Tuberculosis is the Top Infectious Killer Disease

Tuberculosis is an Air-borne Infectious Disease

Latest WHO reports (30th Oct 2017) state that around 53 million lives affected by tuberculosis have been saved since 2000, reducing the mortality rate by 37%. Still, TB is the top infectious killer disease and leading killer of people with HIV in 2016. There were 10.4 million new TB cases globally, 10% of which were people living with HIV. Seven countries account for 64% of the total cases, with India leading the charts, followed by Indonesia, China, Philippines, Pakistan, Nigeria and South Africa. Almost 1.7 million people died from TB, out of which 400,000 people were co-infected with HIV. On the positive side, this is a drop by 4% compared to 2015.

In India, almost 220,000 people die from tuberculosis every year and it remains as the biggest health problem in our country. With 1.7 million new cases in 2016, India continues to be the largest contributor to the global statistics with up to a quarter of the 6.3 million new cases of TB (rise from 6.1 million in 2015). But on the positive end, there was a 12% decrease in the number of deaths due to TB compared to the previous year and also the number of new cases decreased by 1.7%, according to World Health Organization reports. But despite this decline, India still accounts for about 32% of the world tuberculosis cases.

What is Tuberculosis & Why is it Prevalent in Such High Numbers in India?
Tuberculosis is an air-borne disease caused by germs primarily affecting the lungs along with other body parts such as the kidneys, brain or the spine. Symptoms include weakness, tiredness, fever, weight loss and night sweats. When TB affects the lungs, coughing, spurting blood and chest pain are common. So, when a person with TB sneezes, coughs, speaks or sings, germs are expelled into the air and can stay for several hours depending on the environment. Other people who breathe this infected air can acquire TB disease (latent TB infection). Individuals with latent TB infection have no symptoms as the germs are inactive, but can develop into TB disease anytime in the future. People with TB disease experience TB symptoms as the germs are active, multiplying and destroying tissues in the body.

Reasons for Tuberculosis Dominance in India

1. You are at a greater risk of being affected by TB if you come from, or travel to, countries where TB is dominant and where there are huge populations of homeless people. India is definitely in this category as it is the country with the largest number of diagnosed patients.
2. India is still a developing country where economy is low, and most people cannot afford the money for the prescribed treatment or drugs. Presently, only 1.5 million patients receive free treatment from the government for TB and only 16% of people with drug-resistant TB receive appropriate treatment.
3. Pollution dispersion throughout the country also makes India susceptible to TB. Pollution affects the air people breathe causing numerous disease. As tuberculosis is an air-borne disease, chances of getting TB are higher and can consistently only increase for India. Air pollution is the leading cause of many common killers, details of which are available in the website www.firsteatright.com.

 
Bridging the Monetary Gaps
 
More effort needs to be taken to close gaps in care and financing.

1. Underreporting and underdiagnoses of TB cases exist, specifically in countries with weak health systems and unregulated private sectors. Out of the total 10.4 million cases, only 6.3 million cases were detected and notified officially in 2016. Pity is that, India, Indonesia and Nigeria account for almost 50% of this global gap.
2. Only one in five multidrug-resistant patients receive proper treatment. India and China account for 39% of the global gap and treatment success is only 54% globally.
3. For TB care and prevention, the money allocated in developing countries fall almost US$ 2.3 billion short of the US$ 9.2 billion needed in 2017. Apart from this, at least an extra US$ 1.2 billion per year is required to allocate funds for new vaccines, diagnostics and medicines.
   
   

Treatment
Just like the rise in TB, treatment for TB is also on the rise. Tuberculosis can be treated by consuming multiple drugs for 6 to 12 months. It is crucial that patients with TB should take the prescribed drugs exactly for the prescribed time period to avoid recurrence of the infection or resistance by the germs. TB that becomes resistant to drugs is harder and expensive to treat.
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The Indian government started the Revised National TB Control Program (RNTCP) in 1997 putting into practice the WHO recommended DOTS (Directly Observed Treatment Short Course) strategy to develop ideas and data on TB treatment. In 2016, the RNTCP notified 17.5 lakh TB patients and is planning to conduct its first TB national prevalence survey in 2017-2018. In March 2017, the Government of India announced its aim to eradicate TB by 2025.