Aimed at intensifying government’s fight against TB, the Union Government has decided to spent Rs.600 crore on overall management of the disease. In the Union Budget, Union Finance Minister Arun Jaitley has announced that the government would allocate additional Rs. 600 crore to provide nutritional support to all TB patients at the rate of Rs. 500 per month for the duration of their treatment. The initiative has been taken to provide aid to the poor and malnourished patients, in addition to the free medicines that are being provided to them by the government.
The government has been taking various initiatives to fight spread of TB across India. For this, it has launched a special campaign of Active TB Case Finding to identify the TB patients in high risk areas, besides introducing more than 600 CBNAAT machines, expanding rapid molecular diagnostic services in every district of the country and identification of 100 high-priority districts for intensified TB control services.
The introduction of miracle drug, Bedaquiline, has marked a new beginning for the treatment of MDR/RR-TB in the country. It has been introduced in five states from 2016 with an objective of extending its coverage throughout the country in the future.
The government has adopted TB Surveillance System under which it has been made mandatory for every private practitioner, clinic, hospital and nursing home has to notify the public health system about the TB patient on the same day of diagnosis. NIKSHAY platform has been developed to get notification about TB cases including drug resistant TB patients from public and private healthcare institutions.
For quality diagnosis of the disease at different levels, the government has established 13888 Designated Microscopy Centres, 628 Cartridges Based Nucleic Acid Amplification Test (CBNAAT) laboratories, 28 Intermediate Reference Laboratories, 37 Culture & DST laboratories and six National Reference laboratories in the country.
It is important to note that the government has achieved success in terms of providing sure cure for TB through WHO recommended DOTS (Directly Observed Treatment, Short-course chemotherapy) under Revised National TB Control Programme (RNTCP) running in the country for eradicating the disease. The increase in the number of notification of cases every year is a testimony of the fact that the substantial work is being done on the ground to bring fruitful results.
TB MENACE IN INDIA
India accounts for one-fourth of the global TB burden and has been included among 30 High Burden Countries for TB, MDR-TB and TB/HIV by World Health Organization (WHO).
According to Global TB Report-2017 released by WHO, India reported 19,36,158 TB cases in 2016 with total new and relapse cases in 2016 being as high as 17,63,876.
The main cause of concern is the increase in number of new and relapse TB cases. It has also been reported that the global number of new and relapse TB cases notified and the notification rate per 1,00,000 population have both been increasing since 2013, mostly explained by 37% increase in notifications in India. China, India and Russian Federation have reported 47% of the global number of MDR/RR-TB cases. The total number of notified cases and the number of reported deaths due to TB in the country has become a cause of concern. This indicates the amount of work that needs to be done to eradicate the epidemic from the country.
TB in Jammu and Kashmir
As per the TB India Report-2017 released by Ministry of Health and Family Welfare, Government of India, the state of Jammu and Kashmir reported 9,937 TB cases in 2016 with
699 notified by private health sector. State Tuberculosis Officer, Jammu, Dr. Sujata Sharma said the state is gearing up to start the use of ‘Bedaquiline’ in the hospitals for the treatment of Multi-Drug Resistant TB (MDR-TB).
She said that Chest Diseases Hospitals are functional in twin capital cities of Jammu and Srinagar with special wards for TB patients to reduce the risk of infection to other patients. The government is in the process of establishing special Drug Resistant TB wards in the state. “District Tuberculosis Officers (DTOs) have been deployed in six District Hospitals to diagnose and treat the TB patients,” she said, adding the facility of testing is available in every district hospital while as the process of starting Culture and Drug Sensitivity Test (C&DST) in district hospitals is going on.
She informed that the State Health Department conducts Information, Education and Communication activities in various districts of the state through DTOs to create awareness among the people about TB and its sure cure through DOTS. The sensitization workshops are done to educate the private health institutions about notifying the cases as soon as they diagnose any TB patient. She said the professionals and PG students undertake research activities at Govt. Medical Colleges in the state to strengthen surveillance and tuberculosis notifications, besides improving the quality and efficiency of TB control measures.
Ayurvedic cure — Rajyakshma
Consultant (Physician), Govt. Ayurvedic Hospital Jammu Dr. Suresh Sharma informed the Ayurveda had identified a disease called ‘Rajyakshma’, the king of diseases, which has quite similar symptoms as Tuberculosis in Allopathy. There is a myth that Moon, the King of satellites, was the first one to have been affected by this disease as he was cursed by Lord Brahma.
He said the Ayurvedic philosophy has cure for Rajyakshma but it is the moral duty of every doctor to advise the patient to take WHO recommended DOTS treatment for atleast six months as it is the sure cure for Tuberculosis or Rajyakshma. Dr Sharma informed the biggest mistake that the patients make is that they leave the treatment incomplete when they feel some relief and this becomes the main cause of MDR-TB.