Updated: January 20, 2022 9:21:45 am
Bouncing back from the disruption the first year of the Covid-19 pandemic caused to Tuberculosis detection in the city, the Brihanmumbai Municipal Corporation (BMC) succeeded in detecting 58,642 cases of the infectious disease in 2021, matching its pre-pandemic target and recording a 34 per cent increase over 2020.
Detection of TB cases had fallen by nearly 28 per cent in 2020 with only 43,464 people identified with the illness as compared to 2019 when a total of 60,597 TB patients were detected in Mumbai.
The number of TB-related deaths also marked a decline in 2021 with 2,380 fatalities and a fatality rate of 4 per cent. In 2020, despite fewer TB cases detected, the fatality rate had shot up to 6.3 per cent with 2,752 deaths as compared to 2019 when 3,059 deaths were recorded with a fatality rate of 5 per cent.
As many as 58,642 patients were diagnosed with TB in 2021, higher than the 57,031 detections made in 2018.
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“When the second wave started, the footfall of patients dropped to 4,000 in March 2021. Since last May, we started getting more patients which gradually increased to 8,000 and by last December, we recorded over 12,000 patients,” said Dr Pranita Tipre, in-charge of TB at the BMC.
During the pandemic, several TB patients, who were mostly migrants, headed to their respective homes. To ensure that they don’t drop out from the treatment regimen, the BMC traced over 1,000 migrants, contacted their local TB health department in other states, and facilitated their medication.
Doctors believe that due to the lockdown, relatives of TB patients were forced to stay in over-crowded rooms with them, leading to the spread of the infection. “TB is an airborne disease which spreads in clusters among the families in lockdown,” said Dr Harish Chafle, Senior Consultant, Pulmonology and Critical Care at Global Hospital, Parel, Mumbai. “Also, patients could not get proper follow-up needed for better outcomes,” he said.
To contain the number of defaulters, BMC supplied the drugs door-to-door to the patients which resulted in better adherence to the treatment. “There were around 400 patients who were availing treatment in private but due to job loss and other financial issues, they couldn’t afford to continue with the same.
So, we migrated them to the public system and provided drugs free-of-cost,” added Dr Tipre.
Social activists working for TB patients, though, claim that the data only showed the tip of the iceberg as amid the pandemic, TB diagnostic centres were closed and laboratories were prioritising samples of suspected Covid-19 patients.
“TB patients with compromised lungs are most vulnerable to contracting Covid-19. But there was a drastic drop in TB testing… Considering both the diseases have similar symptoms, many undetected TB patients with Covid-19 co-infection might have gone off the records,” said Ganesh Acharya, a TB activist.
In Mumbai, every year over 5,000 patients are diagnosed with Multi-drug resistant TB. These are patients who have developed resistance to certain drugs given in the TB treatment regime. With better detection of cases, the number of multi-drug resistant TB (MDR-TB) cases also increased by 24 per cent last year, BMC said. According to data, in 2020, the diagnosis of MDR-TB dropped by 23 per cent to 4,367 from 5,673 cases recorded in 2019. But in 2021, the diagnosis of such cases increased to 5,412 in Mumbai.
“A major cause of MDR-TB is default from the first line of treatment by the patients. Default rate was high due to inability to have proper follow-up. Besides, availability of drugs was limited to the patients undergoing treatment for TB,” said Dr Chafle.
“There hasn’t been any flare up of MDR-TB cases. The cases detected in 2021 after robust testing are fewer than pre-pandemic period,” said Dr Tipre.
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