Kerala to achieve TB elimination by 2020

State has been reporting lowest number of TB cases in India

Kerala is poised to be the first State in the nation to achieve tuberculosis (TB) elimination targets by 2020, way ahead of the national targets set for 2025 and the UN Sustainable Development Goals (SDG) target of 2030, through its TB Elimination Mission launched in January this year.

The World Health Organisation defines TB elimination as <1 case of TB per 10 lakh population annually.

Kerala has been reporting the lowest number of TB cases in India. TB notification started falling by 4% annually in the State since 2009. In 2016, as many as 20,951 cases were registered under Revised National TB Control Programme (RNTCP) for treatment, which further went down to 20,409 in 2017, indicating the low TB transmission rate here.

The State has now set the ambitious target of reducing the number of tuberculosis cases to less than 2020 and zero deaths owing to TB by the year 2020. With the national campaign for active case finding of tuberculosis being launched across Kerala last year, the State has been surging ahead of these set milestones.

“The strategies and elimination model that Kerala has adopted, like the intensive surveillance and TB vulnerability mapping initiatives led by task forces in local self-government institutions, are something which have never been tried elsewhere in the world,” says Shibu Balakrishnan, WHO-RNTCP consultant for the State.

As part of the TB Elimination Mission, trained health workers have been going on a house-to-house survey across the State. The survey has already covered 40% of the State’s population.

“In the past three months, 12,000 vulnerable individuals were tested and 150 new smear positive cases of TB, (infectious cases) which would otherwise have been missed or detected much later, have been found and put on treatment.,” Dr. Balakrishnan said.

The other components in TB care — free drugs and speedy, modern diagnostics such as CBNAAT (Cartridge Based Nucleic Acid Amplification Test), follow-up on patients to monitor treatment adherence, patient support mechanisms, addressing co-morbidities like diabetes, nutritional support through LSGs, and pension for TB patients — have all been put in place so that TB deaths and catastrophic expenses on families have been much less. Better engagement with the private sector with the help of the Indian Medical Association has improved TB notification from the private sector.