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In fight against TB, Kutch scores low
22 March 2007

Bhuj: World TB Day is to be observed on Saturday and this year’s slogan ‘TB anywhere is TB everywhere’ is more applicable in Kutch. For this is the only district in the State in the red zone, which means it ranks lowest in detection and cure of TB cases, with detection rate just 48 per cent in the last quarter of October-December 2006. Chief District Health Officer D K Dabhi while confirming this, said, ‘’No fault lies with the health machinery in the district.There is no response from the public to the TB programme here unlike other districts which have better detection rate. It’s the same with the Pulse Polio programme.”

When told that an NGO, alarmed at the high incidence of TB in the border district, had announced an awareness programme to mark the World TB day, Dabhi said that they too had drawn up certain programmes but did not have their details. District TB Officer (DTO) Poonamchand Parmar was more forthright in saying there was a problem with the administration in tackling the high incidence of TB. “Sputum examination is the only sure test for detection of TB. There are 37 Designated Microscopic Centres in the district. While seven are with health centres run by NGOs, 30 are at the district panchayat run Community Health Centres(CSCs) and Primary Health Centres (PHCs). But DCMs has vacant posts of as many as 12 laboratory technicians. How you one expect detection without adequate personnel?” He also pointed to poor referral rate in the district. The CSC and PHC medical officers do not refer suspected cases to DCMs for sure diagnosis and added guidelines required them to refer two to three percent of suspected OPD cases to the DCMs.

“The referral rate has been one to 1.5 percent till now,” he said. He added 70 to 80 per cent TB patients went to the private practitioners who were not experts in the field. The first ever internal evaluation conducted last month here by a 12-member high level team of experts from the state and World Health Organisation(WHO) does no speak well of the district’s TB control programme.It says quarterly meetings for the programme review have not been held in the past two years. It also says that DOT directory had not been prepared and distributed yet in the district. It also says that though a pilot project for collection and transportation of sputum was opened at Nakhatrana, not a single sputum was collected and transported from half of the public health institutes in January this year.

The report also says that sputum of 11 patients could not be diagnosed as 55 percent of samples collected were not sputum but saliva. Sources said that the success of pilot project would have help the district get more TU (TB units), but now the project had been shelved.

Courtesy: - New Delhi,India kutchhis globally , from Mumbai

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