Updated: May 29, 2021 11:13:53 am
The recent surge of Covid-19 cases during the second wave has impacted the TB control programme, with Maharashtra registering a 41 per cent reduction in the number of new TB case notifications to the government between January and April this year. While 16,969 new TB cases were notified in January this year, the numbers dipped to 10,036 in April 2021.
Covid-19 has posed an unprecedented challenge for the health system in general, and the TB programme in particular, said Dr Archana Patil, director of Family Welfare, Directorate of Health Services, Maharashtra. Dr Patil made the comments at a virtual media briefing organised by the state TB Office on Thursday, where she pointed out that on an average, 19,000 new cases were notified monthly during pre-Covid times.
In 2019, a total of 2,27,004 TB cases were notified, of which 83,050 were from the private sector. This dipped to 1,60,072 TB notifications in 2020, when only 64,310 TB patients were notified from the private sector to the government.
From January till April this year, a total of 55,925 TB cases were notified, of which 23,991 were from the private sector. Dr R S Adkekar, state TB officer, told The Indian Express. He, however, pointed out that despite the challenges, the government had taken several measures to ensure availability of TB care.
“Our active case finding of TB patients in December 2020 saw over 8 crore people being screened, 3.33 lakh presumptive TB cases being identified, and over 12,823 patients being diagnosed for TB till January 2021. Community engagement efforts saw the establishment of District TB Forums in all districts to relay community and patient perspectives to the TB programme,” he said.
To ensure every TB patient is detected and notified to the programme, the state took up bi-directional screening and testing of Covid-19, TB and influenza-like illness (ILI), and severe acute respiratory infections (SARI) cases. Between October 2020 and April 2021, over 4,67,032 patients were screened for TB, of which 5,264 patients were found to have the disease, and 96 per cent of them were put on treatment. From October 2020 till April 2021, a total of 58,554 TB patients were screened for Covid-19 and 571 were diagnosed with coronavirus infection.
The use of TB diagnostic machines, CBNAATs (GeneXpert and Truenat) for Covid-19 testing also had a major impact on the delivery of TB services, said state government officials. Several hospitals were converted to Covid-19 facilities and due to the lockdown, fear of contracting Covid-19 prevented new patients from accessing care.
TB officials, however, soon came up with interventions such as doorstep delivery of drugs for existing patients and partnerships with private laboratories to support TB diagnosis. “We are also planning six new laboratories this year and an intensive respiratory care unit at Aundh hospital in Pune,” said an official.
Rs 65.2 crore spent for nutrition support of TB patients in state
The target for eliminating TB by 2025 entails 80 per cent reduction in TB incidence (reduction from 217 cases per one lakh in 2015 to 44 cases per one lakh in 2025) and 90 per cent reduction in TB mortality (reduction from 32 deaths per lakh to 3 deaths per lakh).
Meanwhile, state government data shows that at least 52 per cent of multi-drug resistant TB cases in the state are from Mumbai and 22 per cent are from Thane.
However, Maharashtra’s TB programme has been a frontrunner in implementing innovative strategies to control and end TB. “With the implementation of important initiatives, we are confident that we will soon bring the programme back to pre-Covid levels and ensure we achieve our goal of a TB-free Maharashtra by 2025,” said state TB officer Dr R S Adkekar.
From 2017 till April 2021, the state has distributed Rs 65.20 crore to TB patients under the Nikshay Poshan Yojana. Under the scheme, all TB patients are given a monthly nutrition benefit of Rs 500 per month for the entire duration of treatment.
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