After claiming to have brought the spread of Covid-19 under control, the state government has now turned its focus to reporting tuberculosis cases, which has seen a reduction by nearly 50 per cent on a pro rata basis, especially in the Surat Municipal Corporation (SMC) and Ahmedabad Municipal Corporation (AMC) limits.
In these two municipal corporations were burdened with a spurt of Covid-19 cases for months and continue to report around 100-150 fresh cases every day. In SMC limits, 4,362 TB patients were notified from private facilities till November 5 this year compared to 7,188 patients in 2019.
After seeing this decline, medical officer of health, in a communication dated October 27, wrote to doctors affiliated to the Indian Medical Association (IMA) in SMC, reminding that they have to notify “all TB cases being diagnosed or treated by your organisation/institute… It is seen that TB notification has reduced so much in current year (sic)…”
IMA Gujarat chapter president, Dr Chandresh Jardosh, who is based in Surat, says SMC has been conducting bidirectional checks that includes active and passive surveillance, for the past two months where active as well as passive surveillance for TB detection is being undertaken. He added that it is a “routine” communication from SMC.
“We are lagging behind by 6,000 cases… these will erupt sooner or later. With people staying at home, an undetected TB patient will risk their families with greater exposure. In the next three to four months, we might see a surge in TB cases,” said Dr Jardosh.
TB case reporting from government facilities in SMC has also seen a 50 per cent decline, from 7,464 cases notified in 2019 to 3,753 cases till November 5 this year. SMC City TB officer Dr Kanu Sheladia believes that the decline in cases in Surat can be attributed primarily to routine health activities, including TB screening, coming to a halt due to Covid activities.
“There is a fear of not visiting hospitals, especially government hospitals, due to Covid-19. Also, nearly 18 lakh migrant workers left Surat during the lockdown, perhaps adding to the missed cases. The TB bacillus infects upto 50 percent of the people but only 10 per cent develop TB, that too after several years… hence uninterrupted screening is important,” said Dr Sheladia. Dr Sheladia also added that OPD visits have gone down considerably both in public and private facilities.
A similar situation prevails in AMC jurisdiction, and city TB officer Dr AS Pillai said that while new case notifications are catching up, “overall total notified TB cases reported from public and private facilities has been only 56 percent of that compared to last year”.
In AMC, reporting in government facilities in 2019 was double the total notified TB cases from government facilities this year, which is 6,611.
While the district health departments have hailed Dhanvantari Raths or mobile OPDs, it seems to have done little to serve OPD purposes apart from Covid-19 detection in AMC. According to Dr Pillai, this is because “people are only getting tested for Covid-19 symptoms”.
In SMC, according to Dr Sheladia, messages are being circulated to create awareness between the differences in symptoms of Covid-19 and TB.
“There is a government directive that symptomatic antigen test negatives have to be tested by CB-NAAT along with chest X-ray. Apart from the common symptoms of cough and fever for both the diseases, TB will show weight loss/loss of appetite,” said Dr Sheladia.
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