COVID-19 Impact on the National Tuberculosis Elimination Program Guidelines and Its Relevance to the Indian Population | Chapter 3 | Medicine and Medical Research: New Perspectives Vol. 2

 

The COVID-19 pandemic caused a severe dent in the decades of progress achieved in tuberculosis control and elimination measures, indicating that these measures need to be more structured and resilient. This manuscript focuses on the impact of the COVID-19 pandemic on TB control and also on the measures taken by the Government of India in effectively combating this syndemic.

 

The main objective is to emphasise the impact of the COVID-19 pandemic on TB control and also to highlight the various innovative initiatives taken by the Government of India to keep the spread of tuberculosis under check.

 

The positive trends in tuberculosis elimination strategies observed till 2019 showed a dramatic reversal after the onset of the COVID-19 pandemic. Biological interactions between tuberculosis and COVID-19 agents, lung parenchymal damage occurring in both diseases, multiple lockdowns, the reduced workforce at tuberculosis notification centres, and reallocation of funds to control the new-onset pandemic were some of the reasons for the decline in overall notifications across the globe.

 

The National Tuberculosis Elimination Programme initiated a holistic approach to eliminate TB from South Asia by 2030. Innovative strategies like digitalisation of service delivery systems, telemedicine consultations, and a four-tier hierarchy system resulted in a rise in the number of tuberculosis notifications. Making this campaign a public movement, creating Public Support Groups and propagating an online Nikshay portal for tuberculous notification greatly facilitated efforts to create a tuberculosis-free world.

 

Despite the COVID-19 pandemic causing a temporary slowdown, digitalisation processes and various innovative strategies have kept disease elimination hopes still alive. The government alone may not be able to accomplish this goal. By increasing the Government’s responsibility and accountability, facilitating an effective coalition with communities and civil societies, protecting human rights, promoting ethics in treatment, enhancing the equity of distribution of effective treatment across the community, and calling for global collaboration in setting up strategic goals/targets at the national level, the world could be TB-free by 2035. Combined efforts and collective responsibility from the public, medical, and para-medical support staff are imperative in making this dream of a tuberculosis-free society, soon a reality.

 

 

Author(s) Details

Sriram Krishnamoorthy
Department of Urology & Renal Transplantation, Sri Ramachandra Institute of Higher Education & Research, Chennai, Tamil Nadu, India.

 

Kalpana Ramachandran
Department of Anatomy, Sri Ramachandra Institute of Higher Education & Research, Chennai, Tamil Nadu, India.

 

Please see the book here:- https://doi.org/10.9734/bpi/mmrnp/v2/1345

 

Patterns of Extrapulmonary Tuberculosis Using CBNAAT: A Retrospective Study | Chapter 6 | Medicine and Medical Research: New Perspectives Vol. 11

Background: Extra-pulmonary tuberculosis is a milder form of the disease in terms of infectivity as compared to pulmonary tuberculosis. Diagnosis of Extra-pulmonary TB (EPTB) is a challenge.

Aim: The study seeks to assess the sites of extra-pulmonary involvement during 2013-2017 in a tertiary care hospital cum medical college. The study also wanted to evaluate the role of the Cartridge Based Nucleic Acid Amplification Test (CBNAAT) in the diagnosis of EPTB and compare its efficacy with AFB Culture.

Methods: A total of 470 EPTB cases were diagnosed between 2013 and 2017 from 840 TB treatment records maintained in designated microscopy centre. Specific samples from appropriate sites were taken up for smear for AFB, CBNAAT and AFB culture. The sensitivity and specificity of CB NAAT were also computed. All the analysis was carried out using standard statistically significant STATA 15.1.

Results: There was incremental detection and registration in both TB and EPTB cases from 96 and 50 cases in 2013 to 246 and 150 cases in 2017 respectively. Among the total 470 EPTB cases in 2013-2017 (55.9%), lymph nodes followed by pleura and abdomen were the organs having maximum involvement. Bone involvement was more witnessed in adult males than children (p <0.05). There was male preponderance. CBNAAT results were 100 % sensitive and 87.5% specific. Lymph node samples and pus elsewhere in the body had much better diagnostic yield than serous effusions. The number of patients diagnosed from 2013 revealed a steady increase in numbers till 2017; this is due to improved awareness among the clinicians and availability of new diagnostic modalities in the extrapulmonary presentations and awareness to register in RNTCP services for availing the services.

Conclusions: EPTB needs a high index of suspicion and judicious invasive diagnostic tests. Awareness and availability of diagnostic services in tertiary care institutions have led to increased reporting of EPTB under RNTCP services. CBNAAT can also be utilized as a point of care testing for lymph node aspirate and pus specimens.

 

Author (s) Details

Suman Kumar Jagaty
Department of Respiratory Medicine, Kalinga Institute of Medical Sciences, KIIT (Deemed to be University), Bhubaneswar, India.

 

Swadip Mishra
Department of Respiratory Medicine, Kalinga Institute of Medical Sciences, KIIT (Deemed to be University), Bhubaneswar, India.

 

C. Mohan Rao
Department of Respiratory Medicine, Kalinga Institute of Medical Sciences, KIIT (Deemed to be University), Bhubaneswar, India.

 

Please see the book here:- https://doi.org/10.9734/bpi/mmrnp/v11/2683

Socio-Demographic and Clinical Profiles, along with Some Management Indicators, of MDR TB Patients: A Clinical Research | Chapter 01 | Emerging Trends in Disease and Health Research Vol. 3

 Any TB control effort has a severe hurdle in the form of multidrug-resistant tuberculosis (MDR TB). The goal of this study is to look at the socio-demographic and clinical profiles of 23 MDR TB patients in the Domjur Block, India, in 2018, as well as several management parameters. This cross-sectional study collected data in 2018 on six important socio-demographic characteristics of MDR TB patients in order to determine the effects of these characteristics on the occurrence of MDR TB in that block at that time. The six criteria are age, sex, religion, educational status, occupational status, and family income. In addition, the clinical profile of those MDR TB patients was investigated, as well as certain crucial variables relating to the health center's management of those patients at the Domjur Block. The indicators are designed to aid in understanding how the Government of India's RNTCP (Revised National Tuberculosis Control Programme) performed in that block in 2018. The random sampling approach was used to choose the Domjur Block. Patients were interviewed using a predesigned, pretested, structured questionnaire to gather relevant data. In the case of the socio-demographic criteria, the binomial test, conducted at a 5% level of significance, revealed that only age, educational status, and family income substantially influenced the occurrence of MDR TB at Domjur, with educational status having the greatest impact. As a result, more education and income can aid in the fight against MDR TB. Indicators relevant to the management of MDR TB patients, on the other hand, show that the RNTCP was progressing rather well; yet, more work remained to be done.

Author(S) Details

Bhaskar Chakraborty
Department of Epidemiology, All India Institute of Hygiene & Public Health (AIIH & PH), Kolkata, India.

Sampa Mitra
Department of Epidemiology, All India Institute of Hygiene & Public Health (AIIH & PH), Kolkata, India.

View Book:- https://stm.bookpi.org/ETDHR-V3/article/view/5865