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By K. Zeliang, APR, Nagaland
The Tuberculosis is one of the most infectious diseases in the world causing the maximum number of deaths. The global annual incidence estimate is 9.4 million cases out of which 1.98 million cases from India. This is the highest T.B. burden in the country accounting for one fifth of the global incidence.
According to the health and family welfare Nagaland, two of every five Indians are infected with the T.B. bacillus and about 500 people develop this disease every day and around 1000 die from it three quarters of the T.B. deaths and cases occur in people aged between 15-50 years the most economically productive age group causing the loss of millions of potentially healthy and productive years of life.
The five key components of dots are;
- Political and Administrative commitment
- Case detection by microscopy examination
- Uninterrupted supply of good quality drugs
- Directly observed treatment short course
- Systematic monitoring and evaluation.
T.B. Scenario in Nagaland
Ever since its inception on the 1st of December 2002, 22215 patients have been put under various categories of DOTS treatment (up to 3rd quarter 2010, the case detection rate was 89% (Targeted 70%) and success rate was 92% targeted 85%) in the 3rd quarter 2010 Nagaland has consistently been in the target zone for the last 4 years or more in terms of the two performance indicators. Nagaland is among the 10 high prevalent state and T.B. is one of the most opportunistic diseases in HIV patients. The risk of developing T.B. among them is 60% hence T.B. HIV coordination becomes crucial and to address various issues concerning these two diseases, the district coordination committees, state coordination committee and state working group are some bodies which have been formed.
Multi Drug Resistance (MDR) T.B. and extensive drug resistance (XDR) T.B.
The prevalence of MDR T.B. in new smear pulmonary T.B. case is 3% and 12 to 17% amongst Smear positive previously treated PTB cases. The review of studies with representative sample does not indicate any increase in India of the prevalence of drug resistance over the years despite the presence of some isolated reports. The Department said that, it is not possible as yet to estimate the magnitude and distribute of XDR T.B. from the available data. The use of inadequate regimes and the absence or inappropriate application of DOTS treatment can lead to development of drug resistance levels amongst the community. The heath sector in Nagaland highlighted that the state is planning to start a DOTS plus site to cater those cases which are underway. Treatment in this facility will also be free of cost, and it is anticipated that the establishment of such a site in the state will go a long way in fighting the menace of T.B. in Nagaland.
43 Microscopy centre (MCS) including 11 District T.B. centres (DTC) covering 11 district fully equipped with binocular microscope to conduct sputum examinations and subsequent supply of medicines free of cost.
Some important Information about T.B;
- B. bacillus can infect all the organs of your body except your hair, teeth and nails.
- You can be a HIV/AIDS patient and yet be cured of T.B. infection
- More adults die of T.B. than from any other infectious disease in India.
- If the Treatment for T.B.is left incomplete the patient can develop resistance to T.B. drug which can result in treatment failure.
- Diagnosis and treatment of T.B. is free.
- The state of Nagaland is now fully covered under RNTCP.
The Directorate of health and family welfare Nagaland has suggested that, if someone shows any of these symptoms, to immediately visit the nearest District T.B. centre or microscopy centre.
The symptoms are :-
- Cough for two weeks or more.
- Blood in sputum
- Loss of appetite
- Weight loss
- Low great fever.