Friday, July 14, 2017

Are more TB patients dropping out of treatment in Mumbai? NGO, officials differ

Hindustan Times: Mumbai: Friday, July 14, 2017.
An increasing number of patients are dropping out of treatment for tuberculosis (TB) in the city, according to data collated by a city-based non-government organisation (NGO).
A report released by Praja Foundation on Wednesday revealed an 11% increase in TB patients who have dropped out of treatment from the city’s public hospitals and clinics over five years (2012 - 2016).
According to the report, there were 2,638 patients who dropped out of treatment in 2012, which rose to 2,927 in 2016.
The therapy known as directly observed treatment, short-course (DOTS) (see box) is provided by the government under the Revised National Tuberculosis Control Programme (RNTCP).
Under DOTS, the intake of medicines by patients is monitored to ensure that they adhere to the prescribed dosage and schedule.
Moreover, the number of TB cases registered at government institutions has also increased by a substantial 37%, claims Praja.
“TB treatment usually lasts between six months to a year. The issue is whether the government is doing enough to follow up on all the cases registered for treatment under DOTS?” said Nitai Mehta, from Praja Foundation.
The NGO attained the data through queries made under the Right to Information (RTI) Act.
However, Dr Daksha Shah, the city’s TB officer, said the data has been misinterpreted by Praja as some of the defaulters calculated for each year could have registered in the previous year.
The NGO should have asked for total number of patients under treatment in a particular year, she added.
“Most of the defaulters are patients from villages who go out of the city during their treatment. When they go back to the village without informing the programme officer, it gets very tough to reach them,” she said.
She added that a lot of patients under treatment are alcoholics, who refuse to takemedicines despite repeated counselling.
Doctors said there are dire public health consequences when tuberculosis patients abruptly abandon treatment as they could acquire drug resistance and as a result, infect other people too.
“As these people move freely in the community they infect people with a bacilli strain which is already drug resistant. This is called primary infection and is a major concern now,” said Dr Alpa Dalal, head of department, pulmonary medicine, Thane.