Latest news with #BharatiVidyapeethMedicalCollege
Hindustan Times
24-06-2025
- Health
- Hindustan Times
Harnessing India's medical colleges in the fight against TB
India has made undeniable progress in its battle against tuberculosis (TB). The World Health Organization (WHO) acknowledged a 17.7% drop in TB incidence in the country from 237 to 195 per lakh population between 2015 and 2023 – double the pace observed globally. Despite these advancements, India continues to bear the highest TB burden globally1, making the goal of a TB-free India even more urgent. Against this backdrop, medical colleges have emerged as vital players in the national TB response - providing a template for other disease programmes to tap into their potential for a healthier India. TB (AFP) Harnessing India's vast network of medical colleges is a cornerstone of the nation's ambitious strategy to eliminate TB by 2025. These institutions have transitioned from peripheral actors to central pillars in the fight against TB, contributing significantly to nearly every facet of the National Tuberculosis Elimination Programme (NTEP). Medical colleges have evolved beyond tertiary referral centres to become critical nodes in India's public health infrastructure and the TB elimination response. They serve patients from both within and beyond their districts and states, offering significant potential for case detection not just in TB and respiratory departments, but across all specialties. Equipped with advanced laboratories and specialised centres, nearly all of India's 651 medical colleges are working closely with the NTEP. Notably, 336 medical colleges have centres dedicated to managing drug-resistant TB, a more complex and harder-to-treat form of the disease. With cutting-edge diagnostic tools and clinical expertise in handling health complications, these institutions are leading to better TB care and outcomes. In 2023, medical colleges notified nearly 14% of all TB cases in India – a clear sign of their growing role in this national effort. Medical colleges are playing an increasingly important role in responding to the emerging trends in the TB epidemic. Extra-pulmonary forms of the disease that occur outside the lungs are on the rise and are generally harder to detect and treat. It now makes up 20-24% of all TB cases in India, especially among people with weaker immunity. With their advanced labs, specialist departments, and tertiary care capacity, medical colleges are uniquely positioned to deliver the multi-disciplinary care required to detect and manage these harder-to-treat cases. Medical colleges are also well placed to design and implement innovative health solutions, with research and practice occurring side by side. For example, the Bharati Vidyapeeth Medical College in Pune repurposed its Family Adoption Programme – where each student engages with five families over three years – to integrate community-based TB screening into the existing medical curriculum. This not only helped detect cases in the community, but also taught students to recognise key TB symptoms, demonstrating a scalable model for active case finding. One of our standout achievements has been fostering global collaborations. The ongoing partnership between AIIMS Gorakhpur and Johns Hopkins University through the TB-Free Schools initiative aimed at early detection, treatment, and prevention of TB among students in residential schools, demonstrates how Indian medical colleges can drive impactful international engagement. As this model is scaled, it reinforces what we have long championed—that medical colleges, when systematically integrated with state health systems, are among the most cost-effective and scalable platforms for delivering high-impact TB interventions. By leveraging these institutions, we can enhance passive case finding, improve diagnosis, and ensure timely treatment. With a structured mechanism for accountability under NTEP, medical colleges can become hubs for TB management. Furthermore, they are instrumental in building a competent healthcare workforce by integrating practical, programme-oriented TB management skills into the medical curriculum, thereby preparing a new generation of doctors for the challenges of TB elimination. Through a structured framework of national, zonal, and state-level task forces, medical colleges contribute to operational research, generating vital evidence to refine public health strategies and improve patient outcomes. By embedding themselves within the community through initiatives like the Family Adoption Programme, they also bolster active case finding efforts, ensuring early diagnosis and treatment, thus playing an indispensable and multifaceted role in India's journey towards a TB-free future. For TB and other critical public health challenges, where understanding patient behavior, treatment barriers, and local epidemiology is critical, the ability of medical colleges to connect science with ground-level implementation is key to turning policy into real-world action. They have technical expertise to strengthen surveillance systems, research capacity to strengthen monitoring and evaluation, and educational mandate to build local capability through supportive supervision. The integration of medical colleges into the TB elimination framework has been one of the most strategic shifts under the NTEP. Medical colleges have redefined their role in public health, not only by contributing to TB management, but by setting a precedent for how academic institutions can anchor systemic change. Their success is not incidental; it is the result of sustained collaboration, institutional commitment, and a shared vision of making India TB-free. Importantly, the integration of medical colleges into the TB response offers a replicable framework for tackling other complex health challenges in India – such as anti-microbial resistance, non-communicable diseases, and neglected tropical diseases – through a blend of research, education, service delivery, and community engagement. This article is authored by Dr Ashok Bhardwaj, professor emeritus, MM Medical & Hospital College Solan, Himachal Pradesh and chairperson of the National Task Force for Medical Colleges under NTEP and Dr Bhupendra Tripathi, deputy director, Infectious Diseases and Vaccine Delivery, Gates Foundation, India.
