Nonetheless being alluded in Vedas and ancient texts, tuberculosis never drew much attention before it had been declared as an emergency by WHO in 1993. Till 1820s, it was not alone defined as a single disease rather lacked a nomenclature.
Sighting its deadly nature, WHO is determined to eradicate this menace through End-TB-Strategy-2035 and also collaborating with countries through SDG (Sustainable Development Goal) 2030. Tuberculosis causes 2 deaths every 3 minutes and every second someone new gets infected with TB.
According to WHO fact sheet of 2010 around 1/3 of the world population is infected with TB.The estimated incidence of 2.2 million cases of TB for India out of 9.6 million global is really alarming. India declared tuberculosis to be a notifiable disease in 2012.
It meant that in future all private doctors, caregivers and clinics treating a patient had to report every case of tuberculosis to the Government.
WHO estimates that around 10 lakh Indian individuals are still not notified and poses a threat to the resolution for its elimination by 2035. The government has started Revised National Tuberculosis Control Program (RNTCP) to achieve the vision of ‘TB free India’ and made a National strategic Plan 2012-17.
India has adopted DOTS (Directly observed treatment short course) for removing this menace down through its roots. DOTS strategy is not just a treatment method; in short, it is a cumulative effort which includes political commitment, case detection through quality methods, short course chemotherapy, ensuring patient adherence to treatment, adequate drug supply and sound reporting and recording system.
A slight mismanagement or ignorance can convert the curable form of tuberculosis to deadly resistant MDR/XDR TB.
Improper monitoring and interrupted follow up can covert tuberculosis to its severe forms such as Multidrug Resistant tuberculosis (MDR), which shows resistance to Isoniazide and Rifampicin, the two most effective drugs of tuberculosis and Extensive Drug resistant tuberculosis (XDR), which is resistant to both first and second lines of drugs.
According to one prospective study prevalence of XDR-TB was found to be 5.5% and MDR-TB was about 12% of all tuberculosis cases in India. Unfortunately, private sector has been the main source of mismanagement of TB. Use of incorrect diagnostics, incorrect regimes and lack of supervision of follow up program played a big role for resistance. HIV/TB co-infection also poses a threat to the diagnosis of tuberculosis.
Most of such cases go undetected through smear microscopy. The occurrence of tuberculosis is a plausible threat to all nations especially to poor population of developing countries living in unhygienic conditions. A better coordination of public and private health care institutions is need of the hour to stop the journey of TB towards XDR/MDR-TB