusion: There was a steady increase in the magnitude of initial drug resistance in the community between
1968 and 1986, which probably indicates an unsatisfactory tuberculosis programme during the period.
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