A number of factors - cultural, social, political, economic and technical - have determined the nature of society's response to TB.
It has been shown that most of the infectious TB cases in a rural community in south India are at least conscious of the symptoms of the disease; about three-fourths of them are worried about their sickness; and, about half of them actively seek treatment for their symptoms at rural medical hospital. The existing facilities deal with only a very small fraction of even these patients who are actively seeking treatment. The various study report carried out in India has shown increase in TB and MDR-TB .
India‘s NTP has been designed to mobilize the existing resources in order to offer suitable diagnostic and treatment services for TB patients .India’s health administration department has initialized RNTCP program for suitable administration and organizational reorientation to control TB in India .
- Drugs are made with European / American population in mind, not suitable for sub – continent
All drugs for treatment of TB have been made, taking Europe –American population in mind .Currently there are 10 drugs approved by the United States Food and Drug Administration (FDA) for treating tuberculosis .Although the many (geographical) factors differ in these two region, the same drugs are used for treatment of TB in the Indian sub-continent.
- Similar situation in Africa
India is classified along with the sub-Saharan African countries to be among those with a high burden of TB and the least prospects of a favorable time trend of the disease as of now .Many countries of Africa like India have shown a high increasing morbidity and mortality from human immuno-deficiency virus (HIV) thus tuberculosis (TB) .The similar situation of Africa and India is mainly due to its undeveloped sector.
- Economical status
In India there is a need to re-assess the role of generally identifiable risk factors such as old age, poverty and poor socio-economic status, for development of tuberculosis . In the present study, the multivariate analysis showed an association of TB with overcrowding, poorer housing, lesser education and lower number of consumer articles. The increasing economy of India shows a good impact on the economical status of TB.
- Traditional methods used
Their were no any evidence for the traditional treatment of lung disease like TB in India . But Indian Ayurveda is helping a lot for developing new drugs. In the second half of the 19th century, a new movement for the treatment of tuberculosis came into existence and new drugs were discovered. Presently India is following the same chemotherapeutic method for TB treatment.
- Awareness in Indian population about method of treatment
The awareness of tuberculosis in India is centered on the extent of people’s knowledge regarding the most important facts about the disease .Most people are either ignorant or not fully knowledgeable about the disease, especially in developing countries like India where literacy is low. But some study cases have shown that knowledge among the people about main features of tuberculosis was reasonably high; certainly higher than what was believed. But awareness about the causes and prevention of the disease is still required to a large extent in the country to reduce its severity.
- MDR in India & abroad
During the last four decades, the drug resistance in tuberculosis has been reported frequently in India, but the available information from India is localized to a particular region or is inaccurate or incomplete. The drug resistance patterns vary widely across different parts of the India . Clinical data reported from India and abroad shows there is increase of MDR –TB in India.
- Localized to Pune
Today, Pune is one of the fast urbanizing districts in Maharashtra . The Pune city TB control programme was implemented in1962 on the lines of the National Tuberculosis. RNTCP implementation in Pune city is more progressive compared to other states in India . Various research work has been done in the past, on TB and MDR-TB in Pune. The case detection has been always shown a little less than the expected Drug resistance pattern of Mycobacterium tuberculosis.