TB: Case detection rate very low in State

Note: I was told privately by local doctors in Kalahandi, many people are dying from malaria and TB, however, this is being not reported neutrally due to on going pressure on health department in KBK.

Expressbuzz, March 24, 2010
Sanjeev Kumar Patro

BHUBANESWAR: High-decibel proclamations of over 86 per cent treatment success rate, sputum conversion rate of 88 per cent and cure rate of 82 per cent in new cases notwithstanding there are gaping holes in the State’s anti-TB armoury. An appraisal report by the National Rural Health Mission (NRHM) has laid bare the reality.


Orissa could have a total case detection rate of only 126 per lakh and the new sputum positive case detection at only 55 per lakh affected population.

At only 64 per cent as of April 30, 2009, detections fall far short of the targets set under the National TB Eradication and Control Plan.

The report has observed that the retreatment of sputum positive patients is only 15 per cent against the required 30-35 per cent - which is very low.

Diagnosis rate is also very low as sputum of only 138 TB suspects per lakh population per quarter were examined against the National average of 152 TB suspects per lakh population per quarter.

The report blamed poor OPD attendance in Government health centres, particularly in the coastal areas, poor referral of TB suspects and involvement of only a few NGOs and private sector health facilities for the low case detection rate in the State.

The chinks look more glaring when viewed through the district maps. As many as 14 districts including Bhubaneswar Municipal Corporation have even a lower total case detection rate (TCD) than the below par State average of 126 per lakh suspects. The TCD rate is very poor in all coastal districts except Ganjam. Districts of Jajpur, Bhadrak, Kendrapara, Khurda and Nabarangapur have very low referral rate of below 100 TB suspects per lakh population.

A very low cure rate of below 80 per cent is observed in the districts of Balasore, Bhadrak, Gajapati, Ganjam, Kalahandi, Kandhamal and Nabarangapur.

The lowest cure rate of 66 per cent is measured in Nabarangpur.

Sputum conversion rate is also below 85 per cent in four of the above districts along with Koraput, Nayagarh and Boudh. New sputum positive case detection rate is less than 50 per cent in nine districts. Bhadrak is the poorest performer in Orissa on all accounts.

The gaps in important parameters do not augur well when the TB prevalence per lakh population in Orissa stands at 418. Especially, the low cure rate in tribal districts like Gajapati, Kalahandi and Kandhamal could have a deleterious affect on the belief of the tribal population that TB is a completely curable disease. Also of significance is, owing to severe malnutrition in many tribal districts, the population’s immunity status is compromised and people are doubly susceptible to extra pulmonary TB. Poor detection could propel a TB explosion in such regions.