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An attempt to live in a TB free world
Tuberculosis is a treatable disease, but has been a leading cause of death worldwide, caused by Mycobacterium tuberculosis. As per WHO report 2015, there were an estimated 10.4 million new TB cases worldwide. Children accounted for 10 percent and people living with HIV about 11 percent.
Tuberculosis is a treatable disease, but has been a leading cause of death worldwide, caused by Mycobacterium tuberculosis. As per WHO report 2015, there were an estimated 10.4 million new TB cases worldwide. Children accounted for 10 percent and people living with HIV about 11 percent.
In India TB kills nearly 480,000 people annually, more than 1400 per day. TB control programmes have been there for 50 years, still India remains among 20 High Burden Countries (HBC) among prevalence of TB, TB/HIV and MDR-TB. India also has more than a million “missing” cases every year due to lack of notification.
Govt. of India made TB a notifiable disease, still the rate of notification remains low, but improved 34 percent from earlier. Large gap exists between diagnosis and treatment. All patients suspected for TB and HIV positive individuals where tested simultaneously for both. 55 percent of all notified patients had HIV test done. HIV positive TB patients about 78 percent were on ART (anti retroviral theray).
Majority of cases 85 percent are drug susceptible and about 10-15 percent are drug resistant. Prompt diagnosis of cases both drug susceptible and resisitant and treatment will cure and prevent spread to others.
TB startegy for 2002-2015 was STOP TB. The new startegy is END TB.Currently emphasis of National Strategic Planning (NSP) of TB is to expand new diagnostic modalities Gene Xpert TB / Rifampicin resistance to most centres. Medication now planned to be given daily instead of thrice weekly.
NSP 2016-2025 TB elimination has been planned to integrate into four pillars: Detect, Treat, Prevent and Build.
• Detect: scale up free high sensitive diagnostic tets to all, engage private sector and systemic screening for high risk population.
• Treat: free TB drugs for all, prevent loss of TB cases, universal daily regimen and short corse regimen for drug resistant cases based on DST, eliminate catstrophic cost to families.
• Prevent: scale up air borne infection control measures, treat Latent TB individuals who are carers for smear positive cases.
• Build: strengthen policy implementation and adherence.
(The author is a Sr Consultant Pulmonologist, Gleneagles Global Hospitals, Hyderabad).
By Dr Sudhir Prasad
