Every three minutes, two people are dying of Tuberculosis in India

In an interview with TOI's Santosh.Sonawane, the district Tuberculosis officer Yuvraj Deore, talks about the initiatives being by the department to sensitise people about the deadly disease and to bring those suffering from it under treatment. Excerpts:
What is the biggest challenge the tuberculosis department faces?
Two people are dying of this deadly disease in the country every three minutes.The number of deaths at the national level are worrisome. Our main role will always be to trace people suffering with tuberculosis (TB) and bring them under treatment. We also aim to provide them with the mental and social support they need till they are cured. Last year the district TB department detected 3,754 TB patients, which included 14 cases which were multi drug resistant (MDR) and one extreme drug resistant (XDR).
Why is tracing TB patient a challenge in the first place?
Lack of awareness among patients is one of the major reasons. Secondly, the diagnosis of the illness is also very important. Many patients despite knowing that they are suffering from TB do not come forward for treatment due to the fear of the social stigma attached to the disease. Over the years, however, thing are improving with a very robust network of medical facilities put in place by the government patients are coming forward for treatment, health workers, multi-purpose workers and Ashas working at the village level are also putting in sincere efforts to trace TB patients and bring them under treatment.
Is the tuberculosis department well staffed?
We have a team of 54 people for the district, They trace the patients, counsel them for treatment and ensure that they get uninterrupted drug supply and keep records. This is a lot of work for a small team, however, we make up for the scanty staff in our department, by roping in gram sevaks across the district and sensitizing them about the nature of the disease, how it needs to be identified and asked them convince the patients to visit the hospital to get the necessary tests done before it is too late.
There is a lot of talk of patients defaulting on their treatments, is this true?
The span of treatment for tuberculosis is generally long and over a period of time, patients sometimes stop the treatment in between. But doing this is very dangerous the chances of the TB strain becoming multi drug resistant increase. Therefore, we try to ensure that the patient continues his/her course of treatment until the illness is cured. We have Dot providers (directly observed treatment), who ensure that the patient takes the tablet in front of him/her. Dot providers also get an honorarium for the service.
Is there any new system of tracking patients?
Yes, from January this year, the department is using an online method of keeping track of TB patients' adherence to the treatment in the district. Under this pilot project, the patients have to simply give a miss call on the number, which they see on the wrapper of the tablet and the programme, known as 99 Dots, will keep a track of their medication. Meaning that if 100 patients are giving a missed call on the number, it is assumed that 99 patients have taken the pill as per instruction. The programme has been initiated by the government of India in association with Microsoft in eight cities of Maharashtra. The online system is applicable only for the new TB patients who are registed at the CBNAAT (cartridge based nucleic acid amplification test) machine installed at the Nashik civil hospital.
Is the CBNAAT machine installed at the civil hospital and an NMC hospital working efficiently?
The CBNAAT machine is extremely useful to detect TB and more so in detecting the disease in children. Earlier, detecting TB in children was difficult as the symptoms are very different. With the help of this machine, doctors simply take the gastric lavage from the stomach of children to investigate if the minor is suffering from TB. This machine is also useful in detecting MDR cases as well as tuberculosis of various organs of human body.
Is TB under control in the district?
In Nashik, 95% of the patients are under treatment. The cure rate of the treatment is also over 95%. Apart from this, given the continuous follow-up by the district TB department staff, over the past one and half years, there has not been a single default of MDR or XDR patients in the treatment.