Kerala - Thiruvananthapuram   

TB programme needs more teeth

Staff Reporter

Thiruvananthapuram: Ten years into the implementation of the Revised National Tuberculosis Control Programme (RNTCP), the social stigma about tuberculosis, the lack of awareness among the grassroots on the free treatment available and low acceptability of WHO's DOTS strategy among private sector physicians continue to dog the national programme.

When private hospitals are still the first point of consultation for a majority of the people suspected of having tuberculosis, the fact that only about 40 per cent of private hospitals are implementing RNTCP is a major concern for public health activists.

The State has managed to maintain a consistent cure rate of 85 per cent, but its case detection rate continues to lag at 43 per cent in the community, putting Kerala along with Bihar as the two poor performing States in the country. However, the RNTCP managers in the State point out that the consistent low case detection record of the State could be owing to the fact that the TB incidence in the State is less than the national average. .

Delay in diagnosis is another problem that is yet to be tackled in the community. The standard test for TB - sputum microscopy - is one that was invented several decades ago, but the Designated Microscopy Centres (DMCs) under RNTCP has helped bring down diagnostic period to less than two weeks.

It generally takes anywhere from six weeks to nine months from the onset of symptoms and several doctors' visits before people reach DMCs. By then the infection would have aggravated..

Much more needs to be done to shake off the antiquated image of RNTCP as a routine programme, before it can reach the grassroots.

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