India notifies 24.04 lakh tuberculosis cases, 79,144 deaths in 2019: Annual report

Around 24.04 lakh TB patients were notified in 2019, registering 14 per cent increase over the previous year while the private sector saw an increase of around 35 per cent with 6.78 lakh tuberculosis patients notified, officials said. Launching the annual report, Union Health Minister Harsh Vardhan commended the collective efforts of all involved in the task, and said the government was committed to eliminating tuberculosis from the country by 2025, five years ahead of the global target.

India notified the highest number of 24.04 lakh tuberculosis cases last year as against a WHO estimate of 26.9 lakh cases, indicating that around three lakh patients were missed out in the national TB programme, according to an annual report on the disease released on Wednesday. Gujarat topped the list of best-performing states in tuberculosis eradication under the category of states with more than 50 lakh population, followed by Andhra Pradesh and Himachal Pradesh, the Union health ministry said.   The India TB Report 2020 stated that 79,144 deaths due to tuberculosis were reported in 2019, which is much lower than the WHO estimate of 4.4 lakh fatalities, officials said.

According to them, the "missing cases" -- the gap between estimated incidences and notified cases -- has drastically reduced from over 10 lakh in 2017 to 2.9 lakh in 2019 through greater engagement with private healthcare sector along with other initiatives. Around 24.04 lakh TB patients were notified in 2019, registering 14 per cent increase over the previous year while the private sector saw an increase of around 35 per cent with 6.78 lakh tuberculosis patients notified, officials said.

Launching the annual report, Union Health Minister Harsh Vardhan commended the collective efforts of all involved in the task, and said the government was committed to eliminating tuberculosis from the country by 2025, five years ahead of the global target. To align with the ambitious goal, the programme has been renamed from Revised National Tuberculosis Control Programme (RNTCP) to National Tuberculosis Elimination Programme (NTEP), he said.

On the basis of the score in State TB Index, Tripura and Nagaland were best-performing in the category of states having less than 50 lakh population. Dadra and Nagar Haveli, and Daman and Diu were selected as the best performing Union Territories. "The ranking will surely encourage all states and UTs to improve their performance to attain their targets. Early accurate diagnosis followed by prompt appropriate treatment is vital in ending tuberculosis. The National TB Elimination Programme has expanded both the laboratory network as well as diagnostic facilities to cover the entire country," Vardhan said.

About the stigma attached to TB patients in the country, which is hampering the fight against the disease, Vardhan said, "We as a nation, need to come together to fight tuberculosis and the stigma associated with it so that every TB patient can seek care with dignity and without discrimination." "The community must act as a wellspring of support and comfort for a patient." He underscored the crucial contribution the private sector can make to the national TB programme by mandatory tuberculosis notification and providing quality care. The salient feature of this year is that for the first time Central TB Division (CTD) introduced a quarterly ranking on tuberculosis elimination efforts by all the states and UTs.

Treatment linkage of drug-resistant TB patients, HIV testing of tuberculosis patients, nutritional assistance to in the form of NIKSHAY Poshan Yojana (DBT), Universal Drug Susceptibility Testing (UDST) coverage among notified patients, TB Preventive Therapy (TPT) coverage and financial expenditure are included in the assessment criteria, the Union health minister said. Similar to the previous year's trends, in 2019 over half of the total TB cases were notified from five states -- Uttar Pradesh 20 per cent, Maharashtra nine per cent, Madhya Pradesh eight per cent, Rajasthan and Bihar both seven per cent, the annual report stated. Due to easy availability of molecular diagnostics, the proportion of children diagnosed with TB increased to eight per cent in 2019 compared to six per cent in 2018, the ministry said in a statement. Also, the provision of HIV testing for all notified TB patients increased from 67 per cent in 2018 to 81 per cent in 2019.

Expansion of treatment services has resulted in a 12 per cent improvement in the treatment success rate of notified patients. For 2019, it was 81 per cent compared to 69 per cent the previous year. Direct benefit transfers under Nikshay Poshan Yojana, one of the fastest ever implemented schemes of the Government of India, saw over Rs 462 crore being disbursed as nutritional support to patients, an annual jump of nearly 130 per cent. Mapping of high-risk groups, carefully planned systematic screening and active case finding for active TB cases has improved early detection leading to reduced risks of transmission, poor treatment outcomes and adverse social and economic consequences. This year, 27.74 crore population were screened across 337 districts in 23 States resulting in identification of 62,958 TB cases, the report stated. During 2019, as many as 66,255 multidrug-resistant/rifampicin-resistant tuberculosis cases were diagnosed and 56,569 of them were put on treatment. Of these cases, 40,397 or 71 per cent of patients were initiated on shorter MDR TB regimen at the time of diagnosis of multidrug-resistant or rifampicin-resistant.