Amid Covid Surge, Grim Reminder on TB as Govt Report Shows 24 Lakh Cases, Over 79K Deaths Reported Last Year

As India grapples with a surge in Covid-19 cases in bigger cities and states, a government report revealed that the country reported over 24 lakh tuberculosis cases in 2019, which was a 14% rise compared to 2018. The country however missed notifying fewer TB patients. As against 10 lakh patients whose registration was missed by the government in 2017, 2.9 lakh patients were left behind as part of registration process under the National TB programme. WHO had estimated incidence of the infectious disease among 26 lakh people in India.

However, the number deaths in the government’s annual TB report varied vastly compared to the World Health Organization’s (WHO) estimate. The UN body estimated in its 2019 global TB report that there were an estimated 4.49 lakh deaths in India due to TB whereas the annual government report showed that 79,144 people had died of TB in the country in 2019. Of them, about 1.5 lakh were deaths in children.

Of the 24 lakh cases reported in 2019, 6.7 lakh cases were reported from the private sector, a 35% increase compared to 2018, and this was one of the key reasons for the rise in notified cases. The report also said that due to easy availability of molecular diagnostics, the proportion of children diagnosed with TB increased to 8% in 2019 compared to 6% in 2018.

Under the National Tuberculosis Elimination Programme (NTEP), the government has moved to near-complete online notification of all TB cases in the country through the NIKSHAY portal, the report claimed.

Even as the notified cases rose, the first line standard treatment coverage was not 100%, as per the report. Out of the 24.04 lakh cases notified, the first line of standard treatment was initiated for 22.7 lakh people of the notified drug sensitive TB cases. The government also identified 62,958 cases through active case finding.

This involves actively searching for TB patients among the vulnerable population of the society such as tribals, those below poverty line, those living in slum pockets and even in prisons. This is done to detect the disease at an early stage. In 2019, 27.74 crore people was screened as part of active search programme across 337 districts in 23 districts.

The data on the TB cases in India come at a time when the health system has been overwhelmed by the Covid-19 pandemic and doctors and epidemiologists have warned that the burden on the healthcare system could reduce early detection and diagnosis, leading to problems in TB programme.

India has the highest burden of TB burden in the world having an estimated incidence of 26.9 lakh cases in 2019 as per WHO.