India is a land of 1.2 billion people, with 2.2 million of them suffering from active Tuberculosis. A country where your chances of contracting TB are higher than finding a toilet. Almost 40%of our population is infected with Tubercle Bacillus, either in active or latent form. We are a nation which is growing by leaps and bounds and has gained attention of international community, but are we losing the war at home against TB?
It’s not that our government has not done anything to counter this menace.
Government of India has an ongoing national TB programme since 1993, the Direct Observe Treatment Shortcourse also known as DOTS. It had tripled TB treatment success in India and the cure rate had gone up from 25 per cent to 84 per cent. This strategy was also lauded by WHO as a successful programme.
But come 2012 and our national TB programme was slammed as having the highest burden of TB.Out of the 9 million cases worldwide, India has a share of 2.2million infected patients.
A typical course of antibiotics treatment of TB with first 2 months of initial therapy followed by 6 months of continuation therapy. Most of the patients follow their treatment for first 4 months and once they start feeling better and become asymptomatic, they skip the rest of their course. These patients,also known as defaulters, are starting an epidemic of sorts in this country, Multi Drug resistant TB.
According to official statements the success rate of DOTS is 85%, rest 15% of patients constitute of :
- Relapse of treatment
To know more about lack of patient adherence to the programme and MDR TB, Curofy went to TB and chest medicine department, Gurgaon Civil Hospital. There we met Dr. Vijay Kumar, who has been working with Tb cases for over 20 years. On being asked about patient adherence he said,
“ Doctors at government hospitals are overworked due to which we don’t have time to counsel the patients. If a patient is counseled even for 5 mins we can bring down the number of defaulters to a great extent. What we need is to give patients our time and explain the procedure. They don’t know the consequences of incomplete treatment. Once we get patients to complete their courses, MDR TB will be reduced greatly.”
It is interesting to note that the DOTS programme which was started to eradicate TB has now become a propagator of MDR TB, and unfortunately doctors and attending healthcare professionals are the first collateral damage in this war.
According to a recent survey in Mumbai, 60% of healthcare professionals working in Sewri Hospital, the biggest TB hospital, had MDR TB. That is not only shocking but also dangerous.
Gone are the days India was leading the world in eradicating TB. Today, we have turned into the TB capital of world. We need to buckle up and get head first into this fight against TB.