The Hindu
02-06-2025
- Health
- The Hindu
Small change in MBBS education curriculum can make substantial impact on early detection of TB: study
Tuberculosis (TB) remains one of India's most significant public health challenges, with the country accounting for nearly a quarter of the global TB burden. Despite a robust national programme and the availability of free diagnostic and treatment services under the National Tuberculosis Elimination Programme (NTEP), early detection of the disease continues to fall short. Many individuals with symptoms of TB go undiagnosed for weeks or even months, contributing to continued transmission within communities as well suffering avoidable health complications. The delays in diagnosis are often attributed not just to gaps in health infrastructure but also to a lack of early suspicion at the primary point of care. Patients commonly approach local healthcare providers with symptoms like persistent cough, weight loss, fever, or night sweats. However, these symptoms are frequently misattributed to other conditions or treated symptomatically, without considering TB as a possible cause. This widespread failure to 'suspect TB' -- a critical first step -- has been repeatedly identified as a major reason for missed cases. It is in this context that a community-based screening model was introduced at Bharati Vidyapeeth Medical College in Pune. The goal was to find a sustainable, scalable way to improve TB case detection while simultaneously integrating public health practice into the medical curriculum. The innovation came through the Family Adoption Programme (FAP), a nationwide initiative mandated by the National Medical Commission, which assigns medical students to specific rural or urban communities for continuous engagement throughout their training. The study learnings from integrating TB screening activity into FAP for MBBS students was published in Frontiers in Public Health. The first point of contact and active case finding Swathi Krishna, TB researcher and public health physician based in Pune and key faculty member behind the programme's implementation, explains the rationale, 'In our healthcare system, the first point of contact is often a missed opportunity. Students are the future of that system, so we need to train them not just in hospital-based care but in recognising the realities at the ground level.' Under this initiative, MBBS students visiting households began asking just four simple symptom-based questions related to TB. If any symptom was reported, the case was flagged and referred to the local ASHA (Accredited Social Health Activist) for follow-up and testing. This low-cost, high-reach strategy is referred to as 'active case finding', a method endorsed by the World Health Organization (WHO) and the NTEP, but rarely operationalised at scale in routine community interactions. The results were encouraging: not only did the students identify presumptive TB cases, but they also became more confident in recognising its early signs and engaging with communities on sensitive health issues. The involvement of ASHA workers was crucial. According to Dr. Swathi, 'ASHA workers are already doing so much. When students collect these symptom reports during household visits, it lightens the ASHA worker's load and makes their follow-up more targeted.' In effect, the programme bridged the gap between community-based medical education and primary care outreach, enhancing both the learning experience of students and the reach of public health services. Breaking stigma barriers through continuos awareness Sanjivani Patil, associate professor in the Department of Community Medicine, adds that the model is particularly powerful because of its continuity. 'Unlike a one-off camp, the FAP ensures that students are visiting the same families regularly over three years. This builds rapport. Initially, people are hesitant to talk about TB symptoms because of stigma or fear. But with time, they open up. They trust the students.' Stigma remains a formidable barrier. In many communities, TB is still viewed with fear and shame, leading patients to conceal symptoms or delay care. Awareness about the Nikshay Poshan Yojana—a scheme under the NTEP that provides free treatment, nutritional support, and diagnostics—is also limited. But the presence of students, guided by faculty mentors and supported by local health workers, gradually breaks down these barriers. Community engagement activities such as street plays, awareness rallies, and health talks further reinforce positive messaging and reduce misinformation. From an educational standpoint, the intervention fits seamlessly into the competency-based medical education (CBME) framework. Students are trained to communicate effectively, collect and analyse health data, and understand the social determinants of disease. Their work is assessed through logbooks and field reports, ensuring accountability. As Dr. Patil observes, 'This experience gives students a reality check. In hospitals, they see rare diseases. But in the field, it's about cough, fever, diarrhoea, and skin issues. These are the cases they will encounter as primary care physicians. They learn to think beyond the textbook.' Possibilities of expansion, challenges and further research The programme's design also allows for replication. Every medical college implementing FAP can adapt this TB symptom screening model. Each batch of MBBS students is assigned around 800 households, translating into a wide population base being covered. Urban settings are not excluded -- Urban Health Training Centres (UHTCs) affiliated with medical colleges can deploy the same approach in underserved city neighborhoods, slum areas, or industrial zones. Saibal Adhya, another senior faculty member at the college and co-author of the study, highlights the policy implications. While India's TB programme is well-resourced, he points out that treatment and testing still need to be more accessible at the grassroots level. 'Even though the services are free, the unavailability of drugs or closed diagnostic labs leads people to spend from their own pockets. That's where trust in the system erodes,' he says. He also recommends that regular faculty development sessions and workshops on NTEP guidelines be institutionalised across all medical colleges. 'You cannot expect students to be champions unless their teachers are aligned with national health priorities,' he says. Authors also point out the importance of such TB screening initiatives, as a modest change in routine educational practice can make a substantial impact on both medical training and public health outcomes. Dr Swati says, 'It reinforces the idea that meaningful change does not always require massive infrastructure or funding. Sometimes, it just takes the right questions asked at the right time by the right people.'
