A recent study published by the Praja Foundation has highlighted the increasing threat of tuberculosis (TB). The study has estimated that in 2016-17 nearly 18 people have died per day from TB in Mumbai. The study titled ‘Report on the State of Health of Mumbai’ was done over the course of five years from 2012 to 2017.
It has also shown the huge rise in the numbers of tuberculosis cases. In 2016-17 the number of tuberculosis cases registered at government institutions is 50,001 whereas, in the 2012-13, this number was 34,873. The study states that cases of tuberculosis have increased by 37 per cent in five years from 2012 to 2017. The study revealed that the wards with the maximum number of cases in the city are L (Kurla – 1,254 cases), H/E (Santacruz -659 cases) and R/S (Kandivali – 493 cases).
After analyzing the trends the study extrapolated 6,472 deaths in 2016-17, due to tuberculosis.
A sharp drop has been reported in the Directly Observed Treatment (DOTS), a flagship government program to tackle TB. It is almost reduced in half from 30,828 in 2012 to 15,767 in 2016. The study showed the increased in percentage of defaulters in DOTS treatment increased 9 per cent in 2012 to 19 per cent in 2016.
While commenting on the findings of the study, Milind Mhaske Project Director Praja Foundation said, “18 deaths every day because of the TB is a very serious issue. We are going to present this data before government officials and will ask them to shape a proper policy according to it. We have to make efforts to make Mumbai a better city.”
Dr Lancelot Pinto, Consultant Respirologist expressed his concern on the increasing number of TB cases. He also made a point that more cases of TB come to the private healthcare sector rather than the public healthcare sector. “I am not surprised by the numbers. The risk of tuberculosis is high. We have to take into account another aspect that 50 to 70 per cent patients come to the private sector for the treatment. Our study on the perception of a patient from a private hospital on the public program showed that only 15 per cent of them were aware of the DOTS programme.”
Government officials explained about the drop in enrollment in DOTS program. “We have now started daily regimen in DOTS and the medication has been made available to the private sector as well. So now it is not compulsory for patients to enroll in DOTS to get the tablets. So the number of patients is being divided in public and private sector,” said Dr Daksha Shaha, BMC TB Officer.
The Revised National Tuberculosis Control Program has made changes in the DOTS program. Earlier there was alternate medication regimen which was followed by this program. A year ago the daily regimen had been adopted. According to Dr Vikas Oswal, a Pulmonologist this step was carried out too late. “We are probably the last country in the world that follows the alternate regimen. It has caused damage to our program and the bacteria have become drug resistant. Now a few states have switched over to the daily regimen, which was already being followed in the private healthcare sector.”