Everything from diagnosis to treatment will be done at proposed center of excellence at Wadia hospital under PPP model, a first in the country.
The country’s first center of excellence for treating kids suffering from drug-resistant strains of tuberculosis will be soon created at Parel’s Bai Jerbai Wadia Hospital for Children under a public-partnership, which also involves the civic body.
A team of experts will diagnose and treat young patients of multidrug-resistant (MDR) and extensively drug-resistant (XDR) strains under one roof. The doctors will have access to better detection facilities, including GeneXpert machines, than currently found at public hospitals in the city. Wadia already has a TB clinic.
At present, paediatric patients suspected to be suffering from the two TB strains are screened at the ward level and referred to the local hospital. District TB officers monitor their treatment and if required, the patients are shifted to Sewree TB Hospital.
Once the center of excellence is set up, the children and their parents won’t have to make trips to different places for diagnosis, medication and follow-up care. The BMC will send all suspected paediatric cases to the Parel hospital and pay for the tests. The doctors at Wadia will prescribe drugs provided by the BMC.
The highly infectious disease, caused by Mycobacterium tuberculosis bacterium, is one of the top 10 causes of death worldwide, according to the World Health Organization. India has the highest number of TB patients in the world and cases of children are estimated to be around 10 percent of total adult incidence. However, only 6 percent of the cases reported to the Revised National Tuberculosis Control Programme are children and the figure has remained constant for the past nine years.
People with TB need supervised medication for six to nine months. Many stop the treatment midway, either because they think they are getting better or because the side effects — dizziness, nausea, and joint pains — make it difficult for them to function normally. Almost 90 percent of Mumbai’s TB patients are poor and cannot afford to skip work for long. Breaks in treatment and poor nutrition make them vulnerable to developing drug resistance.
“We need a team of good paediatricians and support staff to treat children believed to be suffering from tougher strains. Wadia hospital has everything,” said Dr Daksha Shah, who heads the civic body’s TB cell. “All aspects of the care, starting from diagnosis, will be handled at one location.”
Often, children are unable or unwilling to swallow a large number of tablets every day during the course and need different formulations. Dr Shah said all such needs will be taken care of at the proposed facility.
“Our aim is to improve detection and care through a public-private collaboration. Referring all paediatric patients believed to be suffering from MDR and XDR tuberculosis will also help us track the cases,” she said.
Dr Minnie Bodhanwala, CEO of Wadia hospital, said it had a TB-detection lab, six dedicated doctors, trained paramedics and four isolated beds. “Our doctors are already treating many drug-resistant paediatric cases. Under the new project, more children will get good care,” she said.
Dr Ira Shah, an infectious disease specialist at Wadia, said the hospital started the TB clinic in 2007. “So far, we have registered 3,200 paediatric patients. Of these, 320 have drugresistant TB. We see 15 new cases every week,” she said. “Caring for children who have developed a resistance is challenging. They have to take six drugs daily for almost two years and an injection every day for six months. The course needs to be monitored closely because there are side effects, which need to be treated.” – Mumbai Mirror