Question

Disease Chosen: Tuberculosis in India (1000 WORDS PLEASE AND KINDLY DONT ATTEMPT IF YOU WILL COPY / WRITE IN YOUR OWN LANGUAGE)

Task: A brief introduction to the disease and population of concern, including statistics on the prevalence of the disease in this population and comparison to data at a global level.

Answer 1

The disease Tuberculosis(TB) is a kind of infectious disease, which is caused by bacteria by the name Mycobacterium Tuberculosis. The disease primarily affects the lungs, but may also cause an infection in other parts of the body like kidneys. The symptoms of the active form of the disease include chronic cough, sputum with blood, night sweats, fever, and weight loss. In the cases of latent tuberculosis, the symptoms may not occur. Other symptoms also occur when the organs apart from the lung are also infected. But more than 80% of TB cases and bacterial infections are limited to the lungs. The TB bacteria can spread through the air and is transmitted through the sneeze, spit, cough, or speak of TB infected individuals. People who smoke, or are infected by the HIV (Human Immunodeficiency Virus) may be more prone to the TB infection. The disease is diagnosed through the culture of body fluids, microscopic examination, and chest X-ray.

Around the quarter of the total world population is presumed to be affected by the TB bacteria. Each year around one percent of the world population gets infected TB. The disease caused 1.6 million deaths, and more than 10 million cases of it were registered worldwide in the year 2017 alone. It is the leading infectious disease causing the greatest number of fatalities worldwide. The incidences of tuberculosis in developed countries are quite low when compared to other countries. Around 95% of the TB related fatalities are registered in developing and underdeveloped countries including India. India along with Indonesia, China, Philippines, and Pakistan accounts for 50% of all TB related death. The Tuberculin test (for testing the TB bacteria) main test positive for 5% to 10% percent of people in the USA, while in many of the African and Asian countries the test would be positive for more than 80% of people. The disease has been affecting mankind since ancient times. TB is treated through medications (including antibiotics), while a vaccine for TB which may decrease the risk of disease for children is also available and is called Bacillus Calmette Guerin (BCG) vaccine. Around 90% to 95% of all TB infections remains to be asymptomatic and do not cause the TB disease.

Tuberculosis in India

Tuberculosis is an epidemic in India and causes around 2,20,000 death each year. The country spent around USD 340 billion in between the year 2006 and 2014 towards containing the spread of disease in its population, and towards its treatment. India remains a “high” TB burden country. According to the World Health Organisation (WHO), out of 9.6 million total cases of TB, around 2.2 million were registered in India alone, in the year 2018. The Indian Ministry of Health and Family Welfare notified that there are around 2.15 million new cases of tuberculosis in the year 2018 only. This information was revealed by credible sources on the World Tuberculosis Day (March 24), 2019.

What’s even more frightening is that the TB bacteria in India is growing resistant to medications and antibiotics. The new forms of TB, viz. Totally Drug-Resistant Tuberculosis (TDR-TB) and MDR (Multi-Drug Resistant Tuberculosis) are found to be stationed and thriving in India. The WHO also claims that the Indian resistance rate is much higher when compared to the world drug-resistant rate of 2% to 3%. Every third HIV and AIDS (Acquired Immunodeficiency Syndrome) patient dies due to tuberculosis in India, and the country holds the quarter burden of the World TB (around 27%). The Indian health ministry has vowed to end the epidemic and the disease in India by the year 2025.

Pollution is one of the leading causes of the spread of TB in India. The country is still a developing economy and therefore much of its health infrastructure may also be in a developing state. The bacteria spreads fast in slum areas that are present in high proportions in metropolitan regions like Delhi and Mumbai, and major cities of India. One room dwellings, hazards like scarce ventilation, overcrowded homes, poor build environment, and others aggravate the risk of exposure to the TB bacteria. Because of low income, the majority of the population may not get the antibiotics and medications required to treat the disease. Poor education and assess standards are also restraints and the majority of the population may fail to reach the government centers where the treatment is provided free of cost. Around 1.5 million patients of TB in India are getting free treatment in government hospitals and medical centers. However, new programs including the Revised National Tuberculosis Control Program aims to increase the access of these poor people to the TB care centers. But the presence of the drug-resistant form of the bacteria is worsening the situation. Data shows that only around 16% people of all TB patients exposed to the drug-resistant form of the bacteria are getting the right and appropriate treatment. The private medical practitioners of the country are not forthcoming in the aid and support that they can provide to the TB containment programs of the government, because of the low on negligible profit margins. Only around 1% of the private medical practitioners have been in support of the practices. Many of the practitioners may not also be aware of the latest drugs that are available and being used for treating the advance and drug-resistant forms of TB bacteria. Apart from poverty and poor housing conditions, AIDS, substance/tobacco abuse, and malnutrition also cause immunosuppression and therefore make the poor Indian population more susceptible to the TB bacteria.

The TB containment programs help save more than 54 million lives globally, in between the years 2000 and 2017. The incidence rate of the disease is also falling by 2% annually worldwide. The largest number of TB cases have been registered in Southeast Asia and the Western Pacific regions (62%). It is closely followed by the African nations, where 25% of the new cases have been registered, in the last years. The major concern is the drug-resistant form of TB resistant bacteria (resists first line medications including rifampicin), of which 5,58,000 new cases were registered in the year 2017 alone. The bacteria grows more powerful as only around 55% of the multidrug-resistant forms of TV have been treated successfully. Countries including India are striving hard to increase their efforts and containment rate for TB, from 2% to 5%.