Soon, TB services on doorstep

Aditi Tandon

Tribune News Service

New Delhi, January 3

The government is eyeing a January 16 launch for the second pulse polio-type public health campaign, this time to address the rising burden of tuberculosis.

The campaign involves reaching 12 crore potential patients living in high-risk areas through house visits or visits in their residential clusters. The Central TB Division has mapped these 12 crore people in 50 high-burden districts across 18 states, including Haryana, Himachal Pradesh, Delhi, Gujarat, Karnataka, Kerala, Madhya Pradesh, Maharashtra and Rajasthan.

The “Active case finding: TB services at the doorstep” campaign will be second only to pulse polio in scale, with the Centre hoping to find one million TB patients the system misses annually.

“The campaign will be conducted in three rounds between January 16 and 30; July 17 and 31 and December 4 and 18. We will reach 12 crore unreached people through house-to-house visits. Those with TB symptoms will be tested and treated immediately to arrest further transmission,” Central TB Division Deputy Director General Sunil Khaparde says.

The campaign will reach potential patients in slums, prisons, old-age homes, construction sites, refugee camps, night shelters, homeless people and street children and orphanages. In rural areas, it will target remote villages, mine workers, stone-crusher workers; populations with high malnutrition; populations known to drink raw milk and consume uncooked meat; weaving, glass industry, cotton mill and tea garden workers.

The campaign follows WHO evidence that the curve of TB incidence (new cases annually) in India is rising instead of dipping. Government reports on new campaign acknowledge that after India’s routine Revised National TB Control Programme achieved complete geographical coverage, TB notification rates increased initially but then became static only to fall in many parts of the country.

“This meant that despite government efforts at symptomatic TB treatment, patients are not availing services with most going to the private sector, leading to misses. Active case finding will help us fill this gap,” a Health Ministry official says.

Based on TB prevalence studies, the Centre estimates that among 12 crore people, 60 lakh will be symptomatic for TB and will need sputum testing. “The campaign has three objectives: screen 12 crore for TB symptoms; conduct sputum testing of estimated symptomatic 60 lakh people and find; and treat additional infectious TB patients, estimated to be three lakh across 50 districts under coverage,” Khaparde says.

India houses 24 per cent of the global TB burden. The Sustainable Development Goal on TB involves reducing new cases by 90 per cent until 2030 – a mammoth challenge for India, where 75 per cent of TB patients are in private hands. India’s success is critical to global TB eradication.