Health Promotive Initiative by Symbiosis for TB Mukta Bharat

[00:01:02]afternoon colleagues faculty and students on behalf of SIS center of healthcare CSC I Dr. Dr. Rohini, Deputy Medical Superintendent HC. Welcome you all. Today's session is part of the health promotion initiative for TB Mhta Bharat. Supporting the government of India's TB free 100day campaign, tuberculosis remains a critical public health challenge.

[00:01:29]However, through targeted awareness, early clinical diagnosis, adherance to treatment and robust community action, eliminating tuberculosis is entirely achievable.

[00:01:42]Before we proceed further, let us anchor our session with institutional guidance.

[00:01:48]I invite you all to listen to an opening message from our director at CFC, Dr. Alka Chandra.

[00:02:11]Namaste CPN lasting more than two weeks should never be could be tuberculosis or TV. The good news is that the TV is given to us and completely curable. Give early diagnosis and proper treatment.

[00:02:27]Know the symptoms. Get tested early.

[00:02:30]Complete the full treatment. Support people affected by disk is every student can become ambassador on let's work together campus every community and TV preva.

[00:02:48]Thank you.

[00:02:53]Thank you Dr. Ala for setting the vision for today's initiative. Moving forward into our schedule, please scan the QR code on your screen. This brief baseline assessment allows us to gauge existing clinical awareness. We will pause for 5 minutes for you to complete it.

[00:05:14]It is now my privilege to introduce our speaker Dr. Sarin Kulkarni. Dr. Kulkarni is an MBBS gold medalist and university topper in medicine with advanced post-graduate training and fellowships from CMRI Kolkata and Apollo Hospitals New Delhi.

[00:05:33]His extensive credentials include specialized certification in pulmonary medicine, diabetical ventilation. Currently he serves as a consultant with SCC and leading tertiary hospitals in Pune.

[00:05:50]Given his profound experience, he will guide us through the pathogenesis, prevention, diagnosis and management of tuberculosis. Dr. Fulkarni, the floor is yours.

[00:06:02]>> Thank you so much Dr. Roi.

[00:06:05]So, uh let's start with the session today and we are going to speak about uh TB Muktarat that is TB free India. Uh and uh we'll start with the presentation. Please uh start the presentation.

[00:06:23]Okay. So why are we talking about TV? So let's understand tuberculosis basically is a bacterial infection which uh is caused by miccoacterium tuberculosis that is a bacteria which causes this infection particular infection. Uh now it is one of the most elderly disease or eldest diseases known to human being. It is spread by droplet method or airway and it is perfectly preventable and 100% curable. So we are working towards a TB bharat that has been our goal since a very very long time. But uh the new government or the government currently which is there in the power has introduced a TB mukd bharat aban. In that aban we are doing this as a awareness session for TB tuberculosis or TB. Now it is very important to recognize what is TB what are the symptoms of TB what we can do to make a early diagnosis and if we do early diagnosis of that patient then we can save life of that patient that's why it is really important to know how to uh uh know what is TB and how to diagnose it.

[00:07:41]So uh every individual in symbiosis outside symbiosis anyone who you know and everyone who is living in India can be the ambassador of TBM Mud Bharat. So we can work towards a healthier society and every individual can contribute in that sense only TB will be defeated and India will win that is TB hara desga next please.

[00:08:09]So let's understand what is TB first. As I told you TB is a infectious disease which is caused by bacteria. Bacteria is one of the small particles which causes infection in human beings. So the name of that particular bacteria is mcoacterium tuberculosis. It spreads through air, via cuff, via sneeze or even while speaking. So whenever a person is uh opening their mouth and the saliva comes out by any method any means it can be a carrier for TB uh transmission. So TB basically uh is a disease of lungs in tuberculosis. There are particularly two types of tuberculosis infection. First we call as pulmonary or lung tuberculosis. In Latin language pulmona means lungs and uh in that sense it is called as pulmonary tuberculosis and whatever is uh not lung tuberculosis is called as extra pulmonary tuberculosis.

