"The study could also identify the major risk factors. Most of the residents in the study area are daily wage earners. The dwellings are housed in 'waadas'. A waada is typically a group of rooms arranged around open courtyards. There are 5-6 small 10 feet by 10 feet rooms around a small courtyard and at least 6 people living in each room. Most of the rooms have no windows or any ventilation worth the name. Firewood is the normal fuel used, adding to the risk factor of indoor pollution, especially for women. The main risk factors are poverty, poor ventilation, poor sanitation, and overcrowding. Usually transmission occurs when an infected person coughs, or when the family is in constant touch with the index case. Only the very lucky ones can escape infection in such a scenario".
"The study also looked into the genetic susceptibility. In the area where the study was conducted there was homogenous population--mostly of Muslim community--who had been living there for more than 5 years. This could help in targeting populations and screening more-at-risk households. It would also help in designing preventive measures".
Prevention is key:
"The more we can prevent TB, the less transmissions will take place. Addressing overcrowding and improving living conditions in the urban slums is key to controlling TB, because they are the hotspots of TB. Just one window in a room for ventilation to let in sunlight and air will go a long way in controlling transmission of TB infection. Slums should be so structured as to have air and sunlight available for the residents".
"The study focussed upon identifying TB hotspots--for which mapping is essential. Once this is done, programme managers can work on that. If we can address and control transmission in urban slums, we will be able to protect the general population and 50% problem of TB will be solved".
"Interestingly, during the study period, the number of women diagnosed with TB increased. Perhaps the PPM DOTS enabled them to access healthcare in nearby centres, rather than travelling long distances to a govt DOTS centre. Also in a PPM programme treatment supervisors had more hold on the patients, by way counselling and ensuring treatment adherence. Another very important finding was that extra pulmonary TB cases are on the rise (whether hot spot area or non-hotspot area). Our aim should be to free the air of TB infection".
Shobha Shukla, CNS (Citizen News Service)
(Shobha Shukla is the Managing Editor at CNS (Citizen News Service) and has extensively written on health issues from several countries globally. Follow her on Twitter @Shobha1Shukla or visit: www.citizen-news.org)
- Shared under Creative Commons (CC) Attribution License
(Note: You can view every article as one long page if you sign up as an Advocate Member, or higher).
