Tuberculosis control in India--past, present and future.

Abstract

Tuberculosis (TB) continues to be a major health problem in India. There has been no perceptible change in the epidemiology of TB since the National Sample Survey 1956-57. Detection of cases has been low over the years since the inception of National TB control programme in 1962 due to passive case finding and high drop out rates among sputum positive patients. Shortening the course of chemotherapy with regimens containing bactericidal and sterilising drugs helped in improving the treatment adherence of patients and cutting down the chain of transmission substantially. Further it is advisable to implement properly the directly observed short course treatment (DOTS) as per WHO guidelines to prevent the development of multidrug resistant TB (MDRTB). Proper management of RNTCP and prevention of MDRTB are all the more important in areas where there is high prevalence of HIV/AIDS co-infected with TB. New vaccine development is also a priority area for research. There is an urgent need for health systems research built into the ongoing programme with proper managerial inputs.