The way to control tuberculosis
- Tuberculosis is worst among endemic diseases, killing 1.5 million people every year (WHO).
TB And India
- India: TB capital of the world, it kills some 1,400 persons every day.
- These are gross estimates, for our health management system has no method to count the exact numbers.
- The National TB Control Programme of 1962 was district-based with public-private participation.
- However, upscaling the model proved unsuccessful and the programme failed to control TB.
Flaws in the programme
- No prescribed method of monitoring trajectory of TB control.
- Assumption that treating pulmonary TB patients alone would control TB was epidemiologically fallacious in India.
- RNTCP failed to elicit people’s partnership in TB control.
Controlling TB
- Human mastery over microbes includes control, elimination and eradication.
- Control refers to the reduction of disease burden through specific interventions to a predetermined level in a pre-stated time period.
- Evidence will have to show that reduction was due to those interventions and not due to a ‘secular trend’.
Conclusion
- Elimination refers to achieving zero frequency of new cases.
- As we have a huge backlog of latent TB, we cannot eliminate TB, but we must aim for a high level of control and document it with measurement.
Prelims Take Away
- TB
- AIDS
- National TB Control Programme