Though notification of tuberculosis goes up, more than 0.5 million patients still missing
India accounts for nine per cent of all HIV-associated tuberculosis (TB) deaths in the world, the second-highest number globally. Around 9,700 people die every year among TB-HIV co-infected patients, according to The India TB report 2020, that was released on June 24, 2020.
A total 92,000 HIV-associated TB patients were recorded on an annual basis, the report said. This is slightly higher than what was reported in last year’s report that pegged this number at 86,000. The last report also said India ranked second-highest in this regard.
Awareness among TB patients about their HIV status has gone up to 81 per cent, from 67 per cent. The treatment success rate in TB patients has hovered around 70-73 per cent in the last two years. From 2014-2016, it was between 76 and 77 per cent.
People living with HIV are the most vulnerable among all those TB patient groups which have other co-morbities and hence, the World Health Organization lays social emphasis on them.
The other such group is TB patients suffering from diabetes. It is specially relevant to India, considering the escalating prevalence of diabetes. Twenty per cent of all TB cases in India also suffer from diabetes, according to the report.
Conversely, diabetes triples the risk of TB. Diabetes can worsen the clinical course of TB and TB can worsen blood sugar control in people with diabetes, the report said.
What is important is screening of TB patients for diabetes. In 2019, among the notified TB patients under the Revised National TB Control Programme, 64 per cent had their blood sugar screened.
The corresponding figure in last year’s report was 29 per cent. Out of all those TB patients screened, eight per cent were confirmed with diabetes, up by one per cent point as compared to the last year.
Eight per cent of TB cases can be attributable to tobacco usage. Morever, tobacco usage among TB patients is on the rise. Last year, the report said out of all TB patients, four per cent were found to be tobacco users. This year, the number has gone up to 14 per cent.
This year’s report highlighted the fact that as many as 2.4 million TB cases were notified in 2020, which was a milestone of sorts. The notification of TB is a major hurdle in surveillance of the disease in India. Around 2.15 million cases were notified in last year’s report, which was also registered as a “milestone.”
However, what remains a major area of concern is the fact that 0.54 million TB cases are still missing across India, according to the report. “Similar to trends in the previous years, over half of the total notifications are contributed by five states namely Uttar Pradesh (20 per cent), Maharashtra (9 per cent), Madhya Pradesh (8 per cent), Rajasthan (7 per cent) and Bihar (7 per cent).
The TB notification relative to population is the highest in Chandigarh (605 / lakh), Delhi (574 / lakh) and Puducherry (313 / lakh) largely owing to these states providing diagnostic care for populations beyond their own boundaries, the report said.
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