Mumbai: BMC is coming to check for TB, leprosy

The outcome of the survey will identify contacts, such as family members, of individuals with multidrug-resistant tuberculosis. Representation pic

The Brihanmumbai Municipal Corporation (BMC) will commence its annual door-to-door screening for tuberculosis and leprosy from November 20. The BMC through its community health workers (CHW) hopes to assess 49 lakh residents in 10.88 lakh houses for early symptoms by December 6.

Explaining the process, Mumbai's TB official Dr Varsha Puri said, "We look to find new suspect cases in this survey and then their diagnosis is carried out for confirmation." Sunita Sutar, a CHW in Bandra, said that it takes two days for the results to arrive. In case a person tests positive for tuberculosis, they are referred to a Direct Observation Treatment (DOTS) centre for TB treatment.

Last year, out of the 9,000 individuals who were identified as suspect cases of TB in all 24 wards of Mumbai, 250 tested positive for the disease. Whereas, about 100 confirmed leprosy patients were identified among the 12,000 suspect cases. "As CHWs, we then keep following up with the patient on whether they have been continuing with their treatment," Sutar said.

The outcome of the survey will identify contacts, such as family members, of individuals with multidrug-resistant tuberculosis (MDR-TB) infection. Thereafter, the contacts will be put on TB preventive treatment (TPT).

Dr Puri said that this survey is also essential for the preventive aspect of TB. "Contacts of MDR-TB patients are traced after the survey and are put on preventive treatment for six months," she said. This is in line with the state government's directive last year to administer all household contacts of MDR-TB patients (with proven fluoroquinolone sensitivity) with levofloxacin."

The TPT move, however, had recently come under criticism from the city's leading pulmonologist, Dr Zarir Udwadia. In an editorial in medical journal Lung India, he noted that any form of therapy in healthy contacts of MDR-TB cases was associated with adverse effects. As a result treatment completion rates, even with six months of therapy, are very poor, Dr Udwadia observed in his editorial.

Meanwhile, for those like Sutar, and many like her who have been CHWs with BMC for a decade now, this annual activity also brings forth a sense of bitterness towards the civic authorities. "We do this work along with our other routine health activities. Our payment is still just R75 per day and the target is 25 houses. How can we survive in a city like Mumbai on such a small amount?" she said.

Nov 20
Day screening commences