Decline in Tuberculosis reporting during COVID-19 pandemic: Experts

Malnutrition and dieting may be one of the causes of TB infection 

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New Delhi: The TB-free India Campaign was initiated by Prime Minister Narendra Modi to eradicate tuberculosis in India by the year 2025, which is five years earlier than the target date established by the international community. The COVID-19 pandemic, however, reversed all the progress and gains that had been made in the fight against TB over the previous years.
Considering the current scenario, it seems tough to carry out the ambitious plan to eradicate TB by 2025 yet everyone needs to stride by the government’s vision to chase the target of TB eradication.
“Malnutrition and dieting make the younger generation very weak and may be one of the causes of TB infection. During the COVID-19 pandemic, we pushed back on our goal of TB eradication because patients stopped taking their medicine, and many couldn’t report to hospitals. Although we have made a comeback in chasing our targets to eliminate TB from India, still, eliminating it by 2025 seems to be difficult,” said Dr Sandeep Katiyar, Pulmonologist, Apollo Spectra, Kanpur, while speaking at the Health4All Episode-47 brought by HEAL Foundation and supported by Viatris.
Dr Katiyar further added, “The exposure to TB patients with their family members, being high, is one of the reasons for the infection. And this is the social responsibility of every individual to follow the basic etiquette to break the chain of infection like if one is sick, one should keep oneself away from the masses to minimise the rate of infection.”
Dr Parul Vadgama, Associate Professor, Medical College of Baroda, found to be in the same opinion, and stated, “Even though there has been a decline in tuberculosis reporting during COVID-19 pandemic, after COVID, we have made a comeback to meeting our targets of TB elimination. Still, it will be challenging to eliminate TB by 2025.”
Two TB survivors – Ms Nandita Venkatesan, a survivor of intestinal TB, and Mr Sagar Malviya, an MDR Tuberculosis survivor who were re-infected with the TB, shared their experiences. And they were found to be unanimous that even after the treatment of TB, getting sick again is a problem for TB survivors. However, they further said that although TB is a life-threatening infection, yet if you stick to the treatment plan and take your medications properly, you can beat the disease.
Dr Katiyar observed, “When it comes to the duration of TB treatment, there is a global nod for short-term anti-TB treatment, which has been reduced from 18 months to 6 months. However, we need to conduct a robust trial before making any recommendations to shorten the treatment so drastically. Else we need to have proper results on it over a longer period before shortening the treatment course. Also, this is the social responsibility of every person to adhere to basic social etiquettes, such as controlling the spread of disease to others and refraining from making others ill.”
Dr Parul further said, “Re-infection happens primarily due to two reasons, first, malnutrition and poor dietary habits; second, the patients don’t pay attention to the ways to prevent infections, like their household condition and wearing masks. However, the number of people wearing masks in COVID has gone up, and it’s also important for people infected with TB. Proper nutrition and infection control are needed to prevent TB, especially MDR and XDR. Medication dropout, also known as the default rate, refers to patients who stop taking their medication after starting it. However, the default rate has decreased with the new medication regimen, which uses tablets rather than injections. DOTS and 99DOTS as a strategy are there to control the default rate of Tuberculosis patients.”
“The Revised National TB Control Programme (RNTCP) introduced the Directly Observed Treatment Short-course (DOTS) strategy to decrease the default rate, which has since been replaced by 99 DOTS and aids patients in completing their TB treatment as quickly and without unnecessary gaps as possible,” added Dr Parul.