Self-reported tuberculosis in India: evidence from NFHS-4

Area of Science:

• Public Health
• Epidemiology
• Socioeconomics

Background:

• Tuberculosis (TB) remains a significant public health challenge in India.
• Understanding the socioeconomic determinants of TB distribution is crucial for effective control.
• Previous studies have highlighted disparities, but comprehensive data on self-reported prevalence and treatment-seeking behavior is needed.

Purpose of the Study:

• To determine the self-reported point prevalence of tuberculosis (TB) in India.
• To analyze the socioeconomic patterns in TB distribution and treatment-seeking behavior.
• To assess public knowledge and social stigma associated with TB.

Main Methods:

• Utilized data from the National Family Health Survey-Round 4 (NFHS-4, 2014-2015).
• Analyzed a nationally representative sample of over 600,000 households and approximately 2.9 million individuals.
• Examined self-reported TB cases, treatment sources, knowledge levels, and social stigma.

Main Results:

• Estimated a self-reported TB point prevalence of 304 cases per 100,000 population.
• Identified a higher TB burden among households with lower wealth status and individuals with less education.
• Observed that 55% of TB cases sought treatment from public services, with significant private sector utilization among the poorest groups.

Conclusions:

• Socioeconomic factors significantly influence TB prevalence and access to care in India.
• Incomplete knowledge about TB transmission and high levels of social stigma persist among the general population.
• There is an urgent need for policies to engage the private sector and implement targeted advocacy for TB control.