New Delhi: India has become the first country in the world to unveil its own model for estimating tuberculosis burden, choosing to step away from the global estimates drawn up each year by the World Health Organization (WHO).
Data from the first TB prevalence survey whose report was released last year, has been used for the model.
Accordingly, India’s TB incidence rate stands at 196 per 100,000 population instead of the 210 estimated by WHO and the estimated deaths from the communicable disease stand at 3.20 lakh instead of the 4.94 lakh that was projected in 2021.
The absolute incidence numbers for 2022 arrived at using the domestic model, standing at 27.70 lakh in 2022 against the 29.50 lakh estimated by WHO in 2021.
The TB mortality rate — according to the Indian model — stands at 23 per 1,00,000 people against the 35 that WHO had estimated in 2022. The pandemic disruption has been estimated at about 4 lakh missed TB cases for each of the two years, 2020 and 2021. The total number of TB notifications last year, official sources say, stood at the highest ever figure of 24.2 lakh cases.
“We saw during Covid how our own death estimates arrived at from the registration which is 99 per cent accurate was about 7 lakh while WHO estimated a far higher number of 4.7 million deaths. This is how they do modelling. That is why we have now developed our own model for TB estimates. We are the only country in the world to do so and when we shared those numbers recently during the Stop TB summit in Varanasi, the world has accepted those numbers,” a top government functionary said on condition of anonymity.
The findings from the domestic modelling effort were shared with 198 delegates from 40 countries who attended the Varanasi meet presided over by Prime Minister Narendra Modi.
The TB model was drawn up by using data from several sources including the Nikshay portal, of private sector drug sales, the sub national certification system where the TB free status of various states are estimated and ranked.
The ‘National TB Prevalence’ survey, conducted by the Union government and released last year on the occasion of World TB Day (24 March), found that the prevalence of tuberculosis among Indians aged above 15 years is 312 cases per 1 lakh population, more than double the global average of approximately 127 cases per 1 lakh people.
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25 per cent notifications from private sector
Officials involved in the tuberculosis programme said that the number of notifications from the private sector have sharply gone up from 4 per cent of cases to 25 per cent. This despite the fact that the TB prevalence survey found last year that while a vast majority of (about 66 per cent) Indians do not seek treatment for their symptoms, among those that do, there is an equal preference for private and government facilities.
India made tuberculosis a ‘notifiable’ disease in 2012, making it mandatory for cases to be reported to government authorities. At 26 per cent, India has the highest TB burden and the rule was to ensure that no case falls out of the system.
Notification is important because unless a patient completes the full course of treatment, there is a chance of the emergence of drug-resistant forms of TB. Moreover an incompletely cured patient may also spread the disease.
India’s TB death rate has remained fairly constant over the years, with officials saying at about 4 per cent of the notified cases — that is around 93,000 per year.
(Edited by Tony Rai)
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