TB in India

Epidemiology

Today, half of the new cases of TB worldwide arise only from six countries, and India is one of them. According to WHO, in 2015, India has the highest TB burden, with estimated incidence of 2.2 million as compared to global incidence of 9.6 million. It is predicted that 40% of the Indian population has TB infection and the majority of them have Latent TB rather than the active form of the disease. Stalling the spread of this disease and preventing its progression necessitates early detection and identification of TB.

Tuberculosis

Tuberculosis (TB) is an air-borne disease, caused by a group of genetically related Mycobacterium complex, which includes M. tuberculosis, M. bovis, M. africanum, M. microti.  Apart from affecting the lungs (pulmonary TB), it can also affect other parts of the body like kidney, spine and brain giving rise to different forms of this disease; Extra pulmonary TB. The infection can be in two stages:

A. Latent TB Infection

In this stage, the bacteria can remain in a dormant state in the body of the individual for years without causing any symptoms.

B. Active TB Disease

When the immune system of the person is compromised, latent TB infection progresses to active disease. People at this stage can easily spread TB infection.

How it Spreads

When a person infected with pulmonary TB sneezes, coughs or speaks, the bacteria in the droplets are inhaled by a healthy person, resulting in TB infection.

Signs and Symptoms

  • Chest Pain
  • Incessant Coughing (with or without blood or sputum)
  • Weight Loss
  • Night Sweats and Fever

Multiple Drug Resistance (MDR) in India

Lack of awareness among the Indian population is making them more prone to drug resistant TB, a complication which is difficult to treat and could be fatal. People with MDR-TB do not respond to the first-line drugs for TB, i.e., Isoniazid and Rifampicin. According to a recent study in Lancet, by the year 2040, the fraction of TB patients with multiple drug resistance will rise to 12.4% of all TB cases in India. Mortality rate of TB patients who develop MDR-TB is around 40% and in patients with extensive drug resistance TB, around 60%. Early and accurate diagnosis is the only key to tackle MDR-TB and control its spread.

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