by The Welthi Bureau
Around 280,000 people die from TB in India annually.
When it comes to TB, India takes the top spot in the world. It accounts for an estimated one-fifth of all the TB cases worldwide.
On the occasion of the World TB Day, Dr. V. Lakshman Babu, a Pulmonolgist at Sunshine Hospitals, explains the increasing incidence of rising multidrug-resistant (MDR) tuberculosis and the various myths that surround the disease.
Q1. What’s the reason behind the rising incidence of multidrug-resistant (MDR) TB in India?
A. Drug-sensitive TB patients develop resistance to powerful first-line anti-TB drugs—namely isoniazid and rifampicin—because of non-compliance with treatment, unjustified drug combinations and incorrect dosages.
One possible reason of acquired MDR tuberculosis in India is an intermittent thrice-weekly treatment schedule, which is associated with a high rate of irregular adherence and increased drug resistance.
Q2. What’s the incidence of MDR TB in India?
A. With 99,000 new cases per year (WHO, 2010b ), India has the second highest number of MDR TB patients in the world, after China. Our country has an MDR TB prevalence of 2–3 percent among new cases and 12–17 percent among previously treated cases.
Going by present disease management rates, a new study states that MDR TB is set to increase by a whopping 152% over the next two decades in India.
Q3. Earlier, TB was considered a poor man’s disease, but now, even the rich and affluent folks who maintain proper diets suffer from it. Why is this so?
A. The risk factors for TB in the upper segments of society include comorbid illnesses like diabetes mellitus and vitamin D deficiency. Smoking, chewing tobacco and regular alcohol consumption are additional risk factors for the affluent in India.
Q4. What are the social and economic consequences of TB?
A. TB has crippling social implications. People stay away from infected individuals due to the easily transferable nature of the disease. Newly infected TB patient—while undergoing treatment—are quarantined for two weeks or more. This isolation ensures that the disease isn’t passed on to others.
It doesn’t matter whether the infected individual is contagious or not; people simply don’t want to be around patients with a life-threatening ailment.
More than men, it’s women who suffer the most from TB. While mother-child bonds are adversely affected due to fear of infection, the sexual lives of TB-positive women become virtually non-existent. Moreover, for women aged between 15 and 44, TB is the third-leading cause of death.
By contributing to dwindling workforces, TB indirectly cuts down on productivity and limits a country’s GDP. The World Bank reckons that TB is responsible for production losses in both the agricultural and industrial sectors.
It’s been found that the world’s poorest countries—who have the highest incidence of TB—will suffer from an estimated loss of nearly $3 trillion over the next 10 years.
5. Can you tell us about some common TB myths?
Myth 1 - TB runs in the family; it’s a genetic/hereditary ailment.
Fact - In 1882, Sir Robert Koch shattered the hereditary myth. He uncovered the real culprit behind TB—a germ that can potentially attack anyone. Heredity or genes have simply no role to play in the infection.
Myth 2 - TB is highly infectious.
Fact - Only prolonged, indoor and close contact with a sputum-positive TB patient may lead to infection. It’s unlikely you’ll get infected if you meet a TB patient outdoors. The germs coughed up by the patient become diluted in the atmospheric air and are swept away with the wind. Moreover, these germs are rapidly killed by direct sunlight.
Myth 3 - All TB patients spread the disease.
Fact - Not all, but about a third of TB patients are contagious. Only patients with infected lungs transmit the disease while coughing. They emit germs into the air, which can be demonstrated by testing their sputum. It’s the sputum-positive patients you need to careful about.
Apart from the lungs, TB can occur anywhere in the human body, from head to toes.
Myth 4 - TB has no cure; it means certain death.
Fact - TB is curable. Effective anti-TB medicines have been available since the 1950’s. However, the main problem is the lengthy course of treatment. Anti-TB meds need to be taken for at least 6 to 8 months. Once symptoms abate within a couple of months, most patients prematurely discontinue their medication.
In India, nearly 60% of TB patients risk relapse and further complications because they never complete their full course of medication.
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