Dr Manoon Leechawengwong said yesterday the fund, under the patronage of the Siriraj Foundation, started research into drug-resistant forms of TB in 2001 and had found 13 cases identified as XDR-TB.

This definition means the TB strain is extremely drug-resistant, especially to first- and second-line drugs. Treatment options for patients with XDR-TB are severely limited.

However, Dr Mongkol na Songkhla, the public health minister, said he had not yet been informed of the XDR cases here. He claimed the ministry monitored drug-resistant forms of TB, but only multi-drug-resistant MDR had been found.

The difference between patients with MDR-TB and XDR-TB is that the first group has more treatment options than the latter. MDR-TB is resistant only to first-line drugs.

XDR-TB recently became world news after a law, unused for 44 years, was invoked to isolate a man in the United States last month. Currently there is no treatment for XDR-TB.

Manoon's disclosure about the confirmed XDR-TB cases contradicted information from the ministry. Last week, Dr Tawat Suntra-jarn, head of the Disease Control Department, insisted there were no cases of Thais infected with XDR-TB.

But Manoon claimed the Health Ministry did not pay enough attention to monitoring and preventing the spread of drug-resistant TB.

"We have to speak the truth and look for a way to prevent the spread of the disease," he said.

In order to identify drug-resistant forms of TB, Manoon said hospitals nationwide had cooperated by sending TB germ samples from patients.

While there are about 80,000 new TB cases each year, he had only been sent 15,000 samples over five years of his research project. Besides the 13 cases of XDR-TB, his lab tests also found about 500 cases of MDR-TB.

Manoon wants the ministry to be more proactive in controlling the spread of TB, especially the strains resistant to drugs. He suggested it seriously examine TB cases to identify XDR and MDR cases.

"If possible, the government should have the power to restrict the movement of those infected with drug-resistant forms of TB - to reduce the chance of them spreading the disease."

He said the main concern was how the country prevented the spread of the disease.

Pennapa Hongthong

The Nation