Clinical establishments in the city have to actively notify cases of tuberculosis (TB) to the Pune and Pimpri Chinchwad municipal corporations, but so far, their efforts to do so have been dismal. As many as 1,306 hospitals, clinics and laboratories are registered to notify TB cases with the Pune Municipal Corporation (PMC), but from January till March this year, only eight hospitals have reported new patients. TB is a notifiable disease and the Centre had sent instructions to the state governments to keep records in 2012 about the disease.
Earlier, doctors in the private sector were free to treat TB patients but were not required to keep a record. On March 16 this year, the Centre directed doctors and chemists to compulsorily notify cases of TB, failing which punitive action can be taken against them. They can face a jail term of six months to two years under the provisions of sections 269 (negligent act likely to spread infection of disease dangerous to life) and 270 (malignant act likely to spread infection of disease dangerous to life) of the Indian Penal Code.
According to data from the PMC’s city TB control unit, a total of 409 TB cases were reported between January and March. While 1,823 pharmacies are registered with the PMC to notify TB cases, civic authorities said several chemists ended up reporting the same patients twice or even thrice. “It is only after our TB health visitor … meets each registered clinic or hospital to collect data that we get information about new TB cases,” said Dr Manisha Naik, in-charge of the PMC city TB Control Unit.
Only a few private practitioners actively report TB cases, said civic officials.
In 2017, 3,319 new TB cases were detected in areas under the Pune Municipal Corporation (PMC). In areas under the Pimpri Chinchwad Municipal Corporation (PCMC), between 2012 and 2017, a total of 2,700 TB cases were notified from the private sector. Last year, in the PCMC areas, the TB control unit detected 1,720 new cases of the disease. “We will now write to state and district level units of the Indian Medical Association, to encourage and motivate their doctors to notify cases,” Dr Sanjeev Kamble, joint director of health, Maharashtra, told The Indian Express.
In 2017, 29,000 doctors had reported nearly 60,000 TB cases across the state, said Dr Kamble.
Many experts believe private doctors use irrational medicine combinations to treat TB, making it drug-resistant, and the patients finally have to resort to government treatment programmes. According to the PMC city TB control unit, from 2012 till date, as many as 490 patients with multi-drug resistant TB were registered. “Of these, 115 patients were treated and cured, while 125 died, and the rest are under treatment,” said Naik.
On the occasion of World TB Day on March 24, both PMC and PCMC are planning to hold a series of awareness programmes.