India TB report 2021

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    The Ministry of Health and Family Welfare released the India Tuberculosis (TB) report 2021 on World TB Day (24th March).

    Major Findings of the Report

    • In 2020, there were 18.05 lakh TB notifications, which was a fall of 24 per cent from 2019 due to the disruptions caused by the Covid-19 pandemic.
    • The notifications rose in the beginning of 2020 (6 percent more than 2019) and by December, they saw11 percent more increase from April projections as per the National Tuberculosis Elimination Programme (NTEP).
    • Due to lockdowns, notifications fell by 38 per cent and 44 per cent in the public and private sectors respectively.
    • Fall in the approved budgets toward the programme from Rs. 3,333 crores in 2019-20 to Rs. 3,110 crore in 2020-21.
    • Over 95 per cent of all cases reported were initiated on treatment in 2020.
    • Around 42 per cent of patients were initiated on a shorter Multi-Drug Resistant (MDR) TB regimen at the time of diagnosis, showing a decline from 2019.
    • Of the reported 24.04 lakh TB cases in 2019, treatment success was 82 per cent, the mortality rate was 4 per cent. 4 percent of patients were lost to follow up and treatment failure and regimen change after initiation of treatment were about 3 per cent.

    World TB Day

    • Each year, it is celebrated on 24th March.
    • Aims
      • To raise public awareness about the devastating health, social and economic consequences of TB.
      • To step up efforts to end the global TB epidemic.
    • History: It marks the date in 1882 when Dr Robert Koch announced his discovery of Mycobacterium tuberculosis, the bacillus that causes TB. The discovery opened the way towards diagnosing and curing the disease.
    • Theme for 2021: The Clock is Ticking.
      • It conveys the sense that the world is running out of time to act on the commitments to end TB made by global leaders.
      • This is especially critical in the context of the Covid-19 pandemic that has put End TB progress at risk, and to ensure equitable access to prevention and care in line with the World Health Organisation’s (WHO) drive towards achieving Universal Health Coverage (UHC).

    Tuberculosis

    • Cause: It is caused by Mycobacterium tuberculosis (bacteria) and it most often affects the lungs.
    • Transmission
      • TB is spread through the air when people with lung TB cough, sneeze or spit. A person needs to inhale only a few germs to become infected.
      • With TB infection, a person gets infected with TB bacteria that lie inactive in the body. This infection can develop into TB disease if their immune system weakens.
    • Symptoms
      • Prolonged cough, chest pain, weakness/fatigue, weight loss, fever, etc.
      • Often, these symptoms will be mild for many months, thus leading to delays in seeking care and increasing the risk of spreading the infection to others.
    • Diagnosis
      • In the case of suspected lung TB disease, a sputum sample is collected for testing for TB bacteria.
      • For non-lung TB disease, samples of affected body fluids and tissue can be tested.
      • WHO recommends rapid molecular diagnostic tests as initial tests for people showing signs and symptoms of TB.
      • Other diagnostic tools can include sputum smear microscopy and chest X-rays.
    • Treatment
      • Bedaquiline for multidrug-resistant (MDR) TB
      • Both TB infection and disease are curable using antibiotics.
      • It is treated by the standard 6-month course of 4 antibiotics. Common drugs include rifampicin and isoniazid.
      • In drug-resistant TB, the TB bacteria do not respond to the standard drugs. Its treatment is longer and more complex.
      • In case of infection (where the patient is infected with TB bacteria but not ill), TB preventive treatment can be given to stop the onset of disease. This treatment uses the same drugs for a shorter time.
    • Global TB Burden
      • Every year, 10 million people fall ill with TB and 1.5 million people die from TB each year, making it the world’s top infectious killer.
      • Most of the people who fall ill with TB live in low- and middle-income countries, but TB is present all over the world.
      • About half of all people with TB can be found in 8 countries: Bangladesh, China, India, Indonesia, Nigeria, Pakistan, Philippines and South Africa.
      • It is the leading cause of death of people with HIV and also a major contributor to antimicrobial resistance.
      • It is one of the top 10 leading causes of deaths worldwide.
    • India’s TB Burden
      • India has 30 percent of the world’s TB cases, which is the highest in the world, followed by Indonesia and China.
      • Tuberculosis continues to be one of India’s most critical health challenges, which typically has devastating health, social and financial consequences for patients and communities at large.
      • With an estimated 2.64 million tuberculosis patients, India has the largest caseload in absolute numbers, globally.
      • The government aims to have a TB-free India by 2025, five years ahead of the global target of 2030.
    • Efforts Taken
      • Global Efforts
        • Global Tuberculosis Programme and Report, 1+1 initiative & Multisectoral Accountability Framework for TB by WHO.
        • Ending the TB epidemic by 2030 under UN SDG target 3.3.
        • Moscow Declaration, 2017 to End TB.
      • Indian Efforts
        • National Tuberculosis Elimination Programme: National Strategic Plan to end TB by 2025 under pillars of Detect-Treat-Prevent-Build (DTPB).
        • Universal Immunisation Programme.
        • Revised National TB Control Programme under the National Health Mission.
        • NIKSHAY portal and TB Sample Transport Network.
        • Development of National Framework for Gender-Responsive approach to TB.

    Source: TH

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