A middle-aged patient with a history of cough with blood-tinged sputum for three weeks duration consults a doctor. The physician puts forth a routine query whether anyone in his family suffers/suffered from tuberculosis? Annoyed, the patient responds: no one in our kindred has ever heard of the disease. The question irked him more than the ailment.
Unfortunately, this happens to be the attitude of a majority of our population. The stigma associated with tuberculosis is more horrid than its pathology. It’s felt as an affront to one’s reputation and underestimation of one’s social status.
Those who believe that tuberculosis is a disease exclusively of the underprivileged read further. Lady Roosevelt, Mohammed Ali Jinnah, Ramanujan, Kamala Nehru, Laennec (inventor of the stethoscope), John Keats, Shelley and a long list of other famous personalities were all victims of this lethal disease.
It is caused by a bacteria known as Mycobacterium tuberculosis, which spreads by droplets sprayed by coughing from infected persons. It can infect anybody and remains dormant for years in the human body, only to rear its ugly head when the individual’s immunity wanes. Besides producing cough and sputum (often blood-tinged), tuberculosis throws up a volley of symptoms including fever at dusk, chest pain, night sweats, loss of appetite and drastic weight loss, which if left untreated, will reduce the patient to a bag of bones before settling him in his grave.
Tuberculosis may affect any organ, but it fraternises the lungs commonly, where the bacteria multiplies, destroys and devastates the lung tissues which are thrown open into the environment along with sputum burgeoning with the bacterial population. Examining the sputum under a microscope will reveal the bacteria and confirm the diagnosis.
Anyone who confronts the aerosolised stuff are likely to acquire the infection. Hence, it becomes mandatory to strictly instruct all patients with tuberculosis to close their mouths with handkerchiefs while coughing and sneezing.
Individuals with diabetes and HIV, alcoholics, smokers, those under physical and mental stress, those who are malnourished and individuals taking long term steroid medications are all prone to tuberculosis.
Unfortunately, India shares one-fifth of the global burden of tuberculosis. Every day more than 5,000 people develop tuberculosis; nearly three lakh children drop out of school owing to the disease and more than one lakh women are rejected by families in the country.
Above all, over 3.5 lakh people die annually i.e., 1,000 people every day, and one death every 1.5 minutes due to tuberculosis.
Recall the 2004 tsunami that struck the west coast of India, taking a toll of nearly 18,000 people. This is roughly 1/20th of what we lose to tuberculosis ever year. The government of India has evolved an excellent programme, Revised National Tuberculosis Control Programme (RNTCP) in vogue since 1997. Under RNTCP, everything from diagnosis to treatment is rendered free of cost to every patient. The patient is the hero of the programme and the responsibility of cure lies with the health care providers.
The treatment is directly observed; drugs have to be taken just three days a week for six months.
The present day treatment strategy adopted internationally is the result of a number of scientific and public health discoveries at the Tuberculosis Research centre, Chennai (TRC), and the National Tuberculosis Institute, Bangalore (NTI).
Let’s join hands and vow not to fall back in battling the scourge. The slogan for world TB day 2013 is “Stop TB in My Lifetime”.
( The writer is Deputy Director of Medical Services (Tuberculosis), Kanyakumari District. Email: firstname.lastname@example.org )