One out of every two patients who are undergoing treatment for Tuberculosis (TB) had either approached a chemist or a non-allopathic doctor, including practitioners of Indian systems of medicine, before getting conventional treatment, says a study conducted by The Foundation for Medical Research (FMR).
The delay in treatment is a cause for worry, because four out of five multi-drug resistant TB patients interviewed by the researchers were detected with the resistant TB bacilli in their first encounter with the disease.
“We have to tackle the issue of delayed diagnosis on a war footing. It’s a common mindset of doctors that a patient with fever is either having typhoid or malaria. A patient with TB might get relief from symptoms with the treatment, but within a few days the symptoms return with severity,” said Dr Om Shrivastav, director, infectious disease department, Jaslok Hospital, Pedder Road.
Dr Shrivastav said that the longer a patient with active TB remains untreated, the higher the risk to the community. “Those with drug-resistant TB will spread the resistant bacteria to others and such drug-resistant TB cases will only increase in absence of timely diagnosis,” he said.
The FMR study found that patients in Mumbai used both private and public health facilities. Close to 55% of the diagnosis was made in the private sector, but 64% of the treatment came from the public sector, indicating that the cost of treatment pushed more patients to the public sector.
“We are tying up with private doctors to improve TB diagnosis. As part of the public-private interface, private doctors can send their patients for free X-rays and subsidised GeneXpert test to detect drug-resistant TB,” said Dr Arun Bamne, public health consultant, Brihanmumbai Municipal Corporation.
Public health experts pointed out that delay in diagnosis could also be caused by patients visiting multiple doctors to confirm the diagnosis, which can also contribute to the delay.
Homoeopathy practitioners said they refer suspected cases of TB to chest physicians. “Diagnosing TB is the easiest thing to do, as all of us have seen and treated many TB patients during our college days and even during practice. On suspecting that a patient has TB, a homoeopath refers the person to a chest physician who can confirm the diagnosis and have a treatment plan. We monitor the treatment of these patients, which lasts for six to 18 months,” said Dr Bahubali Shah, president, Maharashtra Council of Homoeopathy.