Friday, 13 March 2015

Not notifying TB unethical under MCI ethics regulations

Not notifying TB unethical under MCI ethics regulations

As per Municipal Laws and Govt. of India’s Order – “TB is a Notifiable Disease” but over 10 lacs TB patients treated in India every year do not get reported to the appropriate authorities. 

Indian Medical Association in asscoaition with Central TB Division, DGHS, Govt if India have been able to notify 1,04,670 TB patients in the last one year said Padma Shri Awardee, Dr. A. Marthanda Pillai, National President and Padma Shri Awardee, Dr K K Aggarwal, Hony. Secretary General, IMA.

Addressing a Press Conference here, the IMA experts said that "Not notifying TB is a violation of MCI Ethics” under Sections 5.2 & 7.14 and can lead to suspension of the license of the doctor.

TB and Swine flu spreads differently.  Swine flu is a droplet infection while TB is droplet nuclei infection. Infected particles of size more than 5 microns are called droplets infection and of less than 5 microns are called droplets nuclei.

In contrast to larger droplets, airborne droplet nuclei can remain suspended in the air for extended periods, and thus they can be a source of human inhalational exposure to susceptible individuals.

Three feet distance rule of swine flu will not prevent TB.  The TB bacilli remain in the atmosphere for a longer period and do not settle down on the earth.

They may keep on circulating in the room especially if a split AC is used. Similarly in the car, bus, trains or flights, an open TB patient may keep on infecting others.

Airborne precautions should be used in the care of patients with suspected or confirmed tuberculosis. TB is principally transmitted in hospitals by droplet nuclei, and thus the hospital can be a place where TB is transmitted to other patients and healthcare staff.

While prevention of flu requires simple three layered mask, the one for TB prevention requires N95 mask. Individuals entering the room of a patient with known or suspected TB must wear appropriate respiratory protection, an N95 mask. N95 masks filter particles ≥1 micron in diameter with at least 95 percent efficiency given flow rates up to 50 liters per minute. Patients with known or suspected TB should not wear N95 masks, since they are designed to filter air before it is inhaled. Instead, patients with known or suspected TB who require procedures outside an isolation room should wear a surgical mask; these are designed to prevent the respiratory secretions of the person wearing the mask from entering the environment.

All open TB patients needs to be immediately identified, treated till they become sputum negative and non infective.

Most TB positive patients do not disclose about their TB status for social stigma reasons and keep spreading the disease to others. Public needs to be informed that every open sputum case of TB will infect and be responsible for 15 new more cases of TB if not taken care with early treatment.

IMA has asked the government to come out with a policy, in which sputum positive TB cases are given paid leave,  so that TB sputum positive do not hide their illness.

In India 2.1 million new TB cases occur annually and 2,40,000 deaths occur every year due to TB. 

All TB patients are not contagious, but those who are, need to be taken care of.

IMA’s fight in TB is not limited to notification of TB cases.  IMA has sensitized more than 1 lac doctors in providing a Standard TB Regimen in accordance with the standard guidelines.

IMA has also initiated 1771 PHIs (Peripheral Health Institutes) where private doctors are linked with the Govt. RNTCP Project through IMA branches.

IMA has appealed to 2.5 lacs doctors of IMA to notify each & every TB patient, the same can be done through IMA Website or through local Municipal Corporation/Appropriate Authority.  IMA has also communicated to its members that TB patients should not default during their full course of treatment.

As a part of TB awareness, IMA will be organizing a series of programmes for nurses, school/college Principals, TB Rally, medical education programmes for doctors and nursing home owners, all India Medical College TB Slogan contest and release of messages of Padma Awardees etc.  The Campaign will culminate on 7th April with a tableaux will roam around in Delhi & NCR for creating awareness on TB.

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