JOIN USDespite the government spending crores of rupees on preventive measures, the number of tuberculosis cases in Karnataka went up by 23% in just one year. The percentage could be much higher if the numbers from private hospitals are added up.
According to the Revised National Tuberculosis Control Program, the number of patients diagnosed with tuberculosis in 2016 was 60,751 up from 49,396 in 2015. Around 900 of the registered patients are diagnosed with multi-drug resistant TB (MDR-TB), a form of tuberculosis that is resistant to treatment with at least two of the most powerful anti-TB medicines.
According to doctors, TB patients refuse to approach hospitals because of social stigma. This is often a reason for the spread of the disease either at their homes or at workplaces.
“If one person has TB, he will be responsible for 10 more around him in a year,” said Dr Shashidhar Buggi, director of Rajiv Gandhi Institute of Chest Diseases (RGICD). “Most of the time, patients do not complete the period of prescription of the medicine. Once tuberculosis starts showing signs of reduction, they stop taking medicines. More drug resistance means more prevalence of TB.”
That is also one of the reasons for the antimicrobial drug to be resisted by the TB-causing bacteria, as the bacteria is used to the drug and knows how to fight IT, he added.
Dr Buggi said many doctors tended to conclude about the form of TB based on laboratory tests alone, which were often misleading. Such diagnosis is another reason for the drug rejection of the disease in the patients’ body, according to him. “Doctors should conduct clinical tests along with laboratory tests which should correlate before jumping to conclusion,” he said.
The RGICD receives many patients diagnosed with MDR-TB who are referred from private hospitals. After clinical diagnosis, where the patients’ sputum is tested, they are identified as a case of primary TB, which is to be given category-one medication.
Doctors say category-one medication is prescribed to patients with TB in its primary stage. The medication involves tablets while category-two medication is prescribed for patients with MDR-TB, which involves higher dosage of medication that entails both injections as well as tablets.
Dr Sachin Kumar, senior consultant of pulmonary and critical care medicine at Sakra Hospital, conceded that the practice was prevalent in private hospitals, whereby laboratory tests are taken for granted rather than testing the patients’ sputum.
“Such cases, which lead to MDR-TB cases, cost the government at least Rs 2 lakh per person,” said Dr Sanjaykanth, epidemiologist, State Tuberculosis Centre. There is an increase, but the figures indicate the cases from government institutions only as private hospitals fail to notify their cases to the government. The notification issued by the Health Ministry in May 2012 makes it mandatory for all healthcare providers to report every single case of tuberculosis to the government.
“TB cases should be accounted. If they don’t let us know the numbers, how will we know the status of TB in the state,” said Dr R Raghunandan, Joint Director, Tuberculosis, Health and Family Welfare Department.
Experts say there is a lack of coordination between private institutions and the government. Dr Kumar conceded that there was lack of coordination, besides mentioning that private hospitals sometimes do not follow government guidelines.