[00:09:11]So it is uh it can involve lymph nodes it can involve bones it can even involve brain kidneys any organ tissue or cell in our body can be affected by tuberculosis. So we have to maintain or we have to keep that in our mind that TB is not only chest infection. It can be infection of different different organs, tissues or cells of our body. But most common is lungus. So pulmonary tuberculosis constitutes around 60% of TB burden and around 40% or 10 to 40% tuberculosis only is extra pulmonary tuberculosis. That's why we have to be very careful when we are coughing, when we are sneezing or whenever even speaking that we are taking proper precautions. Uh in COVID we understood or we learned what is uh taking precautions about cough, what is uh taking precautions about sneezing and speaking. So wearing a mask whenever you have infection or whenever you are symptomatic is really important and that lies true for all the diseases. Next please.

[00:10:22]So how does TB spread? It basically uh spreads through air. So uh whatever droplets are coming out of our mouth they uh float in air and they reach the next person whoever is next to that particular patient. So air is the main transmission uh vector or main transmission carrier. Then prolong post close contact means if a person person or a patient is TB positive and a health care worker or a family member colleague or a friend is in close contact of that TB patient then they can also have tuberculosis. Crowded poorly ventilated spaces are the risk factor of TB spread because uh there is a air saturation and droplets get saturated in a in that particular nonventilated or poorly ventilated spaces and they can uh lead to higher risk of TB infection. Now there are some myths that how TB can spread and we have to break those myths today. So sharing food, handshakes, touching objects do not spread TB. So sharing food, what does it mean? If you take food from the or if you share food with a tuberculosis patient, it will not give you tuberculosis. Shaking hand or a casual contact with that tuberculosis patient does not transmit tuberculosis.

[00:11:49]So you have to maintain or you have to understand the fact that only air droplet method is the method of transmission of tuberculosis also I told you that 40% can be extra pulmonary ATB but first exposure to the body by of tubercul tuberculosis bacteria is by droplet method so you have to understand that the entry of the microbacterium tuberculosis infection in the body is only due due to air or droplet method not by touching objects or even if a person is wearing some clothes and they are TB positive or if you share their linen that also does not spread any uh TB infection. Next please.

[00:12:36]So what are the symptoms of tuberculosis? First of all understand that understanding symptoms is the main stay of recognizing a TB case. So person can have fever. Now fever can be caused by hundreds and hundreds of diseases.

[00:12:53]But you have to understand the fact that prolonged fever is a sign of tuberculosis. The person also can get night sweats. They can get drenched by sweat in night. That is also one of the pathogammonic sign of fever of tuberculosis. Now cuff which last more than two weeks is a very important sign and symptom of tuberculosis.

[00:13:18]Also if there is a blood in scooter because a person is coughing for a while for two weeks they are coughing. So there is bound to be endothelial or blood vessel injury to that person. So they will bring out the blood in sputum.

[00:13:33]Now blood in sputum is not only specific for tuberculosis. It is more specific for cancers or other dangerous diseases but yes it can be present in tuberculosis as well. So if somebody is bringing out sput blood in their sputum it is a cause to show to a doctor or consult a doctor regarding the same. If a person is having loss of appetite or unexplained sudden weight loss. Now how do how do we uh define weight loss in this case around 5% of body weight is lost in uh 1 month or less than 1 month is called as sudden weight loss or sudden significant weight loss. Now if person is having fatigue lethargy also can one of the reasons can be that you are studying too hard or you are exercising too hard but unexplained fatigue is also one of the signs of tuberculosis. So keep this in your mind.

[00:14:32]Two weeks of fever, two weeks of cuff, blood in sputum, unexplained weight loss can be tuberculosis. If these symptoms persist, then please seek medical advice. And if you see somebody who's having these symptoms, then please advise them to get tested for tuberculosis. That's how you can become a ambassador of TBR.

[00:14:55]Next, please.

[00:14:57]Now, who is at higher risk?

[00:15:00]uh let's go one by one. The person who has weakened immunity. Now there are hundreds of reasons to have weakened immunity. I'll give you some to you.

[00:15:08]I'll give you some examples to you regarding those. Uh first it can be HIV infection. HIV infection gives rise to reduced immunity because there are white cell count in those patient goes down.

[00:15:20]Uh cancer patients the patients who are receiving chemotherapy for cancer.

[00:15:25]autoimmune diseases patient patient who are receiving uh autoimmune means imunotherapy for the autoimmune diseases also can have weakened immunity. Now there can be a higher risk in diabetic patient as well. Why does that happen?

