Controlling tuberculosis

India is believed to have 25 per cent of the world’s TB cases and the estimated rate of spread of TB infection is one person every second and rate of TB deaths two persons every three minutes. About 1,000 ­persons die of TB every day. The Rotary Club of  Madras Southwest launched the HUMA Shasun TB Care ­Project as a ­Community ­Service ­Programme in October 2004 — the club’s silver jubilee year. The project was kicked off by District 3230 Governor ­Benjamin Cherian.

Having a wide resource mix of anti-TB drugs, diagnostic tools and expertise, why are we unable to ­control TB? This despite national programmes in the past, stretching over ­decades. We now have to focus on how to ­control the spread of infection ­effectively rather than merely diagnosis and treatment of the infection.

TB is caused by the ­microscopic organism called Tubercle bacilli or Acid Fast bacilli that are coughed out in millions in the atmosphere by the infected and inhaled by other normal persons, infecting them in turn. The infection could develop into disease if the latent defensive health mechanism of the infected person is not strong enough or if the attacking infection is massive.

At the early stage of the disease, the person would be non-infectious, that is, he would be infected but would not be spilling out the bacilli by coughing or sneezing. But with time, if not treated, the bacilli in him ­multiplies and the ­disease becomes more potent. He would reach a stage of infectiousness, that is, an uncontrolled spread of the bacilli, risking both his family and the air to infection.

So the infection has to be nipped in the bud through proper ­investigation and ­treatment. Mass ­community screening could segregate those with lung problems, whether with or ­without symptoms and the TB cases. The early non-symptomatic ones, could be diagnosed and treated. Thus mass lung screening could ensure a restraint on the spread of TB bacilli and help effective control measures, and is recommended in high risk groups.

The HUMA Shasun TB Care project has screened 46,510 persons through 417 camps. The data generated by the project indicates that the magnitude of respiratory ­ailments including TB could be as huge as 5–6 per cent. Based on this project’s findings, and to meet the need for active and rapid case detection and treatment, Rotary is planning a more extensive launch of TB control measures in the near future.

(The author is Co-­chairman -Operations South India, Rotary India TB Control Programme)

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