Tamil Nadu

Tamil Nadu plans to test for TB along the same lines as COVID-19

Tuberculosis (TB) case findings that were hit in the midst of the COVID-19 pandemic have improved with targeted interventions in the State. Now, to reduce the TB burden to 44 per one lakh population by 2025, Tamil Nadu is aiming at testing more for TB along the same lines of COVID-19 to detect more cases.

Among the key objectives of the National TB Elimination Programme (NTEP) is to reduce the estimated TB incidence rate to 44 per one lakh population and reduce estimated mortality due to TB to 3 per one lakh population by 2025.

“We are trying to reduce the burden of TB. So, like for COVID-19, we need to test more to detect more cases. Nearly 30% case finding was hit in 2020 due to the pandemic-induced lockdowns. Now, we have bounced back to 2019 levels. TB detection rate has improved. Private sector notification of cases took a hit during COVID-19 and has started to pick up now,” Asha Frederick, Additional Director of Medical and Rural Health Services and State TB Officer, said.

According to data available with the State TB Cell, the presumptive TB examination rate (annualised) was 792/lakh in 2020 and 1,121/lakh in 2021 against the target of 1,500/lakh. The total notification against the target of 1,45,000 was 49% in 2020 and 57% in 2021. Public sector notification against the target (90,000) went from 60% in 2020 to 72% the following year, while private sector notification against the target (55,000) was 30% in 2020 and 34% in 2021.

Treatment adherence patterns have improved a lot, she added. “Presently, the cure rate is 84%. The death rate was 5% till 2020. Post-COVID, it is 6%,” Dr. Frederick said.

To improve TB case finding, another 28 new mobile diagnostic units for active and targeted case finding in all districts are being added. “Already, 14 units are plying in the State. The Greater Chennai Corporation alone has seven units. The 42 units will take up screenings in every district. We will not be able to get sputum from everyone. So, X-rays will be taken,”she said.

Improving TB notification is among the focus areas. “Every doctor knows that TB notification is mandatory under the Clinical Establishments Act. Still, there is a gap. To bridge this gap, we are piloting FAST — Find Access Support Treat — centres in Coimbatore,” Dr. Frederick said.

She added: “To step up TB elimination in the private sector, a coalition of professional medical associations, consortium of private hospitals was formed in Coimbatore. The FAST centres are established in the private sector to provide standards of TB care for patients seeking care in the private sector.”

Challenges faced

TB was a challenge in urban and densely populated areas such as Chennai, she said, adding: “In urban conglomerates, we have a more vulnerable population and more migrants. Social determinants are still a challenge. In the rural community, stigma is one of the major challenges, and we are trying to create awareness.”

As a way ahead, there are plans to use Makkalai Thedi Maruthuvam to take up symptomatic screening of the population through the mid-level health providers (MLHP).

“At the sub-district level, each MLHP covers a population of 5,000. We are engaging them to actively initiate symptomatic screening of the population, such as for low grade fever and cough. We will take up vulnerability mapping to know the vulnerable population, have a constant vigil and keep track of them,” she said.

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Printable version | Aug 8, 2022 7:52:28 pm | https://www.thehindu.com/news/national/tamil-nadu/tamil-nadu-plans-to-test-for-tb-along-the-same-lines-as-covid-19/article65306381.ece