Less than one fifth of the population in India remains unaware of the free medical treatment provided by the Government for Tuberculosis( TB) as it continues to remain in the top spot, putting the other diseases like HIV Aids, Sexually Transmitted diseases , Malaria, Leprosy and Tropical diseases behind, in killing the maximum number of people in India every year.
The president of India, Pranab Mukherjee, in his message on the occasion of world tuberculosis day ( March 24th, 2013) said that “ Since 1998, due to the successful implementation of the DOTS strategy; more than 14.2 million people across India have accessed treatment (for TB).”
However, according to a Knowledge, Attitude and Practices (KAP) study done by the Akshaya Project, though 37% of the people knew about 6-8 month treatment to cure TB, only one-third of them visited a health facility for seeking an examination.
While there can be several reasons for this inhibition, the poor financial status of the families cannot be excluded. Directly Observed Therapy- Short Course(DOTS), under the auspices of Government, provides for free tests. “This unfortunately, as is evident from the figures, is not availed by the people,” said Ramya Ananthakrishnan, Medical Director of REACH – an NGO working in TB control.
The free tests given in the Government clinics include Sputum microscopy, a gold standard technique, which uses a phlegm indicator. The patients are asked to spit out the phlegm and the infection is confirmed by spotting the rod-shaped bacilli, using the indicator.
However, “If the Lab staffs test your blood (Mantoux test) and say that you have TB, then you are being taken for a ride,” said Ms Ananthakrishnan. These tests only say whether a person is infected. It doesn’t concur the prevalence of a disease.
If the sputum tests appear positive, then drugs are administered for 6 to 8 months ensuring a supervised, uninterrupted treatment. The first line of treatment includes the drugs – Rifampicin, Ethambutol, Pyrazinamide and INH. If these do not cure the disease, the second line of drugs are given, which include the (Multi Drug Resistant) MDR-TB drugs. These are to be taken for another 18 to 24 months.
TB is caused by the bacteria – rod-shaped cells called Mycobacterium – which spread through air, when an infected person coughs. This sets up home in ones lungs and later reaches other parts of the body through the bloodstream.
Ms Ananthakrishnan in her presentation emphasised on the need to cover ones mouth while coughing in public spaces and on the necessity to dispose the sputum carefully to avoid spreading to others.
She added that special care should be taken if a person is a smoker, a diabetic or a HIV positive patient, since in such cases the immunity is low.
Debunking the idea of TB being hereditary, Ms Ananthakrishnan said, “ anyone can get TB”. Her best advice is to seek medical help in case of a two-week cough as that is a typical symptom of TB which is sadly ignored by many. Other symptoms include Pneumonia, Cavities, Diarrhea, Fibrosis, swollen bones or spine depending on the type of TB and the part it affects.
According to a WHO report, 2009, India carries one fifth of the world’s TB burden, recording a shocking rate of two TB deaths every 3 minutes – A data which supports the statement of it being the TB capital of the world.