March 24 is globally observed as World Tuberculosis Day every year to raise awareness about the disease that is curable but affects approximately 4.1 million people across the world, according to the World Health Organisation (WHO).
India contributes to 27 per cent of the global TB burden. It is estimated that over 35-50 crore people in India have TB infection and over 26 lakh people develop TB annually.
As Covid hogged the limelight, healthcare resources were diverted to combat the rising cases. TB services were thus disrupted in the last two years.
In March last year, an analysis by the Health Ministry notified that Covid brought down TB detection by 25 per cent in India in 2020. Tuberculosis notifications reduced to 18.02 lakh in 2020 from 24.04 lakh in 2019 due to lockdown and diversion of resources, the ministry said.
India also accounted for 34 per cent of an estimated 1.48 million deaths due to TB globally in 2020. Deaths due to TB in the country also rose by 3 per cent compared to 2019, WHO’s 2021 Global TB report said. As per experts, the deaths due to the infectious disease is still on the high.
“The pandemic has reversed years of progress made in tuberculosis control not just in India but across the globe. The absolute percentage of those succumbing to the disease has risen to 5-7 per cent now, up from 1-2 per cent during pre-Covid times,” Anand K., CEO, SRL Diagnostics, told IANS.
“There has been an approximately 25-30 per cent increase in tuberculosis patients especially after Covid wave, as compared to the previous year when there was no Covid,” Dr Vikas Maurya, Hod and Director, Pulmonology, Fortis Hospital Shalimar Bagh, told IANS.
While India is on a mission to become TB free by 2025, there is a significant rise in TB cases among youngsters.
A recent report by Mumbai-based health-tech startup HaystackAnalytics has indicated that India continues to bear the largest share of TB cases in the world, with 65 per cent of the cases being reported in the most economically productive population segment between the ages 15-45.
“We are seeing an increase in the number of young people coming to us with tuberculosis cases. In most cases, they are otherwise healthy people who developed symptoms in the last few months. We’ve discovered that the majority of the time, it’s due to poor lifestyle choices and insufficient sleep,” said Dr. Akshay Budhraja, Senior Consultant, Respiratory & Sleep Medicine, Aakash Healthcare Hospital, Dwarka.
Budhraja added that Aakash hospital has seen more than 50 instances of tuberculosis in youngsters, in the last three months.
The reason is, “during the Covid 19 pandemic, many people had irregular sleep patterns like staying up till late night or early morning, skipping breakfast, and a lot many also followed a strict diet plan or did fasting without consulting the experts”, he said, adding “this lowers the immune system, which leads to diseases like TB”.
Maurya attributed the increase to delayed diagnosis and also due to more spread among families and communities as patients didn’t move outside house for diagnosis.
“Multiple family members of the same family were also found to be positive. Dysregulated immunity in patients with Covid and anti-inflammatory drugs used in the treatment have also been found to be associated with reactivation of TB cases,” He said.
Other factors found to be increasingly associated with the increase of TB cases were presence of comorbidities, especially diabetes, heart disease, chronic lung and kidney disease, and cancer, the experts said.
TB is an airborne infection, and the bacteria are discharged into the air when a person with the infectious condition coughs or sneezes.
“Basic ventilation, natural light (ultraviolet light kills TB bacteria), and good hygiene behaviours such as covering the mouth and nose when coughing or sneezing lowers the chances of infection,” Budhraja said.
Besides, a healthy nutritious diet, regular exercise, and proper sleep can strengthen the immune system, and help fight the infection, the experts said.