Sharp Decline Seen in TB Reporting During COVID-19: Report

New Delhi: Since the onset of the COVID-19 pandemic, India has seen a sharp decline in tuberculosis registration across the country. India registered a decline in the notification of TB cases by about 85% in April this year, after the imposition of the novel coronavirus disease (COVID-19) lockdown, according to theGlobal Tuberculosis Report, 2020.

India has the highest TB burden across the globe, accounting for 26% of the total global cases. A huge percentage of potential cases remained out of the TB registration net, potentially amplifying the problems for India.

The weekly and monthly number of TB case notifications fell by more than 50% between the end of March and late April in India, following the imposition of a national lockdown, according to the report. Slowly, there was some recovery. But as of the end of June, it had failed to reach pre-lockdown levels, according to World Health Organisation. Decreases occurred in both public and private sector facilities.

Gujarat Sees 50% Decline in TB Reporting

Meanwhile, the Gujarat government has claimed to have brought the spread of COVID-19 under control, and said it was now turning its focus to reporting tuberculosis cases, which has seen a reduction by nearly 50% on a pro rata basis, especially in the Surat Municipal Corporation (SMC) and Ahmedabad Municipal Corporation (AMC) limits.

These two municipal corporations were burdened with a large number of COVID-19 cases for months and still continue to report around 100-150 fresh cases every day. In SMC limits, 4,362 TB patients were notified by private facilities till November 5 this year compared with 7,188 patients during the same period in 2019.

According to theIndian Express, after seeing this decline in registration of cases, medical officer of health, in a communication dated October 27, wrote to doctors affiliated to the Indian Medical Association (IMA) in SMC, reminding them that they have to notify “all TB cases being diagnosed or treated by your organisation/institute… It is seen that TB notification has reduced so much in current year (sic)…”

According to the report, IMA Gujarat chapter president, Dr Chandresh Jardosh, who is based in Surat, toldExpressthat SMC has been conducting bi-directional checks that include active and passive surveillance for TB detection over the past few months. He added that it is a “routine” communication from SMC. “We are lagging behind by 6,000 cases… these will erupt sooner or later. With people staying at home, an undetected TB patient will risk their families with greater exposure. In the next three to four months, we might see a surge in TB cases,” said Dr Jardosh.

In AMC, reporting in government facilities in 2019 was twice the number of total notified TB cases from government facilities this year, which is 6,611. The city TB officer Dr AS Pillai toldExpressthat while new case notifications are catching up, “overall total notified TB cases reported from public and private facilities has been only 56% of that compared to last year”.

According to theIndia TB Report 2020, as many as 1,59,158 TB cases were notified in Gujarat in 2019, out of which 1,26,977 were new cases while the remaining had been previously treated.

Gujarat is one of the states with the highest number of TB cases in the country, after Uttar Pradesh, Maharashtra, Madhya Pradesh, and Rajasthan. The state has a cure rate of 76%. The death rate of TB in the state is 6%, also one of the highest across the country.