Uganda registering cases of extra drug-resistant TB, warn experts

Patients with HIV and tuberculosis wear masks while awaiting consultation
Patients with Tuberculosis (TB) should wear masks while awaiting consultation at all health facilities. But due to limited funding by the government in equipping the health facilities with surgical masks and respirators, brave health care workers have a fierce determination to continue to care for patients risking their own lives and feel it is their national responsibility to take care of their own people. Courtesy Photo/Reuters/Finbarr O'Reilly.

Kampala, Uganda | URN | Uganda is registering cases of a complicated form of Drug-Resistant Tuberculosis alias Extra Drug-Resistant TB (XDR TB), according to experts.

Extra or Extensively Drug-Resistant TB (XDR TB) is a type of Multi-Drug Resistant Tuberculosis (MDR TB) that does not respond to second-line medication like Isoniazid and Rifampicin or fluoroquinolone.

While experts say this is not a new form of TB but rather one which was first reported in the country in 2018, they note that more cases are being reported, which should be a concern.

Between 2018 and 2021, Uganda registered around 10 cases of this TB. But experts say that the number could be higher since many TB cases go undiagnosed.

So far, the majority of the Extra Drug-Resistant TB cases have been detected at Mulago National Referral Hospital while some few have been picked in other regions like Karamoja.

Dr. John Paul Otuba, a TB specialist working in Mulago’s TB Treatment unit says the main cause of XDR TB is manmade. He says many patients with Multiple Drug-Resistant TB (MDR TB) and XDR fail to adhere to the treatment.

Dr. Otubo says that this form of TB can also infect people who come into contact with undiagnosed or treated forms of the disease. “You can be in a taxi and someone with XDR coughs. You get exposed to it and can get this form of TB as a result,” he explained.

Compared to other forms of TB, XDR needs a minimum of 2 years (24 months) of treatment for the patient to get well. A combination of at least five drugs is used to treat the condition. Some of the drugs used like amikacin, kanamycin, and capreomycin are linked to causing deafness in patients.

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Dr. Otuba however warns that there’s no clear treatment for this form of TB. He says they use salvageable regimens of weaker TB drugs for treatment, which have a lower success rate.

Dr. Stavia Turyahabwe, the assistant commissioner of health services in charge of Tuberculosis and Leprosy at the National Tuberculosis and Leprosy Programme, says the cases have mainly been registered in the Central region at Mulago National Referral Hospital.

“We have heard of such cases but they are not many. They are being handled well at our treatment sites though many end up at Mulago since it is the national referral where many people seek treatment,” Dr. Turyahabwe.