‘Target is to stop spread': Screening camps at Delhi's urban slums strengthen fight against TB

Indian Express

5 days ago

Sheela Devi (48), a resident of Indira Kalyan Vihar, a jhuggi jhopri cluster in Southeast Delhi's Okhla Industrial Area Phase-1, stepped out to buy vegetables when Subhash, the village head or pradhan as they call him, asked her to visit the TB screening camp operating from his office. The screening was long overdue, she thought to herself.
She has been suffering from fever for the last few months and coughs excessively. 'There is a persistent cough and fever which doesn't fade away,' she added. Her X-ray showed abnormalities and cavities in her lungs. 'Now, we will send her to the Nehru Nagar centre where her sputum samples will be collected for further evaluation,' explained District TB officer Dr Umesh Kumar.
The village head has lent his office space for a screening camp under the Delhi government's TB programme for free for a month.
A team of doctors, under the National TB Elimination Programme (NTEP), are screening patients with the help of a handheld X-Ray machine and AI software, which identifies abnormalities in the lungs and is said to have minimal radiation exposure.
According to the 2019-2021 National TB Prevalence Survey, Delhi was identified as having the highest TB prevalence in India, with 747 cases per lakh population.
Under the NTEP, Delhi has been conducting screening drives in urban slums and has started the first phase of the programme targeting six high-burden areas — Nehru Nagar, Narela, Karawal Nagar, Moti Nagar, Babu Jagjivan Ram Memorial Hospital's chest clinic and Shastri Nagar.
In Nehru Nagar, five areas have been targeted — Indira Kalyan Vihar, Jaitpur, Pul Prahladpur, Nizamuddin and Batla House.
To drive engagement, doctors and volunteers also conduct door-to-door drives, and announcements are made on loudspeakers as well.
Five X-ray machines have been set up in each camp in the slums of South Delhi. 'The programme has been functioning since last December, and we started again in June this year. Our target is to stop the spread of TB, and we need to do catchment at the mass level. Except pregnant women and children below 15 years, everyone else is being screened,' Dr Umesh explained. Since June, more than 10,000 people have been screened, and around 40 people have been identified as TB affected at such camps across the city, said sources.
Along with the mass-level screening, these camps provide prevention therapy to people who are at high risk — they collect the medicines from the nearby DOT centre, a healthcare facility focused on tuberculosis.
'Before prescribing medicines under TB prevention therapy, we confirm about latent TB infection by the Cy-Tb test, a modern skin test for detecting Mycobacterium tuberculosis infection, a bacterium that causes tuberculosis. If it is positive in TB contact persons, we give them the preventive therapy,' underlined Dr Umesh Kumar.
For this, the doctors deployed are particularly targeting the high-risk group, which includes patients with diabetes, those with alcohol or cigarette addiction, those who are not gaining weight and those who are living in families where someone had TB in the last five years. The camp at Indira Kalyan Vihar Jhuggi has been conducting 150-200 X-rays daily at the centre. Even as 5-10% of X-rays highlight abnormalities on average every day, not all of these patients test positive for TB.
'The X-rays highlight if there is fluid in the lungs, signs of pneumonia, old or new pneumonia and cavities in the lungs. If these abnormalities are found, we send the patient for further tests,' said Dr Umesh.
With the X-ray machines, screening takes just 5-10 minutes, and the visitors can get details added to the system, which is convenient for many. One doctor, one technician and one patient mobiliser and a volunteer for registration of people have been deployed at each camp.
Meanwhile, more women than men are visiting the camp at Indira Kalyan Vihar, according to the team. 'This may be because most of the women are at home, and the men of the house go to work. Which is why we are taking this till 4 pm to target the men as well,' said Himansh Parewa, junior field officer who has been mobilising people from the jhuggi cluster.
'We mobilise the community with the help of ANM and ASHA workers and TB health workers from the Dot centres,' he added.
However, this does not mean more women are testing positive. 'Diabetics, malnourished smokers, those with a family history of TB have the highest prevalence, along with those who are living in poorly ventilated areas, which makes slum areas more at risk,' explained Dr Umesh.
A majority of men in the area, according to Himansh, are factory workers who have to leave for work early morning, due to which it remains a challenge to screen them.