Over 63K new TB cases in 2023. BMC calls it a result of better search and diagnostics

Mumbai The city’s new tuberculosis (TB) cases have reached pre-pandemic levels for the second consecutive year, revealed data from the Brihanmumbai Municipal Corporation’s (BMC) health department. According to the find, Mumbai recorded 63,644 new cases last year compared to 56,112 in 2022.

Before the Covid-19 pandemic, the city had registered 51,588 new cases in 2019 and 48,544 in 2018. However, the numbers dropped through the span of the pandemic due to poor detection (37,943 in 2020 and 49,564 in 2021).

The civic body’s health officials said the increase in numbers were the result of better search and diagnostics. Dr Daksha Shah, executive health officer, BMC, said officials followed the Revised National Tuberculosis Control Programme’s national strategic plan for TB elimination which has four pillars -- detect-treat-prevent-build. “We have added a fifth strategic pillar – ‘search’. When we get an opportunity, we search for cases. Since our screening is high, we are diagnosing and reporting more cases,” she said.

Presently, India bears the highest burden of TB cases globally, with Mumbai registering the maximum cases.

Dr Lancelot Pinto, pulmonologist and epidemiologist, PD Hinduja Hospital, Mahim, said delayed diagnosis leads to rapid transmission in the community. “Patients get diagnosed only when they approach a health centre. Audits have often found a delay between onset of symptoms to diagnosis. This delay can be reduced by actively seeking cases by screening in the community, which will play an important role in early diagnosis and limiting spread,” he said.

To detect undiagnosed TB cases, in November 2023, BMC conducted door-to-door screening across all 24 wards for early detection and to prevent the spread. During the campaign, held between November 20 to December 7, 2023, 49 lakh people were screened of which 14,965 presumptive TB cases were identified, and 136 cases of pulmonary TB and extra pulmonary TB cases were found and put on treatment. Among other initiatives to increase the search for TB patients, BMC also rolled out a programme to screen relatives of pulmonary TB patients.

Dr Shah added that the civic body has sensitised outpatient departments such as ENT, gynaecology, orthopaedic, general surgery on TB in organs other than the lungs. “We are doing rapid diagnosis so that we do not lose patients, as they get treated on time,” said Dr Shah. She added that BMC has also increased partnership with the private sector. “Fifty percent of the newly detected cases are from the private sector; it is a good sign as it implies that we are not missing cases from the private sector.”

While he welcomed the civic body’s drive to find new cases, Ganesh Acharya, TB activist, put emphasis on administering medicines to patients on time. He pointed out that in the last few months, TB medicines were in short supply. “If a TB patient discontinues the treatment, it will lead to drug resistance and spread more infection in the community. It will not help the Centre’s TB elimination target,” said Acharya.

Dr Nikhil Sarangdhar, member, Central Committee, Tuberculosis Association of India, said, “If we are recording a rise by testing more, it does not mean we are failing the objective of Centre’s TB 2025 elimination programme. We need to scale up diagnostics, focus on early detection and treatment. TB elimination means bringing down the level of infection spread in the population.”