Dr Kuldeep Singh Sachdeva highlights Diagnostic and treatment delays in TB
New Delhi: Dr Kuldeep Singh Sachdeva, former head of India’s TB elimination program at the Ministry of Health and Family Welfare, has highlighted the persistent challenge of missing Tuberculosis (TB) cases and delays in diagnosis and treatment as significant obstacles to India's goal of ending the infection by 2025.
Despite global efforts and initiatives, the latest research published in The Lancet Infectious Diseases journal revealed only a marginal decline of 0.5% in tuberculosis incidence in India between 2015 and 2020. According to the study, India recorded 213 TB cases per one lakh population in 2020, with deaths ranging between 3.5 to 5 lakh, both figures remaining significantly above the targeted levels.
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“Missing TB cases remain an important source of continued TB transmission. Ending TB is not possible without reaching all cases in the community, diagnosing them early and treating and supporting them towards a cure,” Dr Kuldeep, currently the President and Chief Medical Officer of Goa-based Molbio Diagnostics, told IANS.
Raising public awareness and health-seeking behaviour followed by screening with sensitive tools like ultraportable X-rays, which can be deployed closer to them, are some of the ways to reach such cases, said the public health expert.
“Those who screen positive would need a final confirmation with highly sensitive and specific molecular tests preferably point of care tests as they can be deployed closer to patients even in remote settings. Deployment closer to the cases can save out-of-pocket expenses of the community and does not interrupt the routine day-to-day workflow of the cases and caregivers,” he noted.
Highlighting the concerning delay between diagnosis and treatment, Dr. Sachdeva underscored the urgent need to address diagnostic and treatment delays, which perpetuate disease transmission and lead to adverse outcomes.
“Diagnostic and treatment delays are still being observed. These delays imply continued transmission of infective pools, potential for advanced disease and poor outcomes.
According to IANS, “Universal screening and deployment of point of care rapid diagnostics has the potential to diagnose cases early in the disease process. This coupled with starting treatment within 24-48 hours of diagnosis can interrupt the chain of transmission effectively,” he explained.
According to World Health Organization (WHO) guidelines, rapid molecular diagnostic tests should be the primary diagnostic tool for individuals presenting with TB symptoms. Despite some progress in the adoption of molecular tests in India, the country has yet to reach its full potential in this regard.
India, which accounted for the highest number of TB cases globally in 2022, remains committed to achieving Sustainable Development Goals for TB by 2025.
Even as India aims to achieve the target of eliminating TB by 2025, in 2022, the country accounted for the highest number of TB cases in the world, as per the WHO’s 2023 report. With a whopping 2.8 million TB cases, India “represented 27 per cent of the global burden”.
“India is committed to achieving sustainable development goals for TB by 2025,” Dr. Kuldeep said.
“The country has taken various new initiatives to achieve rapid decline in cases quickly and implementation seems to be on track. The current burden remains high and these efforts need to be sustained for a few years to achieve SDGs,” he added.
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