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ANNUAL TB REPORT 2020

Annual TB Report 2020

Context: 

Ministry of health and family welfare has released the annual TB Report 2020. A Joint Monitoring Mission report, a manual on Direct Benefit Transfer (DBT) to TB patients under the NIKSHAY system, a Training Module, and the quarterly newsletter NIKSHAY Patrika have been also released.

Key findings:

  • Around 24.04 Lakh TB patients have been notified in 2019 an 14% increase in as compared to the year 2018.
  • As against more than 10 lakhs in 2017 of missing cases, there is a reduction of  2.9 lakh cases.
  • Private sector notifications increased by 35% with 6.78 lakh TB patients notified.
  • Because of the availability of molecular diagnostics, the proportion of children diagnosed with TB increased to 8% in 2019 compared to 6% in 2018.
  • Provision of HIV testing for all notified TB patients increased from 67% in 2018 to 81% in 2019.
  • The expansion of treatment services has resulted in a 12% improvement in the treatment success rate of notified patients.  For 2019 it is 81% compared to 69% in 2018.
  • More than 4.5 lakh DOT Centers provide treatment covering almost every village across the country.
  • NIKSHAY also expanded the provision of four Direct Benefit Transfers (DBT) schemes of the program:
    • Nikshay Poshan Yojana to TB patients
    • The incentive to Treatment Supporters
    • An incentive to Private Providers and
    • Transport incentive to TB patients in the notified tribal areas

Tuberculosis (TB):

  • TB is an infectious airborne bacterial disease caused by Mycobacterium tuberculosis.
  • When TB infection becomes resistant to the first line of treatment — isoniazid, and rifampicin it is called Multi-drug resistant TB (MDR-TB). 
    • However, when the infection becomes resistant even to the second-line treatment it is called Extensively-drug resistant tuberculosis (XDR-TB).

The Truenat TB test:

  • It is a new molecular test that can diagnose TB in one hour as well as testing for resistance to the drug rifampicin. 
  • This test for TB uses a sputum sample taken from each patient. 
  • It is a small battery-operated device that requires minimal training and is usable even in smaller settings such as the Primary Health Centre.
  • Truenat uses a chip-based technology and takes just up to 60 minutes for a test, screening, or confirmatory. 

Working of TrueNat test: 

  • The test works by the rapid detection of TB bacteria using the polymerase chain reaction (PCR) Any resistance to rifampicin (RR) is detected by doing a second RTPCR (Reverse transcription-polymerase chain reaction)
  • Earlier gen expert was used to detect 
  • Genexpert versus TrueNat:  The Genexpert machine is designed for larger volumes and needs a reliable electricity supply.  The TrueNat machine is more of a point of care machine, which is not fully automated.  It is designed for situations where there may not be electricity and where the need is for one test to be done at a time.

Govt initiatives: 

  • Cash benefit for TB patients: Tuberculosis patients are getting Rs. 500 every month from the center as social support. The cash benefit for social support will cover the loss of wages, travel, and mainly nutrition. Rs. 500 will be to the private medical practitioner for notification of the disease
  • Nikshay: To keep a track of the TB patients across the nation the government has introduced a system called NIKSHAY. Patients receive daily messages to ensure they continue their medication.
  • Cartridge-Based Nucleic Acid Amplification Test (CBNAAT): It is a rapid molecular test that simultaneously detects Mycobacterium tuberculosis and rifampicin drug resistance. It is fully automated and gives results within two hours.

Source: PIB