HIV control approaches won't work for TB: lessons from SA, Zambia
Tuberculosis and HIV

Guwahati: Assam needs to urgently increase screening for diagnosis of tuberculosis cases and address the shortcomings that have hindered conducting more such tests, a top state government official said here on Wednesday.

Multi-sectoral coordinated efforts, involving all stakeholders, are required to increase screening for possible cases of tuberculosis (TB) infections and fight the stigma associated with the disease, the official said.

The TB incidence rate in Assam is not very high and we are in the 14-15th position in the country in terms of the number of TB cases. But to achieve the target of bringing the caseload to less than 44 per lakh population by 2025, we have a long way to go, Avijit Basu, State TB Officer (STO), department of Health Services, Assam, said.

Four hundred tests per lakh people were conducted for TB detection in the state last year, which has to go up to about 1,500 per lakh population to meet the goal set by the government, Basu said.

Against the target for conducting 62,100 tests in the state in 2021, only 37,725 tests were done, meeting 61 per cent of the goal, the official said.

Basu was speaking at a media roundtable discussion, hosted jointly by the State TB Cell, Government of Assam, and Karnataka Health Promotion Trust (KHPT), titled Winning the Battle Against TB: Adopting a Community-based Approach to Behaviour Change’.

Basu, who is also a joint director of the state’s Health Services, said insufficient diagnostic facilities was also a major problem for detecting possible TB cases.

We need to address logistical and infrastructure shortcomings. In many cases, X-Ray machines or other diagnostic equipment are not working in a hospital when a patient comes for diagnosis, and that patient may not return later, he said.

CBNAAT (cartridge-based nucleic acid amplification test) machines are available in all districts of the state, with Guwahati, Dibrugarh, and a few other places equipped with more than one machine, but there is a need to increase the availability of other diagnostic tools at more healthcare facilities, the health official said.

Basu emphasised a coordinated approach with different stakeholders to achieve the goal set by the government and said, the Health department or government singlehandedly cannot achieve it. A multi-sectoral approach is needed for it.

He stressed the role of organisations like KHPT in this regard, underlining how NGOs and community-based institutions can help in identifying new cases, ensuring that patients complete their treatment, and overcoming the stigma surrounding the disease.

Rehana Begam, programme director, KHPT, also advocated for more involvement of the community in TB screening, detection, and treatment processes.

Quoting the National TB Prevalence Survey 2019-21, she said the all-India TB prevalence rate was 312 per lakh population for the period, against which the figure for Assam was 217 per lakh people.

Paranjoy Bordoloi, state Information, Education and Communication Officer, TB Cell, said TB cases are unreported and under-reported , which should be corrected.

Many people do not get themselves tested for TB. Many who go for treatment in private hospitals are not included in the government database though all TB cases must be reported to the government, he said.

He elaborated on the government incentives for TB patients, including free medicines, Rs 500 per month for nutritious food procurement, and counselling facilities.

A new concept of a donor sponsoring a TB patient by providing any kind of help, be it bearing expenses for additional food, or household expenses, has also been introduced by the government, Bordoloi said.

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