VARANASI: Although India continues to be the largest contributor to global TB cases, there has been a decline in the number of cases in 2021. Reporting of TB cases also improved in 2021 – although it didn’t reach the prepandemic levels, it bounced back from the lows seen during the first year of the pandemic, according to India’s Annual TB Report 2023.
The report was released by Prime Minister Narendra Modi on the occasion of World TB Day on March 24, at Varanasi. The incidence of TB – new cases detected through the year – reduced by 18 per cent in 2021 over the 2015 baseline, dropping to 210 cases per lakh population as compared to 256 cases per lakh population. The incidence of drug-resistant TB also went down by 20 pc during the period from 1.49 lakh cases in 2015 to 1.19 lakh cases in 2021.
Decline in notifications
The report said there was a brief decline in TB notifications in 2020 and 2021 due to the Covid-19 pandemic, but the National TB Elimination Programme (NTEP) recorded a high notification of 24.2 lakh cases, an increase of 13 per cent as compared to 2021.
This translates to a case notification rate of approximately 172 cases per lakh population, according to the report titled, ‘Leading the way – India TB report 2023.’ In 2021, India saw a 19 per cent increase in new and relapsed tuberculosis (TB) patients compared to 2020. In 2022, the highest case notification rate among states was in Delhi (546 per lakh population) and the lowest in Kerala (67 per lakh population).
With 28 per cent of global cases, India is among the eight countries that account for more than two-thirds total TB patient count. Of the total cases in India, about 39 per cent were females, 5.6 per cent belonged to the pediatric age group (less than or equal to 14 years of age) and 23.6 per cent were 55 years or above.
Treatment initiation rate
The report also said 2022 saw the highest private TB case notifications achieved at 7.3 lakh. The treatment initiation rate among the notified cases for 2022 was 95.5 per cent. In 2019-2021, a higher prevalence of pulmonary TB was found in older age groups, including males, malnourished, smokers, alcoholics and known diabetics.
It was also found that the majority (64 per cent) of TBsymptomatic individuals did not seek health care. The common reasons cited for not seeking care were ignoring the symptoms (68 per cent), not recognising the signs to be that of TB (18 per cent), self-treatment (12 per cent), and not being able to afford care (2 per cent).
Rise in MDR, RR cases
The report said 2022 saw an increase of 32 per cent in the number of Multi-Drug Resistant (MDR)/ Rifampicinresistant (RR)-TB cases compared to 2021. In 2022, the total number of patients diagnosed was 63,801. The estimated incidence of MDR/RR-TB in 2021 was 119,000 (93,000-145,000), as per the Global TB Report 2022.
Although elimination of tuberculosis is one of the sustainable development targets to be achieved by 2030 by the world, India has set the target of 2025. The national strategic plan 2017-2025 sets the target of India reporting no more than 44 new TB cases or 65 total cases per lakh population by 2025. The estimated TB incidence for the year 2021 stood at 210 per lakh population.
