FOR THE early detection of latent tuberculosis infection (LTBI) among households in Mumbai, the Brihanmumbai Municipal Corporation (BMC) is for the first time initiating compulsory screening of family members of active pulmonary tuberculosis (TB) patients from January 1, 2022. This could be a game changer by reducing the TB burden by half in the city.

Mycobacterium tuberculosis, the bacteria that causes TB, can live in the body without evidence of clinically evident active TB. This is called LTBI. In most people who breathe in TB bacteria and become infected, the body is able to fight the bacteria to stop them from growing. People with LTBI have no symptoms.

Earlier, BMC had started a pilot project where around 500 samples of family members of 125 pulmonary TB patients were collected to detect LTBI. Now the TB department has decided to make the surveillance mandatory for all the pulmonology TB patients’ kin across 24 wards in Mumbai. In Mumbai, over two-third of the TB patients have pulmonary infection.

Under this, close contacts of the TB patient will be screened for sensitivity of 4S complex — current cough, fever, weight loss and night sweats. “Along with this, we will ascertain the presence of the Mycobacterium through X-ray, blood test (Interferon-Gamma Release Assays, called IGRA) that gauges an individual’s immune reactivity to TB bacteria. If anyone is found positive with the bacteria, we will start their prophylactic treatment so that the bacteria doesn’t become active in them,” said Dr Pranita Tipre, Mumbai’s TB officer.

So far, this TB preventive therapy was limited to children under five years who were exposed to any active TB in the household and people living with HIV who generally have low immunity.

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