Tuberculosis (TB), often referred to as the "White Plague," is a centuries-old infectious disease caused by Mycobacterium tuberculosis bacteria. It primarily affects the lungs but can target other organs as well. TB continues to be a major global health challenge, and in India, it presents a unique set of obstacles and opportunities. In this article, we will explore the different types of TB, available treatments, India's progress, and the challenges it faces in its battle against this ancient disease.
Understanding Tuberculosis
Tuberculosis exists in various forms, with the most common being pulmonary TB and extrapulmonary TB. Pulmonary TB primarily affects the lungs and is highly contagious when the infected person coughs or sneezes, releasing infectious bacteria into the air. Extrapulmonary TB affects other organs like the bones, lymph nodes, or the central nervous system.
Types of TB
1. Drug-Sensitive TB: This is the most common form of TB and can be effectively treated with a combination of antibiotics.
2. Multidrug-Resistant TB (MDR-TB): MDR-TB occurs when the TB bacteria become resistant to two of the most potent first-line anti-TB drugs: isoniazid and rifampin. Treating MDR-TB is more complex and requires a longer duration of treatment with second-line antibiotics.
3. Extensively Drug-Resistant TB (XDR-TB): XDR-TB is a more severe form of drug-resistant TB, resistant to isoniazid, rifampin, fluoroquinolones, and at least one injectable drug. Treatment for XDR-TB is extremely challenging and often less successful.
India's Progress in TB Control
Over the years, India has made significant strides in tackling TB. According to recent data, the incidence of TB in India has decreased by 18% from 2015 to 2021, from 256 cases per lakh population to 210 cases per lakh population. Additionally, the estimates of drug-resistant TB in India have reduced by 20% during the same period, from 1.49 lakh cases in 2015 to 1.19 lakh cases in 2021.
Challenges Faced by India
While India's progress is commendable, several challenges persist:
1. High Burden: India still bears a substantial TB burden, with a quarter of all global TB cases occurring in the country. Factors such as poverty, overcrowding, malnutrition, and limited healthcare access contribute to this high prevalence.
2. Drug-Resistant TB: The emergence of MDR-TB and XDR-TB strains poses a growing challenge. Inadequate treatment and irregular drug supply have contributed to this problem.
3. Diagnostic Gaps: Timely diagnosis remains a challenge, especially in rural areas, leading to delayed treatment and increased transmission risks.
India's Response
The Indian government has implemented a multi-pronged approach to combat TB:
1. National Strategic Plan: India's plan for ending TB by 2025 focuses on early diagnosis, prompt treatment, engagement with the private sector, prevention strategies, airborne infection control, and addressing social determinants.
2. Molecular Diagnostics: The country has scaled up the availability of molecular diagnostic machines, Line Probe Assay labs, and liquid culture testing laboratories for diagnosing drug-resistant TB.
3. Universal Drug Susceptibility Testing (UDST): Ensures that every diagnosed TB patient is tested for drug resistance.
4. Newer Drugs: Introduction of drugs like Bedaquiline and Delamanid for managing drug-resistant TB.
5. Community Support: The Pradhan Mantri TB Mukt Bharat Abhiyan provides additional support to TB patients, including nutritional, diagnostic, and vocational assistance.
The Role of Nikshay Portal and Nikshay Mitras
In the endeavor to combat TB, India has harnessed technology and community involvement. The Nikshay portal is a pivotal digital platform used to track and manage TB cases, facilitating data collection, monitoring, and analysis. It plays a crucial role in the government’s strategy to end TB by 2025 by ensuring early diagnosis, treatment, and patient support.
Nikshay Mitras, community volunteers, are equally indispensable. These dedicated individuals bridge the gap between healthcare services and TB patients. They raise awareness, encourage TB testing, and ensure that patients receive the care they need. Nikshay Mitras also facilitate the implementation of initiatives like the Pradhan Mantri TB Mukt Bharat Abhiyan, which provides additional support to TB patients, including nutritional and vocational assistance. Together, the Nikshay portal and Nikshay Mitras contribute significantly to India’s comprehensive approach in the fight against TB, moving the nation closer to its goal of a TB-free India by 2025.
Conclusion
India's progress in reducing TB incidence and drug-resistant TB cases is a positive sign. However, the challenges remain formidable. Eliminating TB requires sustained commitment, resources, and a comprehensive approach that addresses medical, social, and economic factors contributing to its prevalence. The collaborative efforts of the government, healthcare professionals, and the community are vital in achieving the goal of a TB-free India by 2025. By continuing to invest in research, strengthen healthcare infrastructure, and raise awareness, India can play a pivotal role in the global fight against TB.
Source: PIB
Note for UPSC Aspirants: For UPSC aspirants interested in exploring further, here are some keywords to guide your research: COVID-19, Antimicrobial Resistance, WHO, Vaccines, Communicable Diseases, Community Participation, Ayushman Bharat Yojna.
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