World Tuberculosis Day 2023: India Carries The Highest TB Burden

TB remains a significant public health threat globally, with India carrying the highest burden.

Tuberculosis (TB) remains a significant public health threat globally, with India carrying the highest burden. Here’s how to ‘STOP’ Tuberculosis.

As I quote Pt Jawaharlal Nehru on World TB Day, “Whether we ourselves have escaped from the scourge of tuberculosis or not, there is probably hardly a family which has not had to do something with this dreaded disease” the implications of this deadly disease have been daunting our country since ages and still continuing. The existence of the disease dates back to the Vedas. It has been described as Kshayaroga in the ancient Hindu Scripture Vedas, meaning ‘to decay’. However, it wasn’t until 1882 that the causative agent for TB got discovered by Robert Koch, which further led to World TB Day is observed annually on 24th March to commemorate this discovery.

Tuberculosis, commonly known as TB, is an infectious disease that has been a significant public health issue since time immemorial. It remains a significant global health threat, with an estimated 10 million cases occurring every year. Unfortunately, India shares the highest TB burden across the globe, with 2.69 million cases and 4.5 lakh deaths every year. Shockingly, 40 percent of the Indian population is infected with this bacteria.

Types of TB

TB can manifest in two forms, pulmonary and extrapulmonary. Pulmonary TB symptoms include cough, fever, chest pain, shortness of breath, bloody expectoration, loss of weight, and appetite, but these symptoms are non-specific. Diagnosis is confirmed by sputum examination. TB can also masquerade as other diseases, making it challenging to diagnose.

TB is highly contagious, with people with active pulmonary TB potentially infecting 5-15 persons per year through close contact. Hence, treatment is the only way to cut this chain. The government has committed to planning and providing high-quality evidence-based regimes under the banner of the Revised National Tuberculosis Program.

How to ‘STOP’ Tuberculosis?

Combating TB is an arduous and perplexing task due to multiple deep-rooted issues. Understanding and solving these issues requires effort from all stakeholders. Doing so requires the following, let us understand what the STOP technique is-

S- Stigmas: Stigmas against Tuberculosis have existed for centuries and continue in the 21st century. Women fear verbal abuse, a failed marriage, and social isolation, while men fear disclosing the disease to friends, loss of jobs, or discrimination at the workplace. A study showed that more than 2 lakh people lost to follow-up in the national TB program after diagnosis.

T- Treatment: Patients feel better during treatment and may skip or ignore the number of pills or even stop treatment, leading to treatment failure and progression to drug resistance.

O- Outreach: At the community level, there is a connectivity deficit between the needy and the programs curated for them, hindering contact with services.

P- Prevention: Poor application of preventive measures like cough etiquette, nutrition, health education, ventilation, and counselling fuels the spread of TB.

Counselling about the disease, drugs, and treatment duration is essential to tackle the increasing prevalence of tuberculosis. Community participation in framing slogans and messages for TB and sensitisation for the program can also help. Interventions involving psychological and nutritional aspects for families and patients are necessary. Addressing stigmas by leaders, influential members, or celebrities in the community can help alleviate stigmas.

Key Takeaway

Although TB remains a significant public health threat globally, with India carrying the highest burden, following effective preventive measures can help curb the spread of the disease. It is important to note that to ‘STOP’ the spread of TB will require the concerted efforts of all stakeholders, from the government to individuals in communities. By addressing stigmas, ensuring treatment adherence, promoting outreach, and focusing on prevention, we can combat TB and work towards a healthier world.

The author of this article is Dr. Ambarish Joshi, Sr. Consultant – Pulmonary & Sleep Medicine, Primus Superspeciality Hospital, New Delhi.

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