DOTS centre razed,TB spreads its tentacles in Majnu Ka Tila

However,despite its ‘high-risk’ area status,due to high rates of injecting drug users,TB and HIV patients,the only Direct Observed Treatment-Shot Course (DOTS) centre at Balak Ram Hospital in Majnu Ka Tila was demolished this January. Amid the rubble of the old laboratory,diagnostic centre and polyclinic,now stands a small room where patients,who manage to turn up,are handed the day’s dose of drugs.

For TB health visitors like Rajiv,work has tripled since the DOTS centre was demolished. “There are no follow ups and when patients do not turn up,chances of developing drug resistance increases. This is a congested colony and increasing infection rates among children is a ripple effect of the closure of the centre. In a few more months,rates of multi-drug-resistant (MDR) TB will also increase if nothing is done,” said Rajiv. MDR-TB develops when the DOTS course is interrupted and the levels of drug in the body are insufficient to kill the bacteria. What makes it even more dangerous is that the patient becomes resistant to the first line of treatment,increasing mortality to nearly 80 per cent.

Worried by the increasing prevalence of TB in her area,Vimal Talk has volunteered to become a health worker. “It costs Rs 40 to just go to the DOTS centre and as a result many patients choose not to. I enrolled for training to become a TB health visitor so that I can distribute the drugs myself. Patients will not skip the medicine if it is distributed within the colony,” she says.

“We need more volunteers and the population needs to be motivated. In a few months,the effects of closing down the DOTS centre will start showing with more patients registering for MDR-TB,” says Swapna Naveen,project manager for TB Alert India,an organisation of health workers. Her organisation has decided to push the State Tuberculosis Association for opening a laboratory in the area. “We need extensive coverage in this area if we are to stop the spread of infection,” she added.

THE TB THREAT
Tuberculosis is caused by Mycobacterium tuberculosis and usually attacks the lungs. It is spread through the air,when people who have the disease cough,sneeze,or spit.

When a patient becomes resistant to the first line of drugs used to treat TB,he is said to have developed multi-drug-resistant tuberculosis (MDR-TB). The patient is usually resistant to isoniazid and rifampicin,the powerful first line anti-TB drugs. MDR-TB is spread from person to person as readily as drug-sensitive TB and in the same manner.