TB is a public health emergency that needs multi-stakeholder partnership

Treat every TB case and trace all close contacts

New Delhi, January 27, 2019: A recent study called Such a long journey: What health seeking pathways of patients with drug-resistant tuberculosis in Mumbai tell us published in the scientific journal PLOS ONE has highlighted the several setbacks in the treatment for TB patients. The study, tracking the journey of 46 drug-resistant patients in Mumbai’s 15 high-burden TB wards, reveals how from self-delay to scattered healthcare facilities, TB patients go through a tortuous journey. All this often pushes them to default in treatment.

The TB care pathway involves many providers and facilities and a patient must go through multiple providers before getting the right diagnosis or treatment. There is also the issue of multi-drug resistant (MDR) TB and lack of awareness about the disease among people.

Speaking about this, Padma Shri Awardee, Dr KK Aggarwal, President, HCFI, said, “TB is the third leading cause of years of life lost (YLLs) lost, in the country. It is caused by bacilli spread through droplet nuclei (less than 5 microns) infection. Droplet nuclei can remain suspended in the air for extended periods, and thus are a source of exposure to susceptible individuals. Split AC is not the right atmosphere for sputum-positive cases. Natural windows and fans are better alternatives. TB does not spread through handshakes, using public toilets, sharing food and utensils, blood transfusion and casual contact. TB can be of lungs (pulmonary), or outside the lungs (extra pulmonary). In 85% of cases, lungs are involved.”

Year 2025 has been set as the deadline for a tuberculosis (TB)-free India by the hon’ble prime minister. This is five years ahead of the global deadline set by the WHO.

Adding further, Dr Aggarwal, who is also the Group Editor-in-Chief of IJCP, said, “Early diagnosis and complete treatment is important to prevent and control TB. To address the problem of rising drug resistance, TB is a notifiable disease. The approach to all notifiable diseases should therefore be based on DTR “Diagnose, Treat & Report”: Diagnose early, using sputum GeneXpert test; Treat: Complete and effective treatment based on national guidelines, using FDC; and Report: Mandatory reporting.”

Some tips from HCFI.

• Wash your hands after sneezing, coughing or holding your hands near your mouth or nose.
• Cover your mouth with a tissue when you cough, sneeze or laugh. Discard used tissues in a plastic bag, then seal and throw it away.
• Do not attend work or school.
• Avoid close contact with others.
• Sleep in a room away from other family members.
• Ventilate your room regularly. TB spreads in small closed spaces. Put a fan in your window to blow out air that may contain bacteria.