Zehru Nissa, Jammu and Kashmir
(First published in Greater Kashmir, India on August 3, 2015)
“The growing numbers of people living with diabetes in Kashmir coupled with the mounting evidence that people with diabetes are more susceptible to TB should ring alarm bells,” said Dr Naveed Nazir Shah, HoD Chest Medicine at Chest Diseases Hospital in Srinagar. He said that although diagnosis of most cases of TB was possible through India’s Revised National Tuberculosis Program (RNTCP), there is no such programme for detection of diabetes.“There is no state or national programme that would test people’s sugar levels. However, in case of TB, there is a fair amount of awareness about how cough for more than two weeks needs to be checked,” he said.
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| Photo credit: CNS: citizen-news |
Doctors have expressed concern at the
low levels of awareness regarding the link between TB and diabetes in Kashmir
and have demanded that more efforts should be put for better detection and
management of diabetes in the state.
“The growing numbers of people living with diabetes in Kashmir coupled with the mounting evidence that people with diabetes are more susceptible to TB should ring alarm bells,” said Dr Naveed Nazir Shah, HoD Chest Medicine at Chest Diseases Hospital in Srinagar. He said that although diagnosis of most cases of TB was possible through India’s Revised National Tuberculosis Program (RNTCP), there is no such programme for detection of diabetes.“There is no state or national programme that would test people’s sugar levels. However, in case of TB, there is a fair amount of awareness about how cough for more than two weeks needs to be checked,” he said.
Doctors are also concerned about the
lack of efforts on part of the Jammu & Kashmir Health and Medical Education
department to spearhead health campaigns for better outcomes of TB treatment
and diabetes control.
“Everyone is working in isolation here.
There is no coordination between endocrinologists, physicians, public health
analysts and researchers,” said a doctor. “Moreover,” he added, “What is our
health policy? Is it based on our health realities?”
The World Health Organisation (WHO)
recommends that all people with TB should be screened for diabetes. It also
advocates screening for TB in people living with diabetes, especially in
high-risk populations.
A physician said that, “These
recommendations are more relevant in our setting as we still have a
considerable load of TB, especially in some belts.” He added that researches
have proved that people with diabetes, who are also infected with TB, have a
higher risk of death during TB treatment and of TB relapse after treatment.
With RNTCP running into rough patches
every now and then due to non-payment of salaries of employees of DOTS centres
in Kashmir, these centres are also not able to deliver TB care and control, as
a result of which the TB treatment regimen also suffers.
“What motivation will a DOTS provider
have if his/her salary has not been paid for many months altogether? What
obligation does he/she have to be there for the patient and dispense
medicines?” a member of an association of RNTCP employees asked.
Doctors warn of the complications in
diabetes due to the presence of infectious diseases, including TB. “Proper care
for diabetes is imperative for people with TB,” Dr Shah said. Experts have warned about the
consequences of lack of interaction between infectious disease experts and
life-style disease experts in Jammu & Kashmir. “It is a challenge as how to
have a smoother and better interaction; break down barriers and open
communication among different groups of public health experts,” a public health
expert said.
While the National Disease Control
Programme gives a lot of impetus to TB care and control activities, diabetes is
still considered a life-style disease with no governmental scheme or programme
addressing it. Non-communicable diseases contribute to 39.1% of the national
disease burden against the 24.4 % of the communicable diseases. So it becomes
all the more important to have collaborative efforts, rather than work in
silos, if the goal is to eliminate TB and control diabetes as part of the post
2015 development agenda.
(First published in The Greater Kashmir, India on August 3, 2015)
(First published in The Greater Kashmir, India on August 3, 2015)
Zehru Nissa, Citizen News Service - CNS
August 19, 2015