On the eve of the World Tuberculosis (TB) Day on 24 March, the WHO has sent forth a rallying call for all nations to gear up to end TB. It would be hardly surprising if this call was particularly directed towards India, as an estimated 40% of the total Indian population is said to harbour the organism causing TB. WHO estimates that about 3,00,000 people die from TB related causes in India.
It is not without reason, therefore, that the Revised National Tuberculosis Control Programme (RNTCP) that was launched by the Government in 1997 has been extended across the country in a well-coordinated manner. DOTS, which stands for Direct Observed Treatment, Short-course, has been implemented by RNTCP, based on the research conducted in India on the effectiveness of this approach. If figures released by RNTCP are to be believed, then the DOTS method is effective in curing 8 out of 10 cases of TB, as opposed to the 3 out of 10 cases in the pre-1997 programme.
TB is caused by Mycobacterium, the same genus that causes leprosy, and has been described in ancient Sanskrit manuscripts of 500 BC. The bacterium predominantly affects the lungs, and spreads through droplet inhalation. It is also known to affect bones, gut and the genital tract – leading to infertility. TB mostly affects young adults and those with a poor immune status, such as HIV-positive individuals. TB should be suspected in all those individuals who develop these symptoms:
1. Cough of three weeks or more, with sputum (phlegm) production
2. Fever – especially evening/night rise of temperature
3. Prolonged loss of appetite
4. Unexplained weight loss
The important thing to remember is that treatment is available and is very effective; provided the treatment regime is adhered to and the individual completes the usual six month course with four anti-TB drugs. A major reason for multi-drug resistant TB cases to have risen recently is because the course was left untreated by a significant number of patients.
The issue of TB is tied in with such issues as the socioeconomic status of the country, cleanliness and hygiene, and the effectiveness of primary health care systems. It is therefore particularly relevant that awareness campaigns are undertaken to educate the masses about TB and that it is recognised and treated early. It is incumbent upon us make every effort to eradicate TB, just as we did with polio.
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