Dr. C. S. Jamunantha (MBBS DTCD)
The thematic Map of Jaffna District NSP. TB case detection rate is as follows:-
We need a good infrastructure for TB care. Since we have TB burden. There were 28 patients died in 2017. Almost all the cases are from Teaching Hospital, Jaffna, while on TB medication. It shows that necessity for TB ward for the presumptive TB cases and complicated TB cases. Further there is not particular TB ward in Teaching Hospital, Jaffna.
Diagnosis of Tuberculosis as a spot diagnosis in the clinic or in any other wards is not always possible. Teaching Hospital, Jaffna should have a particular chest ward like other provincial Teaching Hospitals. We should have a search treat and prevent approach.
Sputum examination by microscopy is vital and absence of TB health facility results in delayed diagnosis. Spread of disease and ultimately higher morbidity and mortality. Sputum microscopy should be established at OPD levels.
Preventing the Primary Defaulter
Teaching Hospital, Jaffna needs a MLT to perform sputum Microscopy at OPD. Established lab facilities for AFB at private hospitals and labs should be mandatory. We should commit to diagnose and treat TB through both public and private sector health services. The TB response to be equitable, right based and people centered. We urgently to build equipment and modernize hospital for TB in Northern Province at Myeliddy. Provincial Health Community should take higher measures. We have to recognize the investments in TB care. We need to decisive and accountable Management with evidence based multi sectoral action. It should include National Health Ministry Provincial Health Ministry Provincial Public Services Commission and Private Hospitals and labs.
We need to remove discriminatory laws against people with TB and have to promote right based laws policies and practice that enable access to services. Putting the TB patients in Prison is violating the patients; right. We have to use counseling and social mobilization.
Housing of the TB Patient
The following areas need active screening to achieve END TB Strategy in Jaffna.
- Urban slums
- Poorly ventilated areas AC without exhaust fans).
- Dusty condition.
- Migrants workers
- Internally displace people
- living with Legal barriers.
(Indian fishermen in Prisons).
Transmission at workplaces and schools also be prevented.
Paediatric TB cases should be zeroed.
Development new tools for TB diagnosis is a good horizon with Gene X pert.
X pert MTB/RIF is a diagnostic test usually benefit for critically ill patient and presumptive TB in Pregnancy Paediatric group and in EPTB.