Around 229 per lakh persons have tuberculosis (TB) in Haryana, with more men being affected than women. This is in contradiction of national trends.
Referring to World Health Organization and National Family Health Survey reports, Piyush Goel, consultant, Pulmonology and Critical Care, Columbia Asia Hospital, Gurugram, said 380 cases per lakh women against 220 cases per lakh men are affected by TB nationally while the numbers in Haryana stand at 277 per lakh men against 199 per lakh women.
Perinatal deaths
Dr. Goel said despite the difference between national and State trends, high prevalence rates for both sexes in the State are reasons for major worry.
“Although the disease has severe effects on both men and women, it happens to be one of the top five killers of women in the age-group of 25 to 59 years worldwide. TB has severe impact on maternal health and is linked to sixfold rise in perinatal deaths and twice the risk of premature birth. Further, genital TB, which does not get diagnosed easily, is an important cause of infertility. Pregnant women affected by TB and HIV have a 300% increased risk of infant mortality,” said Dr. Goel.
Stigma
He said: “In India, HIV-infected mothers who also have TB have more than twice the risk of HIV transmission to the unborn child. Women in Indian households still prioritising family health and matters over their own health, added to the stigma and discrimination faced, influences diagnosis and treatment of the disease highly. Economic dependence on male members, and other cultural and financial barriers also hinder timely presentation and treatment of the disease in women.”
Bornali Dutta, associate director, Respiratory and Sleep Medicine, Medanta - The Medicity, said she has been part of the hospital’s “Mission TB-Free Haryana” for the past two years, screening 3,000 patients for over 10,000 chest x-rays. She found that Nuh district was significantly underprivileged in the State with lowest number of health facilities and doctors.
Delay in diagnosis
“We have been working in around 16 districts of Haryana and hope to cover the remaining six in the years to come. We found that lack of health facilities and poverty are the two major reasons hindering timely diagnosis and treatment of the disease. People have a habit of not visiting the doctor till they are not significantly unwell. Since TB patients can remain reasonably functional for several months, it leads to delay in diagnosis,” said Dr. Dutta.
