BMC EXPANDS fight against TB with new schemes

Will Launch Many Initiatives, Including A Door-To-Door Detection Project, To Mark World TB Day On Saturday The civic body has begun intensifying the tuberculosis-control programme it launched in January. It announced on Tuesday an allocation of Rs 6 crore budget for the upgradation of the Sewri TB Hospital and has in the pipeline a number of new initiatives, including a door-to-door detection project and an early detection centre in Dharavi. In addition, it is instructing private hospitals to report all drugresistant TB cases to it.      The rollout of new programmes will begin on World TB Day (March 24) with a pilot project called 'Intensified Case Finding', wherein health officials will go door-to-door in 10 high-risk wards to search for people with TB symptoms. "It will take about six weeks to gather data and analyse it," said Manisha Mhaiskar, additional municipal commissioner (health). Based on the findings, the BMC will "decide how to further control the disease at the grassroots level". It may also extend the project to all 24 civic wards.      For the pilot, the corporation has drawn up a list of particularly vulnerable pockets in the 10 high-risk wards on the basis of case detection rate and the rate at which patients abandon treatment. Among these pockets, Mumbai's TB officer Dr Mini Khetarpal said, are slums, where "the population density and the transmission rates are high".      "We are looking to identify patients quickly and decrease transmission," Khetarpal said. Those with TB symptoms will be referred to the nearest microscopy centre for testing. And cases found positive  will be included in the  Revised National TB  Control Programme.      Apart from  the pilot, the  BMC will inaugurate on  March 24 a  system called GeneXpert at the Dharavi outreach centre of Sion Hospital. The system can detect drug-resistant TB within hours instead of the usual three months. It will also ask a few private hospitals to report multi-drug-resistant tuberculosis (MDR-TB) to it just as private labs have been for the last two months.      "With the help of lab reports, we have been able to trace about 50% of MDR-TB cases. About 40% of MDR-TB patients were found to be living outside the city. We now plan to ask about seven private hospitals with chest medicine departments to report drug-resistant cases to us," said Mhaiskar.      The BMC on Tuesday allocated Rs 6 crore for the upgradation of the Sewri TB Hospital. Apart from providing it a TB lab, work on which has already started, the civic body is looking to fill all vacancies there in the next three months.      The overall thrust of the TB control programme, the BMC said, is to spread awareness. With the cost of medication per year running as high as Rs 2 lakh in some drug-resistant cases, patients should not discontinue the treatment for want of finances. "It is important that patients be made aware and be included in the governmentrun programme. Which is why, we are planning a continuous awareness campaign for the next one year," said Mhaiskar.  CHECKED LIST  A central TB officer has been appointed for Mumbai and a TB officer has been appointed for each of its 24 wards The Sewri TB Hospital has been upgraded and 46 beds added to it to treat MDR-TB (multi-drug-resistant tuberculosis) patients The hospital's operation theatre, which had been lying unused for five years, is back up. Three MDR-TB patients have already undergone surgery there Private labs have started reporting MDR-TB cases to the BMC Half of all MDR-TB patients in the city have been tracked and are being tested for XDR-TB (extensively drug-resistant tuberculosis)  COMING SOON  A number of programmes will be launched on March 24:  The BMC will run a pilot project called 'Intensified Case Finding' in 10 wards, wherein health officials will go door-to-door to identify high-risk patients and give guidance on treatment Private hospitals will have to report MDR-TB cases to the BMC A system for early detection of drug-resistant TB called GeneXpert will be set up at the Dharavi outreach centre A lab to test MDR- and XDR-TB patients will be set up in the Sewri TB Hospital by the end of this year The hospital will start a 24X7 outpatient department