25% TB patients diabetic: Tamil Nadu to intensify testing
CHENNAI: Around 25% of the patients diagnosed with tuberculosis in 2022 in Tamil Nadu were diabetic, analysis by the State Tuberculosis Cell showed, prompting the state government to intensify testing for TB among diabetic patients with symptoms of the bacterial disease by training mid-level health providers engaged in the Makkalai Thedi Maruthuvam scheme. The MTM workers will be incentivised for every positive TB case they find.
According to state TB officer Dr Asha Frederick, patients with TB and diabetes mellitus (TB-DM) take longer to convert from sputum smear-positive to negative under treatment. “There is growing evidence from observational studies that TB-DM is associated with an increase in adverse TB treatment outcomes, including delay in bacteria clearing the system (mycobacterial clearance), treatment failure, death, relapse and re-infection.”
In 2022, the State reported over 93,500 notified TB cases, of whom around 25% had diabetes. “We are now checking for TB among people with diabetes. We will be training mid-level health providers engaged in the MTM scheme to test diabetic patients for TB especially if they show TB symptoms,” Dr Asha told TNIE. Persons having a cough with sputum for at least two weeks, unexplained weight loss or loss of appetite and blood-stained sputum should test for TB.
Over 5,000 in TN died of TB in 2022 alone: Official
Diabetes patients should watch out for uncontrolled diabetes, unexplained fever and cough. Patients with these symptoms should voluntarily come forward and get tested for TB, explained Dr Asha.
MTM volunteers were chosen for this work as they make house visits daily, delivering medicines and checking for diabetes, blood pressure among residents, said officials. The material for the six-hour training programme will be in Tamil. “They will be trained to identify symptoms resembling TB so the patients can be referred for a test,” said Dr Asha, adding that the volunteers will get `500 as a first informant incentive for every positive case.
“Though the State TB cell has volunteers to detect cases, we want to involve staff from other parts of the Health Department in TB detection and awareness so we don’t miss any cases,” she added.
Over 5,000 people in TN died of TB in 2022 alone, she said. To reduce TB deaths, the state is providing refresher training for doctors, including medical officers at PHCs, to identify very sick patients during diagnosis and begin intervention.
For this, 800 beds have been earmarked in specific government hospitals in all districts so sick patients can be admitted and treated, Dr Asha explained. The project, which started last April on a pilot basis, is going well. “Earlier we did not identify patients, who were very sick at the time of diagnosis. Now we started analysing the cause and started intervention,” she said.
MTM staff will get incentives
MTM volunteers will be trained to identify TB symptoms so the patients can be referred for a test, said Dr Asha. They will get `500 as a first informant incentive for a positive case.