Leprosy and tuberculosis (TB) are the latest diseases to be added to a screening programme aimed at detecting disease and underlying risks of disease within children.
The Rashtriya Bal Swasthya Karyakram (RBSK), or “Child Health Screening and Early Intervention Services”, already screens for thirty health conditions prevalent in children under eighteen. Among these are defects at birth, diseases in children (for example heart and lung disease), deficiency conditions and developmental delays including disabilities, together described as “4Ds”.
The programme began in 2013 under the National Health Mission. Up until this point, neither leprosy nor TB were included under the programme. However, with leprosy still continuing past its government-declared elimination target of 2018 and TB reaching crisis point due to drug-resistant strains becoming an ever more pressing issue, the news could not come sooner. India struggles with both conditions. Any scheme reducing cases among the young is likely to yield highly beneficial results.
India was recently declared to be the “leprosy capital of the world”, housing around 66 percent of all the world’s cases. Despite the disease being formally declared eliminated in 2005, disease cases continue to increase. An estimated 135,485 new cases were detected in the 2016-17 period, with some experts saying these figures underestimate the real burden.
It is thought that social stigma combined with a lack of knowledge of the condition have led to pockets of leprosy cases going undocumented, and therefore, untreated. Screening for the disease among the country’s children could be an effective means of not only establishing which children are in need of treatment, but could even aid in documenting which regions of India are more prone to transmission. This, in turn, could aid future programmes pushing for eradication.
In much the same way, the programme may aid in assessing which areas hold a high prevalence of TB. A consistent issue in India has been the lack of data. Health centres — many of which are in the private sector — do not report TB cases to a centralised body. In Pune, for example, there are 6,771 registered healthcare facilities. Only 38 of them report cases of TB. (Maharashtra has recently begun taking steps to improve TB monitoring).
The emergence of drug-resistant strains is an ever-present threat that front line therapies may soon become entirely obsolete. If cases of TB are not detected and curbed within India in the coming years, the country could soon become a reservoir of all but untreatable cases of the disease.
An estimated 25 crore children below the age of eighteen will be screened for both TB and leprosy, with those suspected of having either condition being sent for further tests. Such a programme could strike a huge blow to the prevalence of each disease, making such an undertaking a huge boon for Indian healthcare.
