Tuberculosis an ancient chronic disease caused by Mycobacterium tuberculosis still remains one of the leading causes of death across the globe. Under developed and developing countries being the worst affected. There are three types of TB namely MDR multi drug resistant), XDR (extensively drug resistant) and TDR (Totally drug resistant). India has become highest TB burden country with 3.2 million out of 8.7 million cases globally as per 2011 survey by WHO. Approximately 40% of Indian population is affected by various types of TB. India is the seventh largest country of Asia and second most populous country in the world. It has tenth largest GDP and third largest PPP in the world. From decades several scientific researches have been conducted to understand the mechanism of infection of Mycobacterium and how it can be avoided. However till date TB remains major public health issue particularly in India (Udwadia, 2015).
Several factors act as a risk factor for development of TB. Some of them are mentioned as below:
- Drug abuse
- Low quality of living
Poverty: The socio-economic factor plays major role in acquiring and spreading of TB. The poverty is associated with people staying at overcrowded areas, housings with poor ventilation, malnutrition, stress, denial of several social rights. All these result into easy acquiring and spreading of TB infection (Al-Qahtani, 2014).
Drug abuse: illicit use of drug and alcohols is related to prevalence of TB. A drug addict is immunocompromised hence are easily susceptible to infections. Tb is a opportunistic infection, hence if a drug abuser acquires HIV infection then his chances of getting TB infected increase by several folds (Deiss, 2009).
Diabetes: a person having diabetes has higher chances of getting TB infection. TB research suggests that the infection is more successful in the lower respiratory tract than upper respiratory tract. Diabetes increases the lower respiratory infection risk and this is due to impaired cell-mediated immunity (Faurholt-Jepsen, 2011).
Low quality of living: The quality of life can be defined by the physical, mental, economic, social well being and spiritual status of a person. A person leading life having no knowledge of healthy life, having low mental and economic status is more likely to have TB. This is because such person is unable to distinguish between what is good and bad for his health. Low quality of life will lead to several other diseases that weaken the immune system of the person resulting into easily getting susceptible to several other infections (Al-Qahtani, 2014).
HIV infection: Many cases have been reported for tuberculosis and HIV co-infection and now it has become burden on the healthcare system. It has been reported that TB is one the leading causes for death among HIV infected patients. Several immunological events are behind accelerating the development of co-infection (Gandhi, 2010).
Cultural impact on healthcare in India:
The diverse religions, cultures and languages in India deeply influence its health care system and present several challenges in managing common to complex diseases. Often primary care is not being assessed which results into adverse affect upon health. Cultural bound syndromes are very common within the primary care system in India. There are different food habits, cultural beliefs and family pressure which interfere with the type of treatment and services to be delivered to patients (Worthington & Gogne, 2011).
Programs and planning to eradicate TB:
Several programs both from governmental and non-governmental organizations are being run aiming to minimize the number of cases and slowly to eradicate TB from the country. Government recently started a five year plan (2012 -2017) the theme of which is that all TB patients should get access to quality diagnosis and treatment in the community. Major focus of the plan is early detection of the disease including the drug resistant form.
Al-Qahtani, M. F., Mahalli, A. A. E., Al Dossary, N., Al Muhaish, A., Al Otaibi, S., & Al Baker, F. (2014). Health-related quality of life of tuberculosis patients in the Eastern Province, Saudi Arabia. Journal of Taibah University Medical Sciences, 9(4), 311-317.
Deiss, R. G., Rodwell, T. C., & Garfein, R. S. (2009). Tuberculosis and illicit drug use: review and update. Clinical infectious diseases, 48(1), 72-82.
Faurholt-Jepsen, D., Range, N., PrayGod, G., Jeremiah, K., Faurholt-Jepsen, M., Aabye, M. G., ... & Friis, H. (2011). Diabetes is a risk factor for pulmonary tuberculosis: a case-control study from Mwanza, Tanzania. PLoS One, 6(8), e24215.
Gandhi, N. R., Shah, N. S., Andrews, J. R., Vella, V., Moll, A. P., Scott, M., ... & Friedland, G. H. (2010). HIV coinfection in multidrug-and extensively drug-resistant tuberculosis results in high early mortality. American journal of respiratory and critical care medicine, 181(1), 80-86.
Udwadia, Z. F., & Mehra, C. (2015). Tuberculosis in India. BMJ, 350, h1080.
Worthington, R. P., & Gogne, A. (2011). Cultural aspects of primary healthcare in india: A case-based analysis. Asia Pacific family medicine, 10(1), 1-5.