Introduction

Every year the 24th of March is observed the world over as World TB day (WTBD). In 1882 on this day Robert Koch (click the link for Robert Koch's bio) had announced the discovery of Mycobacterium tuberculosis, the bacteria, which cause tuberculosis (TB) in humans.

A century later in 1982 World TB Day was observed for the first time to commemorate the discovery that paved the way for a global fight against TB. The WTBD is an occasion to generate awareness amongst the masses about this dreadful yet curable disease.

Above: Thin section transmission electron-
micrograph of Mycobacterium Tuberculosis

^ top

TB in India

TB is a major public health problem for India. World Health Organization (WHO) estimates that approximately one third of total TB patients of world live in India alone. According to statistics made available by Government of India five thousand new TB patients are added to the pool of TB cases of the country every day and one thousand men, women and children fall victim to this disease daily.

TB is not only a challenge for the health services of our country; it is also a huge burden on our economy. The total annual financial toll of TB on our economy is Twelve Thousand Crore Rupees (Approx 2666666666.67 US $) One of the major contributing factors to this loss is the reason that most people fall victim to TB when they are in the most productive period of their lives. These hapless sufferers instead of earning bread and butter for their families themselves become a burden on them and the community. To put it in plain words, TB is a stumbling block in our road to development.

^ top

Understanding TB

Let us understand the symptoms of TB. The first and foremost symptom of TB is cough. This cough may be dry to begin with but is later associated with expectoration. At times the sputum may be tinged with blood. Fever which usually accompanies the cough, characteristically begins in the evenings and abates by midnight following cold sweats. Patients also experience chest pain, breathlessness, loss of appetite and weight. In the absence of proper treatment the condition of a patient deteriorates rapidly and leads to a fatal outcome.

TB spreads through air. Whenever a patient with active disease coughs, sneezes or even speaks, TB bacteria are released into the air. They enter the body of the next person through the breath and initiate the disease. A TB patient can pass on the disease to fifteen to twenty persons in one year. That is why WHO has chosen the theme ‘Every Breath Counts- Stop TB Now!’ for this year’s WTBD. It is possible to control TB. A cure is possible, but it is crucial that TB patients take the full course of treatment on a regular basis.

^ top

DOTS Strategy

WHO has developed an effective strategy for TB control. It is called Directly Observed Treatment Short-course or DOTS. A key element of DOTS is that patients receive treatment under supervision of health workers. DOTS services are now available to seventy percent population of our country. By the year 2005 these services will cover whole population. DOTS facilities are being provided in entire State of Haryana, Himachal and in nine districts of Punjab.

^ top

How DOTS works

Under DOTS every patient who has cough for three weeks or more is advised to get his/her sputum tested for TB bacteria. The facilities for sputum test are available free of cost at all public health institutions. The sputum is tested on three occasions within two days and if TB bacteria are present the patient is taken up for treatment. The full course of treatment, which is provided free, normally lasts for six months. The distinguishing feature of DOTS is that medicines for entire course of treatment are put in a separate box earmarked for each patient. The patient has to visit the nearest hospital thrice in a week on alternate days to consume the drugs in the presence of a health worker for the first two months of treatment and once in a week for next four months. The sputum is tested again at the end of second and sixth month. A patient is declared cured only if the sputum of the patient is free from TB bacteria. If a patient defaults during the treatment course, health workers visit his/her residence and ensure that treatment is resumed and completed.

^ top

The message of WTBD

The WTBD theme this year reminds us about the way TB spreads. Breathing is the basis of life. Unfortunately India has a very sizeable pool of TB patients who continue to infect more and more people through breathing. Government of India is expanding DOTS services across the length and breadth of the country at a considerable financial cost. These efforts will bear fruit only if each and every Indian understands his/her responsibility. Let us ensure that every man, woman or child who has cough for three weeks or more comes to DOTS centres and completes full course of treatment.

DOTS has helped country after country to control TB and now it is our turn to win our battle against this deadly scourge.

^ top