To detect cases of latent infection, the government has launched a door-to-door screening campaign for tuberculosis (TB).
The Union health ministry has started a campaign to find patients before they develop full-blown TB and put them on preventive treatment. The campaign has been launched in five Indian states, while the official launch will take place in January 2017.
Large-scale screening will be a part of several measures that are planned as part of the revised strategy to bring down TB cases by 50% in the next two years.
“This will be to pick up cases much before they develop into a full-blown TB. We are introducing a new gene-based test that was recently launched in UK and is more accurate. Those with symptoms like cough, fever or loss of appetite will be screened on priority,” said Dr Jagdish Prasad, director general health services (DGHS).
“Picking up cases early and putting them on treatment will bring down the prevalence rate, cut the transmission risk and in turn will also reduce deaths. Initially, the numbers may rise but in the long run it will be a concrete step towards eliminating the disease from India,” said Dr Prasad.
Treatment modality is also being revised, with a plan to put TB patients on first line of treatment on a daily medicine regimen, to ensure better treatment outcome.
Currently, patients not registered under the DOTS (Directly Observed Therapy Short Term) programme are provided intermittent (alternate day) medicine dosage.
The health ministry has rolled out the new treatment plan in five states, and later will scale it up to other states from July 2017 onwards. The states being covered in first phase– Kerala, Bihar, Maharashtra, Himachal Pradesh and Sikkim.
“Ideally one should take the medicine daily for a consistent level of drug to be maintained in the body for better results. Breaks in between can lead to longer treatment duration and greater risk of non-compliance,” said Dr Prasad.
The government will also involve private practitioners who will be able to avail the testing facility at public health centres and get access to medicines for their patients, provided they notify authorities of the incidence of the disease.
There is also a plan to even register chemists as DOTS providers, and include corporate hospitals into their fold so that each case can be tracked.
The move was planned after a pilot study commissioned by the health ministry in Bihar and Gujarat found that private doctors were treating almost as many TB patients as government doctors were.
An estimated 15 lakh new infections are notified each year in India. In effect, the incidence and even prevalence of TB cases could be nearly the double of what gets documented.
“If the government is making medicines available even to the private sector then it will be easier to track numbers. The aim is to have all cases notified,” said Dr Prasad.
The ministry also is putting in place an IT-based patient-tracking system, like in case of HIV/AIDS.
“Currently we rely on the data made available to us by the treatment supervisor, with this new system in place, data will be authenticated at three levels— district, state and central level. The system will also have e-medicine provision to also track demand-supply gap to tide over medicine scarcity,” he said.