New Delhi :
India has the largest number of multi drug-resistant tuberculosis cases, 27 per cent of the global total, Minister of State for Health Ashwini Choubey informed the Lok Sabha on Friday. In a written reply, he said, however, as per the latest global TB report, India ranks 38th in the number of MDR-TB patients per lakh population (9.6). "The estimated number of multi drug resistant/ Rifampic in resistant TB (MDR/RR TB) patients in India for 2018 is 1,30,000, which contributes to about 27 per cent of the global burden," Choubey said.
Resistance to anti-TB drugs can occur due to faulty prescriptions which was previously rampant in the private sector, and is now being managed through better engaging the private sector for detection andtreatment of TB, he said.
Resistance can also occur if the treatment is discontinued before the prescribed time, Choubey explained. To address the issue, the Revised National Tuberculosis Control Program (RNTCP) conducts Information,Education and communication (IEC) activities to increase awareness in the public.
The programme recognizes that a delay in treat mentinitiation may cause adverse outcomes. Hence, since 2016 RNTCP has shifted from notification at treatment initiation to notification at diagnosis. This helpsin following up all the patients who are diagnosed and ensure that they areinitiated on treatment, the minister said.
The government has taken several other corrective measureslike Active Case Finding (ACF) in vulnerable and high risk populations toactively screen symptomatics and detect TB patients, private sector engagementto increase notification and provision of public health action and ensuringavailability of free diagnostics and medicines to patients seeking care in theprivate sector as well.
It has also initiated strengthening of sputum collection andtransport mechanisms to ensure early diagnosis. The programme has also tied upwith India Post to increase access.
Other mechanisms being strengthened at the local levelinvolve MoUs with courier agencies, human couriers. Measures also includeincreasing the network of rapid molecular diagnostics to ensure detection of drugresistance at the earliest
The Programme has rolled out Universal Drug SusceptibilityTesting (UDST) since 2018 as per which resistance testing for Rifampicin ismandatory for all notified TB patients, he said.
Communication campaign aimed at raising levels of awareness,reduction of stigma among community, both through mass and mid media are alsobeing held. Prime Minister had launched ‘TB Free India’ campaign on March 13, 2018to end TB in India by 2025.
To pursue the goal, the government has been implementingNational Strategic Plan (NSP) (2017-25) to End TB by 2025. Active Case Findingis one of the most important strategy being implemented to find the missingcases in the community.
In 2017, three rounds were conducted as national campaign,more than 5.5 crore population had been screened and a total of 26,781 additionalTB cases were diagnosed.
In 2018, three rounds were conducted as national campaign,more than 18.9 Crore population had been screened and total 47,307 additionalTB cases diagnosed.
The health minister also launched the TB Harega Desh JeetegaCampaign on September 25, 2019 in which new sets of IEC material have beenlaunched and disseminated to states.