[00:15:41]Because there is a endothelial injury or blood vessel injury. Whenever there is a blood vessel injury, it gives rise to lesser blood supply which leads to uh improper exchange of nutrients, oxygen and carbon dioxide along with removal of bacteria. So that's why any disease which can cause vessel problems can lead to higher risk of tuberculosis. Then malnutrition it again leads to weakened immunity because less amount of protein is intake protein is taken and less amount of immunity is built up in those cases. Tobacco use or alcohol use. It is very important to know that tobacco or alcohol both can cause endothelial injury that is blood vessel injury and sub subsequently it causes lesser blood supply in that individual leading to higher risk of tuberculosis and again close contact with TB patients. the patients who are known to have TB, their family members, their friends, their colleagues, uh healthare, healthare workers who are treating those TB patients are always at higher risk of contracting TB. So it is necessary for anybody who is taking care of tuberculosis patient to get tested for tuberculosis as uh the disease is progressing to know whether you yourself have contracted tuberculosis or not.

[00:17:08]Next please.

[00:17:11]So as I told you in your in the earlier uh slides uh TB can be 100% prevented and it can be 100% cured. So understand that fact that whatever god or whatever the almighty has given to us it can never be 100% regenerated even by the body and uh we doctors can help you but never can achieve 100% recovery from any infection but yes it can be cured totally from the body that means the burden of tuberculosis bacteria will be uh taken away from your body and you will be cured of the bacteria per But whatever damage it has caused it might remain in 1 2% or if it is longlasting it can remain in higher percentage as well. So how it can be prevented? Let's see one by one. First of all whatever we learned in COVID you have to keep that in mind all the time always uh and you have to keep uh uh alerting everybody regarding the same also. So cover your mouth while cuffing while sneezing. There is a way of vampire cuff also where you put your uh forearm in uh in front of you or your arm in front of you whenever you are coughing or sneezing that prevents the bacteria from uh passing in the air or air droplet method gets prevented.

[00:18:37]Ensure that your work area or your home is properly ventilated. It should not be saturated. Whenever a person is coughing, sneezing or speaking, it can get uh saturated uh with bacterias and with viruses. So, uh ensuring good ventilation is a way of preventing those saturations. So, maintain good nutrition. It can give rise to good immunity, buildup of immunity and antigen, antibodies or white blood cells in your body. So, good nutrition is always a way to go. Seek early medical advice if you have the symptoms which I've already enumerated such as fever, unexplained fever, unexplained cough more than 2 weeks, blood in sputum, uh unexplained weight loss and fatigue which is also unexplained or there is no reason for it then please seek early medical advice. You can have tuberculosis or if you notice somebody who is having these symptoms ask them to seek medical advice. uh it is always uh better to prevent tuberculosis than to treat it later on and complete the treatment if you are diagnosed with tuberculosis. I can't stress this fact enough that the TB burden in India is rising because the person or the TB infection patient does not complete the proper treatment. That's why reinfection and relapse are coming again and again.

[00:20:06]The treatment for TB infection is longlasting. It lasts almost 6 to 9 months. So it is very easy for patient not to adhere to it. So they need encouragement. They need support and always uh ask them whether uh they are completing the treatment. They are adhering to the regimen. If they are not, encourage them to adhere to the regimen. So the person will get 100% cured. If you or if any person leaves the treatment in between or midway there is a chance of getting uh drugresistant TB or uh incomplete cure of tuberculosis and then it can relapse or there can be reinfection of tuberculosis. Next please.

[00:20:50]I already told you TB is curable. The TB infection can be 100% gone from your body with treatment. The treatment for six uh treatment for pulmonary tuberculosis is for 6 months and for extra pulmonary that is TB of anything other than chest is of 9 months. The TB treatment is available for free in government programs. You can go to any government government hospital and get TB treatment for free in uh at any point of time and uh they are bound to help you as it is uh made free from the government. So make sure that you uh take treatment early. So if uh treatment is started early the complications do not rise and we can prevent those complications from happening. Now stopping medicines in midway can be very dangerous. I've already told you the microbacterium tuberculosis persist in body uh for very long time and it takes a longer treatment for it to go away or to get uh what do you say eliminated from the body. So it has to be a longtime treatment. Do not stop the medicines in between. It can lead to drugresistant tuberculosis. Why it is becoming harder and harder for doctors to treat TB or why the government has to come up with new new plans to treat TB is uh this is the very reason for it that people who have or patients who have tuberculosis usually tend to stop the treatment in midway when they uh feel that I'm cured of it or I do not have any symptoms anymore they stop the medicines and it can lead to drugresistant TB. What does that mean?

