Mumbai: Experts warn of tuberculosis outbreak amidst COVID-19 pandemic

Updated: Jun 25, 2020, 07:44 IST | Vinod Kumar Menon | Mumbai

TB experts in the city have cautioned the government not to ignore a TB outbreak amidst the pandemic, as it is a major killer in India

Doctors say the migrants who miss out on their TB treatment could develop drug resistant TB. Representation pic/Bipin Kokate
Doctors say the migrants who miss out on their TB treatment could develop drug resistant TB. Representation pic/Bipin Kokate

Health experts are worried about the large number of migrant who left the city due to the COVID-19 pandemic, as in the process, some could have missed out on their tuberculosis (TB) treatment. They fear it could develop into drug resistant TB and increase the spread of the disease in other parts of the country, where they have gone. TB experts in the city have cautioned the government not to ignore a TB outbreak amidst the pandemic, as it is a major killer in India.

Dr Wiqar Shaikh, senior asthma and allergy specialist, said, "Affected migrant workers will have to be closely monitored by their state governments, to not only continue their anti-tuberculosis treatment, but also to watch out for Multi-Drug Resistant TB (MDR) TB."

Dr Shaikh warned that TB is an extremely common condition in our country, with a high mortality rate even today. He added, "Approximately five new cases of TB emerge in our country out of every 1,000 people, so around 2.7 million new cases emerge every year. Out of this, (MDR) TB is around 1,30,000 new cases every year. The mortality with TB every year is 4.40 lakh in India. Approximately more than 95 per cent TB cases in the world are mainly seen in developing countries. Infact, 96 per cent of deaths due to TB in the world are from developing countries like India. And 75 per cent of all TB cases are in the economically productive age group of (15 years to 50 years) which is damaging to the country. If TB is properly treated, particularly by adhering to the Direct Observation Therapy (DOTs), the cure rate is more than 80 per cent, unfortunately the majority of patients do not come back for monitoring."

Worse than COVID-19?
Shaikh further added, "Nearly 4.40 lakh deaths every year in India are attributed to TB, and this is nearly five per cent of the deaths in the country. So COVID-19 is nowhere close to the mortality due to TB".

Dr Lalit Anande, Medical Superintendent at Sewri's TB hospital, expressed similar concerns saying, "Many migrant workers who have left the city while under treatment for tuberculosis, carry a high-risk of spreading the same in the state they have headed to. If they are not traced and given medication for tuberculosis, they carry high risk of slipping into MDR-TB."

Dr Anande added, "The COVID-19 pandemic has brought the immunity of most vulnerable human beings to the lowest level. Mycobacterium tuberculosis (mtCP) known for causing TB, attacks the human body, when the immunity level falls. The spread of tuberculosis will be rampant, if corrective measures of screening for tuberculosis are not taken up immediately."

Pune-based Dr Padmaja Jogewar, State Tuberculosis Officer, attached to the Central Tuberculosis Division, said, "After the lockdown (March 23 to June 24) the number of patients taking treatment for TB in the state is around 15,683 (government/civic hospitals) and 7,410 patients (in private treatment), which has seen a drastic fall as compared to the January to March number (51,827 patients in government, civic and private hospitals). We have issued letters to all concerned state/civic-run hospitals directing them to keep check on the migrant crowd and touch base with those under treatment from our data bank, so they can be provided the required dosage of medication."

BMC's pilot project
The Brihanmumbai Municipal Corporation (BMC) has a new strategy to combat TB after the lockdown. Dr Pranita Tipre, Deputy Health Officer (TB), BMC said, "We have given medicines for a month to all patients before the lockdown started. Thereafter after our staff reached out to them with medicines in case they were residing in Containment Zones. A fortnight ago, we started a pilot project in three BMC ward limits (G/N ward (Dadar), N ward (Ghatkopar) and P/South ward (Goregaon), only for screening TB cases and monitoring patients. New patients can avail of the facility by approaching the ward office."

She said they have also started calling TB patients to monitor their treatment. They will also provide free medicines to patients who were seeking private treatment. "Those who have migrated from Mumbai can also contact us, so that we can direct them to the district TB officers in various states, so that their treatment can continue" said Dr Tipre.

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