Alcoholism main reason for men quitting TB treatment

Nagpur: While efforts are on at the national level to eliminate tuberculosis (TB) by 2025, there are no signs of any decrease in the incidence of the disease at the regional level. Though there is no significant increase, there is also no fall in the number of cases reported in the six districts in Nagpur division in the last four years.

Dr Sushant Meshram, professor and head of chest medicine at the Government Medical College and Hospital (GMCH), says a majority of patients leave the medicine course half way when they start getting some relief.

“Men also do not comply with the regimen because of their addiction to alcohol. This as one of the main reasons for non-compliance of the full regimen in TB treatment. Women leave the course due to their overall negligence towards themselves,” said Meshram.

Chandrapur and Nagpur districts have reported the highest number of TB cases from 2014 to 2017. Chandrapur had 2,977 cases in 2014 followed by 2,260 in 2015, 2,163 in 2016 and 2,265 in 2017. In Nagpur division, 9,416 patients were TB positive in 2014 while this figure in 2015 was 9,335, followed by 8,900 in 2016 and 9,258 in 2017.

Every year 29 lakh new TB patients are added and every day about 4,500 patients die of the disease in India. In 2017, two lakh new cases were detected in Maharashtra. GMCH alone had 1,893 new cases in 2017. Of these, almost 30% were young patients.

GMCH alone reported 1,594 cases in 2016 and 1,893 cases in 2017. The hospital also had 47 multi-drug resistant (MDR) cases in 2016 and 56 in 2017. In the two years, the hospital also received two extra drug resistant TB.

Meshram said he doesn’t have enough data to support the claim but believes it to be true. “The Centre has initiated several new steps to ensure that all TB patients get free medicines and continue with the full regimen,” added Meshram.

For the first time, the Centre has appointed counsellors under the Revised National TB Control Programme (RNTCP) to help TB patients. The GMCH got two 2 1/2 months ago.

“Under the new treatment plan, duration of drug resistance therapy (DRT) has been reduced to 11 months against the earlier 24-month regimen. The second line of drugs are given to patients under the guidance of health workers. Yet, the default rate of patients continues to be very high and there is need to find newer ways to handle the issue,” said Meshram.

In the present programme, after any person is detected with TB, health workers follow their nearest relatives and neighbours, test them also for TB and give them prophylactic treatment if they test positive. This is called as the ‘active cases’ follow up. But, ironically, this also doesn’t seem to be yielding the desired results.