title: Prevalence of Multidrug Resistant Pulmonary Tuberculosis in North Bihar.
abstract: BACKGROUND
  Multidrug resistant tuberculosis (MDR-TB) is caused by Infection with Mycobacterium tuberculosis which is resistant to both isoniazid (INH) and rifampicin (RIF), with or without any other anti tubercular drug. It is caused by resistant mutant strains due to inadequate treatment and poor compliance. Due to time taking conventional diagnostic methods, drug resistant strains continue to spread. Therefore rapid diagnosis and treatment of MDR-TB strains are prerequisites for the worldwide fight against TB.
  
  
  OBJECTIVE
  To determine the prevalence of MDR TB in North Bihar by molecular diagnostic method and to facilitate early diagnosis and treatment. Also, to find out the number of those diagnosed cases who were successfully initiated the treatment in MDR TB Centre of DMCH.
  
  
  METHODS
  This six month observational study was carried out in IRL Darbhanga, Damien TB research Centre of the Darbhanga Medical College and Hospital, Bihar, India. During the period of February-July 2014, 256 sputum samples were collected from suspected cases of multidrug resistant tuberculosis, from 6 districts of North Bihar around Darbhanga. These samples were subjected to routine microscopy and culture to detect Mycobacterium tuberculosis. Positive cases were subjected to drug sensitivity test by a molecular diagnostic method, Using Genotype MTBDR plus kit.
  
  
  RESULTS
  Out of 256 sputum samples from suspected cases of MDR TB, 122 cases were microscopy positive for tuberculosis. Among these 122 cases, tuberculosis was confirmed by PCR in 114 cases. Finally with the help of Line Probe Assay (LPA), 39(15%) samples were found to have resistance to both INH and Rifampicin. Male female ratio was 4:1.
  
  
  CONCLUSIONS
  The Prevalence of Multi drug resistant pulmonary tuberculosis in North Bihar is 15%. It needs early diagnosis by molecular diagnostic method and prompt treatment to reduce the spread of MDR TB cases.
authors.affiliation: Professor, Department of Biochemistry, Darbhanga Medical College , Darbhanga, India .
authors.forename: Sunita
authors.initials: S
authors.lastname: Tripathy
authors.affiliation: Senior, Medical Officer, DRTB Centre , DMCH, Darbhanga, India .
authors.forename: Rajesh
authors.initials: R
authors.lastname: Kumar
authors.affiliation: Associate Professor, Department of Preventive and Social Medicine, DMCH , Darbhanga, India .
authors.forename: Surya Deo
authors.initials: SD
authors.lastname: Singh
keywords: DR TB (Drug Resistant Tuberculosis); INH (Isoniazide); IRL (Intermediate referral laboratory); LPA (Line Probe Assay); Programmatic management of Drug Resistant TB (PMDT)