India has become the first country in the world to introduce its own model for estimating the burden of tuberculosis, opting to move away from global estimates compiled annually by the World Health Organization (WHO). The model used data from the first TB prevalence survey, the report of which was published last year.
Accordingly, the TB incidence rate in India is 196 per 100,000 population instead of the WHO estimate of 210 and the estimated deaths from the communicable disease are 3.20 lakh instead of the 4.94 lakh projected in 2021. The absolute incidence figures for 2022 arrived at using the domestic model were 27.70 lakh in 2022 against 29.50 lakh in 2021 WHO estimates.
The TB death rate – based on the Indian model – is 23 per 1,00,000 people, compared to the 35 estimated by WHO in 2022. The disruption of the pandemic is estimated to be around 4 million missed TB cases in each of the two years, 2020 and 2021. The total number of notifications o TB last year, according to official sources, reached a peak of 24.2 million cases.
“During Covid, we saw our own estimates of deaths from registration, which is 99 percent accurate, was about 7,000, while the WHO estimated a much higher number of 4.7 million deaths. This is how they model. Therefore, we have now developed our own model for TB estimates. We are the only country in the world to do so and when we shared these numbers during the Stop TB Summit in Varanasi recently, the world accepted these numbers,” said a top government official on condition of anonymity.
The results of the domestic modeling were shared with 198 delegates from 40 countries who attended a meeting in Varanasi chaired by Prime Minister Narendra Modi.
The TB model was built using data from several sources, including the Nikshay portal, private sector drug sales, a sub-national certification system that estimates and ranks TB-free status in different states.
The Union government’s ‘National Tuberculosis Prevalence’ survey, released last year on the occasion of World Tuberculosis Day (March 24), found the prevalence of tuberculosis among Indians above 15 years of age to be 312 cases per 1 lakh population. than twice the global average of approximately 127 cases per 1,000,000 people.
25 percent of announcements from the private sector
Officials involved in the tuberculosis program said the number of notifications from the private sector has increased sharply from 4 percent of cases to 25 percent. This is despite the fact that a TB prevalence survey last year found that while a large majority (about 66 percent) of Indians do not seek treatment for their symptoms, there is an equal preference for private and government facilities among those who do.
India made tuberculosis a notifiable disease in 2012, making it mandatory to report cases to government authorities. India has the highest TB burden at 26 percent and the rule was to ensure that no case fell out of the system.
Notification is important because if the patient does not complete the full course of treatment, there is a possibility of developing drug-resistant forms of TB. In addition, even an incompletely cured patient can spread the disease.
India’s death rate from TB has remained fairly constant over the years, with officials citing about 4 percent of reported cases — that’s about 93,000 a year.
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