Keeping up with the ambitious target set by the Centre of eliminating Tuberculosis by 2025, Maharashtra has stepped up efforts to detect more patients with TB. Last year, more than 12,74 lakh persons infected with Covid and influenza-like illness were screened for TB and at least 8,668 were detected with the twin infection of coronavirus disease and tuberculosis. Dr R S Adkekar, Maharashtra TB officer told The Indian Express that TB case notifications have gone up. “Last year, more than two lakh TB cases were detected across Maharashtra and till June this year one lakh cases have been notified,” he said. Data in 2020 showed that of the 1.3 lakh persons (who had Covid) screened for TB, at least 2,163 were detected with the disease. Overall, there have been 14,438 TB deaths in the last two years. About 7,453 persons with TB died in 2021 as against 6,985 who succumbed in 2020. Challenges with providing and accessing essential TB services had meant that many people with the disease were not diagnosed in 2020. While TB services, among others, had been disrupted by the Covid-19 pandemic in 2020, the impact on TB had been severe according to the World Health Organisation (WHO) who had projected that the number of people developing TB and dying from the disease could be much higher in 2021 and 2022. Even as there are not many studies on the effect of Covid on TB patients, health officials attached with the National TB Elimination Programme said that several national programmes were impacted during the pandemic. Dr Sanjay Gaikwad , chairperson of Zonal Task Force for TB Elimination, Western India told The Indian Express that the entire machinery was involved in Covid management during the pandemic. “There was a lockdown and the TB case notification also had gone down. However, efforts are being taken to bounce back and detect more cases and strictly monitor the patients. Most cases were undiagnosed and post Covid there has been suppression of immunity,” Dr Gaikwad said. With the country focussed on eliminating TB by 2025 — five years ahead of the global target, Pune and Pimpri Chinchwad health authorities are now working hard to address the problem. Maharashtra has set different targets for detecting new TB cases according to endemicity of the disease, population and other factors for each district. In Pune, the target was to identify more than 8,000 new TB cases annually and across the city, TB control officers were able to detect close to 7,000 cases in 2021. From January to December 2021, the city TB control unit detected 6,937 new TB cases as against 5,618 in 2020. This year, from January till June, about 3,294 new cases of TB have been detected. In Pimpri-Chinchwad, there were 2,060 new TB cases in 2020 while in 2021, about 2560 TB cases were notified. Till June this year, a total of 1,458 new TB cases have been detected. More than 1,100 persons who had tuberculosis (TB) succumbed to the disease in the last two years in Pune city and Pimpri Chinchwad. A total of 824 persons died in Pune city and 309 in Pimpri Chinchwad in 2020-2021. In Pune city, there were 439 deaths due to TB in 2020 and 385 in 2021. This year there have been 48 deaths in the city from January till June while 39 have died in Pimpri Chinchwad during the same period due to TB. In 2020, there were 147 TB deaths in Pimpri-Chinchwad while another 162 in 2021. This year, a total of 87 persons who suffered from TB have died in Pune city and Pimpri-Chinchwad. Dr Balasaheb Hodgar, Pimpri-Chinchwad TB Control officer told The Indian Express that the number of deaths due to TB were also related to delayed diagnosis due to migration of persons from other states to the city areas. Addiction, irregular treatment and comorbid conditions of the patients are also among the factors that are associated with the number of deaths due to TB, Dr Hodgar said. Dr Prashant Bothe, Pune city TB control officer told this newspaper that Accredited Social Health Activists were trained to collect sputum of suspected TB patients from slums and other areas in the city. “There are 170 ASHAs involved in the TB control programme and an amount of Rs 30 is given for collection of samples to transport it to the diagnostic microscopy centres. Each ASHA has the charge of at least seven to eight slums and with this network we are able to identify more cases. The introduction of six TruNat testing machines and two Cartridge-based nucleic acid amplification test (CBNAAT) has helped in the rapid diagnosis of TB,” Dr Bothe said. Apart from this, there are 650 facilities in the private sector that are now notifying TB cases to the PMC health department.