[00:22:37]What does drugresistant TB mean? It means that whatever treatment is basically in guidelines. Whatever is the first treatment given to the patient, uh the bacteria becomes resistant to that particular treatment. So we have to give another treatment to that particular person and there are chances that the bacterium can become extremely drugresistant that is XDR or PDR that is pan drugresistant TB. In that condition any medicine which we give does not make any difference to the patient. So stopping midway is very dangerous. Again complete the treatment. Complete the whole course of the treatment. It is mandatory. It is essential to be totally cured from tuberculosis. Next please.

[00:23:27]Now let's see some myths and let's uh break those myths. So first myth which we want to address is TB is incurable. I have already told you that TB is curable and can be eliminated from the body.

[00:23:41]Next is TB spreads through food. It does not I have already told you handshakes close contacts sharing food sharing bed linen clothes does not transmit tuberculosis. It spreads only through air by droplet method. Next myth is tuberculosis patient should be isolated completely. Now the treatment is going to last for 6 to 9 months. As humans are social animal we cannot be isolated from people for 6 to9 months. We had uh or we have seen what are the effects of isolation during covid time. So patient needs continuous support. They need treatment and for that fact they have to be isolated for only time when they are contagious. Once the symptoms go down and their sputum smear comes negative, they can go around in uh their campuses, if they are in college, if they are in hostel, they can go about their normal routine and they need proper support to get uh to adhere to the regimen of uh 6 to9 months.

[00:24:48]Next myth is TB is a disease of only poor. Anybody can contract tuberculosis as TB is endemic to India. Around 1/4 of every case in world of tuberculosis is in India. So around 25 to 26% of global burden is only in India for tuberculosis. So TB is not the disease of only poor but yes there is a higher risk of uh poor people or poverty uh people in poverty to contract TB because of poor ventilation and crowded spaces but anybody can contract TB. TB does not need to be only airway TB or lung TB. It can be TB of uh other tissues as well.

[00:25:35]Next please.

[00:25:38]Now usually uh there are some diseases uh which come along with stigma. For example HIV, for example mental diseases, for example uh depression, for example cancer and also for example tuberculosis. There lies usually a stigma for tuberculosis patients. But that stigma hurts. It does not support.

[00:26:04]It usually discriminate. So we have to uh achieve the goal of TB Muktarat. In that case we have to support and not discriminate. So understand that TB patient deserve dignity and respect.

[00:26:19]Avoid stigma and giving misinformation.

[00:26:22]If you do not have proper information, seek advice. Uh you can uh consult with HCSC doctors. They can give you proper information regarding tuberculosis. How does it spread? How can we take care of you ourselves? and how we can prevent it. Encourage testing and treatment. I have already told you the fact that early testing or early diagnosis leads to prevention of complications.

[00:26:47]Treatment in timely manner is really important to avoid the emergence of drugresistant TV.

[00:26:55]Family and community support is really really important. If a person does not have stigma regarding particular disease, they are likely to adhere to the regimen as it is long-lasting. If there is a support and uh if a person keeps asking them whether they have taken the treatment or not and uh if there is a person to inquire about it, it is highly likely that they will stick to that regimen and uh complete the TB treatment so they can have 100% or full recovery. Next then as symbian or as a ambassador of TB Muktarat or TB free India what can be your role of uh in this campaign. So first you have to take the nikshai pledge. Now kshai is the uh name of uh TB or tuberculosis in Sanskrit or Hindi language. So niksh means uh TV muk. So you have to take that pledge. Then second step which we can do is spread awareness. Whatever I'm telling you, you can go and tell that to your friends. You can spread this around in your family. You can spread this around in your society or any uh place where you frequently visit. So what does that or what will that do? That will create awareness. If anyone who has these kind of symptoms can come to health care uh system and if they do have tuberculosis then they can get diagnosed and even if one person gets diagnosed because of our TBM aban or due to your role in this aban then uh this is worthwhile doing. Next step which we can do is uh we can encourage early testing. What do we mean uh by that? If anybody has these symptoms, fever, night sweats, cough of more than two weeks, fatigue, unexplained weight loss, encourage them to get tested. The testing is also free in government uh institutes or government hospitals.

