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Tamil Nadu
FOR EFFECTIVE CONTROL: (From left) Rajeshwari Ramachandran, former deputy director, Tuberculosis Research Centre; S. Sowmya, deputy director of the centre; and Nalini Krishnan, director-projects, REACH, at a seminar in Chennai on Sunday. CHENNAI: Sputum test is the best way to detect tuberculosis of the lungs, according to Rajeshwari Ramachandran, former deputy director, senior grade, Tuberculosis Research Centre, Chennai. “Sputum test is simpler and cheaper than X-ray. But for some strange reason, it does not have the same status,” she said, speaking at a seminar on tuberculosis organised here on Sunday by the Chest Foundation of India to mark the World Tuberculosis Day, which falls on March 24. Concurring with Dr. Rajeshwari, Ram Gopalakrishnan, senior consultant physician, infectious disease and tropical medicine, Apollo Hospitals, speaking at the evening session, said the sputum test was under-utilised by physicians. “It should be the first test that should be done.” Relying on other methods to detect tuberculosis of the lungs often led to misdiagnosis and over-treatment or under-treatment. Tuberculosis of the lungs is the most common form of the disease, Dr. Rajeshwari said. “Ninety per cent of the patients have TB of the lungs.” Half the number of such patients could infect others; whenever they coughed, sneezed, talked or spat, they let out tuberculosis germs into the air. A healthy person needed to just inhale a small number of these germs to get infected. Those who spread the disease were termed ‘sputum positive.’ A single patient could affect 10 or more people in a year. Hence, treating ‘sputum positive’ patients was the key to arresting the spread, Dr. Rajeshwari said. Government hospitals followed regular procedures to prevent the spread of the disease, she said. This was done by prioritising sputum-positive patients for diagnosis and treatment. But private medical establishments did not adopt these procedures. Raj B. Singh, chief respiratory physician, the Chest Centre, said there was no regulatory mechanism to ensure that private practitioners followed guidelines, such as performing the sputum test for suspected TB of the lungs. Apart from educating private practitioners, there could be a regulation to refer all TB patients to a government hospital. But this would be effective only if the public health infrastructure had adequate capacity, which it did not currently have, Dr. Gopalakrishnan said. Private practitioners needed to be roped in to control the spread of tuberculosis, said Nalini Krishnan, director-projects, Resource Group for Education and Advocacy for Community Health. The community had to get involved too, as tuberculosis did not affect a single patient but the whole community.
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