Sustaining the trend of tuberculosis (TB) notifications made in 2022, Karnataka has registered 81,331 TB notifications in 2023, achieving 81% of its annual target.
While this signifies the State’s improved case detection measures, what is a matter of concern is that public notifications have gone down from 60,236 in 2022 to 58,125 in 2023, a drop by nearly 4%. However, private notifications have gone up by 14% in 2023 compared to 2022.
According to data from Nikshay portal, under the National TB Elimination Programme, India registered the highest notifications in 2023 (25,30,055), achieving 92% of the annual target. Among the larger States, Uttar Pradesh exceeded its target of 5.5 lakh recording 6.27 lakh TB notifications in 2023. Uttar Pradesh is followed by Rajasthan and Maharashtra that achieved 91% of their target and New Delhi with 90% achievement last year, data revealed.
Private notifications
While over half of all tuberculosis patients seek care in the private sector, case notifications from the private sector have always been way behind the targets set by the government. While private doctors are reluctant to notify cases, laxity on part of chemists in monitoring the sale of anti-TB drugs that are covered under Schedule H1 of Drugs and Cosmetics Act has also hit the State’s fight against the infectious disease.
In 2023, Karnataka recorded a 14% rise in private notifications - up from 20,385 in 2022 (when the total notifications were 80,621) to 23,306 in 2023.
In 2021, there were 21.45 lakh new tuberculosis case notifications in India of which only 6.93 lakh were from the private sector. Karnataka reported 72,636 case notifications that year of which 19,652 were from the private sector. Earlier, annual targets were fixed based on population. From 2022 onwards the targets were revised on the basis of prevalence,
State Joint Director (TB) Shivayogappa U. said a comprehensive district wise analysis will be done to ascertain the reason for drop in public notifications. Based on the analysis, targeted interventions can be taken up to improve case detection, he said.
Notifiable disease
TB has been a notifiable disease in the country since May 2012. Despite awareness regarding mandatory TB notification, a significant number of private practitioners do not report cases and this has led to cases being missed out of government data. Missing cases who are lost to follow up are one of the prime reasons for quick spread of the infection.
After incentivising private notifications, the Union Health Ministry criminalised non-reporting of tuberculosis in early 2018 and as per the government notification, doctors, hospital authorities, chemists and druggists could face a jail term for not notifying TB cases.
Stigma attached
Several practitioners find reporting a hassle as many patients do not want to reveal the infection mainly because of stigma. Among other factors is migration. Many patients also give up treatment because of side effects or as soon as they feel better. This can increase the risk of developing drug-resistant TB which is more difficult and expensive to treat.
