Even as 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.

Says Dr Zarir Udwadia, chest physician, PD Hinduja Hospital, Mumbai, "Nation-wide study is urgently needed as India today has the unique distinction of having the maximum number of MDR-TB and XDR-TB cases in the world with one Indian dying every two minutes because of the epidemic which is increasing on an epic scale. More so as, death rates have 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 based on the figures extrapolated from few good centres working on TB control which is not representative. However a government study is underway but a conclusive, representative and authentic epidemiological data is yet to be heard of, he added, as most of the data on the disease profile can be gained from a city like Mumbai which has become the hub of TB over the past few decades.

According to sources, a first-of-its-kind study to assess the disease profile of tuberculosis in Mumbai was also scheduled to start at Asia’s biggest TB hospital, state run GTB Hospital at Sewri in collaboration with Bhabha Atomic Research Centre (BARC) last year with assistance from the central government but has not seen the light of the day. According to sources, there are 200 MDR patients in the hospital on which the study could have done successfully.

The study was meant to assess the rapidly changing disease profile of TB in Mumbai. It will be a welcome change for over 1200 TB patients (including both MDR-TB and XDR) admitted in the hospital.

The hospital is known to treat patients ranging from first line treatment to critically ill MDR TB patients for the past several years. Considering the fact that doctors are baffled with an increase in TB related multi-drug resistant cases in the recent past, a study on the disease profile bears a lot of significance, more so, as this kind of study has not been done in the past. A study is also being planned by BMC in association with Foundation for Medical Research (FMR), according to informed sources.  

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.

There is an incidence of estimated 2.2 million TB cases in India. Hence, there are nearly a million cases of patients who are unable to avail government services as most of them are managed in the private sector. 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.