The government is planning to come out with a TB prevalence survey across the country which would entail a community based study to detect TB. This would involve collection of sputum samples and digital X-Rays subject to symptoms found in the community being surveyed.

The prevalence survey being planned would be a house-to- house survey for which statistical methods will be used to determine the sample size which will further be distributed across the country.

Says Dr Soumya Swaminathan, director general, Indian Council of Medical Reseach (ICMR), “This will be quite a big exercise involving lakhs of patients. A drug resistant survey, which was long overdue, is also currently being done on 5000 patients across the country to determine sensitivity of 13 anti-TB drugs. The drug resistant survey would provide a wealth of information as it involves doing genotyping studies from TB strains collected from across the country to offer clinical data on molecular epidemiology of TB in the country.”

India has the highest tuberculosis burden in the world, accounting for nearly one-fourth of the global incidence. Experts advocate that there is a need to have epidemiological data on TB through a nationwide surveillance as was done in China a few years ago. In India, death rates have also increased over the past several decades despite the official data showing 100 per cent coverage of Directly Observed Treatment, Short-Course (DOTS) programme in the country.

Official estimates show emergence of only 3 per cent new MDR TB cases and 17 per cent re-treatment cases based on the figures extrapolated from very few good centres working on TB control which is not representative.

Implementation research projects using more sensitive diagnostics like Genexpert has also been upscaled to pick up TB and MDR TB in children. Now there is also a thrust upon designing treatment regimens to offer optimal and shorter dosages for children suffering from TB. A trial is also likely to start on TB meningitis in India with respect to treatment dosages. A prevention study is also planned to screen household contacts to pick up candidates who might be having latent TB.

According to data available with Revised National Tuberculosis Programme (RNTCP), there were 53 MDR-TB patients in 2012 which rose to 5000 in 2014. Also in case of XDR TB, there were 32 patients in 2012 which increased to 240 in 2014. In 2012, out of the estimated global annual incidence of 8.7 million TB cases, 2 to 2.4 million were estimated to have occurred in India.