New Delhi: Over 20 lakh people develop Tuberculosis (TB) in a year in India. While the national TB control programme is trying to reach the affected, its biggest challenge lies in tackling 15 per cent drop out from government’s treatment programme.
According to analysts, for India to be TB free, the government programme will have to reach out to the ones reeling under difficult circumstances. Take the case of Radha Devi’s family, battling with poverty, alcoholism, malnutrition and co-infections.
At different stages over the last three years, three members of this family were affected by TB. Each case was different and each one responded differently. Surprisingly, only one of them was benefited from the government’s treatment programme.
Radha Devi’s husband, an out of work tailor, had become an alcoholic. As a patient, he was difficult and irrational. For him, the fixed OPD hours at government hospitals were a problem.
A private practitioner was available through the day and the family somehow managed to take him there.
Radha Devi said, “His health began to improve after he got treated by a private doctor, but after two months, he resumed drinking alcohol.”
He died after he developed numerous complications. A little before his death, his 23-year-old daughter Sonia found she had TB.
Sonia’s case was different. She had school education that made her both aware and motivated to fight against TB. She completed her treatment from the Government’s DOTS centre. DOTS stand for Directly Observed Treatment, Short Course.
Sonia said, “I had no idea what DOTS meant, but when my father got TB, I sought information from the hospital and other sources. I began finding out about TB and how one gets infected.”
A year later, her 17-year-old brother Sumit also got affected by TB. Sumit who was frail after an earlier gastrointestinal surgery developed jaundice. Sumit was unable to deal with the toxicity of the drugs and the government’s treatment programme was unresponsive to his condition.
At a private hospital, the dose was adjusted to suit him. Radha Devi said, “At the hospital, they conduct a blood test and give the dose accordingly.”
TB has existed in India for several thousand years, but still, all patients do not find access to treatment. It is well established that TB is a highly contagious bacterial infection.
When people with TB in their lungs or throat cough, laugh, sneeze, sing, or even talk, the germs that cause TB spread into the air, if another person breathes in these germs, there is a chance they will become infected. If left untreated, TB can even cause death.
Skilled counselling under the Government’s programme could have helped families like Radha Devi’s meet the treatment challenges and break the chain of transmission.
The family lives in Delhi’s Sangam Vihar, Asia’s largest slum, but no health worker or counsellor visited them.
Three people with TB in a family had not set off alarm bells in the health system. Clearly, the national TB control programme will have to address these gaps.