World TB Day: 43 TB cases reported every day from Uttarakhand
Malnutrition, high tobacco consumption and poor ventilation in buildings, coupled with low socio-economic status, have resulted in 43 people being diagnosed with tuberculosis (TB) every day in the statedehradun Updated: Mar 23, 2018 21:49 IST
Malnutrition, high tobacco consumption and poor ventilation in buildings, coupled with low socio-economic status, have resulted in 43 people being diagnosed with tuberculosis (TB) every day in the state.
Between 2014 and 2016, there were 46,249 such cases registered in the state, according to a report tabled by the Centre in parliament recently.
In 2014, the number of TB cases notified in Uttarakhand was 15,578. It rose to 15,590 in 2015, but declined to 15,081 in 2016.
“The low nutrition levels in Uttarakhand are a cause of concern,” says Dr Rameshwar Pandey, head of TB and chest department, Doon Hospital.
“The level of tobacco consumption is also high in the hills. Whereas in plains, especially in slums, people have poor ventilation and many people have to live in congested and smoky rooms. All these contribute towards prevalence and spread of TB.”
He said on an average, the hospital receives 10-15 new TB patients every day. “Most cases have pulmonary TB which infects the lungs. If untreated, a TB patient can infect at least 5-10 people before dying,” he said.
Speaking about challenges in eradicating TB, Dr DVC Kala, state TB officer, said societal conceptions are hard to overcome.
“TB is still considered a social taboo. People are unwilling to take treatment fearing isolation and backlash. Another hindrance in eradicating TB is the cases in private sector. Many of these patients don’t follow the full treatment because of the expenses involved,” said Dr Kala.
He said the health department started active case finding system last year wherein health workers traced patients in two districts.
“Earlier, patients used to register themselves in hospitals when diagnosed with TB. But many cases could not be traced in this manner. From this year, active case finding is being implemented in all districts,” he said.
The WHO has set a target of eradicating TB by 2030. However, during a summit on TB in New Delhi, Prime Minister Narendra Modi asked the central and state governments to complete the task by 2025. The Uttarakhand government, in turn, has set an ambitious task of achieving the feat by 2024.
Meanwhile, another problem that medical practitioners across the world are encountering is the increasing prevalence of multi-drug resistant TB (MDR-TB). It is a stage of TB when a patient becomes resistant to medicines.
According to the Global TB Report 2015 that was prepared by the WHO, the number of MDR-TB cases was 71,000 in India.
However, in 2017, in a fresh report WHO re-estimated the number of MDR-TB cases in India to be 84,000.
Like the rest of India, prevalence of MDR-TB is a cause of concern in Uttarakhand, too. In 2017 alone, there were 5,946 cases suspected to have MDR-TB, of which 448 were diagnosed.
The most number of diagnosed cases were in Dehradun (139 cases), followed by Haridwar (101 cases).
“Patients become resistant to drugs generally when they stop taking drugs midway or do not take them in the prescribed manner,” said Dr Ruchi Dua, assistant professor of pulmonary medicines, All India Institute of Medical Science (AIIMS), Rishikesh.
Speaking on this, Dr Kala said MDR-TB cases are seen more in the private sector because it has been found that patients stop taking medicines after few months, either because they are no longer able to afford the treatment or simply because of callousness as people become complacent after getting some positive results initially.
To tackle this, the government has started working with private practitioners for better monitoring of cases. “We assure them that we won’t encroach upon their patients. In case a patient stops taking medicines, we provide it to him/her,” said Dr Kala.
He said for systematic monitoring of cases, the health department has started collecting data on the number of cases and the medicines sold by private practitioners.
“TB has also been declared a notifiable diseases, so all practitioners are now duty bound to inform us about any new case,” he said.