|
1
|
Jeyashree K, Thangaraj J, Rade K, Modi B, Selvaraju S, Velusamy S, Akhil S, Vijayageetha M, Sudha Rani D, Sabarinathan R, Manikandanesan S, Elumalai R, Natarajan M, Joseph B, Mahapatra A, Shamim A, Shah A, Bhardwaj A, Purty A, Vadera B, Sridhar A, Chowdhury A, Shafie A, Choudhury A, Dhrubjyoti D, Solanki H, Sirmanwar K, Khaparde K, Parmar M, Dahiya N, Debdutta P, Ahmed Q, Ramachandran R, Prasad R, Shinde R, Baruah R, Chauhan S, Bharaswadkar S, Achanta S, Sharath BN, Balakrishnan S, Chandra S, Khumukcham S, Mandal S, Chalil S, Shah V, Roddawar V, Rao R, Sachdeva K, Murhekar M. Estimation of tuberculosis incidence at subnational level using three methods to monitor progress towards ending TB in India, 2015-2020. BMJ Open 2022; 12:e060197. [PMID: 35902192 PMCID: PMC9340578 DOI: 10.1136/bmjopen-2021-060197] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES We verified subnational (state/union territory (UT)/district) claims of achievements in reducing tuberculosis (TB) incidence in 2020 compared with 2015, in India. DESIGN A community-based survey, analysis of programme data and anti-TB drug sales and utilisation data. SETTING National TB Elimination Program and private TB treatment settings in 73 districts that had filed a claim to the Central TB Division of India for progress towards TB-free status. PARTICIPANTS Each district was divided into survey units (SU) and one village/ward was randomly selected from each SU. All household members in the selected village were interviewed. Sputum from participants with a history of anti-TB therapy (ATT), those currently experiencing chest symptoms or on ATT were tested using Xpert/Rif/TrueNat. The survey continued until 30 Mycobacterium tuberculosis cases were identified in a district. OUTCOME MEASURES We calculated a direct estimate of TB incidence based on incident cases identified in the survey. We calculated an under-reporting factor by matching these cases within the TB notification system. The TB notification adjusted for this factor was the estimate by the indirect method. We also calculated TB incidence from drug sale data in the private sector and drug utilisation data in the public sector. We compared the three estimates of TB incidence in 2020 with TB incidence in 2015. RESULTS The estimated direct incidence ranged from 19 (Purba Medinipur, West Bengal) to 1457 (Jaintia Hills, Meghalaya) per 100 000 population. Indirect estimates of incidence ranged between 19 (Diu, Dadra and Nagar Haveli) and 788 (Dumka, Jharkhand) per 100 000 population. The incidence using drug sale data ranged from 19 per 100 000 population in Diu, Dadra and Nagar Haveli to 651 per 100 000 population in Centenary, Maharashtra. CONCLUSION TB incidence in 1 state, 2 UTs and 35 districts had declined by at least 20% since 2015. Two districts in India were declared TB free in 2020.
Collapse
Affiliation(s)
| | - Jeromie Thangaraj
- ICMR- National Institute of Epidemiology, Chennai, Tamil Nadu, India
| | - Kiran Rade
- World Health Organization, Country Office for India, New Delhi, India
| | - Bhavesh Modi
- GMERS Medical College & Civil Hospital, Gandhinagar, Gujarat, India
| | - Sriram Selvaraju
- ICMR - National Institute for Research in Tuberculosis, Chennai, Tamil Nadu, India
| | | | - Sasidharan Akhil
- ICMR- National Institute of Epidemiology, Chennai, Tamil Nadu, India
| | | | | | | | | | | | | | - Bency Joseph
- ICMR- National Institute of Epidemiology, Chennai, Tamil Nadu, India
| | | | - Almas Shamim
- WHO-NTEP Technical Assistance Project, New Delhi, India
| | - Amar Shah
- USAID India Mission, New Delhi, Delhi, India
| | - Ashok Bhardwaj
- MM Medical College & Hospital, Kumarhatti, Solan, Himachal Pradesh, India
| | - Anil Purty
- Pondicherry Institute of Medical Sciences, Puducherry, India
| | - Bhavin Vadera
- Wadhwani Institute of Artificial Intelligence, Mumbai, India
| | - Anand Sridhar
- WHO-NTEP Technical Assistance Project, New Delhi, India
| | | | - Asif Shafie
- Central TB Division, Ministry of Health & Family Welfare, New Delhi, Delhi, India
| | - Avijit Choudhury
- World Health Organization, Country Office for India, New Delhi, India
| | | | | | | | | | - Malik Parmar
- World Health Organization, Country Office for India, New Delhi, India
| | - Nisha Dahiya
- Central TB Division, Ministry of Health & Family Welfare, New Delhi, Delhi, India
| | | | | | | | - Ranjeet Prasad
- Central TB Division, Ministry of Health & Family Welfare, New Delhi, Delhi, India
| | - Rohini Shinde
- Central TB Division, Ministry of Health & Family Welfare, New Delhi, Delhi, India
| | | | | | | | | | | | | | | | | | - Sudarsan Mandal
- Central TB Division, Ministry of Health & Family Welfare, New Delhi, Delhi, India
| | | | - Vaibhav Shah
- WHO-NTEP Technical Assistance Project, New Delhi, India
| | | | - Raghuram Rao
- Central TB Division, Ministry of Health & Family Welfare, New Delhi, Delhi, India
| | - Kuldeep Sachdeva
- Central TB Division, Ministry of Health & Family Welfare, New Delhi, Delhi, India
| | - Manoj Murhekar
- ICMR- National Institute of Epidemiology, Chennai, Tamil Nadu, India
| |
Collapse
|