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Govt trying to bring TB patients in RNTCP fold

A sensitisation programme for private doctors on the Revised National Tuberculosis Control Programme (RNTCP) in Ramanagara district by the government a few months ago, led to 90 per cent of them referring TB cases to the government designated units for treatment. The result: Besides more number of sputum cases being recorded, the follow up and treatment compliance by TB patients improved.

Ramanagara is just one of the 10 top performing districts in the State, which has seen improved collaboration with private doctors. In other districts of the State, including the BBMP area (BBMP is considered as a district in RNTCP), the government has been facing hurdles in involving private practitioners to bring TB patients in the RNTCP fold.

According to RNTCP State joint director Dr Kumaraswamy Lal, 50 per cent of the people suffering from TB visit a private doctor for treatment. So, while 68,673 cases of TB have been registered in 2010-11, the actual numbers may be higher. “Although we have 2,290 private practitioners practising adhering to RNTCP, not everyone has signed MoUs. Doctor who have not signed MoUs, send only those patients, who cannot afford treatment, since the drugs are provided free of cost under RNTCP,” he said.

Under RNTCP, private doctors, who have signed MoU, are given Rs 400 as honorarium per referred case, with community volunteers receiving Rs 250. Yet, considering the City’s population, only 210 private practitioners were involved in the programme.

Drug resistance

Besides topping the chart of high burden TB countries in the world, India also has the dubious distinction of having the highest number of Multi Drug Resistant TB (MDR-TB) cases, states a WHO report. A survey has found that MDR-TB prevalence is 3 per cent of all new cases and 14-17 per cent of retreatment patients.

Hence, the State is going to start its first MDR-TB laboratory at Rajiv Gandhi Institute of Chest Diseases (RGICD) by April or May. 

To be launched on a pilot basis in five districts – Bangalore urban, Bangalore rural, BBMP, Kolar and Tumkur – the lab will conduct survey of MDR-TB cases and introduce DOTS Plus, the second line of TB drugs. 

But the treatment of Extensively Drug-resistant TB (XDR-TB) or the testing facilities are yet to start in the State. 

While Dr Lal denied any XDR cases in the State, RGICD Director Dr Shashidhar Buggi said one XDR case from Bangalore was detected last year, with another in the process of being confirmed. RGICD is the only institute in the State providing second line drugs for the last six-seven years. 

In fact, the health secretary sanctioned Rs 25 lakh from the Health Department in 2010-11 for MDR-TB treatment, although the institute comes under Medical Education Department. 

“I started the programme with the CM’s relief fund as MDR cases from across the State were coming to my institute for treatment. Currently, we have over 400 MDR cases registered with us,” revealed Dr Buggi.  

Apart from involving private practitioners, the government should also include the general public as that will eliminate the stigma surrounding TB, he felt.

(Published in Deccan Herald on 23rd March, 2011)

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