India's burden of TB Growth

Despite various efforts having been undertaken by the Centre until now, the disease burden of tuberculosis (TB) in the country continues to remain very high. India accounts for more than a quarter of the 10.4 million new patients globally. Experts say malnutrition and the problem of patients not taking their medicines regularly, are the main reasons for the burden. 

A recent study found that a large percentage of pulmonary TB patients in India suffer from malnutrition, a problem that most experts have overlooked. “Under-nutrition increases the severity of TB, it reduces patients’ speed of recovery and increases their chances of suffering side-effects of the medicine. The likelihood of their becoming one among the 4,80,000 Indian lives that TB claims every year is also possible,” said pulmonologist Dr S Patrick, adding, that low weight is a classic symptom of TB. 

Although the government provides free medication for TB, the problem of patients not taking their medicine regularly or stopping treatment early, has led to the rise of multidrug-resistant TB, or MDR-TB.  “Several thousand TB patients across India stop treatment because their malnourished bodies cannot cope with the acute side effects, which range from loss of appetite, nausea, vomiting, burning stomach to skin rash, jaundice and burning,” said Dr Senthil, a TB expert. “Not completing the full course of medication which takes at least six to eight months for uncomplicated TB leads to drug resistance, making the infection more difficult to treat. Stopping treatment midway is a major reason why so many people in India die each year from this respiratory infection,” he added. 

Problems of overcrowding and the presence of a large number of slums are other factors responsible for the high burden. “Overcrowding and increasing population trigger the rapid spread of TB in a community,” said Dr Kumar, Nodal officer, MDR TB. “Also, the increasing prevalence of diabetes increases the threat of TB, as diabetes suppresses immunity levels and causes the reactivation of latent TB,” he added. 

Raising awareness is key to wiping out the disease and would have to involve the government and private and public sectors working together, he opined. “The country’s efforts are failing because treatment is not just about writing prescriptions and giving away free medicines. Doctors need to talk to the patients and counsel them on the importance of continuing their medication,” said Dr Senthil.

High temperature

Shivering

Weight loss

Fatigue

Body pain

Loss of appetite

Stagnant cough

Constant irritability