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BMC to start DR-TB centre in private hospitals
A meeting for the same was held last month after which the Mumbai TB office has received 2-3 corporate hospitals coming forward. “We are waiting for more corporate hospitals to come forward before rolling out the initiative,” said Dr Varsha Puri, deputy executive health officer and Mumbai TB officer
Mumbai: In order to meet the Centre’s ‘End Tuberculosis by 2025’ target, the Brihanmumbai Municipal Corporation (BMC) has now roped in private hospitals to treat drug-resistant tuberculosis. Drug-resistant TB is caused by TB bacteria that are resistant to at least one first-line anti-TB drug. According to WHO, people with drug-resistant TB face significant economic and social costs and only 1 in 3 access quality care. Reaching the missing patients remains a significant public health challenge.
Therefore, to make TB treatment more accessible for patients the BMC plans to start drug-resistant tuberculosis centres (DR-TB) in private hospitals.
“Starting a DR-TB centre in private hospitals is one of the many initiatives that we are taking to eliminate TB. We are waiting for an expression of interest from the stakeholders for being part of this initiative. The centres will be closely working with the BMC TB office,” said Dr Mangala Gomare, executive health officer, of BMC.
A meeting for the same was held last month after which the Mumbai TB office has received 2-3 corporate hospitals coming forward. “We are waiting for more corporate hospitals to come forward before rolling out the initiative,” said Dr Varsha Puri, deputy executive health officer and Mumbai TB officer.
While private Dr-TB is presently functional in PD Hinduja Hospital and KJ Somaiya Hospital, Dr Yatin Dholakia, secretary of Maharashtra State Anti-TB Association said having more DR-TB centres in private hospitals will improve access to DR-TB treatment.
“It is a known fact that the majority of TB patients prefer going to a private physician/hospital. Drugs like Bedaquiline, and Delamanid are only available in the public health system. Private chemists can’t stock them. Private doctors have to refer their DR-TB cases to the public system for management. There are many private physicians who are not referring the DR-TB patients to public centres for treatment,” he said.
Dr Dholakia added that having more private centres will increase the DR-TB treatment ambit. “Many patients do not want to come to public TB centres due to long waiting lines etc. For them, having more DR-TB centres in private hospitals will be a boon,” he said.
Dr Lancelot Pinto, pulmonologist and epidemiologist, PD Hinduja Hospital-Mahim said as high as 50-70% of TB patients first approach the private sector. “It will be beneficial to the patients as they will be getting a standardised drug-resistant regimen through the government. Monitoring and follow-up will be easier,” he said.
Dr Pinto added that by involving private hospitals that have consultants experienced in TB treatment, can manage DR-TB better. “Opening up to all private practitioners, it will be difficult to monitor the quality of treatment and care,” he said.
Mumbai has been seeing more than 5,000 drug-resistant tuberculosis cases every year. In 2022, Mumbai saw 5,758 drug-resistant TB cases. In 2021, the city recorded 5,978 DR-TB cases while in 2020 there were 4,775 cases reported. In 2019 and 2018, there were 5,997 and 5,343 cases respectively.
BMC had also started 23 adverse drug clinics which helped them bring down the loss to follow-up (LTFU) percentage from 16% to 2% in the last five years. BMC officials said they had found many DR-TB patients left the treatment due to adverse drug effects. They found 95% of the adverse drug effects were minor problems like allergic skin reactions, body aches, gastritis etc which are now addressed in BMC’s adverse drug reaction clinics and have helped retain patients to complete the TB treatment. The Mumbai TB official also said they are looking at artificial intelligence to predict tuberculosis (TB) patients who have a high probability of defaulting and not completing the treatment.
