Covid drags TB plan back to 2013 level

Covid fear, lack of diagnostic tools hinder the programme

The plan to eliminate tuberculosis by 2025 has suffered a severe setback due to the pandemic, taking the status back to 2013 in terms of diagnosis, notification, timely treatment and controlling deaths.

Covid-19 has hit the National Tuberculosis Elimination Programme (NTEP) badly as primary health centres, district hospitals, diagnostic machines and the private health sector are unable to notify tuberculosis patients. The reasons: patients are scared to come to hospitals due to the fear of contracting

Covid-19, lack of public transport and financial constraints due to lack of income. Notification in different states has dropped by 30 to 70 per cent since March.

To add to the problem, medical colleges and human resources working for the NTEP have been diverted to Covid-19. The biggest challenge being observed is lack of diagnostic machines. All the testing machines are being utilised for Covid19, and that is proving to be a major setback in tackling tuberculosis.

Dr Subhakar Kandi, south zone chair for NTEP in the medical colleges of Telangana state, Andhra Pradesh and Karnataka, said, “Each month taken to return to normal is going to lead to additional unaccounted TB deaths. The lockdown has negated all efforts. We are back to square one in the elimination programme. Till supplementary efforts are put in place, tracking of missed and unaccounted cases will be a huge challenge.”

Deaths in 2021 due to TB are likely to increase to the levels noted in 2013 which were the highest at 5.5 lakh.

There are estimates that each year an additional 50,000 deaths due to TB will be noted till 2025 due to the impact of the pandemic.

The need is to have active tracing of TB and intense community engagement to get over the fear of and stigma associated with Covid-19. With most healthcare workers and doctors busy with Covid-19, supplementary channels for the restoration of TB will require will from state governments to revive it.

In a paper submitted by Johns Hopkins University where India is featured as the country with highest TB cases, it has been recommended that digital technology must be used to reach out to patients, understand and respond to symptoms and ensure delivery of medicines at their doorsteps. The notifications need to be revived and for that the centres in rural areas and medical colleges must be provided separate pathways which will help them detect cases early.

Dr Mehboob Khan, superintendent of Chest Hospital, says, “We have kept a separate building for TB patients. There was a problem from March to June but since then, patients are coming for treatment and procuring their medicines. Due to Covid-19, we are giving medicines for a month.”