Kochi

‘More TB patients dying of co-morbid conditions’

Focus now on reducing vulnerability

The death of around 90 tuberculosis patients in Alappuzha in 2015 told a different story about TB care in Kerala even though the State has done well in implementing the Revised National TB Control Programme.

An investigation into the death of patients revealed that in around 60% of cases, there were other co-morbid conditions that were the actual causes of death. However, as the patients were on TB treatment, deaths were reflected in the State’s data as TB deaths. There were 40.3% patients who had died of TB.

The study published in The Indian Journal of Tuberculosis in 2019 titled ‘Why are people dying due to tuberculosis - A study from Alappuzha district’ led by Dr. Karthika M., Associate Professor, Community Medicine Department, Medical College, Alappuzha, had revealed that there were deaths caused by myocardial infarction, cancer, stroke, renal or liver failure, chronic pulmonary obstructive diseases and other causes including suicide.

Her study concluded that the co-morbid conditions in over 60% of patients who had died while on TB treatment had perhaps caused the deaths. Dr. Karthika had conducted a verbal autopsy on the guidelines of the World Health Organisation, meeting the family members of the patients who had reportedly died of TB.

This study led to a policy change in the State TB control programme where co-morbid conditions are detected early. As a result, the first step was to reduce the vulnerability quotient of TB patients. Another was to improve screening for patients and finally, early detection of TB in patients visiting non-communicable disease clinics.

Eighty-six per cent of vulnerability mapping has already been done at the panchayat level, said Dr. Manu M.S., pulmonologist at the State TB Training and Demonstration Centre and State TB-NCD nodal officer.

The State’s TB elimination programme has identified the 55-65 year age group with diabetes as the most vulnerable in the population.

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Printable version | Apr 3, 2020 2:15:40 PM | https://www.thehindu.com/news/cities/Kochi/more-tb-patients-dying-of-co-morbid-conditions/article30898677.ece

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