Tracing dropout TB patients a challenge for civic body

The dropouts assume significance in the light of the fact that doctors stress the importance of continued medication

With the Brihanmumbai Municipal Corporation (BMC) entering the second phase of its anti-tuberculosis programme last month, officials are finding it difficult to trace dropout patients and ensure that they complete treatment. According to BMC officials, the dropout among several patients, who were enrolled for treatment under the Revised National Tuberculosis Control Programme (RNTCP), can mostly be attributed to change in their residential address.

"Many of the fresh and previously detected cases come from the slums. However, many of the patients shift from the address provided and hence end up dropping out of the treatment. Then it becomes impossible to trace them," said Dr Mini Khetarpal, special tuberculosis officer, BMC.

The dropouts assume significance in the light of the fact that doctors stress on the importance of continued medication, failing which increased resistance develops. "It is a medical fact that incomplete adherence to a certain regimen makes the bacterium more drug-resistant and thus, more virulent. Incomplete medication is one of the main reasons that have given rise to multi-drug resistance strains of the tuberculosis bacteria," said Dr Z Udwadia, consultant chest specialist at Hinduja Hospital.

In the first phase of its anti-tuberculosis programme, which started in February this year, the BMC had screened 6,561 people across 10 wards in the city. Of these, 1,407 people were diagnosed with multi-drug resistant tuberculosis. "We are treating 885 people and 179 are in the process of being enrolled for treatment. The remaining are seeking private help or are from outside the city," said Additional Municipal Commissioner Manisha Mhaiskar.

In its second phase, the BMC will continue screening people as part of its door-to-door survey.

"As was seen in the successful anti-malaria programme, we will follow the template of early detection, treatment and follow-up. We have trained more than 400 medical officers of the BMC in tuberculosis management," she added.

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