Tuberculosis (TB) is no longer a disease that just affects the poor, as an increasing number of people from the higher strata of society are falling prey to the disease.

According to the recent observations made by the Mumbai District TB Control Society (MDTCS), most people from the affluent class in the city are suffering from extra pulmonary TB (any TB outside of lungs).

The 2010 report of the Revised National TB Control Programme (RNTCP) states that 20% of TB cases in the world are from India.

And, as of 2010, Mumbai has 16% of sputum positive suspect cases, with 55% being new sputum positive and 33% being smear positive re-treatment cases.

According to Dr Santosh Revankar, member secretary, MDTCS, people from the higher strata are mostly immuno-compromised.

“TB is an airborne disease and even though many recover from it, there are cases where the bacillus travels through the lymph nodes in extra pulmonary sites like the heart, spine and even skin,” said Revankar.

“Overcrowding in a place also contributes to rampant increase in TB. For example, a pregnant lady’s immunity is lower because of blood dilution so the internal strength of the body to fight against the bacillus comes down.”

Revankar added that the general trend among the affluent class is that they tend to hide the disease because there is a stigma attached to it.

“Other trends observed are that they take treatment from consultants, who do not stick to regulations recommended by the World Health Organisation (WHO). So many cases don’t come forward. But, we have a dedicated surveillance now which is changing attitudes.

Every fever and cough case, which doesn’t respond to antibiotics is investigated further for sputum acid fast bacilli test,” said Revankar.

According to Revankar, while TB is the biggest killer in India, the good news is that there is a direct observed treatment, which is consuming the medicine before the health officer and not at home.

“The RNTCP has revised the dosage, duration and methodology in curing TB to cut down on default rate of patients undergoing treatment at home,” added Revankar.