The paper by Shah and Rahangdale on drug resistant tuberculosis (TB) in children is an eye opener to some neglected aspects of TB problem in India [1]. However, the term "partial XDR" as coined by the authors is eye-catching but superfluous; all of their study strains were MDR (multidrug resistant) with fluoroquinolone resistance.

Primary MDR TB in children, as illustrated by Shah and Rahangdale has already become a difficult problem. If a child acquires infection from an MDR TB adult, preventive chemotherapy with isoniazid or rifampicin or a combination will be ineffective.

Extensively drug-resistant (XDR) TB in adults in India is an emerging problem, already an emergency in our opinion, but not yet 2.4% of all MDR cases as mentioned by the authors. As far as we can verify, the World Health Organization has recognized only 1 case of XDR TB in India, while many such cases have been reported in the literature [2]. We strongly recommend to the Indian Academy of Pediatrics to urgently develop policy options for community level prevention of TB and take them up with the national TB control program at the highest level.

1. Shah I, Rahangdale A. Partial extensively drug resistance (XDR) tuberculosis in children. Indian Pediatr. 2011;48:977-9.