The Enigma of Subclinical Tuberculosis in India

- Subclinical Tuberculosis (TB), which is a form of TB where the patient does not exhibit regular symptoms, is a rising threat in India.

- Despite advancements in diagnosis and cure, the prevalence of such latent TB is slowing down the overall decrease in TB incidence rates.

- Subclinical TB, often undetectable through routine screenings, is usually identified using chest X-rays or molecular tests.

- In the National TB Prevalence Survey of 2019-2021, Subclinical TB accounted for nearly 42.6% of all cases. Tamil Nadu reported a similar statistic at 39%.

- Asymptomatic individuals with Subclinical TB can still infect others, maintaining the disease's transmission, especially in high-burden countries like India.

Broad Spectrum Screening - The Need of the Hour

- The idea of universal screening, irrespective of symptoms, as employed by countries like Vietnam has successfully reduced TB prevalence.

- A similar large-scale screening campaign in India requires strategic policymaking, including mobile health units and proactive grassroots community engagement.

The Global Burden of Tuberculosis

- Tuberculosis, caused by Mycobacterium tuberculosis, is an airborne infectious disease, primarily affecting the lungs.

- The disease manifests in prolonged cough, chest pain, weakness, fatigue, weight loss, fever, and night sweats.

- People with weakened immunity, malnutrition, diabetics, or tobacco users are at a higher risk of developing TB.

- Approximately 25% of the world's population is infected with TB bacteria, with 5-10% developing into active TB disease.

- The spread of TB is preventable with early detection, medical attention, and targeted treatment including antibiotics and vaccines.

- However, Multidrug-resistant TB continues to pose a public health problem, with only 40% of patients accessing crucial treatment.

The Shadow of TB on HIV

- People living with HIV are 16 times more prone to developing active TB, making it the leading cause of death among the HIV- positive population.

- Lack of proper treatment can lead to death in 60% of HIV-negative people and almost all HIV-positive people with TB.

The Global Inequality in TB Prevalence

- TB predominantly affects adults in low and middle-income countries, accounting for over 80% of global cases and mortalities.

- The highest burden lies in WHO's South-East Asian and African regions.

- In 2022, TB claimed 1.3 million lives, including 167,000 HIV positive individuals, second to Covid-19.

Global and National Drive against TB

- In India, initiatives like the National TB Elimination Programme aim to eradicate TB by 2025, supported by the Ni-kshay Mitra, DBT for TB patients, TB-Mukt Panchayat, and Pradhan Mantri TB Mukt Bharat Abhiyan.

- At the global level, WHO's Global Tuberculosis Programme, the Global Plan to End TB 2023-2030 align with UN's Sustainable Development Goals aiming to end tuberculosis as a public health challenge by 2030.