Lok Sabha Question No. 3356 (UNSTARRED), answered on 2015-12-18
Subject: Tuberculosis among Women
Ministry: HEALTH AND FAMILY WELFARE
Asked by: KALIKESH NARAYAN SINGH DEO, KIRTI (JHA) AZAD, PONNUSAMY VENUGOPAL

## GOVERNMENT OF INDIA MINISTRY OF HEALTH AND FAMILY WELFARE DEPARTMENT OF HEALTH AND FAMILY WELFARE

## LOK SABHA UNSTARRED QUESTION NO. 3356 TO BE ANSWERED ON 18 TH DECEMBER, 2015

## TUBERCULOSIS AMONG W OMEN

## 3356. SHRI KALIKESH N. SINGH DEO: SHRI KIRTI AZAD:

DR. P. VENUGOPAL:

Will the Minister of HEALTH ANDFAMILY WELFARE be pleased to state:

- (a) the present status of the National Anti - Tuberculosis Drug Resistance Survey along with the findings thereof, State/UTwise;
- (b) whether the Government has collected the data regarding the number of women suffering from tuberculosis (TB) including genital tuberculosis in the country, if so, the details thereof and if not, the reasons therefor, State/UT - wise;
- (c) the steps taken/proposed to be taken by the Government t o remove reported disparity in the reporting and treatment of women diagnosed with TB and social stigma attached to it;
- (d) the funds allocated and utilized for the aforesaid purpose during each of the last three years and the current year, State/ UT - wise ; and
- (e)  the  fresh  measures  being  taken  by the  Government  for  prevention  and  control of tuberculosis (TB) including genital tuberculosis among the women in the country?

## ANSWER

## THE MINISTER OF HEALTH AND FAMILY WELFARE (SHRI JAGAT PRAKASH NADDA)

- (a): The  Revised  National  Tuberculosis  control  programme  (RNTCP)  has  initiated  a National  Anti - Tuberculosis  Drug  Resistance  Survey  in  a  representative  sample  of  5280 patients from 120 Tuberculosis Units. As on date 5247 patients have been registered o which 3238 are new cases and 2009 are previously treated cases, 112 of the 120 Tubercu Units have completed the intake.

At this stage of the survey it is not possible to give the findings.

(b)&(c): While RNTCP collects data on women suffering from Tuberc ulosis, however, in the present compiling system segregated data on the site of disease is not captured Tuberculosis in females is included in the count of Extra Pulmonary TB.

The details regarding TB and Extra Pulmonary Tuberculosis among women, State/UT wise for the last 3 years are at Annexure - I & II .

No disparity in the reporting and treatment of women diagnosed with TB has bee reported to RNTCP through the health system. Also, there has been no  finding in this regard reported by the previous Joint Monitoring Missions or any other expert group in their of the RNTCP.

The health communication strategies in RNTCP focus on early diagnosis, treatmen prevention, and social aspects of Tuberculosis whi ch also caters to stigma associated with the disease.

(d): The funds are released to the States for implementation of the RNTCP which inclu diagnosis and treatment of tuberculosis in women and for related health communication.

The  funds  released  and  ut ilized  for  States/UTs  during  the  last  three  years  and  th current year is at Annexure - III .

(e):  The  Government  has,  inter - alia,  taken  following  action  under  Revised  National Tuberculosis Control Programme (RNTCP) during the 12th Five Year Plan:

- RNTCP is being supported under the National Health Mission.
- Maintaining a network of more than 13,000 Designated Microscopy Centers and more than 4,00,000 DOTS Centers.
- Alignment  of  Tuberculosis  Units  with  Block  Programme  Management  Units  under National Health M ission (NHM).
- Diagnosis of Drug Resistant TB undertaken at 64 Culture & drug susceptibility tes (CDST) laboratories, of which 51 laboratories are also equipped with rapid molec test.  Additionally,  Cartridge  Based  Nucleic  Acid  Amplification  (CBNAAT )  Test Machines have been installed at 121 sites for early detection of Rifampicin resi among TB cases.
- Under RNTCP the treatment of drug sensitive and drug resistant TB cases is bei provided free of cost.
- To generate awareness and demand amongst the community, audio visual campaigns and other advocacy communication and social mobilization activities, are undertak

Total number of Females patients among New Sputum Positive, New Sputum Negative, New Others and Relapse reported under RNTCP

