India to estimate TB burden using own system

Published
29th Mar, 2023

Context

India has become the first country in the world to estimate the Tuberculosis (TB) burden in-country and launch its own mathematical system to estimate the disease burden.

About the Model:

This model was constructed based on;
- The natural history of diseases,
- individual status of infection, disease,
- health care seeking, missed or correct diagnosis,
- Treatment coverage and outcomes including cure and death.
The TB model was drawn up by using data from several sources, including the Nikshay portal of private sector drug sales, the sub-national certification system where the TB-free status of various States is estimated and ranked.

Status of TB in India:

India’s TB incidence rate stands at 196 per 1,00,000 population, instead of the 210 estimated by the WHO, and the estimated deaths from the communicable disease stand at 3.20 lakh, instead of the 4.94 lakh that was projected in 2021.
The Health Ministry noted that as per this data, the global TB reduction numbers stand at 11% while the reduction in TB cases in India is 18%.

National TB prevalence survey 2019-21:

The National TB Prevalence survey in India was conducted from 2019 to 2021 to know the actual disease burden of TB at a national level.
The survey estimated the point prevalence of microbiologically confirmed pulmonary TB (PTB) among person’s ≥15 years in age in India at the national level and for 20 individual states / state groups.
The survey also explored the health seeking behaviour and estimated the prevalence of TB infection.
Key Findings:
- Delhi has the highest burden of all forms of TB and pulmonary TB — at 747 per 100,000 and 534 per 100,000 respectively.
- Gujarat has the lowest burden of all forms of TB at 137 per 100,000 while Kerala is the lowest in pulmonary TB at 151 per 100,000.

About TB:

TB is caused by a bacterium called Mycobacterium tuberculosis, belonging to the Mycobacteriaceae family consisting of about 200 members.
In humans, TB most commonly affects the lungs (pulmonary TB), but it can also affect other organs (extra-pulmonary TB).
TB is a very ancient disease and has been documented to have existed in Egypt as early as 3000 BC.
TB is a treatable and curable disease.
Transmission: TB is spread from person to person through the air. When people with lung TB cough, sneeze or spit, they propel the TB germs into the air.

Treatments available for TB:

Drugs:

For previously treated cases of TB, the intensive phase is of 12 weeks, where injection of streptomycin is given for eight weeks along with four drugs FDCs (INH, Rifampicin, Pyrazinamide, and Ethambutol).
Second-line drugs are the TB drugs that are used for the treatment of drug-resistant TB. The second line drugs include levofloxacin, moxifloxacin, bedaquiline, delamanid and linezolid.
Vaccines: Currently, the following two vaccines have been developed and identified for TB, and are under Phase-3 clinical trial:
- VPM (Vaccine Projekt Management) 1002
- MIP (Mycobacterium Indicus Pranii)