BMC to use malaria model to take on TB

The civic body’s 165 health posts activated to stop the spread of the disease

By Jyoti Shelar

Days after Mumbai reported the country’s first cases of totally drug-resistant (TDR) tuberculosis; the city administration said on Tuesday that it would replicate its malaria-fighting model to tackle the killer lung disease.

The BMC’s decision received the support of medical experts sent by the Central government to take stock of the situation arising from the discovery of TDR cases here. The effort to limit the spread of tuberculosis – and its deadlier form – will now include awareness campaigns, door-to-door checks for identification of suspected cases; mapping of areas where most instances are reported and immediate hospitalisation.
The civic body will also ask its 165 primary health centres, or posts, across the city to focus on TB cases, and ensure that people showing symptoms of the disease are promptly referred to public hospitals. These methods form the backbone of BMC’s fight against malaria, and have helped civic officials bring down the number of malaria deaths in the city. These methods form the backbone of BMC’s fight against malaria, and have helped civic officials bring down the number of malaria deaths in the city.

Ordinary TB can be cured by taking antibiotics for six to nine months. However, if the treatment is interrupted, or the dose is reduced, stubborn TB-causing bacteria fight back and mutate into a tougher strain, which standard drugs cannot eliminate. Mumbai has reported 15 patients with totally drug-resistant TB. Of these, five have died.

The team of experts sent by the Centre met BMC officials on Tuesday, and “broadly approved” their plan to use the malaria model. “The team will give its final recommendations tomorrow (Wednesday),” said Additional Municipal Commissioner Manisha Mhaiskar.

The team includes an expert each from the WHO. They visited Hinduja Hospital in Mahim, where 12 cases were detected, and TB Hospital in Sewree. Three more members will join the team on Wednesday, following which it will give its final report for preventing the spread of TDR TB. Mhaiskar said that that the civic body had already started implementing the malaria model. “We have handed booklets that detail TB symptoms to all our health workers. They will now begin their door-to-door checks,” she said.

Door-to-door surveillance
BMC’s health workers will visit homes to identify people with TB symptoms. They will take sputum samples of suspected cases, and send them for TB tests.

Mapping of critical areas
There will be special focus on wards with a huge slum population, as the rate of transmission of diseases is more in such areas. Cleanliness drives and health camps will be organised in such wards to create awareness among slum dwellers.

Early detection
A large number of TB patients ignore initial symptoms such as coughing, fever, night sweats, and weight loss, and even try self medication. The BMC will organise camps to spread awareness on the symptoms. To tackle malaria, it held such camps every Sunday. Doctors from KEM, Sion and Nair hospitals examined patients and put them on medication.

Radical treatment
Health workers will be assigned TB patients, and asked to ensure that the latter complete the course of medication. When TB medication is halted, or the dose cut down, TB bacteria battle back and mutate into a tougher strain.

Awareness drives
The civic body had designed a ‘Fight the Bite’ campaign to create awareness on malaria among citizens. A similar drive will be started for TB. People will be urged to focus on hygiene — avoid spitting on roads, covering the mouth while coughing or sneezing — and maintain cleanliness in their areas.

Source: Mumbai Mirror

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