One Health Approach to Tuberculosis in India (Essay Sample)

ONE HEALTH APPROACH TO TUBERCULOSIS IN INDIA Student's Name Course Date One Health Approach to Tuberculosis in India Introduction TB is a bacterial infection associated with Mycobacterium Tuberculosis. TB mainly targets the lungs but can also infiltrate other organs of the body. India had about six million TB cases in 2022, representing a 13% increase compared to the previous year. The national prevalence rate was approximately 312 cases per 100,000 people. India recently reported a mortality rate of 37 per 100,000 population. In 2023, TB cases dropped by 13% due to the implementing of the National TB Elimination Program (NTEP). TB is highly contagious and is spread through droplet nuclei that are expelled into the air when an infected individual talks, coughs, or sneezes. TB in India is said to be primarily prevalent among the poor population due to factors such as malnutrition, HIV co-infection, and poor housing. The government has initiated many programs, such as the Pradhan Mantri TB Mukt Bharat Abhiyaan, for early detection and proper management. However, India still carries the most significant TB burden globally. Recent research indicated that India accounts for 34% and 26% of global TB deaths and prevalence, respectively.[ Kannan Thiruvengadam, Rajendran Krishnan, and Malaisamy Muniyandi, "The Prevalence of Self-Reported Tuberculosis in the Andaman and Nicobar Islands, India: Evidence from the NFHS-IV and V," Tropical Medicine and Infectious Disease 8, no. 10 (2023): p.464, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10611087/] [Mansukh Mandaviya, India TB Report 2022: Coming Together to End TB Altogether, (New Delhi: Ministry of Health and Family Welfare Government of India, 2023), p.7, https://tbcindia.gov.in/WriteReadData/IndiaTBReport2022/TBAnnaulReport2022.pdf] [Mansukh Mandaviya, India TB Report 2022: Coming Together to End TB Altogether, (New Delhi: Ministry of Health and Family Welfare Government of India, 2023), p.67, https://tbcindia.gov.in/WriteReadData/IndiaTBReport2022/TBAnnaulReport2022.pdf] One Health concept should be applied to TB in India because humans, animals, and the environment contribute to its spread. For instance, zoonotic TB, which is transmitted from cattle to people, is highly prevalent in rural areas. For effective TB control in India, there must be a One Health approach in these areas of health to help diagnose and avert it. Besides, an A One Health intervention is needed to control tuberculosis in India because of its human-animal-environment interrelationship. Integrating the health care system makes it possible to have a solid response to TB, improving overall public health and avoiding a disease relapse. Notably, India has had many problems in its TB control strategy because of cultural barriers and financial difficulties that hindered early detection and treatment. The Revised National Tuberculosis Control Program (RNTCP) was launched in 1997 to provide TB care for free; however, issues like poverty and ignorance persisted. As a result, health care has become a mirage, especially to rural dwellers, where cultural factors always push people to delay seeking medical attention. Also, the socioeconomic impact of TB, such as loss of income and productivity, increasingly hinders the fight against TB. This paper examines TB and proposes interventions to address it and stakeholders that can help achieve the intended goals.[Mansukh Mandaviya, India TB Report 2022: Coming Together to End TB Altogether, (New Delhi: Ministry of Health and Family Welfare Government of India, 2023), p.143, https://tbcindia.gov.in/WriteReadData/IndiaTBReport2022/TBAnnaulReport2022.pdf] TB in the People Currently, in India, there are many ongoing interventions to tackle the disease among people. The National Tuberculosis Elimination Program (NTEP) spearheads TB prevention in the country. Under this program, the government provides free diagnosis and treatment, which is crucial in managing TB. Another point worth mentioning is that the government has initiated the Pradhan Mantri TB Mukt Bharat Abhiyaan to end TB by 2025. This focuses on nutritional and social support. Altogether, these elements characterize TB prevention initiatives. TB is known to be transmitted from one human being to another, and in the Indian scenario, the major factors include delayed diagnosis, noncompliance, and social-cultural issues. When people with symptoms of tuberculosis do not seek treatment, they continue spreading the bacteria to other individuals. This is made worse by the social aspect of the disease since most people with TB are inclined to conceal their sickness because of the consequences of having the disease. Research has shown that this stigma is quite apparent in rural areas and especially among the lower class since they do not have adequate information and knowledge on the disease. Also, there is a significant issue of poor compliance with the recommended TB treatment regimen. The outcome is that most of the patients develop relapses and stop taking the drugs as soon as they feel better, thus leading to the development of drug-resistant strains of TB. This non-adherence is usually due to the long time it takes to cure TB, which takes between 2 to 6 months, and the side effects of the drugs used.