World TB Day: Cases dip; lockdown and Covid fear to blame

According to the Brihanmumbai Municipal Corporation (BMC), the city recorded a sharp drop in the number of diagnosed patients of tuberculosis (TB) during 2020

According to the Brihanmumbai Municipal Corporation (BMC), the city recorded a sharp drop in the number of diagnosed patients of tuberculosis (TB) during 2020. This is attributed to the lockdown, due to which the diagnosis of hundreds of suspected TB patients was delayed. Today is World TB day.

World TB Day: Cases dip; lockdown and Covid fear to blame

On average, over 50,000 individuals get diagnosed with TB in Mumbai annually. When the Covid-19 pandemic started in March 2020, the city came to a standstill and as a result, TB diagnosis fell by 28.7% compared to 2019. Some could not opt for early treatment due to lack of public transport while others avoided visiting hospitals for fear of contracting Covid-19.

Data shows in 2019, there were 60,597 people diagnosed with TB in the city, including 5,673 who had multiple-drug resistant (MDR) TB and 794 with extreme drug-resistant (XDR) TB. In 2020, of the 43,464 diagnosed with TB, 4,367 had MDR-TB (a drop of 23%) and the detection of XDR-TB fell by 74% with 200 patients diagnosed in 2020. However, with the lockdown being relaxed, the number of diagnosed patients has been going up. “Every month, we generally record 5,000 new TB diagnoses which got badly affected in the initial months of the lockdown. In April, we registered around 1,000 cases. But since December last year, the turnout has increased. In January, we got over 5,500 TB patients,” said Dr Pranita Tipre, in-charge of TB in BMC.

Doctors said delayed diagnoses has resulted in group infections. “We are witnessing a large amount of TB infection among paediatric patients. As many patients live in overcrowded rooms, the delay in diagnosis ended up infecting those around them. Also, due to Covid-19, people avoided going out which further contributed to spreading the infection in-doors,” said Dr Bela Verma, head of paediatric medicine at Sir JJ Hospital.

In 2020, a total of 2,068 MDR-TB patients were treated with the newest anti-TB drug —Bedaquiline. The number was far lesser in 2019 when the drug was only given to only 1,089 patients with MDR-TB.

The BMC has taken up several initiatives to curb TB cases in the city. This year, BMC will start culture-based phenotypic drug susceptibility testing (DST) laboratories for drug resistance detection in Kasturba and King Edward Memorial (KEM) hospitals.

“For faster detection of TB, we have started using Artificial Intelligence (AI) techniques. We have partnered with NGO, STOP TB and an AI company, Qure.ai, for the diagnosis of TB patients within 3 minutes. This will help in reducing initial dropouts and delay in start of the treatment. In addition, another AI company, Wadhwani.AI, would help us to predict patients who have a high probability of default,” said Dr Tipre.

The BMC has initiated two drug trials - the first one in collaboration with the National Institute for Research in Tuberculosis and Indian Council of Medical Research, and the second one on XDR-TB medicines with the NGO, Médecins Sans Frontières, which is also known as Doctors Without Borders.

3 TB-Covid co-infection deaths

As reported earlier by HT, a total of 241 TB patients were diagnosed with Covid-19 co-infection last year. There were, however, no fatalities. According to data provided by BMC, three of the 42 people diagnosed to be suffering from TB-Covid co-infection have died this year.

Data indicate that the infection rate of TB patients tested for Covid-19 has risen this year, from 1.8% last year to 2.1%.

“As Mumbai is witnessing a second wave and the number of daily Covid-19 infection rate has already surpassed last year’s figure, we expect a rise in co-infection among TB patients also,” said an officer from BMC.