[00:29:12]Usually we tend to tell them to uh do a sputum test. Uh there are two sputum tests which you are encouraged to do. It has one has to be a morning sputum test.

[00:29:23]The next can be morning or spot sputum test. If that also comes negative then we tend to tell them to do a chest X-ray. Now this is early testing. This is only for screening. In this screening if a person gets uh tested positive for tuberculosis then we can tell them to get treated and that's how you uh you can play your role in TBFree India. Now the next step which you can take is promote treatment completion. I have already told you if you support the particular person who has TB it is likely that they will adhere to the treatment as it is longlasting and they can complete the treatment and can get 100% cure of tumor cross also. Always support people affected by TB. Avoid stigma. Avoid misinformation.

[00:30:13]If you support those uh cases or if you support those patients, it is likely that we can achieve this TB mu TB muktarat aban or goal of being TB free India. Next please uh as HC what do we do if you have these symptoms? So HC is present in all the campuses. So if you do have these symptoms which I've already enumerated, you contact HC immediately.

[00:30:43]If you do have uh any problem uh like fever, cough or unexplained weight loss, you can come to our doctors. Our doctor can recommend you to get tested. If you do come positive, we can initiate you in treatment. You can also visit your nearest healthcare facility. If you are on leave or if you are at home uh at break or on holiday, you can go to your nearest healthcare facility and get tested there. If your cuff persists for more than 2 weeks or more, you have to seek evaluation. You have to seek investigation. Do not self-medicate.

[00:31:21]Self-medication can give rise to more harm than good. So you have to make sure that you contact HCC, visit the nearest healthcare facility or seek any doctor's advice for investigation and evaluation.

[00:31:36]Next please.

[00:31:38]So uh I am going to uh enumerate this once again that TB can be 100% cured. It can be eliminated from your body if you complete the treatment. Uh you have to complete the treatment. No midway leaving the treatment is no way to go uh get earlier tested. If you see somebody who has these symptoms, ask them to get tested and that's how TB Harga and Dingga.

[00:32:07]>> Thank you Dr. Kulkarti for that highly informative and clinically ini insightful session. We deeply appreciate you sharing your time and expertise with us today. We will now open the floor to the audience for a brief Q&A session.

[00:32:24]Please step forward with your questions.

[00:32:34]So sir, the first question is can a person continue attending college or work while undergoing tuberclossis treatment?

[00:32:44]>> Okay. Uh so uh person can continue to attend college or work uh if their contigious period is over that is more than two weeks are done and after 2 weeks we usually tend to ask them to do a sputum smear test once again. If three samples are negative they can continue their work and their college as uh routine. But if uh they are still contagious that means that they have symptoms such as cold cuff then uh it is uh recommended that they should not be attending college or work during that time.

[00:33:21]>> The second question is what precautions should roommates or family members take if somebody is diagnosed with TB?

[00:33:29]>> Uh the precautions has to be taken like wearing a mask frequently washing your hands. uh also you have to make sure that uh you and the patient is taking proper nutrition properly hydrating and uh if they have TB of the second type that is uh extra pulmonary TB then they get uh whatever the symptoms are for example if it is TB of brain or TB of bones they are properly adhering to the treatment regimen.

[00:34:01]Uh on the similar lines the qu third question is are the symptoms of uh pulmonary tuberculosis and extra pulmonary tuberculosis the same? Uh no actually pulmonary tuberculosis presence as uh cuff uh unexplained weight loss uh and more of a respiratory symptoms such as there can be shortness of breath as well. There can be blood in sputum but if extra pulmonary tuberculos is there there uh what does that mean? uh any uh organ or any tissue other than lung then whichever tissue is involved the person will have a symptom of that particular organ system. For example, if they have tuberculosis of gut or abdomen then they can have uh digestion problems. They can have loose motions. If a person has t TB of brain they can have persistent headache. They can have phototohobia.

[00:34:54]They can have neck rigidity and unexplained fever. And usually weight loss is there in all the uh TB diseases may it be pulmonary or extra pulmonary.

