At 1.4 lakh cases, Maharashtra is top drug-sensitive tuberculosis state

MUMBAI: Even as the public health department claims to have effectively controlled major diseases in the state, Maharashtra has earned the dubious distinction of being home to the largest incidence of both drug-sensitive and multidrug-resistant tuberculosis (TB) cases in the country in 2013.

A senior bureaucrat told TOI that while the Centre has drafted a multi-pronged strategy to tackle TB and despite its best efforts, Maharashtra has seen a spurt in both types of TB cases. The disturbing figures were part of a recent Central government report.

The bureaucrat further said a World Health Organization (WHO) report on the disease, though, states that both drug-sensitive TB as well as TB-related mortality has reduced in the country. "But we are not happy with the manner in which TB is being tackled in the state. We will have to step up our drive and target more patients for effective treatment,'' he said.

Ministry of health and family welfare records show that Maharashtra reported 1.36 lakh cases of drug-sensitive TB, followed by Andhra Pradesh at 1.08 lakh, Rajasthan at 1 lakh, West Bengal 93,274, Madhya Pradesh 89,545, Tamil Nadu 79,576 and Karnataka 67,572.

The largest number of multidrug-resistant cases-at 4,439-were also reported from Maharashtra, followed by 2,538 from Rajasthan, 2,122 from Gujarat and 1,007 from West Bengal.

The bureaucrat said globally, WHO has estimated that 2.9 million cases were not even recorded, as they were either not diagnosed or diagnosed but not reported to the national programme. Of these, an estimated 31% cases are from India. In the Indian context, the bureaucrat said, "it is likely that a substantial proportion of this sub-group was treated in the private sector, and not notified to the health department.''

At a recent conference on TB, he added, leading activists expressed doubts over free distribution of medicines to patients. Under the revised national TB control programme, it is the state government's responsibility to provide all medicines free of cost and that there should be no waiting list. "The activists' contention was the administration was reluctant to provide free medicines. As a result, there was a huge waiting list. Not in urban areas, but in rural parts of the state where there was an acute shortage of medicines.''

A former hospital dean said, in view of specific allegations by activists, the public health department must review the entire programme and ensure that all TB patients are given free medication.

"We should have a random sample-checking system, to enable us to assess the implementation of the programme. At the same time, it should be made mandatory for all private practitioners to report TB cases to civil surgeon or civic hospitals,'' the dean said.