India may miss TB elimination target

The alarming TB numbers suggest that by 2040, there will by 63 million new cases of TB and 8 million deaths as per London School of Hygiene and Tropical Medicine( LSHTM) study published in PLoS and quoted in our press ( Dec.13). It seems to belie Indian National goal of elimination of TB by 2025.

Another disquieting fact as raised by a health NGO in Delhi is that there is shortage of drugs for treating TB patients. We have had a paradigm shift of Sanatoria of inpatient TB treatment to the outpatient or the at-home treatment, but the surveillance by PHC concerned or a Volunteer and the ANM or Volun-teer to monitor the drugs taken mostly on alternate day basis and ticked on the chart may not be strict. Here the bottlenecks are encountered and at times the monitor fails to visit on a particular day or the patient may miss the dose on a particular day and there is a mutual compromise and dropouts are reck-onable. Here the said shortage of drugs may lead to dropouts. It may be suggested that for strict surveil-lance, the old type of Sanatoria may be reintroduced to put the patients on induction who may have difficulty to adhere to the schedule if while at home. The nutritious and supportive diet protocol is pos-sible in a Sanatoria setup rather than at home mostly in a compact congested households of the poor and the marginalised.

HIV-AIDS makes a major chunk among TB new cases and following rise in TB cases cited in LDHTM study, there should be a comprehensive study and the surveillance of both TB and HIV/AIDS should be strictly incorporated.

–Dr T Ramadas, Visakhapatnam