TB on rise; health officialsblame it on social stigma

Call it an outcome of the failure of the civic authorities to keep Amritsar filth-free and the resultant unsanitary conditions prevailing in the city, particularly in the slum areas; or inability of the health authorities to effectively pursue their own campaigns or attribute it to the decreasing immunity among the residents for pulmonary ailments - the constantly increasing instances of tuberculosis (TB) continue to pose a major challenge to the district health authorities.

The disease has a direct bearing on the occurrence of HIV-AIDS (human immunodeficiency virus infection-acquired immunodeficiency syndrome) and is among the first signs of the AIDS among people diagnosed with the HIV. According to health experts, the duo is so closely connected that they are often termed as 'co-epidemic'. Experts further said those diagnosed with the HIV were usually tested for the TB and vice-versa.

The fact - the city leads the state as far as figures of the HIV-AIDS are concerned - is not new to the residents. As far as TB is concerned, the city receives approximately 5,000 cases annually. That the instance of TB is increasing is evident from the fact that this year the district health officials have diagnosed 102 Multi Drug Resistance (MDR) tuberculosis patients, who had been taking treatment earlier, but had left midway only to return again.

The TB patients mainly include residents from indigent backgrounds and dwellers of slum areas. Health experts said life in the extremely cramped quarters and filthy slum areas provided the disease carrying bacteria a veritable atmosphere to proliferate.

The slum colonies where high occurrences of TB are usually reported every year include areas situated in Verka, Hindustani Basti, Haripura, Indira Colony and its surrounding localities. The sanitation aspect in these areas are far from satisfactory with garbage heaps dotting every nook and cranny and puddles of stagnant water forming in ruts of roads whenever it rains and staying that way for days.

This year more than 3,579 cases of TB have been reported till October, with some of the previously diagnosed patients too returning to take treatment. The number of new patients diagnosed till October stands at 1,136, including 702 males and 436 females.

In 2012, a total of 4,348 patients were diagnosed with TB and more than 2,900 cases of TB were reported in 2011 in Amritsar. The number was even higher in 2010 when over 3,866 cases were reported.
Apart from unsanitary conditions prevailing in the city and the high incidence of HIV-AIDS, a major challenge confronting the physicians treating TB is the high dropout rate and social stigma still attached to the disease.

"Irrespective of the fact that the treatment of TB is available at their doorsteps whereas there is no medicine available for HIV-AIDS, the number of TB patients opting for treatment is lesser than those of the HIV positive. This is because of social stigma still attached to the disease,"said Dr Naresh Chawla, district TB officer.

Rajeev Choudhary, district coordinator, Project Axshaya, Amritsar, said as far as the treatment of TB was concerned, the challenges were many, but efforts were being made to sensitise the patients to overcome the inhibitions caused by social stigma still attached to the disease and to get themselves diagnosed and treated in time through specially organised awareness programmes.

Major symptoms of TB
· A bad cough that lasts for three weeks or more
· Pain in the chest
· Blood in cough

Minor symptoms
· Weakness or fatigue
· Weight loss
· Lack of appetite
· Chills
· Fever
· Sweating at night

Data of current and previous years
· Total number of cases till Oct 2013 - 3,579 (including previously diagnosed patients)
· Fresh cases till Oct 2013 - 1,136
· MDR TB cases till Oct 2013 - 102
· Total number of cases in 2012: 4,348
· Total number of cases in 2011: 2900
· Total number of cases in 2012: 3866

Major challenges
· Social stigma
· High dropout rate
· Drug resistance of most patients