As fresh detections slowly rise to pre-lockdown numbers, delay in receiving culture reports and inadequate nutrition remain key concerns
MM Munshi TB clinic in Khar. Pic/Pradeep Dhivar
The COVID-19 pandemic has been affecting the patients of another highly infectious disease — tuberculosis (TB). While its detection fell in the early months of the pandemic, TB detection is gradually catching up with its pre-COVID average. However, the lack of transport, delayed test reports and inadequate nutrition have hit TB patients hard.
According to the civic body, prior to the pandemic, around 5,000 fresh TB were reported every month. During the months with the highest COVID cases, TB numbers plummeted to less than half primarily due to lack of public transport. "In April and May, we were seeing less than 2,000 cases. There was improvement June onwards as more people visited hospitals and there were around 2,400 new cases every month," said Dr Pranita Tipre, deputy health officer for TB in Mumbai.
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Based on figures from the civic health department, there were 2,396 new patients in August that increased to 2,785 in September. There were over 300 cases reported in the first week of October. Similarly, at the Sewri TB Hospital, the number of admissions dropped from 493 in January to 196 in April and then gradually increased to around 200 admissions per month between May and August. In September, the number increased to 296 admissions.
Aid not enough
Due to lack of adequate public transport, the civic body tasked their chest physicians to stay in touch with patients telephonically and even tied up with private doctors who volunteered to monitor TB patients. While the distribution of medication for TB patients continued throughout the pandemic through dispensaries and deliveries in containment zones, the city's TB activists say that there are other issues that need to be addressed.
Ganesh Acharya, TB survivor and activist
Mumbai-based TB survivor and activist Ganesh Acharya pointed out that he has been approached by several people who don't have enough to eat. Referring to the government's nutritional aid of Rs 500 per month, Acharya said, "People have received the amount but it's just not enough. They use the money to get medicines. Due to the pandemic, many TB patients have lost their jobs. The government should give them food grains and increase the aid to at least R1,500." He added that many TB patients live in far-off parts of the Mumbai Metropolitan Region and are unable to reach city hospitals due to lack of access to local trains.
Nutrition woes
TB patients are advised to have a high-protein diet and food insufficiency has forced Sanjana Jadhav, 29, (name changed) to try and extend her stay at the Sewri TB Hospital. Jadhav, who has been suffering from TB for the past decade, has spent most of the last two years in the hospital. "Since I have TB, my husband keeps his distance and doesn't take care of me. After being hospitalised for more than a year, when I returned home, he would abuse me endlessly and wouldn't give me much to eat. If I asked for eggs, he would refuse saying that he lost his job and had no money," she said.
The TB hospital at Sewri. file pic
Due to lack of proper nutrition, Jadhav grew weak and wasn't able to take the medicines either. Her condition worsened and she had to be hospitalised again in August. "At the hospital, we get better food. We are given eggs and milk. For women like us who have no jobs, the government should give us some food supplies so that we can fight the disease. I want to stay at the hospital because if I go back to my husband, I won't get enough nutrition," she said.
Even though medications are available to patients, getting the reports for tests on time is a big challenge and due to the pandemic, the delay can be of several months.
Timely reports a challenge
Rajesh Sawant, a 53-year-old Andheri resident was diagnosed with pulmonary TB in March and was prescribed a long list of medications.
Sawant said that after taking the medications for March and April, the doctors had to prescribe different medicines based on his first culture report. He had given another sample in June and is still waiting for the results. "With every culture report, the doctors update the medication. But in the past three months, whenever I have called, they say the report is delayed because of COVID. Even though my symptoms are mostly gone, I still have to take six tablets and doctors can't do anything until I get the report," he said.
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