THOUBAL, MANIPUR: At the tender age of 22, life was unfolding with dreams and aspirations for Avijit from Thoubal Khetri Leikai in Manipur. He was on the cusp of embracing his ambitions when an unexpected turn of events altered the course of his life’s journey. When he went for a routine thyroid examination, he was told that he needed a retest. Subsequent diagnosis revealed that he had an advanced case of tuberculosis (TB) and if there was no immediate medical intervention then he may survive for only 8 months. This news did not leave him in despair.

Avijit

Instead, Avijit decided to fight and conquer TB. After gaining guidance from TB experts, he chose to fight the disease with bravery and fortitude and committed himself to a rigorous treatment regimen accompanied by nutrition and a balanced diet, Today, at the age of 27, Avijit is cured of this disease and is working as a teacher in Manipur.

Avijit is one amongst the many patients who have benefitted from government’s endeavor to make TB treatment accessible. Now the patients in this high prevalence state need to be aware about the existing programs and should have the will to follow the treatment to get fully cured. Approximately 40% of the population in India is already infected with TB, making it a significant health challenge.  In Manipur, though, the incidence is 71 cases per one lakh population.

“The emergence of HIV in the early 1980s complicated efforts to control TB, as HIV weakened the immune systems,” says Dr. W. Shashi Singh, Manipur State TB Officer for TB Resurgence, Campaigns, awareness, and introduction of Pradhan Mantri TB Mukt Bharat Abhiyaan for the elimination of TB told Health On Air.

As of October 17, 2023, Manipur has reported 1,392 TB patients, a decline from the 2,511 cases reported in 2022. The treatment success rate stands at 68%, with 933 individuals cured, 783 completing treatment, 10 facing treatment failure, 107 lost to follow-up, 82 succumbing to the disease, and 24 remaining unassessed for 2022, he adds.

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Singh says what often hinders TB treatment is lack of awareness about government programs and lack of faith in government-sponsored treatment plans, which in fact are the most reliable.

The case-study of Laishram Chalamba, a small-scale jeweler from Laishram Leikai, Uchiwa Wangma, Thoubal District, Manipur throws light into resistance to medication against TB patients when use of information can successfully alter one’s course of life.

Laishram Chalamba

Chalamba first became aware of his TB infection at the age of 27 in 2002. He seems to be carrying the disease since the age of 17. Persistent fever and debilitating weakness had taken hold of him so that he could no longer walk. His family had to transport him to RIMS (where) hospital on a bicycle. Initially hesitant to accept government-provided medication, Laishram found the cost of TB tablets to be prohibitive, compelling him to discontinue the treatment after just one month.

It wasn’t until he sought help at RIMS hospital again in 2002 that he was officially diagnosed as a TB patient. For a correct diagnosis, Laishram took a skin test. Subsequently, he was directed to the Primary Health Center (PHC) in Mayang Imphal, where he was provided with free medication. Throughout his treatment, which required taking seven tablets daily for six months and consuming additional nutritious food, Laishram Chalamba’s story is a testament to the importance of early diagnosis and prompt treatment for TB.

“TB is communicable and can affect your loved ones, so do not conceal symptoms like prolonged fever or persistent cough; instead, seek a diagnosis and initiate treatment promptly. Thanks to the Pradhan Mantri TB Mukt Bharat Abhiyaan and his determination, Laishram Chalamba has successfully defeated TB and now enjoys a healthy life while continuing his work as a small-scale jeweler, surrounded by his happy family,” says Chalamba when asked to give a message from his learning.

Dr. W. Shashi Singh underscores the pivotal role of community engagement in the battle against TB, highlighting the “Ni-kshay Mitra” initiative. “This program offers additional support to TB patients, featuring diagnostic, nutritional, and vocational aid. Donors, including elected representatives, corporations, NGOs, and individuals, provide diverse forms of assistance. “Ni-kshay Mitras” can opt for support spanning 1-3 years, including crucial nutritional provisions, diagnostic aid, and vocational training,” says Dr Singh.

Currently, Manipur boasts 93 “Ni-kshay Mitras,” with 38 among them being elected members such as MLAs and ministers. Dr. Singh elucidates the available schemes for TB, encompassing free medicines, the “Nikshay Poshan Yojana” (NPY) for TB patients, financial incentives targeting tribal patients, private providers, and treatment supporters.

“To bolster awareness and utilization of government schemes, Manipur has initiated partnerships with Johns Hopkins Program for International Education in Gynecology and Obstetrics (JHPIEGO) in India, a nonprofit global leader in the creation and delivery of transformative health care solutions for the developing world. Collaborating with Community Health Officers (CHO) and Health and Wellness Centres (HWC) staff, they are bolstering monitoring, reporting, and the integration of TB services. This includes timely TB screenings at drug addiction centers and correctional facilities. Essentially, these endeavors constitute a community-awareness program, effectively bringing vital healthcare services to the doorsteps of the local population,” says Dr Singh.

The World Health Organization aims to eliminate tuberculosis by 2030, while the Ministry of Health and Family Welfare’s Pradhan Mantri TB Mukt Bharat Abhiyaan aims to achieve this goal by 2025. “I hope we can defeat TB through people’s participation”, claims Dr. Singh.