Mumbai: TB deaths increase by 42 per cent in 2021

Even as Mumbai recorded a rise of 35.37 per cent in tuberculosis (TB) cases last year as against 2020, the number of deaths has gone up by 42 in the same period. According to the data provided by the Brihanmumbai Municipal Corporation (BMC), 1,478 TB deaths were registered in 2019, which dropped to 1,352 in 2020, however in 2021, the number of patients died of TB increased to 1,917. Moreover, 204 TB deaths have been registered in the city between January to March 21 this year. Health officials attributed this surge to better reporting of TB cases and deaths during the pandemic. Moreover all these deaths cannot be associated with TB as some of them were contracted to covid-19 due to which they succumbed.

Mumbai’s TB officer Dr Pranita Tipre said the numbers of TB deaths shown in data is the collaborated death which also include other causes of death. The number of cases are updated on the portal and if anyone succumbed due to other reasons it is shown as TB deaths only.

“There is no bifurcation of deaths so overall data is considered as TB deaths. In the last two years TB patients have contracted covid infection and have succumbed to it but it has been updated as TB deaths. However, the cause of TB deaths has reduced during the pandemic,” she said.

Dr Tipre further added “We have been conducting several awareness camps in each city's ward to educate citizens about TB. Moreover they are following bidirectional guidelines of the centre on conducting RT-PCR tests on TB patients.”

Meanwhile, this year, the theme of World Tuberculosis Day is “invest to End TB. Save Lives.” The theme focuses on the need for investments and resources that are required to eradicate this disease. It's a way of conveying these needs to global leaders to reinforce their commitment to fighting this disease. Tuberculosis is one of India's major public health problems. According to World Health Organization (WHO) estimates, India has the world's largest tuberculosis epidemic. In 2020, India accounted for 26% of the incident TB cases across the globe.

Explaining Covid-19 and Tuberculosis co relation Dr Prasad Padwal, Pulmonologist from Apex Hospitals Mulund said, “In many cases, people also confused the symptoms of TB with Covid-19. During the lockdown people could not access Hospitals, as most of the Hospital converted into Covid Hospitals, so most patients with other ailments were neither accepted nor treated. The reason for increased probability of tuberculosis in post-Covid patients are factors like altered immunity, lung inflammation and stress due to Covid, use of steroids for Covid treatment and worsening of blood sugar control. Poverty and a lack of financial resources are also associated with malnutrition, poor housing conditions, substance misuse, and HIV/AIDS incidence. These factors often contribute to a weakened immune system and are accordingly correlated with a higher susceptibility to TB in india.”

Dr Anant Pandhare, Medical Director – Dr. Hedgewar Hospital said there is a need to ramp up the efforts to fight tuberculosis. The substantial decline in case notifications in India is one of the biggest indicators that shows tuberculosis programmes, amid the pandemic, have taken a back seat. Being the home to a quarter of the global burden of the disease, we fear an imminent increase in TB mortality rates if urgent measures are not taken both on a state and national levels.

“To achieve the mission to eliminate TB by 2025, we need to strengthen our TB mitigation strategy which requires an increased level of awareness among people about the disease. It is also crucial that TB patients overcome social insecurities and access TB care and utilise the government’s TB programme. In the case of Mumbai, the recently launched virtual tuberculosis clinic is a significant step to tackle TB cases and prescribe the treatment promptly. BPaL trial is also showing promising results in difficult to treat TB (Resistance TB), and could be beneficial in bringing down the total case-load in times to come,” he said.