“Every case must be notified, and treatment provided accordingly”
New Delhi, March 19, 2019:
The World Health Organization has indicated that about 15% of the global tuberculosis (TB) burden is now attributed to diabetes. A recent review pointed out that diabetes can double the lifetime TB risk. As per a review paper published in Diabetes Metabolism Research and Reviews recently, the prevalence of TB in diabetes and diabetes in TB was at least two-three times higher than that found in the general population.
In TB infections, the stress responses by the body result in impaired glucose tolerance, a risk factor for diabetes. TB drugs (namely, rifampicin) also make it more difficult to maintain glucose control. People with diabetes should seek treatment if they have a cough lasting more than two weeks, fever, night sweats and/or weight loss.
Speaking about this, Padma Shri Awardee, Dr KK Aggarwal, President, HCFI, said, “To control TB, it is important to prevent diabetes. This is true especially in a country like India where rates of TB are amongst the highest and the incidence of type 2 diabetes is also rising sharply. Diabetes can go undiagnosed for a long period, so it makes sense to do proactive screening for diabetes in all patients with TB. Conversely, diabetes should be on the clinical radar when caring for people with TB. If an elderly develops TB, rule out diabetes and if an elderly develops diabetes, rule out TB. Rule out TB in every case of uncontrolled diabetes.”
India has the highest TB burden country in the world in terms of the absolute numbers of incidence cases each year. Mortality due to TB is the third leading cause of years of life lost (YLLs) lost, in the country.
Adding further, Dr Aggarwal, who is also the Group Editor-in-Chief of IJCP, said, “All open TB patients need to be immediately identified, and treated till they become sputum negative and non-infective. Most TB-positive patients do not disclose their TB status due to the fear of social stigma and so keep spreading the disease to others. The public needs to be informed that every open case of TB will cause 15 new cases of TB, if not treated in time. TB is a curable disease. Full and adequate treatment is important for complete recovery.”
Some tips from HCFI
TB is a notifiable disease and therefore, the approach should be based on DTR “Diagnose, Treat & Report”: Diagnose early, using sputum GeneXpert test; Treat: Complete and effective treatment based on national guidelines, using FDC; and Report: Mandatory reporting.”
- Wash your hands after sneezing, coughing or holding your hands near your mouth or nose.
- Cover your mouth with a tissue when you cough, sneeze or laugh. Discard used tissues in a plastic bag, then seal and throw it away.
- Do not attend work or school.
- Avoid close contact with others.
- Sleep in a room away from other family members.
- Ventilate your room regularly. TB spreads in small closed spaces. Put a fan in you window to blow out air that may contain bacteria.