Efforts on to cover cases outside Revised National TB Control Programme

With the Centre’s efforts to make tuberculosis a notifiable disease not yielding enough data, Tamil Nadu has decided to launch a study in four districts to ascertain the number of patients going to private practitioners.

The study is already on in Tiruvallur and Tuticorin districts, and will be initiated for three months beginning July in Madurai and Tirupur, according to State TB control officials.

“The aim is to find all those being treated in the private sector and bring them under the Revised National TB Control Programme’s DOTS schedule. We can even supply the drugs to these patients via the private practitioners themselves,” says the official. DOTS, or directly-observed treatment (short course), is the name given to the national TB control programme’s strategy.

In May last year, the Central TB Division (CTD) issued a government order making TB a notifiable disease. However, this has apparently not produced the desired results. Therefore, the CTD urged States to address this challenge, explains Ramya Ananthakrishnan of REACH, an NGO that has been working on involving private practitioners in TB treatment and the DOTS programme.

State TB officials say while there has been some response to the notification, doubts remain over whether all private practitioners have begun notifying all cases of TB that come to them.

“If case detection in the government sector is at 70 per cent, we are assuming that the remaining 30 per cent of the cases are being treated in the private sector. If this is true, then it is not a problem,” explains Dr. Ramya.

However, if this assumption is not right, and it turns out that only 10 per cent are being treated in the private sector, this means that 20 per cent are not being treated for TB at all. That is a cause for worry, she says.

The CTD is also working on a ‘line listing’ of patients, to get details of every individual patient into their database. Eventually, the database may also be used to channel payments or benefits to these patients, adds Dr. Ramya.

“With this study, we hope to understand the true dimensions of the problem outside the public health care system,” State health officials add. These four districts have been chosen primarily because of their robust TB control capabilities. “The aim is to take case detection to at least 90 per cent,” say sources.

While in Tiruvallur, private doctors have been advised to give a ‘missed call’ to a particular number in Tuticorin, doctors are required to drop a postcard, intimating the authorities if there is a positive case.

Staff from the TB control division will then come to collect details patient and follow up the case too, the sources said.

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