On the lines of its anti-polio drive, the health ministry has launched a 15-day door-to-door campaign across the country for early detection, diagnosis and treatment of tuberculosis to eliminate the disease. Under the campaign, health department workers, Accredited Social Health Activists (ASHAs) and TB supervisors will make door-to-door visits to find TB patients and give them free medical treatment till they are cured, said Dr Sunil Khaparde, Deputy Director General (TB), Health Ministry.
According to the World Health Organisation, an estimated 2.8 million cases of TB occur in India every year, out of which 1.7 million cases are reported. “Around one million cases of tuberculosis get missed every year. The aim is to detect these missed out cases by going to every household.
“These are the most vulnerable population including those living in slums, mine workers, unorganised labourers, prisoners and migrants among others,” Khaparde said.
Under the third phase of the Revised National TB Control Programme, the centre in collaboration with the states have identified 186 high-risk districts. The phase is called Active Case Finding (ACF).
The programme was launched in January last year and the second phase of the exercise was carried out in July. “In both the campaigns together, 15,000 cases of TB were detected and the patients were put on treatment.
“The health ministry aims to reduce incidences of TB by 90 per cent by 2025 and reduce mortality due to the disease by 95 per cent by 2030 under the Revised National TB Control Programme,” Khaparde said.
Talking about the challenges faced in TB elimination, Kharpade said that more than 60 per cent of the patients go to private hospitals during the first contact. “There is no adherence system. Also the treatment protocol as prescribed under the standards for TB cases is not followed as a result of which the treatment is not completed and in majority of the cases there is a relapse.
“So we are sensitising the private hospitals so that they notify us the cases,” he said. In a bid to achieve the goal of eliminating tuberculosis (TB) by 2025, the ministry recently rolled out the daily drug regimen to combat the disease across the country.
Under the new treatment policy, patients are being given fixed drug combinations (FDCs), three or four drugs in a single pill, on a daily basis instead of thrice a week (the intermittent drug regimen). “Patients are being given fixed drug combinations (FDCs), three or four drugs in a single pill, as against seven tablets, which will reduce the pill burden.
“Besides, dosage will be determined according to the patient’s body weight. Previously, it was same for all adults,” Khaparde said.
“Also, children suffering from tuberculosis won’t have to take the bitter tablets anymore as they will be replaced with easily-dissolvable and flavoured drugs,” he said. Since 1997, under the RNTCP, patients were being administered drugs thrice a week (the intermittent drug regimen).
According to a senior health ministry official, daily treatment regimen is likely to be more effective with lesser relapses and it is expected to reduce drug-resistance with greater compliance.
The World Health Organisation revised its TB management guidelines in 2010, recommending that the daily drug regimen be adopted under the RNTCP.
According to the health ministry data, the TB incidence was estimated to be 217 per lakh population in 2015 which reduced to 211 per lakh population in 2016.
Despite the reduction, India topped the list of seven countries, accounting for 64 per cent of the 10.4 million new tuberculosis (TB) cases worldwide in 2016, according to a new global report which was released by the WHO yesterday. Also, India along with China and Russia accounted for almost of half of the 490,000, multi drug-resistant TB (MDR-TB) cases registered in 2016.
According to the report, under-reporting and under-diagnosis of the TB cases continues to be a challenge, especially in countries with large unregulated private sectors and weak health systems.
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