TB deaths rise 28% in Maharashtra: Data

Even as Maharashtra recorded a marginal rise of 9% in tuberculosis (TB) cases last year as against 2017, the number of deaths has gone up by 28% in the same period.

Even as Maharashtra recorded a marginal rise of 9% in tuberculosis (TB) cases last year as against 2017, the number of deaths has gone up by 28% in the same period. While the state government attributed the increase to better reporting, experts raised the need to build stronger immunity in communities.

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According to data provided by Union health minister Dr Harsh Vardhan in Parliament on December 6, Maharashtra recorded the second-highest number of TB cases in India in 2018, after Uttar Pradesh. In 2017, Maharashtra recorded 1,92,458 cases, which increased to 2,09,642 in 2018. Of every 32 people diagnosed with TB in the state, one succumbed to the infection. The number of deaths rose to 6,476 in 2018 from 5,066 in 2017.

Dr Padmaja Jogewar, a state TB official, said the number of registered TB patients has risen due to better reporting of patients from private sectors and is reflected at both state and national levels.

The Union health ministry said TB notifications across India went up by 17% in 2018 over the previous year. In 2017, not notifying TB cases was made a punishable offence.

Notifications from the private sector health care providers increased by 40% to 5.4 lakh, contributing to 25% of all TB notifications, according to the India TB Report 2019, launched in October.

TB experts said the increase in reported cases may not be only due to mandatory notification and stressed the need for better schemes to tackle TB.

“The scheme of providing ₹500 [for nutrition] is both insufficient and not reaching patients. We have cases where patients are being asked to open bank accounts before being provided treatment,” said Blessina Kumar, Global Coalition of TB activists.

Specialists also said not all the data may be accurate. “Patients often suffer from comorbid diseases along with TB. If a patient died because of a heart attack or kidney failure, doctors often write TB in the death certificate as the cause of death, which misleads the process of data collection,” said Dr Yasin Dholakia, president of Maharashtra State Anti-tuberculosis Association.

India has said it will eliminate the disease by 2025, five years ahead of the global target. To achieve this goal, medical experts and activists said attention needs to be paid to counselling to deal with side effects of treatment (which include depression and anxiety), better medicine and improving immunity.

According to Brihanmumbai Municipal Corporation (BMC) data, Mumbai has the highest number of drug-resistant TB patients in India (5,000) but only 50% are prescribed new drugs. “New drugs (bedaquiline and delamanid) are given to patients when their condition worsens. The government needs to make these drugs universal,” said activist Ganesh Acharya.

The second line of treatment also requires patients to build immunity through an improved diet, which is a challenge since according to Directorate of Health Service (DHS), almost 60-70% of those diagnosed with TB in Maharashtra are from lower socio-economic backgrounds.