Drug resistant TB still poses a threat in India

Tuberculosis is one of the ten major causes of mortality worldwide.

Pvt doctors callous in notifying disease, Service providers to face jail in case they hide TB cases


By Manzoor-ul-Hassan

New Delhi: The burden of Multidrug Resistant Tuberculosis (MDR-TB) is still a major challenge in India because a large number of patients go unreported due to callous approach of private practitioners in reporting the disease.

Tuberculosis was declared notifiable diseases in May 2012 and it became mandatory for private practitioners in the country to notify the local health authorities about cases of tuberculosis.

However, seven years down the line most of the private doctors and clinics don’t adhere to the compulsory guidelines.

Despite this order, notification of tuberculosis cases from the private sector has remained low and the majority of notified cases are from the public sector.

A report published by Central TB Division of Ministry of Health and Family Welfare said that TB notification by private practitioners is just 29 per cent in India while the rest of the reported cases are the patients who are getting treated under the Government of India (GoI) sponsored Revised National TB Control Programme (RNTCP) at different health institutions and DOT centers.

“Only 3.8 lakh TB patients have been notified by private practitioners in 2017 in India which are just 29 percent of the total patients treated by them,” the report says.

It says the total reported cases including those notified by public-sector health institutions have gone up to 18.3 lakh in 2017.

The unreported cases throw a challenge of rising cases of drug-resistant TB.

As per official figures, Tuberculosis kills 4,80,000 Indians every year while there are more than a million cases which still go unreported per year.

“Most of these cases are either undiagnosed or inadequately diagnosed or treated in the private sector,” as per the report.

It says that some of the states have negligible reporting by private practitioners.

While most of the Union Territories have zero reporting percentage, some major states like Odisha, Himachal Pradesh, J&k, Arunachal Pradesh, Assam, Chandigarh, Sikkim, Mizoram and Haryana are also at the bottom vis-a-vis reporting percentage by private practitioners.

Dr Ashwini Khanna, a leading Pulmonologist in Delhi said that Drug resistant TB continues to pose a challenge to the government.

However, he said, some initiatives taken by the health ministry’s Central TB Division had improved the situation to a large extent.

“The doctors and other service providers related to TB will land in jail if they don’t notify TB,” he said.

Dr Khanna, who is also the State TB Officer in Delhi claimed the notification issued in March 2018 has improved the situation in many states including Maharashtra, UP and most of the northern states.

The government aims to eliminate tuberculosis by 2025 and it will be possible only when all infected patients are brought under the treatment protocol.

It has also introduced its own online portal for TB notification (http://nikshay.gov.in) on which notification can be done easily by generating a user ID and password with the help of any simple Android application-based phone or with a computer. However, most of the private practitioners are callous about the existing norms and the reporting platform NIKSHAY.

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