Battle against tuberculosis: Challenges, strategies, and the role of public awareness

Sowmya Raju | NT

Bengaluru: World TB Day, observed on March 24 each year, serves as a reminder of the global fight against tuberculosis (TB).

In India, the day takes on even greater significance due to the country's high TB burden.

Dr Pavan Yadav, Lead Consultant - Interventional Pulmonology & Lung Transplantation at Aster RV Hospital, sheds light on the pressing issues surrounding TB in India.

India grapples with a significant share of the global TB epidemic, accounting for roughly a quarter of all TB cases worldwide.

The World Health Organisation's Global Tuberculosis Report 2023, states, India reported an estimated 2.64 million cases in 2022, making it the country with the highest number of TB cases globally.

Challenges in control and elimination

Dr. Yadav highlights several hurdles hindering TB control in India.

"Socioeconomic determinants, healthcare infrastructure limitations, and diagnostic and treatment gaps pose significant challenges," he explains.

Factors like poverty, malnutrition, and overcrowded living conditions exacerbate TB transmission and impact.

Additionally, the healthcare system grapples with inadequate access to quality diagnostics, delayed diagnoses, and incomplete treatment adherence, fostering the spread of TB and drug-resistant forms of the disease.

The impact of COVID-19 on TB services

The COVID-19 pandemic has further strained India's TB control efforts. "The diversion of healthcare resources, coupled with lockdowns, disrupted TB diagnosis and treatment services," notes Dr Yadav, referencing a study from The Lancet Global Health journal.

This disruption raises concerns about undiagnosed cases and potential spikes in transmission rates, emphasising the need for resilient healthcare systems capable of maintaining essential services during health crises.

Recognising the urgency of the TB epidemic, the Indian government launched the National Strategic Plan for Tuberculosis Elimination (2017-2025).

Dr Yadav states, "This comprehensive approach aims to eliminate TB by 2025 through early detection, prompt treatment, increased public awareness, and strengthened surveillance systems."

Innovative strategies, including digital technologies for adherence monitoring and the Nikshay system for case notification and treatment monitoring, are integral to this effort.

The role of the BacilleCalmetteGuérin (BCG) vaccine in preventing TB, particularly in children, is also pivotal. Dr. Yadav emphasises the critical importance of completing the full course of anti-tuberculosis treatment (ATT).

"Non-adherence or incomplete treatment can lead to drug-resistant TB strains, complicating treatment and increasing fatality risks," he warns.

Ensuring adherence to prescribed regimens is paramount in combating TB effectively. Several factors elevate the risk of TB infection, particularly in high-burden countries like India.

Close contact with TB patients, immunocompromised states, socioeconomic factors, substance use, and healthcare exposure all contribute to heightened susceptibility.

To mitigate the risk of TB, Dr. Yadav advises the general public can adopt preventive measures such as maintaining good hygiene, avoiding crowded spaces, oosting the immune system, and getting vaccinated.