What are the difficulties in tuberculosis control in India?

As per the Global Tuberculosis Report 2018 by World Health Organization WHO TB is one of the top 10 causes of death and the leading cause from a single infectious agent As per the best estimate globally 10 million people developed TB out of which 27 were from India As per an estimate there were new 2790000 cases in India in 2016Ministry of Health amp Family Welfare Government of India has developed an ambitious National Strategic Plan 201725 for the elimination of TB Various measure taken by Government includes free diagnosis and treatment of tuberculosis cases health education measures and active case findings However any government programme cannot succeed without active participation from peopleFollowing are major issues which create hurdles in Tuberculosis control in IndiaMode of transmission TB is an infectious disease and mainly spreads by droplets when the patient with bacteria in sputum coughs sneezes talks and spits Millions of Bactria spread in the atmosphere during these activities Lack of civic sense in general population such as spitting anywhere and not covering the mouth while coughing or sneezing help the spread of TB People living or working in small illventilated overcrowded rooms further compound the problemSocioeconomic issues TB is also a social disease and is described as a barometer of social welfare Malnutrition is rampant thus lowering the body immunity to any infection including tuberculosis Poverty is a major issue and many TB patients do not comply to treatment because of issues such cost of treatment cost of travel to health care institution loss of daily wages etc Poverty malnutrition poor housing poor quality of life lack of awareness lack of education population explosion early marriages large families etc are all interrelated social factors that make TB control difficult TB started declining in the western world long before the advent of AntiTB drugs This has been attributed to improved quality of lifeAdherence to the treatment One of the major problems in TB treatment is that it is prolonged at least for 6 months and patients stop the treatment when they feel better or develop some side effects or due to some other social reasons Not completing the treatment is dangerous because there is a strong chance of relapse of the disease and the TB germs become resistant to the medicinesThe emergence of Drugresistant TB germs This is now a major problem in TB control Drugresistant cases require the second line of drugs which are more costly and toxic and treatment is prolonged beyond 6 monthsAssociated medical problems Associated medical problems such as concurrent HIV infection alcoholism uncontrolled diabetes smoking further weaken the immunity thus making control and cure difficultWhat can be done by the general public and TB patients to help the Government in TB controlEarly Detection Seek medical help or encourage others to do so when there are symptoms such as chronic cough lasting more than 3 weeks blood in sputum chest pain fever night sweats loss of weight loss of appetite and fatigue Early detection and treatment are highly effective in controlling the spread of the disease Family members and near contacts of TB patients also should be screenedAdhere to treatment Take full treatment for at least 6 months or more as advised by the doctor Do not miss even a single dose of medicine Every TB patient before starting the treatment must be counselled about this issue It is the duty of family members to see that the patient takes the medicine regularly and completes the treatment as per the advice of the doctor In case of any side effects promptly consult your doctorCivic sense Follow common precautions such as covering the mouth while coughing or sneezing Do not spit on roads or in publicDiet Adequate nutrition plays an important role in recovery as it boosts the immunity system which fights against the infection A person suffering from TB should consume a well balanced and nutritious diet consisting of adequate carbohydrates proteins vitamins and minerals Our Indian diet of rice dal roti vegetables including green leafy vegetables salads and fruits is adequate In addition follow the advice of your doctor regarding the dietLifestyle changes The TB patient while on treatment should ensure that shehe gets adequate sleep remains active unless sheis very sick drinks adequate water and strictly avoids alcohol smoking tobacco or narcotic drugs If a patient has any associated illness such as diabetes or HIV it should be treated adequately Adopting a healthy lifestyle even in noninfected individuals enhances immunity thus contributing to TB controlBCG Vaccine Ensure each newborn child is administered BCG vaccine within the first month after birthPsychological support TB can lead to a lot of psychological distress for the patient as well as the family members This can lead to depression and a sense of loneliness Hence it is necessary to look for symptoms of mental illness and help herhim cope with the disease This will help in improving their thinking pattern compliance to treatment and accelerate the recoveryPublic Awareness Awareness in general public should be enhanced through print media television posters pamphlets social media etcTuberculosis is curable Concerted efforts of all stakeholder such as general public TB patients and their family members health professionals health care institutions government lawmakers media and NGOs will help the Government of India to achieve its ambitious goal of TB eradication by 2025 Dr Santosh Datar Medical Director Ziqitza Healthcare Ltd ZHLCatch up on all the latest Crime National International and Hatke news here Also download the new midday Android and iOS apps to get latest updates