[00:35:06]>> What lifestyle and dietary measures help a person recovered faster from TB?

[00:35:12]Uh basically uh ensuring that uh adequate proper or good nutrition protein rich nutrition with high fibers with ample amount of carbohydrates lesser amount of salt later a lesser amount of sodium more amount of potassium. Hydrating yourself in uh ensuring that there is adequate water intake is usually a way to go from recovering quickly or recovering easily from the tuberculosis infection. It does not make sure that TB will go away without treatment but it will be adjun to the treatment if you do follow all of these symptoms all of these things.

[00:35:55]>> All right. So uh someone has asked the question is extra pulmonary tuberculosis more contagious.

[00:36:02]>> No uh extra pulmonary tuberculosis usually not contagious because only way of transmission of tuberculosis is air.

[00:36:10]So droplet method which is tuberculosis of chest is usually a way of transmission of the disease. Extra pulmonary tuberculosis what does that mean? The particular person has contracted tuberculosis but the infection has gone out from the lungs to another tissues. It can infect any of the tissues but there is no chance of that tissue to spread around the disease in any way but a person can have gut tuberculosis and can spread by fal oral root but it is very rare.

[00:36:45]>> Okay. Uh so does tuberculosis infection remain in the body even after it after it's cured?

[00:36:52]Tuberculosis infection remains in body in dormant method if uh dormant way if uh patient has not completed uh the total course of the tuberculosis treatment but if they have cured of it of they have completed the course there is a chance that they will not have tuberculosis again but I will not give 100% guarantee the two ways person can have tuberculosis again is infection that means I've already told you there is a 25% uh global burden of tuberculosis is there in India so TB is endemic in India so person can get reinfected by tuberculosis the person who has already undergone complete treatment of tuberculosis can get reinfected by tuberculosis and there also can be relapse if they stop the treatment midway or they uh do not complete it whatever Whatever was duration was suggested by the doctor they do not complete it or they do not complete the regimen then it can remain in the body uh in dormant method.

[00:38:02]>> Right? The next uh question is where can we get treatment for TB? Is it in all hospitals or is it only in government hospitals?

[00:38:11]>> No, we can take treatment in all hospitals but uh government hospitals usually provide treatment for free. If you go to corporate hospitals or private hospitals, the chances are there that the treatment will not be free for you.

[00:38:24]If you want a free treatment, you can always go to government institutes and government hospitals. Of course, you can have paid tablets or paid treatment also and for that purpose, you can go to any hospital, but government go gives you for free.

[00:38:39]>> The next question is, are there any food restrictions?

[00:38:43]uh food restrictions. Whatever we tell to any infected patients in any disease, do not consume high calorie or calorie rich food. Spicy, oily should not be taken. Smoking has to be avoided or quit permanently. Alcohol intake should not be done. Uh it should it should not be fried food. Preferred domestic or home-cooked food which is nutritious.

[00:39:09]All of those simp all of those things can be followed along with adequate water intake or hydration.

[00:39:17]>> Are there any restrictions to exercise?

[00:39:20]>> Uh initially when person is contagious we should not be advising the patient to do any exercise when they are in isolation. If a person has pulmonary tuberculosis immediately they should not go to any intense exercises for at least 4 months. They should avoid intense exercises but do not stop with exercise totally. The lung exercises or the spyometry or the physiootherapy of chest has to go on. In that way we can make sure that your lungs are are in proper condition and remain in proper condition throughout your treatment.

[00:39:56]>> All right.

[00:39:58]Uh thank you all for an engaging discussion. Please look at this screen and scan the QR code. This final evaluation is vital for us to measure the session's impact and educational outcomes. We will pause for 5 minutes for you to complete it.

[00:45:24]Thank you everyone. Before we conclude, for anyone who wishes to review today's material or for those who could not join the live broadcast, the full recording will be uploaded to the learning management system LMS. It will remain accessible on the portal until 30th of July 2026.

[00:45:43]As we conclude, let us carry forward the national resolve that drives this mission. TVA, thank you once again for your active participation in the Symbiasis Health Promotive Initiative and for your unwavering commitment to a TV muktarat.

[00:46:00]Thank you SS Odial for all your help.

[00:46:02]Have a wonderful day.