MUMBAI: For the last two months, pulmonologist Dr Vikas Oswal, who works in Govandi, has been witnessing a worrying trend: an increase in the number of women in the 15-30 age group coming in with severe tuberculosis.
Tuberculosis diagnosis in the city fell in 2020 due to the Covid-induced lockdown, with around 40,000-odd cases registered as against 60,000-plus in 2019.
“Before the Covid pandemic, I used to see 30 new TB cases in my practice every month,” said Oswal, who is attached to the TB control programme running out of the BMC-run Shatabdi Hospital in Govandi. After the lockdown-induced lull, he has been seeing 45 new cases a month. “It is a cause for concern,” he said.
Most of these girls and women have severe TB disease affecting their lungs. “These girls stayed home during the lockdown and none in their homes had Covid or tuberculosis, yet they have worrying TB complications,” said Oswal.
TB detection in Covid times fuels a worry that the SARS-CoV2 virus could be making the patient susceptible to a series of bacterial infections, including TB. A senior doctor in the BMC-run KEM Hospital in Parel said: “We have seen 150 youngsters who needed hospitalisation because of severe ill-health. They didn’t report a history of Covid, but had SARS2 antibodies. Some of these patients were diagnosed with TB later during their hospitalisation.”
On June 14, the Kerala public health department issued a directive stating that post-Covid patients should undergo a TB screening test four to six weeks after recovery. Kerala health secretary Rajan Khobragade’s note said “temporary immunosuppressive effects and lung inflammation caused by Covid-19 might be leading to re/activation of the dormant bacilli to TB disease”.
Incidentally, Govandi has the highest incidence of TB in Mumbai, which is often referred to as the TB capital of India. However, pulmonologists in other parts of the city haven’t reported any rise in TB cases yet. Dr P Prabhudesai from Lilavati Hospital said there has been no rise in TB cases among post-Covid-19 patients. “As per our protocol, we ask post-Covid patients to undergo a chest scan a month later. TB can easily be picked up,” he added.
BMC’s TB control officer Dr Pranita Tipre said TB detections in 2021 so far are around 20,000. “In 2019, we had 60,000-plus, but we realised a third of these patients came from outside BMC limits. They couldn’t travel to hospitals such as JJ in Mumbai during the lockdown in 2020, resulting in a drop in numbers,” she said.
