India registers 16% decline in TB incidence: Annual India TB report

March 28, 2024

According to the annual India TB report, India has witnessed a 16% decline in tuberculosis (TB) incidence from 2015 to 2022, surpassing the global decline of 9%.

The National TB Elimination Programme, India TB Report 2024, also highlighted that 25.55 lakh cases of TB were notified last year, the highest since the launch of the National Tuberculosis Elimination Programme (NTEP) in the 1960s.

State-wise Notifications

Uttar Pradesh recorded the highest number of TB case notifications compared to the previous year, followed by Bihar. Out of the total notified cases, over 8.4 lakh cases were from the private sector, marking a 1.17% increase from 2022 and a significant rise since 2017.

Treatment Coverage and Mortality

India’s treatment coverage improved to 80% of the estimated TB cases, a 19% increase over the previous year. The report also stated that TB mortality was 23 per lakh population, with an 18% decline compared to 2015, when it was 28 per lakh population.

Achievements and Milestones

India achieved a case notification rate of approximately 179 cases per lakh population in 2023, narrowing the coverage gap to 0.2 million.
The programme diagnosed 63,939 cases of multidrug-resistant TB (MDR-TB), highlighting its commitment to addressing drug resistance.
In 2023, more than 20.5 crore individuals were screened for signs and symptoms suggestive of TB as part of active case-finding efforts.
Out of the total TB cases notified in 2023, 60.7% were men, 39.2% women, and 0.04% transgender.

About TB

Tuberculosis (TB) is an infectious disease caused by the bacteria Mycobacterium tuberculosis. It primarily affects the lungs but can also impact other parts of the body. TB is spread through the air when an infected person coughs, sneezes, or speaks. Common symptoms include persistent cough, fever, night sweats, and weight loss.

Diagnosis involves chest X-rays, sputum tests, and skin tests. Treatment typically consists of a combination of antibiotics taken for several months. TB remains a major global health problem, particularly in developing countries.

Types of TB

There are two main types of tuberculosis (TB): latent TB and active TB.

Latent TB

Occurs when a person is infected with the TB bacteria but does not show symptoms.
The immune system contains the bacteria, preventing them from spreading and causing illness.
Not contagious, but can develop into active TB if left untreated

Active TB

Occurs when the TB bacteria multiply and cause symptoms
Can affect the lungs (pulmonary TB) or other parts of the body (extrapulmonary TB)
Contagious and can spread to others through airborne droplets

Additionally, there are other forms of TB:

Miliary TB:

A rare form of active TB that occurs when the bacteria spread through the bloodstream
Affects multiple organs simultaneously

Drug-resistant TB:

Occurs when the TB bacteria become resistant to one or more of the standard antibiotics used for treatment
Can be classified as multidrug-resistant TB (MDR-TB) or extensively drug-resistant TB (XDR-TB)

TB-HIV Co-infection

TB and HIV are two major public health problems globally, particularly in India. People living with HIV (PLHIV) have up to 20 times higher risk of developing active TB compared to those without HIV infection. In 2023, the total number of TB-HIV co-infected cases was 34,476, out of which 94% and 95% were started on antiretroviral therapy (ART) and Co-trimoxazole Prophylaxis Therapy (CPT) drugs, respectively.

National TB Elimination Programme

The National TB Elimination Programme (NTEP), previously known as the Revised National Tuberculosis Control Programme (RNTCP), was launched in 1997 and has since made significant progress in reducing the burden of TB in India. Its main features are:

DOTS (Directly Observed Treatment, Short-course) strategy: This is the core of the program, ensuring proper diagnosis, treatment, and monitoring of TB patients.
Free diagnosis and treatment: The program provides free diagnostic services and anti-TB drugs to all patients seeking treatment in the public health system.
Public-private partnerships: The program engages with private healthcare providers to increase access to TB care and improve case notification.
Active case finding: The program conducts door-to-door screening in high-risk areas to identify and treat TB cases early.
Nikshay: A web-based platform for case-based monitoring and management of TB patients, ensuring adherence to treatment and follow-up.
National Strategic Plan (NSP) for TB Elimination 2017-2025: The NSP outlines the interventions and strategies to achieve the target of ending TB in India by 2025, five years ahead of the global target.

India’s Efforts and Goals

India aims to eliminate TB by 2025, five years ahead of the global Sustainable Development Goal (SDG) target of 2030. The country’s efforts to ensure early detection, treatment initiation, and community engagement have contributed to the decline in TB incidence and mortality. However, with 28% of cases, India remains among the eight countries accounting for more than two-thirds (68.3%) of the total TB patients’ count, as reported by the World Health Organisation (WHO).

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