India reports 19% jump in TB cases in 2021: India TB Report

India reported a sharp 19 per cent rise in tuberculosis cases in 2021 over the previous year, revealed the India TB Report 2022 released by the Union Health Minister on Wednesday. The total number of incident TB patients (new and relapse) notified during 2021 were 19, 33,381 as opposed to that of 16, 28,161 in 2020.

At the same time, there has been an increase in the mortality rate due to all forms of TB between 2019 and 2020 by 11 per cent in India. In absolute numbers, the total number of estimated deaths from all forms of TB excluding HIV, for 2020 was 4.93 lakh, which was higher by 13 per cent than the 2019 estimate.

In 2019 India had reported an 11 per cent jump in TB cases to 24.04 lakh patients over the previous year. In 2020, after the initial two months of pandemic (March and April) the TB notifications dipped by 38 per cent as compared to January and February. TB notifications started to pick up towards the end of 2020, and a total of 1.8 mn cases could be notified, an increase of 11 per cent from the projections made around April-end.

The pandemic has hit the process of TB notifications in the country. The TB India Report 2022 said, “Admittedly, the fight against Tuberculosis (TB) encountered setbacks in decades of gains.” India aims to eliminate TB by 2025 according to the National Strategic Plan for Elimination of Tuberculosis (NSP 2017- 25) and eighteen States have committed to Ending TB by 2025 by formally implementing State specific Strategic Plans.

“The programme had been able to catch-up with the dip in TB notifications that was observed around the months when the two major Covid waves happened in India,” the report said, adding that factors such as changes in the health seeking behaviour of patients with chest symptoms as well as diversion of human and material resources were seen across the country.

According to the Global TB Report 2021, the estimated incidence of all forms of TB in India for 2020 was 188 per 1 lakh population. In India, childhood TB remains a staggering problem, contributing to approximately 31 per cent of the global burden. Over the last decade, consistently, children constitute 6-7 per cent of all the patients treated under National Tuberculosis Elimination Programme (NTEP) annually, pointing to a gap of 4-5 per cent in total notification against the estimated incidence.

Comorbidities like malnutrition, diabetes, HIV, tobacco smoking, and alcohol impact a person with TB in predisposition and severity. Around Rs 1,488 crore were paid to 57.33 lakh TB patients under the Nikshay Poshan Yojana (NPY) as direct benefit transfer (DBT) from April 2018 to February 2022.

In 2021, among 21,35,830 patients diagnosed, 20,30,509 (95 per cent) patients were put on treatment.

Around 61 per cent were male and 39 per cent were female among the patients put on treatment. Among the total notifications, 6 per cent of patients were in the paediatric age group. Of the total patients notified in 2020, 83 per cent were successfully treated while 4 per cent died during treatment.

 On Wednesday, the results of a National TB Prevalence Survey were also released, which showed that the majority (64 per cent) of the symptomatic population did not seek healthcare services. The reasons behind this was that 68 per cent were ignoring symptoms, 18 per cent were not recognizing TB symptoms, 12 per cent were on self-treatment, and 2 per cent could not afford to seek care.

The survey carried out between 2019 and 2021 also showed that cases of confirmed pulmonary TB cases for those above 15 years was 316 per lakh population, and this varied from 151 per lakh in Kerala to 534 per lakh in Delhi.

The prevalence of all forms of TB for all ages in India was 312 per lakh population for the year 2021 and the highest prevalence for all forms of TB was 747 per lakh in Delhi and the lowest was 137 per lakh population in Gujarat.