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Daily News Analysis

Tuberculosis notifications in 2020 down by 25% in India, global report says

17th October, 2020 Health

Context: The COVID-19 pandemic, combined with impacts on care-seeking behaviour, threatens to reverse the recent progress in reducing the global burden of tuberculosis (TB) disease, the World Health Organization (WHO) warns in the latest Global TB Report.

Global TB report findings:

  • “There is already evidence from several high TB burden countries of large reductions in the monthly number of people with TB being detected and officially reported in 2020, especially in India and other countries,”
  • India accounts for 26% of TB cases in the world, the TB notifications during the period January-June 2020 in India fell by 25% compared to the same period in 2019.
  • Overall, there has been a recovery from the lowest point in mid-April. Decreases occurred in both the public and private sector.
  • In India, notifications of people newly diagnosed with TB increased 74% from 1.2 million to 2.2 million between 2013 and 2019.
  • There is still a gap in the number of people newly diagnosed and reported in the world and the estimated number of people who would have developed TB in 2019.
  • In the case of India, this gap accounts for 17%. This gap is due to a combination of underreporting of people diagnosed with TB and underdiagnosis (if people with TB cannot access health care or are not diagnosed when they do).
  • The report says that the global number of TB deaths could increase by “around 0.2-0.4 million in 2020 alone, if health services are disrupted to the extent that the number of people with TB who are detected and treated falls by 25-50% over a period of three months”.

Problems cited are

  • reassignment of people from national TB programs to COVID-1-related duties,
  • reductions in the number health-care facilities treating people with TB,
  • a reduction in collection of data.

Tuberculosis (TB)

  • It is an infectious disease usually caused by Mycobacterium tuberculosis (MTB) bacteria.
  • Tuberculosis generally affects the lungs, but can also affect other parts of the body.
  • Most infections show no symptoms, in which case it is known as latent tuberculosis.

TB drug resistance types

  • Mono-resistance: resistance to one first-line anti-TB drug only
  • Poly-resistance: resistance to more than one first-line anti-TB drug, other than both isoniazid and rifampicin
  • Multidrug resistance (MDR): resistance to at least both isoniazid and rifampicin
  • Extensive drug resistance (XDR): resistance to any fluoroquinolone, and at least one of three second-line injectable drugs (capreomycin, kanamycin and amikacin), in addition to multidrug resistance
  • Rifampicin resistance (RR): resistance to rifampicin detected using phenotypic or genotypic methods, with or without resistance to other anti-TB drugs. It includes any resistance to rifampicin, in the form of mono-resistance, poly-resistance, MDR or XDR.

The National Tuberculosis Elimination Program

  • It is the Public Health initiative of the Government of India that organizes its anti-Tuberculosis efforts.
  • It functions as a flagship component of the National Health Mission and provides technical and managerial leadership to anti-tuberculosis activities in the country.