TB elimination by 2025: Pune study highlights challenges faced by patients in diagnosis and care of tuberculosis

Conducted in collaboration with Dr D Y Patil Medical College Hospital and Research Centre, Pune, and Harvard Medical School, USA, the study, published recently in PloS One, provides practical suggestions to improve TB and MDR-TB care.

“Educating private providers about MDR-TB risk and available rapid molecular assays can help the timely diagnosis of MDR-TB and reduce patients’ out-of-pocket costs,” Dr Sachin Atre, adjunct faculty and research consultant at the department of community medicine at Dr D Y Patil Medical College, Hospital and Research Centre, and the lead author of the study, told The Indian Express.

Dr Atre said dismissal of symptoms, non-courteous behaviour, lack of hygiene in the referral centres, forced stay with other patients, and lack of support for psychological/psychiatric problems were identified as a few additional challenges that patients faced at the NTEP care centres.

At the RNTCP/NTEP, measures such as training health workers to build rapport with patients, maintaining hygienic environments in the health centres with adequate isolation of participants with MDR from other serious cases, referral of patients with psychiatric symptoms to mental health specialists and monitoring drug shortages can help in improving care delivery, the study suggests.

While efforts are being made to improve the infrastructure of the health centres as India has set a goal of TB elimination by 2025, study authors say patients expressed several unmet needs.

“Addressing those would help the NTEP managers to better cater to them. The needs/challenges are almost similar throughout the country. New technologies such as Whole Genome Sequencing for rapid and accurate diagnosis of drug-resistant TB are now available at affordable costs. Scaling up such technologies and making them practically available for all patients to guide the appropriate treatment would be a major step toward preventing TB and drug-resistant TB transmission in the community and protecting public health,” Dr Atre added.