July 29, 2023

Every year, 24th of March is celebrated as World TB Day and this year, too, WHO has a slogan as, “Wated- Leaders For TB-Free World!”

24th of March is the day, when hundreds of years ago, Robert Koch identified bacteria, Mycobacterium Tuberculosis as the cause for this rampant disease. The disease which was prevalent in Europe and USA in those days, have practically taken our health system for a toss due to its high communication rates and our huge population in these days!

Although TB remains a global problem, as a developing nation, India stands amongst topmost when TB is counted and we have this disease as top priority amongst all infectious diseases in our country.

Is the only problem of overcrowding, population, poor haelth infrastructure especially at rural places is the cause for huge burden of this disease? Definitely, they are the top threats, but what is more important is the awareness about the disease and the public message spread especially on the occasion of World TB Day! This day is dedicated as an honour to the great scientists for their continuous research in the development of newer treatment options being made available and also, as a respect for those who have lost their lives and for the courage for those who are fighting with their disease!

It is our huge responsibilty to identify this disease, as any chronic cough of more than 2-3 weeks duration should undergo chest X-ray and possibly, sputum examination, as it can be TB. Th e other common symptoms of evening fever, weight loss, malaise, night sweats should not be forgotten.

The diagnosis may not be always as easy as it looks and TB in our country can affect each and every organ of the body, may it be glandular TB, intestinal TB, brain affection, spine affection or genitourinary TB. These extrapulmonary diseases are mostly not contagious and they dont spread the disease to the others. Not surprisingly, in our country, TB remains one of the commonest cause of infertility, too! The magnitude of this disease is humangous and the disease kills globally with an average of 1-2 deaths per minute!

For an open case of TB, just covering the mouth with a well covered disposable mask , coughing in sleeves, not to spit in public and at public places, using washrooms for spitting and flushing them instantly, surface cleaning at home and practising daily exercise and nutritious high protein diet are common practices which can be followed by even an uneduated person and can help significantly to drop the disease spread.

Amongst the doctors, we should have more education and awareness about the disease and the latest methods of diagnosing the disease at an early stage with newer techniques like GenXpert testing in sputum. This test can diagnose more fulminant, MDR or resistant TB cases effectively and in no time, as compared to conventional TB Culture and Sensitivity tests which take 4-6 weeks for the diagnosis. An utmost suspicion should be thought of in any case presenting as fever of unknown origin and it should not be forgotten that TB remains close differential diagnosis in many of challenging cases in our country.

The treatment, sputum test, newer GenXpert tests are all available even in Goverment set ups for free and should be utilised to their maximum, if cost is the issue. Even, most costly treatments and tests are available at no price with many of the Goverment set-ups, but they need to be channelised through proper system and fear of going to Governemnt hospitals needs to be withdrawn from public.

Treatment for resistant TB, may be longer than 2 years and should be left only with the specialists and fear of MDR-XDR TB should not be always thought of as these diseases are purely man made and are seen more commonly only in subset of population, where first line treatments are not compliant.

So, it is my sincere appeal to all our readers that the slogan of this World TB Day can be brought in reality not by one or the other person, but it is our responsibilty to be a leader in our society, in our community, in our neighbourhoods and identify the disease symptoms, get proper treatment from the authorities and yes, it can be the beginning of healthy nation.