A Woman's Drug-Resistant TB Echoes Around the World

MUMBAI—As dawn broke on July 16, a tiny woman pushed a metal trunk aboard a train, pausing a moment to cough into the green-and-black-print scarf around her head. Her husband carried a comically large water jug.

"You've decided to travel with Powai Lake," Rahima Sheikh quipped to her husband, referring to a lake near the city of Mumbai. She helped him stow the jug under their seat.

Then, promptly at 6:35 a.m., the Gorakhpur Express heaved out of the station, carrying Mrs. Sheikh on a 1,000-mile journey home, where she expected to die.

Over the past six years, Mrs. Sheikh, 40 years old, mortgaged her family's rice fields, spent her father's and brother's life savings, and crisscrossed India in search of a cure for tuberculosis. But instead of getting healthier, Mrs. Sheikh grew increasingly resistant to medication with each failed treatment. This year, Mrs. Sheikh became one of India's first documented cases of TB that is resistant to virtually all the medicines approved to treat it.


In recent decades, tuberculosis, a fatal infection characterized by the coughing of blood, was generally treatable. The Wall Street Journal reviewed years of Mrs. Sheikh's medical records, interviewed her doctors and TB workers across India and traveled with her as she pursued treatment.



Her six-year journey to all-but-incurable TB exposes a blind spot in an Indian medical bureaucracy that, for decades, neglected to implement widespread testing or treatment for drug-resistant strains. As a result, a curable disease has mutated into a killer.



The global community is worried about the danger. Health officials have urged India and other countries with increasing drug resistance to take stronger action. And this year the U.K. added India to the list of countries whose citizens must be tested for TB to obtain a visa of six months or more.



India has no national count of patients resistant to one or all of 12 commonly used TB drugs. The government cites a study in the state of Gujarat showing less than 3% of patients there are resistant to at least the two most-powerful ones.



Experts say these figures far understate the problem. For example, the Mumbai hospital that reported four fully drug-resistant patients this past December, had counted 15 by May. Since then, the hospital has stopped counting because of the controversy created by the bad publicity, according to the head of the lab.


Source : http://online.wsj.com/article/SB10000872396390444273704577633431646496346.html      2012/9/9

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