‘GTN’ strategy for ending the disease should be mandatorily followed by health experts across India
In its latest 2018 Global tuberculosis (TB) Report, the WHO has indicated that countries are still not doing enough to end TB by 2030. The global body called for an unprecedented mobilization of national and international commitments and urged for decisive action from nearly 50 heads of state and government. Despite a decrease in the number of TB deaths in the past year, underreporting and under diagnosis of cases continues to remain a major challenge.

To urgently improve detection, diagnosis and treatment rates, the WHO and partners launched a new initiative in 2018 to set the target of providing quality care to 40 million people with TB from 2018 to 2022. This was while predicting that at least 30 million people should be able to access TB preventive treatment during the period.

Speaking about this, Padma Shri Awardee, Dr K K Aggarwal, President, HCFI, said, “TB is a preventable and curable disease and yet despite advances in TB care, India continues to have the highest burden of both TB and MDR TB patients and accounts for about a quarter of the global TB burden. An estimated 1.3 lakh incident multi-drug resistant TB patients emerge annually in India, which includes 79000 MDR-TB Patients estimates among notified pulmonary cases. India also has the dubious distinction of being among the top three countries, where the gap between estimated TB incidence and reported cases is the highest at 25%. This wide gap in the incidence of TB and the reported cases highlights the IMA End TB Strategy of ‘GTN’, where G stands for GeneXpert test (sputum diagnosis), T for Trace (contacts) and Treat. N is to Notify the disease at Nikshay (mandatory).”

India has set 2025 as deadline to be free of TB. Although preventing and controlling TB is a collaborative effort, doctors are major stakeholders in the control of TB. Control of TB depends on early detection, which means early and better treatment to prevent further spread of TB. Contact tracing interrupts the chain of transmission of the disease by early diagnosis of cases as well as timely and complete treatment.

Adding further, Dr Aggarwal, who is also the President (Elect), CMAAO, said, “All household and close contacts of patients with infectious TB should be traced, screened and treated with a full course of ATT if found to have TB. Most of us doctors regularly treat many patients of TB. We should now reiterate our commitment to ‘GTN’ and file our returns. Ask yourself, how many GeneXpert tests you have ordered… how many contacts you have traced and screened for TB…and how many TB patients you have notified at Nikshay. You can notify even today, if not done earlier. It is not necessary to notify the day you diagnose the patient as having TB.”

In a video on Medtalks. in, Dr K K Aggarwal speaks about MDR-TB as a public health and medical emergency. He says that the entire country is in a state of “angina” with an impending “TB attack”. GTN (glyceryl trinitrate) is used to relieve angina and prevent an anticipated heart attack such as before exercise. A similar “GTN” is needed to prevent “TB attack”. Medtalks is a free and complete healthcare learning and patient education platform. It provides continuous medical education (CMEs), learning and information to stakeholders including doctors, paramedics, nurses, allied healthcare workers, and patients.

Some tips from HCFI to avoid spread of TB infection
• 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 your window to blow out air that may contain bacteria.

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