Docs fail to notify TB cases, put many at infection risk: Survey

With more than seven out of 10 private doctors in the city keeping their patient's tuberculosis status a secret, public health authorities feel the medical fraternity is putting the community at a greater risk for the infectious disease. Doctors are required to notify tuberculosis cases to an appropriate government official, but most doctors said they simply did not have the time to fill forms or feared they would be violating patient confidentiality if they notified them.

In 2012, the Government of India declared tuberculosis as a notifiable disease and doctors in the city have to report new cases to the health department officials of the Greater Chennai Corporation. But a survey of 190 private practitioners in the city by the National Institute for Research in Tuberculosis showed that while nearly 80% of the doctors referred patients to the government service, only 33% of them reported that their patients had tuberculosis."There is no way to check if these patients went to the government hospitals for treatment. Some of them could have been lost and they could spread the infection to others," said Dr Beena Elizabeth Thomas.

More than half the doctors said they did not report the disease because they did not have the time and a quarter of them said they feared it would breach confidentiality. Some doctors also feared they would be offending their patients "That's not true," said Dr Selva Vinayagam, who heads the department of community medicine at Madras Medical College. "When it comes to public health issues, individual rights are overridden by community rights. It is important to prevent outbreaks by keeping those infected under quarantine. Notification will help public health authorities the chance to do this," he said.

The highly infectious disease is transmitted through air and usually affects the lungs, but can also affect other parts of the body, including spine, brain and kidneys. People with tuberculosis are given a cocktail of antibiotics known as first-line drugs for up to nine months.

Although treatment is available free of cost in most government hospitals under the revised national tuberculosis programme through directly observed treatment, many people skip treatment leading to resistance. Statistics show that at least one in 25 TB patients belongs to a class called XDR-TB, a short form of extremely drug resistant tuberculosis. These patients do not get cured even with the second line of drugs and about one in five patients is a threat of this treatment failing.