Status of Pulmonary TB: The Lancet Study

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• According to a new study published in The Lancet, India has the highest population with household exposure to pulmonary tuberculosis (TB).

Major highlights of the report

• Overall statistics: An estimated 38 million people live in households across 20 high-burden countries where at least one person has pulmonary TB.
  • This includes India.
• Country-wise estimates: India accounted for 30 per cent of the total figure, with 11.4 million people facing household exposure to TB.
  • It was followed by Pakistan (5.2 million), Indonesia (2.7 million), Nigeria (2.5 million) and the Philippines (2.2 million).
• Demographic estimates: An estimated 1.11 million children aged 0-4; 2.28 million children aged 5-14; 5.94 million people aged 15-49; and 2.02 million people above 50 years in India face household exposure to infectious disease.
• States with the highest TB notifications: In 2020, Uttar Pradesh had the highest share of tuberculosis notifications in India with over 20 per cent.
  • Maharashtra and Madhya Pradesh followed with relatively lower notification rates with eight and seven per cent, respectively.

What is pulmonary tuberculosis?

• Pulmonary TB, also known as consumption, spread widely as an epidemic during the 18th and 19th centuries in North America and Europe.
• Pulmonary TB is curable with treatment, but if left untreated or not fully treated, the disease often causes life-threatening concerns.
• People with latent TB aren’t contagious and can go about their day-to-day lives as usual, but if you have pulmonary TB disease, you need to stay home and avoid close contact with others.
• Symptoms of pulmonary TB: cough up phlegm, cough up blood, have a consistent fever, including low-grade fevers, have night sweats, have chest pains, have unexplained weight loss.
• Pulmonary TB spreads by shaking hands, sharing food or drink, sleeping in the same bed.

Tuberculosis (TB)

• It is caused by bacteria (Mycobacterium tuberculosis) that most often affect the lungs.
• Tuberculosis is curable and preventable.
• TB is spread from person to person through the air.
  • When people with lung TB cough, sneeze or spit, they propel the TB germs into the air. A person needs to inhale only a few of these germs to become infected.
• When a person develops active TB disease, the symptoms (such as cough, fever, night sweats, or weight loss) may be mild for many months.
  • This can lead to delays in seeking care and results in the transmission of the bacteria to others.
• Tuberculosis mostly affects adults in their most productive years. However, all age groups are at risk.
• Over 95% of cases and deaths are in developing countries.
• In 2020, the largest number of new TB cases occurred in the WHO South-East Asian Region, with 43% of new cases.
  • Followed by the WHO African Region, with 25% of new cases and the WHO Western Pacific with 18%.

Multidrug-resistant TB

• Multidrug-resistant tuberculosis (MDR-TB) is a form of TB caused by bacteria that do not respond to isoniazid and rifampicin, the 2 most effective first-line anti-TB drugs.
• Anti-TB medicines have been used for decades and strains that are resistant to one or more of the medicines have been documented in every country surveyed.
• Drug resistance emerges when anti-TB medicines are used inappropriately, through incorrect prescription by health care providers, poor quality drugs, and patients stopping treatment prematurely.

Global TB Burden:

• A total of 1.5 million people died from TB in 2020 (including 214 000 people with HIV). Worldwide, TB is the 13th leading cause of death and the second leading infectious killer after COVID-19 (above HIV/AIDS).
• Most of the people who fall ill with TB live in low- and middle-income countries, but TB is present all over the world.
• TB occurs in every part of the world. In 2020, the largest number of new TB cases occurred in the WHO South-East Asian Region, with 43% of new cases, followed by the WHO African Region, with 25% of new cases and the WHO Western Pacific with 18%.
• In 2020, 86% of new TB cases occurred in the 30 high TB burden countries. Eight countries accounted for two-thirds of the new TB cases: India, China, Indonesia, the Philippines, Pakistan, Nigeria, Bangladesh and South Africa.

Efforts Taken:

• Global Efforts:
  • Global Tuberculosis Programme and Report, 1+1 initiative & Multisectoral Accountability Framework for TB by WHO.
  • Ending the TB epidemic by 2030 under UN SDG target 3.3.
  • Moscow Declaration, 2017 to End TB. 

• Indian Efforts:
  • The government aims to have a TB-free India by 2025, five years ahead of the global target of 2030.
  • National Tuberculosis Elimination Programme: National Strategic Plan to end TB by 2025 under pillars of Detect-Treat-Prevent-Build (DTPB).
  • Universal Immunisation Programme.
  • Revised National TB Control Programme under the National Health Mission.
  • NIKSHAY portal and TB Sample Transport Network.
  • Development of National Framework for Gender-Responsive approach to TB.

Source: DTE