Covid-19 hits TB programme in Chandigarh

Naina Mishra

Tribune News Service

Chandigarh, December 20

Pandemic has put enormous challenges and unprecedented stress on the healthcare system, and the National Tuberculosis Elimination Programme (NTEP) was no exception. Chandigarh has witnessed 38 per cent shortfall in the tuberculosis (TB) cases in 2020 when Covid-19 was raging in the Union Territory.

A total of 4,319 TB cases were notified under the TB programme in 2020 (Jan-Dec), which was 38.5% less than the total cases notified in 2019 (which was 7,026). In 2021, in spite of a severe second wave of Covid-19, the programme has been able to report 3,948 TB cases (till Oct, 2021). Even the testing for TB diagnosis reduced after 2018 and only 13,817 tests were conducted in 2021.

The data pertaining to TB notification was tabled in the Lok Sabha.

“In normal (pre-Covid) times, a significant number of CT chest requisitions used to be for evaluation of lungs for pulmonary TB. However, due to lockdowns and disruption in access to TB services, fewer people could be diagnosed, treated and followed-up for TB in the past one and a half years,” said Dr Mandeep Garg, who is a renowned chest radiologist with the Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh.

“During the two waves of Covid-19 in India, especially the larger second wave, the services of a majority of medical personnel were required to be relocated for Covid-19 care, which to some extent, did affect the various programmes being run by the Government of India for diseases like TB,” he added.

Prof Digambar Behra, formerly associated with Department of Pulmonary Medicine, PGI, said, “The National Tuberculosis Elimination Programme has been badly affected due to Covid-19 as all health facilities were closed for a long time and patients were devoid of the access to health system. All resources and manpower were directed to Covid care. This has been the biggest setback to this programme as we have again reached from where we started in 2016. Earlier, there was an increasing trend in TB case notification every year. Many patients also did not report to hospitals even if they had symptoms because they feared Covid.”

Prof Behra said, “We need proactive TB case finding approach, particularly into the vulnerable groups like slum dwellers and those with comorbidities. Even as the health facilities have now opened, the notification hasn’t gone up and the picture is still grim. We have to catch the patients through aggressive testing. Another way is through implementation of bi-directional TB-Covid screening and TB screening/testing for all presumptive cases with influenza like illness (ILI) and severe acute respiratory infections (SARI).’

“We have to recast the TB programme by supplementing more people and reaching out to village heads as well as NGOs,” he added.

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