Your servant can give you TB
By Sonoo Singh
Tribune News Service

CHANDIGARH, Sept 18 — "You are always at risk in case of using domestic help in the house, if the servant has not been examined for tuberculosis (TB)." This is the opinion of experts today, in the wake of almost 1,100 cases of TB having been registered from slums and colonies of the city, since 1998. The urban sector meanwhile had registered around 750 such cases from January 1998 to December 1998.

Domestic help, which enters urban homes in the from of 'malis', 'dhobis' and 'kaamwalis' come from Saharanpur, Gharwal, Muzaffarnagar, and the Terai belt. In these regions, cases of TB are found in abundance. Experts say that since the tuberculosis bacilli can survive till three months to three years, all domestic help should be screened for TB.

In the past also, tuberculosis rates have always been higher in urban than in rural communities because of more crowding in cities. More crowds provided a greater opportunity for the transmission of the bacilli, and poor sanitation and hygiene.

"Our clinic provides X-rays tests, treatment and medicines, all free of cost, so why not use the facilities and help in eradicating the disease? The cook or the cleaner in the house, in case they have TB, can easily pass on the infection to others in the house," said Dr R.K. Kapoor, of the Chest Clinic in the Sector 22 polyclinic.

Not only are symptomatic cases more in slum areas and colonies, which are full of migratory population, but also the number of defaulters is more here. Experts say that finding cases of TB is not difficult today because a lot of awareness has been generated on this disease. The difficulty however, lies in ensuring that full treatment is taken by patients. The treatment for TB takes something from six months to one year.

Doctors also say that since tuberculosis bacilli stay and prosper in closed, dark and humid conditions, it is essential to have sunlight and ventilation in houses. Things like defuming the house or cleaning and white-washing it alone will not help. Dr Kapoor said, "In such cases, the whole family should have themselves examined for tuberculosis."

TB spreads in two ways — through the respiratory route, directly from an infected person, or through the gastrointestinal route. Most human tuberculosis is acquired by inhaling bacilli from the sputum or other fluid discharges of infected persons. Doctors say that minute droplets discharged by sneezing, coughing and even talking can contain hundreds of tubercle bacilli which may be inhaled by a healthy person.

Due to social stigma still attached to it and the myth that it is a disease of only the poor, even today, many educated persons do not get themselves examined. However, the success rate of the complete cure of TB in fresh cases is almost 80 to 90 per cent, with relapsable cases being not more than seven per cent.

Sources say that the Revised National Tuberculosis Control Programme (RNTCP), which has already been implemented in 102 districts of the country will now shortly be introduced here as well. A significant thing about the RNTCP will be a supervised regime of the treatment for TB under a programme called DOTS (Directly Observed Treatment with Short-course drugs).

Doctors are highly concerned about the rampant spread of the HIV/AIDS virus which will greatly increase chances of a TB-infected individual to develop active tuberculosis. Experts claim that even in such cases, tuberculosis is curable.