Drug, AIDS connection to TB worries health officials

Aparna Banerji

Tribune News Service

Jalandhar, July 30

As many as 191 patients of tuberculosis have died in the district between January 2013 to December 2015. Also, 12,741 cases of TB have been reported to the local Civil Hospital between 2013 to 2015, with the death cases almost touching 200.

While Jalandhar has a big population of TB patients – very few of whom are actually being reported to the local Civil Hospital – the incidence of multi-drug resistant (MDR) TB and the vicious web of drugs and AIDS has caused the Health Department to take a serious note of the situation.

Of the 12,741 TB cases, as many as 5,3978 are females while as many as 6,552 are males. As many as 1,261 were suspected of having MDR TB while 96 have been diagnosed with suffering from it.

Additionally, of the 495 people tested with the cartridge based nucleic acid amplification test (CB-NAAT) facility since February 26, a whopping 107 tested positive for HIV.

Of the 12,741 TB patients reported from the first quarter of 2013 until December 2015 in the district – as many as 191 deaths have taken place in the district and failure has been reported among 127 patients. The number of defaulters is 637 and the number of patients transferred to another medical facility is 166.

However, the silver lining is the high rate of cure, thought to be rare among the TB patients, especially in recent times – 91. 7 pc (11,683) patients with TB having been cured. 107 of 495 tested this year so far found HIV positive; 34 resistant

There is a high incidence of HIV among TB patients. Notably, with the inauguration of the CB-NAAT machine at the Civil Hospital this February, the diagnosis of patients at the Civil Hospital itself had been facilitated. Formerly, the samples were being sent to Patiala to differentiate between the MDR and non-MDR patients. But the setting up of the facility at the Civil Hospital, Jalandhar, has ensured quick reportage.

Of the 495 people tested with the CB-NAAT facility since February 26, a whopping 107 tested positive for HIV and 14 of them were children. As many as 34 patients were also suffering from a resistant strain of TB.

Health and Family Welfare Minister, Punjab, Surjit Kumar Jayani, had inaugurated the CB-NAAT machine at the TB Centre in February this year. The machine – for the first time—- promised reports to patients within two hours, while earlier they had to wait for days for their reports to be sent from Amritsar.

Lack of notification

While there are thousands of private hospitals/clinics/dispensaries in the district, a majority of them do not report to the Civil Hospital. There are only 15 establishments which report the incidence of TB to the Civil Hospital. Being a notifiable disease, it is imperative for all organisations to report cases of TB reported to them to the Civil Hospital.

According to sources, “Hundreds of patients, which constitute a majority in the district, have been reporting to private hospitals. But since the Civil Hospital is not getting them, these are almost going unrecorded. And the gravest threat is from the MDR strain.”

MDR includes patients who develop resistance to normal TB drugs. Since the medicines for MDR TB are only available with the Civil Hospital – lack of reportage or diagnosis from private players is causing a situation which could be endemic.

Diagnosis of OST patients for TB

Jalandhar had also recently become the first district in the state where the Intensified Tuberculosis Case Finding Pilot Project was launched among opioid substitution therapy (OST) patients today. The project was launched on July 8. Aimed at diagnosing dormant cases of TB among the patients on opioid substitution therapy, the project has been arranged for by the Voluntary Health Association of India (VHAI), New Delhi, which has arranged for free digital X-ray facility of each registered OST patient at the OST Centre, Jalandhar.

Already showing results, as many as 50 OST patients have already been diagnosed under it of which two have tested positive for TB. Experts say the reportage of these is also expected to go up as more and more patients are brought into the loop.