Experts welcome guidelines to check TB amid cough

While the Union Health Ministry has issued directives asking health experts to check on Tuberculosis amid persistent coughs health experts have welcomed the move stating that TB cannot be ignored amid the Covid19 pandemic and it has always been a major silent killer in India too Recent data published by WHO also highlights the concern globallymidday was the first to highlight the issue of a tuberculosis outbreak amid the pandemic in an article on June 25 2020 wherein thousands of migrant workers had to quit taking their multidrug resistant MDR TB medicines midway due to the lockdown increasing the spread of TB in remote villages and rural indiaDr Wiqar Shaikh professor of Medicine Grant Medical College and Sir J J Group of Hospitals has welcomed the new guidelines from the Ministry of Health The new guidelines say that there is no evidence for the use of injectable steroids in patients who do not require oxygen supplementation or continuing steroids after the patient has been dischargedAgreeing with this Dr Shaikh said that on the contrary the indiscriminate use of steroids should certainly be discouraged He recalled that the extensive use of steroids during the first two waves had resulted in a massive surge in the number of cases of fungal infections also called mucormycosis Dr Shaikh said that the guideline was to advise Covid patients to check themselves for TB if cough persists for two to three weeksHe said that WHO said in 2019 71 million people were diagnosed with TB and in 2020 the figure fell to 58 million WHO estimated that currently 41 million people suffering from TB have not been diagnosed or have not reported to the authorities He said that India has the highest number of patients suffering from MDR TB as well as deathsChronic cough new dilemmaldquoSince the Covidrelated nationwide shutdown in March 2020 most migrants returned with their families to their native places This was evident in Mumbai in crowded slum settlements of Dharavi where almost 80 per cent of migrants moved out Tens of thousands of migrants who were on TBDOTS and MDR TB treatments returned to native places without following up on treatmenthellip The public health experts are concerned that major pandemics of HIVAIDS TB malaria reproductive infections preventable childhood immunisations etc have suffered immense damage and the people need to be rehabilitated to prevent upsurge in cases of TB and other infectious diseasesrdquo said Dr Subhash Hira professor of Global Health at University of WashingtonSeattle and advisor to WHOTDRGeneva lsquoStay hydratedrsquoldquoCough is one of the most common symptoms of postCovid syndrome Fatigue dyspnoea pain and socalled brain fog cognitive impairment including confusion and memory loss are associated accompaniments Usually it subsides with time However if it persists beyond three weeks then a pulmonologist consultation is advisable to rule out other causes such as TB and COPD especially when the patient is diabetic and on steroids Simple measures may be very helpful in controlling cough such as adequate hydration with warm water and soups periodic steam inhalation lying on one siderdquo said Dr Ketan Vagholkar professor of surgery attached to D Y Patil Medical CollegelsquoScreen those who missed TB treatmentrsquoldquoTB was a major health concern in India even before the pandemic Many workers and poor people who went to their hometowns in the lockdown were taking TB medicines from government centres Now since they are coming back to the city Again we must screen them about their TB status and see if they continued their treatment If we lose track of them TB can spread to othersrdquo said Dr Santosh Bansode Head of the Department Emergency Medicine Wockhardt Hospitals Mumbai Central Dr Lalitkumar Anande Medical Superintendent at Sewri TB Hospital a wizard who has dedicated his experience of over three decades handling only TB cases expressed similar concern and said ldquoMany migrant workers who were under treatment for TB and have left the city carry a high risk of spreading the same in the state they have headed to If they are not traced and given medication they may slip into MDRTBrdquolsquoBoost immunty naturallyrsquoldquoThe pandemic has brought the immunity of the most vulnerable humans to the lowest edge who are already stressed out mentally due to issues at both personal and professional front And the Mycobacterium mtCP known for causing tuberculosis usually is a silent killer it attacks the human body when the immunity level falls The spread of tuberculosis has already become rampant and we are now coming across new mutants of TB including the Beijing strain which only indicates that more and more research needs to be donerdquo said Dr Anande When asked about the promise to eradicate TB from the country by 2025 Dr Anande said ldquoIt is the vision of our countryrsquos prime minister and it could be accomplished provided collective efforts are pumped into the said directionrdquo