Tuberculosis

Tuberculosis (TB) is a disease caused by bacteria called Mycobacterium tuberculosis. TB is an ancient disease and has been documented to have existed in Egypt as early as 3000 BC.
TB most commonly affects the lungs (pulmonary TB), but it can also affect other organs (extra-pulmonary TB).
TB spreads through the air when a person with TB of the lungs or throat coughs, sneezes, or talks.
Common symptoms of TB are:
- Cough for three weeks or more, sometimes with blood-streaked sputum; Fever, especially at night; Weight loss and Loss of appetite.

Who is at risk?

People infected with TB bacteria have a 5–10% lifetime risk of falling ill with TB. Those with compromised immune systems, such as people living with HIV, malnutrition or diabetes, or people who use tobacco, have a higher risk of falling ill.
However, TB is curable and preventable.

Treatment for TB

Directly Observed Treatment Short-course (DOTS) is the strategy followed for treatment of TB. Tuberculosis treatment requires at least 6 months of treatment.
Currently, BCG (Bacillus Calmette-Guerin) is the only licensed vaccine available for the prevention of TB.
BCG works well in certain places but not so well in others. Generally, the farther a country is from the equator, the higher is the efficacy.
However, BCG gives excellent protection against severe forms of tuberculosis in children.

What is Multidrug-resistant TB?

Anti-TB medicines have been used for decades and strains that are resistant to one or more of the medicines have been documented in every country surveyed. Drug resistance emerges when anti-TB medicines are used inappropriately, through incorrect prescription by health care providers, poor quality drugs, and patients stopping treatment prematurely.
Multidrug-resistant tuberculosis (MDR-TB) is a form of TB caused by bacteria that do not respond to isoniazid and rifampicin, the 2 most effective first-line anti-TB drugs.
MDR-TB is treatable and curable by using second-line drugs. However, second-line treatment options are limited and require extensive chemotherapy (up to 2 years of treatment) with medicines that are expensive and toxic.

India and TB

According to the WHO’s Global TB Report, 10 million people developed TB in 2019 with 1.4 million deaths. India accounts for 27% of these cases.
BCG was first introduced in a limited scale in 1948 and became a part of the National TB Control Programme in 1962.
National Tuberculosis Elimination Programme (NTEP) aims at eliminating TB by 2025 in India. It is crafted in line with other health sector strategies and global efforts, such as the World Health Organization’s (WHO) End TB Strategy.

Nikshay Portal: Nikshay is a unified ICT system for TB patient management and care in India and allows both public and private sector health care providers to manage their patients.
Nikshay Poshan Yojana (NPY): Under the Nikshay Poshan Yojana government provide financial help to TB Patients for their treatment. The government provides Rs 500/- per month financial incentive to TB patients for their treatment and food. Nikshay Poshan Yojana Money will be transferred directly to the patient’s bank account.

Why in News?

A recent research by the All India Institute of Medical Sciences, Bhubaneswar, suggests that the country has made remarkable strides in combating tuberculosis and stands a chance of eliminating it by 2025.
There are multiple challenges along the way, topped by limited budget allocation. Shortage of funds hinders the adoption of comprehensive strategies, and the expansion of diagnostic facilities and treatment options. The study calls on the government to prioritise TB elimination through higher budget allocation.

Other Recommendations

Early detection:

Enhanced diagnostic capability is another key aspect of the battle against TB. It is essential to equip healthcare facilities with advanced diagnostic technologies to accurately detect TB and determine drug resistance.

Social factors

Equally important is the need to address the social, economic, cultural, and nutritional vulnerabilities in the fight against tuberculosis. Factors such as overcrowding, migration, social stigma, and poor nutritional status contribute to the spread and persistence of the disease.

Role of private sector

India’s TB treatment is not centralised as it is not uniform. Nearly 50 per cent of TB patients are diagnosed in the private sector and the rest by the government sector. Although the private sector reporting of tuberculosis has gone up from 4 per cent to 25 per cent, there is a huge gap due to underreporting.
The inclusion of private healthcare providers in TB elimination efforts can vastly expand the reach of diagnostic and treatment services.

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