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India’s Tuberculosis (TB) crisis
Context
Despite the government’s commitment to “eliminate high-burden infectious” TB by 2025, ‘India is still far from reaching its goal’. There are six key challenges identified: TB diagnosis and access; lack of access to free, quality treatment and drugs; adequate nutrition and mental health support; stigma-free and gender responsive care; economic support; and high quality care.
1: Dimension- Barriers in India’s progress in combating TB
- Insufficient diagnosis and treatment access, stigma, and socioeconomic barriers continue to impede India’s progress in combating this disease.
- Poverty:Socioeconomic conditions create vulnerabilities to the disease.
- Undernutrition: It is a major risk factor for both the occurrence of new cases and the occurrence of severe TB that can result in TB deaths.
- Delayed diagnosis, and a lack of access to quality care.
- Multi-drug resistance worsens matters.
2: Dimension- The right healthcare intervention
- Comprehensive care for children: Children constitute 6–7% of all patients treated under the national TB elimination programme
- Focus on nutrition: The state should immediately focus on increasing the duration and quality of inpatient care, particularly for very severe undernutrition.
- Effective diagnosis: There is a need to expand diagnostic facilities, include mobile testing units, improve access to molecular testing at affordable prices, and provide quick and accurate results.
- Addressing social factors: There is a need to address the social factors that aggravate the infection (poverty, stigma, etc).
Tamil Nadu Case Study (state-wide differentiated TB care model)
- The first published report?of a state-wide differentiated TB care model in Tamil Nadu (TN-KET), in 2023, showed that to reduce TB deaths in resource-limited settings, triaging — quickly examining patients to decide who is most seriously ill and must be treated first — can identify those with the immediate need for comprehensive assessment and inpatient care.
- Considering 70% of TB deaths happen within the first two months, it is important to triage patients at TB diagnosis.
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Fact Box: World TB Report 2023
Treatment
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