Maharashtra is working on modalities of undertaking a screening drive to check for hypertension, diabetes, tuberculosis and Covid-like symptoms to pick high-risk populations and provide them early intervention. The drive is likely to commence from the rural pockets of the state.
Earlier this week, the central government issued guidelines to conduct bi-directional screening for tuberculosis and Covid-19 to ensure none of the two respiratory illnesses are missed.
“In two-three days we will plan the entire screening process and start it across the state. We plan to screen high-risk populations for hypertension, diabetes and severe acute respiratory illness. We are in early stages of planning,” said Health Secretary Dr Pradeep Vyas. He said for massive screening of Covid-19 patients for TB and vice-versa, state has to strategise on testing machinery. “CBNAAT (cartridge-based nucleic acid amplification test) can be used for TB and Covid-19, but we have to get as many cartridges and look at cost. RT-PCR and antigen test cost are expected to go further down,” Vyas said.
As per the Ministry of Health and Family Welfare, TB is associated with 2.1-fold risk of Covid-19 infection, and prevalence of TB among Covid-19 patients has been found to be 0.37 – 4.47 per cent in different studies. The ministry has advised states to test all newly diagnosed and existing TB patients for Covid-19 since cough remains a common symptom for both, and to screen Covid-19 patients with cough beyond two weeks for TB. The guidelines also suggest TB screening for all severe acute respiratory illness and influenza like illness. The guidelines suggest use of CBNAAT or TrueNat for testing TB.
While TB notification has witnessed an overall decline by 26 per cent during January to June this year compared to last year in India, in Maharashtra the decline is almost double at 44 per cent.
In Mumbai, a 36 per cent drop in notification is recorded in the same period— from 36,056 cases to 22,805 cases in January to July. Dr Daksha Shah, deputy executive health officer, said, “It is a good move to test for both infections. Although mortality in Covid-19 patients with TB is not high, anyone with cough for more than 15 days should be tested for both infections to improve notification. At the time of taking a swab for Covid-19, it is possible to also collect the sputum.”
A senior state health official, however, said they need to arrange for logistics to start mass screening of existing TB patients. “The TB pool is in lakhs. Door-to-door visits will be required to test them for Covid-19,” the official said.