[Mansukh Mandaviya, India TB Report 2022: Coming Together to End TB Altogether, (New Delhi: Ministry of Health and Family Welfare Government of India, 2023), p.164, https://tbcindia.gov.in/WriteReadData/IndiaTBReport2022/TBAnnaulReport2022.pdf] [Dimpal Pathak, Guru Vasishtha, and Sanjay K. Mohanty, "Association of multidimensional poverty and tuberculosis in India," BMC Public Health 21, no. 1 (2021): p.14, https://bmcpublichealth.biomedcentral.com/counter/pdf/10.1186/s12889-021-12149-x.pdf] The present strategies have faced many challenges but have been efficient. The Directly Observed Treatment (DOTS) strategy ensures that patients complete their treatment under the supervision of the health care providers. It has improved the treatment results and reduced the mortality caused by TB. However, drug-resistant TB strains and the pressure on health facilities are still significant issues. In addition, COVID-19 has impacted TB services in a manner that has slowed down the diagnosis and treatment process. However, the government is still working on a recovery strategy to increase the availability of funds and formulate unique plans to address the problem.[ Kirti Garg et al., "Impact of COVID-19 on the National Tuberculosis Elimination Program in Uttarakhand, India: A Mixed-Methods Research Study," Infection Prevention in Practice 5, no. 1 (2023): p.26, https://www.sciencedirect.com/science/article/pii/S2590088923000021] TB in Animals India has a 7.8% prevalence of this disease in dairy and farm cattle, with 303.76 million bovines. The country focuses on preventing TB in animals, particularly cattle, to address the problem. Mycobacterium Bovis is a causative agent of bTB, an animal-to-man transmissible disease. The measures currently being practiced in India to control and prevent bTB include using a tuberculin skin test to screen and test the cattle population. These diagnostic tools help identify infected animals that can be isolated or even put to death to prevent the spread of the disease to the herds and humans. The Indian government, together with veterinary health services, has launched several programs to enhance the control and prevention of TB. The National Animal Disease Control Program (NADCP) aims to vaccinate and perform animal diagnostic tests for diseases like TB. In this program, cattle are vaccinated against bovine brucellosis and foot-and-mouth diseases, besides being tested for bTB. Also, efforts are made to increase the biosecurity status of farms, such as cleaning and disinfection, properly disposing of cattle dung, and feeding the animals clean quality feed and water. These measures are essential in the prevention of TB and the prevention of transmission from animals to man.[Partha S. Jana, "Bovine Tuberculosis in India: The Need for One Health Approach and The Way Forward," Indian Journal of Veterinary Public Health 9, no. 2 (2023): p.4, https://ijvph.org/wp-content/uploads/2024/02/2_PS-Jana.pdf] [Partha S. Jana, "Bovine Tuberculosis in India: The Need for One Health Approach and The Way Forward," Indian Journal of Veterinary Public Health 9, no. 2 (2023): p.6, https://ijvph.org/wp-content/uploads/2024/02/2_PS-Jana.pdf] Domesticated animals play a very crucial role in the spread and virility of TB. M. bovis usually spreads through the consumption of raw milk or contact with infected cattle. This transmission mode is deadly as it affects the health of rural people. The economic impact is also huge as the farmers lose the animals, and they then have to spend cash on treatment and other measures to help prevent the spread of diseases. Some measures used in the fight against zoonotic TB include educating farmers on testing and handling milk and meat products. However, current programs are costly to implement, and it is also impossible to access the rural areas to conduct tests, hence the inefficiency. The veterinary and public health departments should work together more closely, and there should be more funding and resources for the surveillance and control of TB. In the case of controlling and preventing TB in India, animal and human health interventions will need to be employed in the One Health approach.[Partha S. Jana, "Bovine Tuberculosis in India: The Need for One Health Approach and The Way Forward," Indian Journal of Veterinary Public Health 9, no. 2 (2023): p.6, https://ijvph.org/wp-content/uploads/2024/02/2_PS-Jana.pdf] Addressing TB in the Environment TB, from an environmental perspective in India, consists of various approaches that aim to reduce the impact of the environment on TB and its consequences. Some of the environmental factor...