According to Nikshay portal, the national dashboard under the Revised National TB Control Programme (RNTCP), there has been 35% increase in private sector notification nationally– 5.40 lakhs in 2018 as compared to 3.98 lakhs in 2017. Maharashtra, however, recorded a dip of 0.81 %, with 69143 notifications in 2017 and 68539 notifications in 2018.
The private sector notifications are important for TB control efforts for various reasons. Several studies point out that a majority of patients prefer going to private sector when they first get initial symptoms of TB. Without notification of cases coming to private sector, it is impossible to ascertain the magnitude of active TB infection (including the MDR cases) in the state and whole of country.
Second, private sector treatment not only leads to high out of pocket expenditure, it is also prone to inaccurate diagnosis and ineffective drug regimens. The irregular and non-standard treatment increases chances of development of multi-drug resistance in TB patients.
In Maharashtra, there are a few districts where the decline in private notifications have reduced significantly. Malegaon Corporation, for example, recorded 420 private notifications (against the target of 661) in 2017, where as in 2018 it recorded only 157 as against the target of 1051. Nashik Corporation registered 1133 (exceeding the target of 858) private notifications of TB cases in 2017; it reduced to 925 (as against the target of 1363) in 2018.
Dr Tushar Sahastrabuddhe, endocrinologist from Pune said, “Even after making notification of TB cases a compulsory exercise, many doctors are not proactively notifying TB cases. Lack of willpower to take extra efforts and notify cases is hindering notification of new TB cases.”
Dr Padmaja Jogewar, state TB officer, said, “We have been counselling doctors and coming up with stringent provisions if doctors do not adhere to the notification. We are trying our best to make private practitioners register new TB cases.”