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Notification of TB cases needs to be made strict: Experts

New Delhi: Strict enforcement of laws on TB notification, infection and control at all levels and uninterrupted laboratory supplies are some of the steps needed for control of tuberculosis, experts said on Monday.

“It is very important to integrate home-based care, rehabilitation and social support for people with drug-resistant TB,” Dr Amod Kumar, head of community medicine, St Stephen’s Hospital, Delhi, said.

Dr Kumar and others were part of a team of health advocates who met Planning Commission member Syeda Hameed to hand over a report of the review done on 14 sites in India where multi-drug resistant tuberculosis (MDR-TB) is being treated.

MDR-TB is a serious and difficult-to-treat form of tuberculosis resistant to many antibiotics.

The team has documented how standard guidelines for Programmatic Management of Drug-resistant Tuberculosis (PMDT) of Central TB Division are getting implemented.

“PMDT guidelines were being followed in all the 14 sites we visited in the public sector. Our team also visited government sites along with few programmes managed by non-profit agencies and a private laboratory in Delhi and were very inspired to see that not only are the guidelines being strictly upheld, but an enormous effort has also gone into establishing and managing these sites,” Bobby Ramakant of CNS Vote For Health campaign said.

The report has a series of personal stories of cured MDR-TB patients, as well as those with MDR-TB or Extensively Drug-Resistant TB (XDR-TB) who are currently receiving treatment from government PMDT sites.

Despite challenges of health systems and the highest TB disease burden globally, India has come a long way in its response to providing access to standard WHO-recommended anti-TB treatment through Directly Observed Treatment Short course (DOTS) to more than 14.2 million (1.42 crore) people across the country.

However, TB continues to remain one of the key public health priorities in India. Drug-resistant TB is one of the major concerns, and India is on track to providing universal access to quality diagnostics and treatment services for all patients with drug-resistant TB in the next five years. [IANS]

One Comment

  1. Prof. Manoj Sharma Prof. Manoj Sharma Tuesday, July 30, 2013

    Tuberculosis and Cancer has one thing in common the confidentiality that sufferer wants…due to Stigma attached to the disease . Many of the policy makers are convinced that confidentiality aspect should over weigh the early detection and quicker treatment.And this is one point that has brought disaster to our community. Actually anti tuberculosis or anticancer campaign is contradicting this perception of those advisors who are miles away from the reality. By not agreeing to declare cancer as a notifiable disease they are criminally promoting a late stage presentation where the misery is so much that patient starts reporting to a doctor who may or may not be able to clinch the diagnosis of cancer and hence add to delay by non specific prescriptions. This is the reality of our Cancer OPDs that some of the policy makers have not known and they overwighed the terms like confidentiality, embarrassment ,public shame against the suffering and incurability of cancer that has become the order of the day just because cancer is still not declared as a notifiable disease despite willingness of many who matter in directing health affairs of the country and also managing cancer patients on daily basis.

    1- Advantage of Cancer Notification
    A-Harvesting of larger number of cancer cases that are in curable stages.It is the prevention of the “Great Delay” factor in the recognition of the disease and diagnosis of the disease that makes cancer incurable. Cancer notification will take care of this factor and cases will be reported in much early stages.
    B- As the awareness increases the early curable and pre-malignant disease detection will increase and THIS IS WHAT WILL REDUCE THE ECONOMIC BURDEN ON HEALTH SERVICES AND THE INDIVIDUAL FAMILY THAT FACES BANKRUPTCY EITHER DUE TO EXPENSIVE TREATMENT OR DUE TO THE DEATH OF BREAD WINNER OF THE FAMILY DUE TO INCURABLE DISEASE .
    C-Cancer Notification shall Create More Awareness about cancer in public as well as physician and word goes to the lowest level of primary centre about the disease .The awareness of the word cancer , at many places simply does not exist.
    2- Stigma ( Not to disclose about the disease) does not exist in 80-90 percent of cancer patients of India that come from the rural or poor socio economic conditions. Even with increase cancer awareness as in case of Breast cancer awareness in particular, the stigma factor does not exist.
    If at all it exists ,a proper awareness on cancer and the very tragic outcome of late diagnosis will remove this stigma of hiding the cancer disease .
    3- Stigma Theory is contradictory and is totally unfounded because we are already talking about greater cancer awareness ,asking people to come and have a check up and get cancer detected in early stage then where is the stigma to conceal the disease. Example: Tamil Nadu where rural women( literacy levels are higher) are going to hospitals and asking for cancer screening.
    4- No doubt the early detection of cancer is by screening programmes but it is the declaration of cancer as a notifiable disease that will detect cancer cases that need curable treatment and hence the time wasted and the delay that happens in diagnosis and commencement of treatment will be prevented.
    The perception of one professor of oncological sciences in one of the conferences is that Govt. is not declaring cancer as a notifiable disease because if more number of cases will pour in we do not have cancer treatment facility is wrong as it only means that let the patients be detected in a stage when they suffer from pain and agony and when the disease is already incurable. As such there is a waiting list for most of the cases . By cancer declaration at least we will prioritise and rush for the treatment of those who are curable and thus the delay in waiting that results in incurability because of delay or unnoticed diagnosis will be prevented
    It is here the canceronomics that shall start working. An early curable detected cancer will have less of expenditure because hospital occupancy and wastage on costly cancer chemo-radiotherapy and surgical regimen will be much less when compared to the war that is waged against advance disease cancer with all the might available in market or corporate sector.
    Declaring cancer as a notifiable disease will save lives, create preventive awareness and remarkably reduce financial burden on Govt. Health Services as well as on patients personal economy.

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