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