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Tuberculosis epidemiology in India: a review
1National Tuberculosis Institute, Bangalore, India. vin_chadha@rediffmail.com
Summary
Tuberculosis (TB) remains a significant public health challenge in India, characterized by high disease rates and transmission. Addressing TB requires understanding its prevalence, incidence, and the growing threat of drug resistance and HIV co-infection.
Area of Science:
- Epidemiology
- Infectious Diseases
- Public Health
Background:
- Tuberculosis (TB) presents a substantial public health burden in India, marked by high disease prevalence, incidence, and transmission rates.
- Historical disease surveys since the 1950s indicate significant levels of smear-positive pulmonary TB (PTB), culture-positive TB, and combined positive cases.
Purpose of the Study:
- To summarize the epidemiological landscape of tuberculosis in India.
- To highlight key metrics including prevalence, incidence, annual risk of tuberculous infection (ARTI), and trends in HIV co-infection and multidrug resistance (MDR).
Main Methods:
- Review of disease surveys conducted across India since the 1950s.
- Analysis of data on TB prevalence, incidence, ARTI, HIV seropositivity, and multidrug resistance (MDR).
Main Results:
- Prevalence rates for various forms of TB range from 0.6 to 12.7 per 1000 population.
- Incidence rates for smear-positive and culture-positive PTB are reported between 1.0-1.6/1000 and 1.0-2.5/1000, respectively.
- Average ARTI was estimated at 1.5% in a 2000-2003 study, with significant variation in HIV seropositivity (0.4%-28.8%) and MDR-TB proportions (0.5%-5.3% in new cases, 8%-67% in previously treated cases).
Conclusions:
- India faces a persistent challenge with high rates of TB transmission and disease.
- Increasing HIV co-infection and varying levels of multidrug resistance, particularly in previously treated individuals, necessitate targeted interventions.