Time of India
18-05-2025
- Health
- Time of India
Bone marrow transplant changes two-year-old bedridden Adhiraj's life
MUMBAI: There's a reason two-year-old Adhiraj Gaikwad 's parents admitted him to a hospital in Mumbai for diarrhoea rather than a facility closer to home near Swargate in Pune. For one, Adhiraj was born with not one but two rare genetic disorders . Additionally, he underwent a bone marrow transplant to cure one of the conditions at this city hospital five months ago. On Friday, doctors at Kokilaben Ambani Hospital in Andheri said he is improving and should be discharged soon. 'As the transplant is quite recent, we have to get him here for regular checks and in case of any infection,' said his 34-year-old father, Mayur, who left his job as a marketing executive to gather funds for Adhiraj's treatment. The bone marrow transplant (BMT) cured him of one of the rare conditions called Mucopolysaccharidosis Type 1 (MPS 1), also known as Hurler syndrome or gargoylism, which affects only 10 in a million children. However, Adhiraj continues to suffer from Fanconi-Bickel Syndrome , a rare glycogen storage disease in which the body is unable to process glucose and galactose. It has no cure, and the patient can only eat a corn starch-based diet for life. by Taboola by Taboola Sponsored Links Sponsored Links Promoted Links Promoted Links You May Like Want Lower Bills Without Changing a Thing? elecTrick - Save upto 80% on Power Bill Learn More Undo Adhiraj, who was born 28 months ago, missed developmental milestones in the first six months. 'He wouldn't roll over like other children do and seemed grossly underweight,' said his father. After visiting multiple doctors, his parents were advised by doctors at Bharati Vidyapeeth Medical College in Pune to conduct genetic tests that revealed MPS1 and Fanconi-Bickel Syndrome. Due to these conditions, the child was non-verbal, had bodily and facial deformities, along with impairment of vision and mobility, said the doctors. MPS1 was previously referred to as "gargoylism" as the children had certain facial features such as a prominent forehead, widely spaced eyes, a prominent nose, and a short neck that led to the association with mythical gargoyles. Through online support groups, the Gaikwads first went to KEM Hospital in Parel, which is a designated Centre of Excellence (CoE) for rare diseases by the union health ministry. The hospital provided the special enzyme shots for a few months but recommended a bone marrow transplant for Adhiraj. MPS1, a lysosomal storage disorder in which an essential enzyme called hyaluronidase is not produced in the body, has a low incidence of one in 100,000 live births. 'India possibly has 200 children born with this disease,' said KDAH's paediatric oncologist Dr Santanu Sen, who treated Adhiraj. Most children with MPS1 never get diagnosed. Soon after birth, they develop coarse facial features, their development gets impaired, their intelligence gets compromised, and organs such as the liver and spleen become big and their joints get stiff. 'They often suffer from infections and could get cataracts and heart problems,' said Dr Sen, adding that the children rarely survive beyond eight years. The enzyme replacement treatment that KEM offered for free to Adhiraj costs between Rs 2.2 lakh to Rs 2.5 lakh per vial. A child needs two vials per week, with the monthly treatment costing around Rs 18 lakh. 'Hence, BMTs are a good option for children with MPS1. But, worldwide, less than 100 BMTs have been for this disease,' said Dr Sen. Before Adhiraj returned to Mumbai with his current diarrhoea problem, the Gaikwads had begun noticing changes in his health. 'It's like a switch in the brain has been turned on, and suddenly the withdrawn child who wasn't moving much has changed,' said the doctor. Mayur said his son was 7.5 kg at 22 months when he underwent the BMT. 'He has put on weight, and we have been noticing a lot of change in him. He is now able to sit with support. He smiles, laughs, and interacts a lot more than before,' he added. The family has already spent lakhs on his treatment so far. 'While the social workers at KDAH helped us generate funds for the transplant, we will need finances for his rehabilitation and management of the Fanconi-Bickel Syndrome,' he added.
