A family member is the best person to administer DOTS: Dr NS Dharmshaktu
Dr NS Dharmshaktu, special director general, ministry of health and family welfare speaks to dna's Disha Shetty about the role of AYUSH practitioners in TB treatment and dealing with the stigma attached to the disease
What role do you see AYUSH practitioners playing in the fight against TB?
If a patient has faith in AYUSH (ayurveda, yoga, naturopathy, unani, siddha and homoeopathy), he will go to that practitioner. S/he might be able to provide symptomatic treatment. Many AYUSH practitioners are also administering DOTS (Directly Observed Treatment, Short-Course) treatment for TB. They should not prescribe anything that is not prescribed as part of the National TB programme. Even Asha worker, when trained, can administer DOTS.
How can we deal with the stigma attached to TB?
The stigma can be reduced by providing support to the family. Three or four people can be selected from the village who can support those suffering from TB and raise their voice against discrimination in schools or workplaces. Because adherence to treatment is important, the DOTS provider needs to be close to the family as it will help motivate the patient to continue treatment. We have to demonstrate that TB is curable. Many of those living in villages have not seen it happening, so they have a deep-rooted fear that TB will destroy their families.
With respect to MDR-TB (Multi-Drug Resistant TB) do we need to change our strategy?
No, our strategy is very good. We have introduced modern diagnostic procedures in every district. We can provide more counselling and support to the families. Many patients turn to private practitioners, who are not prescribing the standard course. So the one receiving wrong treatment then becomes resistant. All the practitioners will have to be involved and oriented about the right kind of treatment. Unfortunately, a lot of quacks are functioning in the rural areas.
Can an incentive-based model encourage patients to stick to the treatment?
Family support is a good incentive. This is why the best DOTS administrator is a family member. This will also help in dealing with the risk of stigma.