Mumbai reported a 20% rise in the number of Extensively Drug-Resistant tuberculosis (XDR TB) cases last year. From 555 cases of the deadly TB strain in 2016, the number jumped to 670 in 2017. Multi-Drug-Resistant (MDR) TB cases went up by 11%, while primary TB cases jumped by 8% in the same period.
Civic officials, who released this data ahead of World TB Day to be observed on Saturday, attributed the rise to improved diagnostic facilities and notification from the private sector. But most doctors working at the ground level say that overcrowding of the city, shortage of housing, poverty, malnutrition and migration together help the TB bacteria flourish.
As many as 4,891 MDR TB cases were reported in 2017 as compared to 4,374 in 2016. The number of primary TB cases went up to 45,675 from 42,115 in 2016.
Mumbai’s TB officer Dr. Daksha Shah said, “Nearly 70% doctors from the private sector are now notifying cases. We have also upgraded our diagnostic facilities, due to which detection has gone up substantially. That explains the rise.” Dr. Shah said the Brihanmumbai Municipal Corporation (BMC) is doing its best as far as detection and treatment is concerned. “But aspects like living conditions and migration have to be tackled too.”
She said the rise in drug-resistant cases was because many patients taking treatment in the private sector were shifting to the public sector for free treatment. “Therefore, new drug-resistant cases get added to our list.” On an average, drug resistant TB treatment costs ₹2 lakh. If one counts the loss of wages, cost of travel and other expenses, it is more than ₹3.60 lakh.
In 2017, the BMC carried out three rounds of an active case finding survey, in which 17 lakh people were screened. During this, 6,630 TB suspects were detected and 304 patients were diagnosed. The BMC now plans to undertake another survey in May with the help of community health workers and a private pharmaceutical company.
Mumbai-based pulmonologist Dr. Salil Bendre said TB is no longer a disease of the poor. “We are getting drug-resistant patients in their twenties, many of whom are from the middle and higher classes,” he said. Dr Bendre said the overall TB diagnosis in the city has improved vastly over the years.
