The Brihanmumbai Municipal Corporation (BMC) has roped in private hospitals to tackle drug-resistant tuberculosis in Mumbai, as it strives to meet the Centre’s ‘End Tuberculosis by 2025’ target. The efforts taken by the civic body to combat drug-resistant tuberculosis in Mumbai by including private hospitals have the potential to improve access to the treatment. The inclusion of more DR-TB centres in private hospitals will be beneficial for those who prefer private physicians/hospitals
Mumbai has been witnessing over 5,000 drug-resistant tuberculosis cases annually, with 5,758 cases recorded in 2022, according to BMC officials. In 2021, the city recorded 5,978 DR-TB cases, while in 2020, 4,775 cases were reported. BMC officials stated that reaching missing patients remains a significant public health challenge. A detailed report regarding the same was published in the Hindustan Times.
Making TB Treatment Accessible in Private Hospitals
To make TB treatment more accessible for patients, the BMC plans to establish drug-resistant tuberculosis centres (DR-TB) in private hospitals. BMC officials believe that private hospitals will help expand the DR-TB treatment ambit, as most TB patients prefer private physicians/hospitals. Private chemists cannot stock drugs such as Bedaquiline and Delamanid, which are only available in the public health system, according to Dr Yatin Dholakia, secretary of the Maharashtra State Anti-TB Association. Private doctors must refer their DR-TB cases to the public system for management, and many private physicians are not referring DR-TB patients to public centres for treatment.
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More DR-TB Centres in Private Hospitals Will Help Improve Access to Treatment
The inclusion of more DR-TB centres in private hospitals will help improve access to DR-TB treatment, as many patients do not want to visit public TB centres due to long waiting lines, etc. Dr Dholakia said that having more private centres would be a boon for those patients. At present, private DR-TB is functional in PD Hinduja Hospital and KJ Somaiya Hospital.
BMC Awaits Expression of Interest from Stakeholders
“Starting a DR-TB centre in private hospitals is one of the many initiatives that we are taking to eliminate TB. We are waiting for an expression of interest from the stakeholders for being part of this initiative. The centres will be closely working with the BMC TB office,” the publication mentioned quoting Dr Mangala Gomare, executive health officer, of BMC.
Corporate Hospitals Step Forward
After a meeting last month, the Mumbai TB office received expressions of interest from 2-3 corporate hospitals. Dr Varsha Puri, deputy executive health officer and Mumbai TB officer, said that they are awaiting more corporate hospitals to come forward before launching the initiative.
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BMC’s Efforts to Reduce Loss to Follow-Up Percentage
BMC officials reported that they had found many DR-TB patients leaving treatment due to adverse drug effects. To combat this, BMC had also introduced 23 adverse drug clinics in the last five years. These clinics have helped bring down the loss to follow-up (LTFU) percentage from 16% to 2%. BMC officials discovered that 95% of the adverse drug effects were minor issues such as allergic skin reactions, body aches, and gastritis, which are now being addressed in BMC’s adverse drug reaction clinics, helping to retain patients to complete TB treatment.
Looking Towards Artificial Intelligence
The Mumbai TB official said that they are looking towards artificial intelligence to predict tuberculosis (TB) patients who are likely to default and not complete the treatment. The official stated that this would help the BMC to take proactive measures to reach out to such patients and improve their adherence to the TB treatment.
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