Bengaluru: A few BBMP clinics haven’t received a single tuberculosis patient since a national lockdown was imposed on March 24, 2020.
Dr Bhanu Prakash, a doctor at a BBMP clinic near Rajajinagar, informed The Observer: “After the national lockdown was imposed on March 24 because of Covid-19, BBMP health clinics have had no patient for the DOTS treatment.” Before the lockdown, 20 TB patients visited the clinic every month to receive DOTS treatment.
“Either some patients have stopped the medication or moved to other bigger BBMP clinics due to availability of DOTS medicine all the time,” he added.
The Karnataka government, in a recent press release, said 48,242 cases of TB were discovered in the state between January and October 2020, according to a Times of India report. Bengaluru accounted for 14,000 cases. The data were obtained from door-to-door surveys. In 2019, a total of 91,000 TB patients were detected in the state with a 6.2% death rate, the highest in the country.
Tuberculosis and Covid-19 are infectious diseases that primarily attack the lungs. They present with similar symptoms of cough, fever, and difficulty in breathing. The prevalence of TB among Covid-19 patients has been found to be 0.37-4.47% in different studies.
DOTS helps patients finish TB therapy as fast as possible. People have to register at primary health centers to receive treatment. Each TB patient is assigned a social worker whose job is to deliver DOTS treatment; he/she has to ensure the patient swallows the tablets.
Mayuri Johari, a resident doctor at the Chinmaya Mission Hospital, Indiranagar, said: “WHO recommends that TB patients should have six months of treatment. This consists of a two-month intensive phase followed by a four-month continuation phase.”
TB treatment fails because a patient doesn’t take his medicines regularly; it leads to the development of drug-resistant TB, making drugs ineffective, she said.
The pandemic has affected strategic interventions of tuberculosis programs, resulting in an almost 35% decline in TB case notification in 2020 as compared to the previous year in Karnataka, according to the National Centre for Biotechnology Information.
Devaraja, a social worker, said: “I have been assigned 14 TB patients to administer DOTS treatment. I currently work with nine patients; the other five have discontinued their treatment.” Those who stopped taking the treatment had lost their jobs and returned to their native places.
N. Divakara, a senior health inspector of the BBMP’s west zone, said: “Since the Karnataka government has done a door-to-door survey, we will plan accordingly on how to approach the DOTS programme.” The government faced serious challenges during the first three months of the lockdown. Very few TB patients were given DOTS treatment.
At present, health staff from the TB programme have been diverted for Covid-19 duties.
Pulmonologists say that in the past 11 months, many cases went undiagnosed because of travel restrictions and a fear of the virus. They also believe the chances of the disease spreading are high as patients have not received a full dosage of medicines, and interruption can lead to drug resistance.
WHO has urged countries to maintain continuity of essential services for people affected with TB during the pandemic as there was a 13% increase in TB deaths in the first three months of the pandemic.
In November 2020, launching a Jan Andolan against TB, Union health and family welfare minister Harsh Vardhan said: “We wish to make 2021 a year of Tuberculosis.” Under the National Strategic Plan for Tuberculosis Elimination, the government is working to eradicate the disease by 2025.
