TB loss to follow up rate drops to 1.4% in two years

In 2019, the rate came down to 5% (2,222) and further took a plunge to 4% (1,604) in 2020. The rate further dropped to 1.4% (716) in 2021

Mumbai Two years after a pilot project was initiated in association with Tata Institute of Social Science (TISS) on tuberculosis (TB) survivors acting as counsellors for TB patients, Brihanmumbai Municipal Corporation (BMC) said it has helped the city retrieve patients who had lost to follow with treatment.

Most of these TB champions have beaten the multi drug-resistant TB and have faced stigma and harsh side effects of the antibiotics like hair loss, skin discolouration etc (HT Photo)

According to the BMC, in 2018, the loss to follow up rate was 7% (2,130 TB patients dropped out of the treatment). In 2019, the rate came down to 5% (2,222) and further took a plunge to 4% (1,604) in 2020. The rate further dropped to 1.4% (716) in 2021.

It was in mid-2019 that BMC’s Mumbai District TB Control Society, along with TISS launched Saksham Jan Urja project based on ‘Peer Counselling Model’, where nine TB survivors were roped in and designated as “Saksham Saathi”.

“We had started the programme with TISS to reduce loss to follow up rate. In a year, we managed to bring 200 patients back on regular treatment,” said Dr Pranita Tipre, Mumbai TB officer.

“Apart from bringing down the loss to follow up rate, we managed to screen 747 patient contacts and screened more than 7,189 patients for post-treatment follow up. Seeing the results of the project, we decided to have a TB Champion in each of our 24 wards,” said Dr Tipre.

Tipre said the eligibility criteria of recruiting TB champions were being TB survivors, good communication skills and willing to work with BMC. Most of these TB champions have beaten the multi drug-resistant TB and have faced stigma and harsh side effects of the antibiotics like hair loss, skin discolouration etc.

“My initial symptoms were hair loss, weight loss and fever. I was initially treated for typhoid by the local doctor for a month. I lost four months of treatment as I was not diagnosed. I had suicidal thoughts. I didn’t face stigma but with family support, I managed to complete the year-long treatment. While talking to the patients, I give my example and motivate them to continue with the treatment,” said Preeti More (20), BMC’s youngest TB champion.

BMC said a TB champion is paid ₹10,000 a month and works on a 9-4 pm shift. Their day begins with calling TB patients in their respective wards who have defaulted in taking the medicine. Each TB champion makes 25-30 calls a day and meets the patient personally if required.

“These champions have helped us address the gaps we had in our TB treatment programme. For example, one of them pointed out that the staff had rude behaviour. We then had a sensitisation programme for our staff and resolved the problem,” said Dr Tipre.

She said the biggest benefit of having TB survivors as counsellors is that patients could relate to the day-to-day problem they face because of the disease and treatment side-effects.

While speaking to HT, Vicky Salve (23), TB champion, who has been working in the project since day 1, said he faced discrimination in the residential society he stays. “I was under treatment before the pandemic and used to wear a mask which raised questions in the society. They had a society meeting and prohibited me from taking the lift. They actually went and found out that I was diagnosed with TB. TB medicines already had side effects and I was depressed. The stigma added to it,” he said.