Tuberculosis (TB) is counted among the top 10 killer infectious diseases. According to a report of World Health Organization (WHO), TB is a worldwide pandemic and a leading cause of death.
Tuberculosis (TB) is caused by bacteria (mycobacterium tuberculosis) which most often affect the lungs. It travels from person to person via the medium of air. When a TB infected person coughs, sneezes or spits, the germs are propelled out into the air and only a small amount is needed to be inhaled to get infected. When a person develops active TB (disease), symptoms like cough, fever, night sweat, weight loss, etc, may be mild for several months, which leads to delay in seeking care and results in transmission of the bacteria to others. It is estimated that a TB infected person can affect nearly 10-15 persons over the course of a year.
Tuberculosis is curable and preventable. About one-third of the world’s population has latent TB, which means people have been infected by TB bacteria but are not (yet) ill with disease and cannot transmit the disease. Since 2000, fortunately, 53 million lives have been saved through effective diagnosis and treatment. Active drug-sensitive TB disease is treated with a standard 6-month course of 4 antimicrobial drugs that are provided with information, supervision and support to the patient by a health worker or trained volunteer. The vast majority of TB cases can be cured when medicines are provided and taken properly.
In India, historically speaking, the fight against TB can be broadly classified into three periods: the early period, or before the discoveries of X-ray and Chemotherapy; the post-independence period, during which nationwide TB control programmes were initiated and implemented; and the current period, during which the ongoing WHO-assisted TB control programme is in place. India’s DOTS (Directly Observed Treatment-Short Course) programme is the fastest-expanding and the largest programme in the world in terms of patients initiated on treatment and the second largest in terms of population coverage.
There are certain challenges in controlling TB in India, such as poor primary health-care infrastructure in rural areas of many states, unregulated private health care leading to widespread irrational use of first-line and second-line anti-TB drugs, spread of HIV infection, lack of political will, and corrupt management. Multidrug-Resistant TB (MDR-TB) is another emerging threat to TB eradication and is a result of deficient or deteriorating TB control programme.
Tuberculosis is a preventable and curable disease if detected and treated early. It has low prevalence in developed nations which means people living in such areas need not take precautions to prevent the infection. However, some measures of prevention are suggested for those living or travelling to areas and countries that have a high prevalence of the infection.
Bacillus Chalmette Guerin (BCG) vaccination can be used as a weapon against tuberculosis. The BCG vaccine is given to all infants in countries where the disease is prevalent. The BCG vaccination is recommended for three main groups of people. One of these are babies born in areas where the rate of Tuberculosis is high and those babies with one or more parents or grandparents born in countries with a high rate of Tuberculosis. Before the vaccine is given, the person is given a Monteux skin test to check for latent tuberculosis.
WHO with its “STOP TB” strategy has given a vision to eliminate TB as a public health problem from the face of the earth by 2050.
The writer is a research scholar. [email protected]