Need for Age-responsive TB care in India

By Amigos IAS

Why is it in the news?

  • India’s elderly population is increasing due to advances in healthcare and longer life expectancy.
  • In 2011, 9% of India’s population was over 60, expected to rise to 12.5% by 2030.
  • Older individuals often face challenges in getting timely TB diagnoses and managing the disease due to comorbidities.
  • Tuberculosis (TB) affects over 25 lakh Indians annually and kills at least 1,000 people every day.
  • The prevalence of TB among people over 55 is much higher than the national average.

More about the news

  • TB symptoms are often mistaken for signs of old age, leading to delayed or missed diagnoses.
  • Management is complicated by comorbidities, leading to irregular treatment adherence and poor outcomes.
  • Older people may experience reduced “will to live” due to lack of social and emotional support.
  • Access to healthcare services, reliable health information, and nutritious food is limited for older individuals.
  • Many elderly individuals rely on savings or family support and may lose economic independence.
  • Further, limited social welfare schemes are available for the elderly.
  • TB-related stigma and ageism contribute to mental health challenges, loneliness, and anxiety.

Building Age-Responsive TB Care

  • Investment in the health and unique needs of the elderly is crucial.
  • Holistic care models are needed to reduce the need for elderly individuals to interact with multiple healthcare providers.
  • Health professionals need better training in understanding and managing TB in the elderly with comorbidities.
  • Improved case-finding methods for the elderly, including mobile diagnostic vans and active case finding in geriatric settings.

Protocols and support for the elderly

  • Develop technical and operational protocols for diagnosing and treating TB in the elderly.
  • Implement support protocols, such as elder-focused community care models, doorstep delivery of medicines, and peer support.
  • Strengthen data collection and analysis for elderly TB cases and collaboration within the healthcare system.
  • Establish a research agenda focused on TB in the elderly to understand trends, drug resistance, co-morbidities, and equity issues.
  • Investigate intersectionality with gender, disability, class, and caste in elderly TB cases.

 

Tuberculosis (TB)
  • TB is an infectious disease caused by Mycobacterium tuberculosis.
  • It primarily affects the lungs but can impact other body parts.
  • It is treatable and curable.
  • Transmission occurs through the air when infected individuals cough, sneeze, or spit.
  • Common symptoms include cough with sputum, chest pains, weakness, weight loss, fever, and night sweats.
  • The Bacille Calmette-Guérin (BCG) vaccine is used to prevent TB.
  • In 2020, 1.5 million people died from TB, and 10 million fell ill with the disease globally.

 

TB in India

  • India has the highest TB burden in the world.
  • Approximately 26 lakh people contract TB, and about 4 lakh die from it annually in India.
  • Challenges in controlling TB in India include poor rural healthcare infrastructure, unregulated private healthcare practices, poverty, lack of political will, and corruption.

 

Pradhan Mantri TB Mukt Bharat Abhiyan

  • An initiative by the Ministry of Health and Family Welfare (MOHFW) to eliminate TB in India by 2025.
  • Objectives include improving treatment outcomes, involving communities, and leveraging Corporate Social Responsibility (CSR).
  • Components include the Ni-kshay Mitra Initiative for additional support and the Ni-kshay Digital Portal for community involvement.

 

Other initiatives:

 

Global Efforts

  • WHO’s “Find. Treat. All. #EndTB” initiative with the Global Fund and Stop TB Partnership.
  • WHO releases the Global Tuberculosis Report.

 

India’s Efforts

  • National TB Elimination Programme aims to end TB by 2025.
  • National Strategic Plan (NSP) for Tuberculosis Elimination (2017-2025).
  • Nikshay Ecosystem (National TB information system).
  • Nikshay Poshan Yojana (NPY) provides financial support to TB patients.
  • TB Harega Desh Jeetega Campaign.
  • Development and clinical trials of TB vaccines VPM 1002 and MIP.
  • Ayushman Bharat Digital Health Mission for digital health IDs and improved diagnostics for TB patients.

 

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