Lucknow: For 18-year-old Divyansh, life has been a perpetual struggle since he lost his father in 2016 to tuberculosis (TB) — which the latter had contracted while working at a factory in Punjab. Later, his mother too was attacked by the disease to succumb to it in 2017.
The young man has a faint memory of his parents’ demise. He was left with two elder brothers to manage the affairs. However, the situation further deteriorated when he too contracted TB at the age of 15 in 2021.
“Under the impression that I had recovered from the disease, I underwent a six month course to cure it. But I was wrong, it kept relapsing again and again. I had to undergo medical treatments twice within a period of nine months. Someone then advised me to visit the centre for tuberculosis at the government-run super speciality hospital in Azamgarh. Under the supervision of Dr. BK Patel, the head of the centre, I felt unprecedented relief,” he described while talking to The Mooknayak.
He claimed he has recovered fully in the past one year, although six months of the 18-month course of the treatment are still left.
However, the treatment has taken a huge financial toll on Devyansh and his family. “One of my brothers, who is married, works as a daily-wage construction labourer, while the other owns a small shop — which is barely enough to meet our daily expenses,” he narrated the ordeal.
The undergraduate student had to sell the jewellery of his mother to meet his medical treatment cost, which runs to around Rs 2000-3000 every month.
He gets a financial assistance of Rs 500 as a part of the Nikshay Poshan Yojana. But according to him, it is insufficient to meet the expenses required for a protein-rich diet.
According to a report by the World Health Organisation (WHO), last year, there were around 28 lakh TB cases in India. It made up 27% of the global burden of disease.
On the other hand, neighbouring China, the world’s most populous country, accounted for only 7.1% of the worldwide TB cases.
Around 2 lakh people succumb to tuberculosis every year, making the ambition to make the country TB-free by 2025 appear a distant possibility.
Divyansh is one of the 1.1 lakh people in the country who are afflicted with Mdr-TB (multidrug resistant tuberculosis).
The Mooknayak spoke to Dr BK Patel, a senior medical officer at the Government Medical College & Super Facility Hospital, Chakrapanpur (popularly known as PGI of Azamgarh).
He clarified TB may not necessarily affect the poor only; however, it is more pronounced among the improvised because of their poor food habits devoid of nutrition and hygiene.
Dr. Patel, has also adopted five patients, and pays for their nutritional support as a financial help under the Nikshay Mitra scheme — which seeks people to adopt one or more TB patients and look after their nutritional and medical needs.
This adoption not only allows to break the stigma surrounding the disease but also mitigates the burden of the government.
A study published in The Lancet — the most respected weekly peer-reviewed medical journal — also suggested that adequate nutrition support and effective therapy help reduce TB by half.
“Yes, we can end TB”, the theme for World TB Day this year, has been a carried over theme from the previous year. In India, the target year for ending TB has been advanced to 2025 as against the global target of 2030.
The WHO in its Global TB Report 2023 released on November 7, 2023, had acknowledged India’s success in reducing TB incidence by 16% and TB mortality by 18% since 2015. The treatment coverage, according to the report, has increased to 80% of the estimated cost. It’s a hike of 19% compared to the previous year. In 2022, over 24.22 lakh TB cases were registered against 28 lakh in 2021, as per the WHO report.
Population density: India is the second-most populous country globally, with a high population density. In cities, people live cheek-by-jowl with each other, which acts as a nidus for communicable diseases like TB.
Poverty and malnutrition: Poor living conditions, inadequate nutrition and lack of access to healthcare services make people vulnerable to the disease.
Limited healthcare infrastructure: Despite efforts to improve healthcare infrastructure, many parts of India still lack adequate medical facilities, especially in rural areas. This limits access to TB diagnosis and treatment services for a significant portion of the population.
High prevalence of HIV/AIDS: The co-infection of TB with HIV/AIDS is a significant concern in India. HIV damages the immune system, making patients more vulnerable to TB infection. This phenomenon further complicates the treatment of the disease.
Drug-resistant TB: The emergence of drug-resistant strains of TB, particularly multidrug-resistant TB (MDR-TB) and extensively drug-resistant TB (XDR-TB), has created a big hurdle in the treatment of the disease.
To address the TB burden in India, the government has implemented various initiatives, including the Revised National Tuberculosis Control Programme (RNTCP) — now known as the National Tuberculosis Elimination Programme (NTEP). It aims at improving TB diagnosis, treatment and prevention services across the country through a decentralized approach.
Additionally, efforts are being made to raise awareness about the disease, improve healthcare infrastructure, enhance diagnostics, provide free or subsidized treatment and promote research into new diagnostics, drugs and vaccines.
Despite these efforts, addressing the TB challenge in India requires sustained commitment, increased funding, strengthened healthcare systems and collaboration between government agencies, healthcare providers, non-governmental organizations and international partners.
The portal serves multi purposes:
Case notification: Nikshay facilitates the notification of TB cases by healthcare providers. It helps in tracking the number of diagnosed cases, their demographics and treatment outcomes.
Treatment monitoring: The portal allows for the monitoring of TB treatment adherence and outcomes. Healthcare providers can enter information about the treatment regimen prescribed, medications dispensed and patient follow-up.
Drug stock management: Nikshay assists in the management of TB drug stocks at various healthcare facilities. It helps ensure the availability of essential anti-TB medications to patients throughout the treatment duration.
Reporting and analysis: The portal generates reports and makes analyses based on the data entered by healthcare providers. These reports help in assessing the TB burden, treatment outcomes and the effectiveness of its control interventions at national, state and district levels.
Patient management: Nikshay provides a platform for tracking individual TB patients throughout their treatment journey. This includes recording patient demographics, diagnostic information, treatment history and laboratory test results.
Integration with other health systems: The Nikshay portal is integrated with other health information systems in India to facilitate data exchange and interoperability. This integration improves coordination between TB control efforts and broader healthcare initiatives.
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