India: Finally, tuberculosis declared a notifiable disease
NEW DELHI: India has finally declared tuberculosis (TB) a notifiable disease. The announcement signifies that with immediate effect, all private doctors, caregivers and clinics treating a patient suffering from TB will have to report every single case of the air-borne disease to the government.
The notification was sent to all states on May 7. Till now,
doctors in the private sector were free to treat TB patients,
and weren't required to keep a record.
The notification said, "In order to ensure proper TB diagnosis
and case management, reduce TB transmission and fight
emergence of drug resistant TB, it is essential to have
complete information of all TB cases. Therefore the healthcare
providers shall notify every TB case to local authorities -
district health officer/chief medical officer of a district
and municipal health officer of a municipal corporation, every
month."
Those who come under the ambit of healthcare providers include
"clinical establishments run or managed by the government,
private or NGO sectors, and individual practitioners".
According to the Union health ministry, private sector is the
first point of contact for health services for 60% of Indians.
"Most patients start treatment of TB in private sector.
Private doctors use irrational combinations to treat, making
them drug resistant. They finally land up in government
treatment programme," said a senior official of the revised
national TB control programme (RNTCP).
Multi-drug resistant TB has become a menace in India. Every
year, the country reports 15 lakh new cases of TB. WHO says
around 73,000 of the notified new TB cases in 2010 were
already multi-drug resistant. Of these, less than 3,000 were
detected.
A ministry official said, "It's of utmost importance that the
private sector reports all TB cases to the RNTCP which has
hi-tech labs to test for resistance and provides high quality
drugs and testing free of cost to all patients."
WHO says, 2.1% of all new cases in India are MDR-TB, while as
many as 15% of re-treatment TB cases are developing MDR-TB.
The notification added, "Early diagnosis and complete
treatment of TB is the cornerstone of TB prevention and
control strategy. Inappropriate diagnosis and
irregular/incomplete treatment with anti-TB drugs may
contribute to complications, disease spread and emergence of
drug resistant TB."
Undiagnosed and mistreated cases continue to drive the
epidemic in India. In 2010, an estimated 2.3 million TB cases
occurred, and 360,000 patients died of TB, or about 1,000
deaths per day.
Nearly one in six deaths among adults aged 15-49 are due to
TB. Nearly 100,000 cases of serious multi-drug-resistant TB
(MDR-TB) are estimated to occur in the country annually, and
each MDR TB case costs more than Rs 1 lakh to diagnose and
treat.
A ministry note said though a large number of TB patients in
India are diagnosed, they are not referred to or notified to
RNTCP.
"Develop and deploy systems for notifying patients at TB
diagnosis from all sources. With improved notification, RNTCP
could improve case management and reduce TB transmission and
the spread of drug-resistant TB," the note said.
Highly infectious diseases such as plague, polio, H5N1 (bird
flu) and swine flu are in the list of notifiable diseases.
The 12th five year Plan for TB control added, "All diagnosed
TB cases will be notified irrespective of their treatment or
registration status."
The Times of India
