Although the number of new TB cases worldwide remains a matter of concern – the figure stood at nearly 9 million in 2010 – the incidence rate has been falling since 2002, according to a recent report of the World Health Organisation. Estimates of the year-wise number of deaths reveal a declining trend. Against this background, India presents a dismal picture. Last year, the case detection rate — the first and the most vital parameter — was only 59 per cent of all cases (both smear positive and smear negative). China, on the other hand, has made tremendous progress in this area — the case detection rate increased from 33 per cent in 2000 to 74 per cent in 2006 to 87 per cent in 2010. Prevalence was halved between 1990 and 2010 and the annual rate of decline, which was 2.2 per cent between 1990 and 2000, rose to 4.7 per cent in the next decade. The mortality rate was slashed by almost 80 per cent, and the incidence rate fell by 3.4 per cent, over the past 20 years.
The key factor behind China's success is the mandatory web-based TB reporting system that has been in operation since 2005. This covers virtually every health facility in the country. In addition, all TB deaths are required to be registered in all the 31 provinces. These hard-nosed initiatives have enabled the country to measure the prevalence of even multi-drug resistant TB (MDR-TB). In stark contrast, underreporting of TB incidence for 2010 in India was as high as 41 per cent, in WHO's reckoning. The reasons for this are not difficult to find. Data are collected only from the government-run institutions and there is no mandatory system for private practitioners to report every confirmed TB case. With many patients seeking treatment from non-government doctors, India's contribution to the world's notified cases in 2010 was surely much higher than WHO's estimate of 24 per cent. It is well established that a flawed reporting system and an inaccurate data base undermine the formulation of effective policies. Many private medical practitioners fail to diagnose the disease; and even when they do that, they tend to follow a regimen that is not standard, thereby contributing to the emergence of more MDR-TB cases. Two people die very three minutes in laid-back India from this infectious disease. The government must give the highest priority to the battle against TB, emulating countries that have done dramatically better on this front.
Government should find a way to track the cases that are being treated in the private health sector and make compulsory for the private practitioners to follow the TREATMENT REGIMEN AS SUGGESTED BY THE WORLD HEALTH ORGANIZATION
This piece of article is once again a reminder to Health authorities and policy making body to draw their attention to devastating disease.Throughout all the previous 6 decades after independence, India has remain a failed state to curb TB.All the concerned departments ranging from policy making bodies such as Health Ministries to Public health centers have remained a mute spectator to the deadly disease and watching the menace of death causing illness with shameful inactivity.When only around 1% of GDP is spent on total health care sector and when the share of public health care is just only 20% to 25% of total health care sector,India can not hope to fight TB and other diseases.We need to revamp our strategies right from the ground level and making small targets to eradicate this disease.More expenditure on Public health care facility, mandatory investigation of TB on all public and private health care units and increased national level awareness among masses are need of the hour .
I understand that diagnosing TB is very difficult, don't know the reason - lack of experienced doctors or the nature of the disease. Fortunately, in my wife's case, it was identified in very early stage even though there were no symptoms of cough, fever etc..except small lymph node. But I have seen many people for whom it took more than 6months for diagnosis and had to endure extreme pain and complicated surgeries.
I could remember and recollect my experiences when infected with this disease in my earlier boyhood days .I was about 10 years old at that time.I went through a rigorous and regular treatment in chennai. The hospital was T.B.Hospital in chetput and the doctor attending was on Dr.Ramaswamy,a very young doctor from Nungambakkam.According to him my problem was not very acute and he took all the care to get me treated. I had to go to that hospital alternate days for two months and I was given injections those days.As per his guidance and advice my Brother Srinivasan took full care of me at home,in addition to escort me to the hospital to and fro a distance of 5 KM from our residence.May be due to the dedication of the doctor and the affectionate attendance of my brother I got completely cured. I hope all those get infected with this disease get the same type of Doctors and relatives to become clear of the deardful disease.
It cannot get clearer than this. TB is no ordinary disease, given its infectious nature it can wipe out a large number of people in a short time, and MDR-TB just compounds the issue. India's lack of infrastructure in hygene, sanitation and its disgusting practice of open defecation can be attributed to the prevalance of TB in rural areas, in cities drug abuse, improper medication and lifestyle contribute to the growth of this menace. India has the tools necessary to combat TB head on and win, but for some reason it is being lethargic. Wake up India, before its too late.
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