7,500 child TB patients go untreated in Madhya Pradesh

Paediatric TB drugs in short supply; norms forbid purchase of medicines from non-government sources

By Kundan Pandey
Published: Friday 22 March 2013

Shortage of tuberculosis medicines designed for children has left thousands of paediatric patients in Madhya Pradesh in the lurch. Scarcity of the drugs has paralysed the entire mechanism of tuberculosis (TB) control in the state as children affected by the disease are not being monitored.

The supply of the drug from Central government’s agency, Government Medical Store Depot (GMSD), has been insufficient over the past six months, claimed officials. The state received its last consignment on January 21 this year. However, only 100 doses of the medicine were delivered.

The drug crisis has affected around 7,500 children suffering from tuberculosis in the state.

S N Batham, in charge of state drug stores (TB), Madhya Pradesh, said that the problem has been there for over six months now and is further deteriorating. “The principal secretary of health has written to the Centre many times regarding the medicine crunch in the state, but to no avail,” he said.

Available data shows Madhya Pradesh has received only 585 doses of paediatric medicine for TB in the last two quarters. “In Madhya Pradesh, at least 4,000 new paediatric TB cases are diagnosed every quarter. Thus, for two quarters, the requirement for these medicines stands at 8,000 doses, while the state has received only 585 doses in the last two quarters,” said an official. Such figures point to a shocking shortfall.

According to the World Health Organisation, children with TB weighing less than 30 kg should be administered paediatric medication. The medication, too, varies according to weight. A child weighing 6-10 kg, for example, is to be administered a certain combination PC 13, while a child weighing 11-17 kg should get a different combination, PC 14.

In the absence of paediatric doses, doctors are resorting to breaking or crushing the medicine intended for adults and administering them to paediatric patients. Doctors agree that this cumbersome process is indeed the wrong way to treat these patients. Batham says that that giving patients these crushed pills will not help as the children may not get the correct dose or could get an overdose of the medicine they require.

“We have written to the Union government regarding this umpteen times. The last reminder was sent a few days ago, but nothing has changed. We haven’t received the medicines yet,” said J L Mishra, joint director, health, and director of the TB control programme in the state. “Such are the norms that even if we wish we could not purchase any medicine from outside. The medicine has to be supplied from the Union government agency,” he says.

The shortage of medicines has impeded the monitoring of paediatric TB patients. In Jhabua district of Madhya Pradesh, for example, records of child TB patients are not available. Irfan Hussain, associated with the TB district programme, failed to provide the list of children who had contracted tuberculosis in the past six months. He said that there is no data available as the document is prepared only if the children receive treatment.

Drugs shortage has paralysed the monitoring system
Quarterly period   Number of children detected with TB  in Jhabua district
Jan- March (2012)         30
April- June (2012)         39
July-September (2012)          29
Oct-December (2012)         Untraced
Jan-March (2013)          Untraced


Inadequate number of doses delivered by the Centre
Date of receipt of medicine    Quantity (Name of     medicine)         Usage
October 21, 2012    300 doses (PC 14) TB treatment medicine meant for children weighing between 11 and 17 kg
November 24, 2012   100 doses (PC 14) (TB treatment medicine meant for children weighing between 11 and 17 kg
December 31, 2012    100 doses (PC 13) TB treatment medicine meant for children weighing between 6 and 10 kg
January 21, 2013    85 doses (PC 13) TB treatment medicine meant for children weighing between 6 and 10 kg
Source: Records of state drug store

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