| State                |   2012 |   2013 |   2014 |
|----------------------|--------|--------|--------|
| Andaman & Nicobar    |    299 |    292 |    276 |
| Andhra Pradesh       |  31329 |  29603 |  30361 |
| Arunachal Pradesh    |    820 |    904 |    978 |
| Assam                |  10195 |  10182 |  11074 |
| Bihar                |  21908 |  19105 |  19377 |
| Chandigarh           |   1087 |   1118 |   1137 |
| Chhattisgarh         |   8212 |   7434 |   8720 |
| Dadar & Nagar Haveli |    101 |    125 |    124 |
| Daman & Diu          |     76 |    260 |     93 |
| Delhi                |  20720 |  20212 |  21462 |
| Goa                  |    645 |    620 |    564 |
| Gujarat              |  19669 |  19769 |  21560 |
| Haryana              |  11016 |  11388 |  12133 |
| Himachal Pradesh     |   4520 |   4578 |   4856 |
| Jammu & Kashmir      |   4983 |   4395 |   3951 |
| Jharkhand            |  10052 |   9481 |   9666 |
| Karnataka            |  20727 |  18562 |  18514 |
| Kerala               |   7433 |   6820 |   6702 |
| Lakshadweep          |      7 |     10 |     12 |
| Madhya Pradesh       |  27440 |  28104 |  31802 |
| Maharashtra          |  44612 |  45595 |  45512 |
| Manipur              |    844 |    702 |    641 |
| Meghalaya            |   1810 |   1775 |   1713 |
| Mizoram              |    867 |    768 |    728 |
| Nagaland             |   1181 |   1193 |   1156 |
| Orissa               |  14720 |  13357 |  13418 |
| Pondicherry          |    404 |    398 |    434 |
| Punjab               |  13759 |  12878 |  13442 |
| Rajasthan            |  28223 |  26066 |  26098 |
| Sikkim               |    678 |    630 |    613 |
| Tamil Nadu           |  22147 |  21834 |  22679 |
| Tripura              |    631 |    599 |    576 |
| Uttar Pradesh        |  92004 |  84976 |  85214 |
| Uttarakhand          |   4898 |   4291 |   4837 |
| West Bengal          |  25828 |  24630 |  24993 |

The above data includes the EPTB cases in females

## Revised National Tuberculosis Control Programme State/UT wise Extra Pulmonary TB Cases in Females

| State/Year          |   2012 |   2013 |   2014 |
|---------------------|--------|--------|--------|
| Andaman             |     90 |    102 |     93 |
| Andhra Pradesh      |   6916 |   6648 |   7096 |
| Arunachal Pradesh   |    252 |    277 |    316 |
| Assam               |   2173 |   2343 |   2473 |
| Bihar               |   2185 |   1626 |   1894 |
| Chandigarh          |    507 |    499 |    524 |
| Chhattisgarh        |   1735 |   1397 |   1651 |
| Dadar &Nagar Haveli |     21 |     52 |     49 |
| Daman &Diu          |     22 |    110 |     17 |
| Delhi               |   9716 |   9736 |  10479 |
| Goa                 |    263 |    248 |    237 |
| Gujarat             |   4569 |   4624 |   4937 |
| Haryana             |   3530 |   3476 |   3815 |
| Himachal Pradesh    |   1572 |   1640 |   1710 |
| Jammu &Kashmir      |   1348 |   1241 |   1212 |
| Jharkhand           |   1246 |   1030 |   1120 |
| Karnataka           |   5586 |   5427 |   5363 |
| Kerala              |   2912 |   2867 |   2979 |
| Lakshadweep         |      2 |      5 |      2 |
| Madhya Pradesh      |   5479 |   6127 |   7074 |
| Maharashtra         |  12854 |  12933 |  14098 |
| Manipur             |    277 |    266 |    203 |
| Meghalaya           |    749 |    749 |    738 |
| Mizoram             |    375 |    394 |    369 |
| Nagaland            |    360 |    356 |    354 |
| Orissa              |   4155 |   3910 |   3978 |
| Pondicherry         |    188 |    190 |    201 |
| Punjab              |   4192 |   3707 |   3796 |
| Rajasthan           |   6891 |   6434 |   6455 |
| Sikkim              |    264 |    230 |    206 |
| Tamil Nadu          |   6873 |   7011 |   7304 |
| Tripura             |    178 |    150 |    153 |
| Uttar Pradesh       |  17477 |  15786 |  16407 |
| Uttarakhand         |   1490 |   1297 |   1349 |
| West Bengal         |   7826 |   7363 |   7648 |

## Revised National TB Control Programme State wise Releases & Expenditure (Cash)

## ANNEXURE-III

(Rs. in lakhs)

| Sl.No.   | Name of the State / UT   | 2012-13   | 2012-13     | 2013-14   | 2013-14     | 2014-15   | 2014-15        | 2015-16                    | 2015-16     |
|----------|--------------------------|-----------|-------------|-----------|-------------|-----------|----------------|----------------------------|-------------|
| Sl.No.   | Name of the State / UT   | Releases  | Expenditure | Releases  | Expenditure | Releases  | Expenditure    | Releases (upto 11.12.2015) | Expenditure |
| 1        | Andhra Pradesh           | 1612.50   | 1883.80     | 1782.22   | 1620.70     | 1195.55   | 1092.37        | 1363.41                    | 759.99      |
| 2        | Andaman & Nicobar        | 33.70     | 40.38       | 73.08     | 57.34       | 59.37     | 77.91          | 65.52                      | 48.87       |
| 3        | Arunachal Pradesh        | 387.40    | 362.33      | 408.57    | 441.23      | 364.51    | 367.95         | 371.53                     | 139.04      |
| 4        | Assam                    | 871.95    | 876.50      | 1170.40   | 1140.93     | 1796.01   | 845.25         | 1020.32                    | 584.27      |
| 5        | Bihar                    | 1722.51   | 1511.81     | 890.04    | 1605.98     | 1269.60   | 1769.56        | 2126.81                    | *           |
| 6        | Chandigarh               | 71.97     | 72.12       | 113.02    | 123.52      | 151.66    | 100.65         | 109.61                     | 77.8        |
| 7        | Chattisgarh              | 317.34    | 1069.14     | 788.18    | 1059.49     | 1321.91   | 208.23         | 0.00                       | *           |
| 8        | D & N Haveli             | 35.86     | 32.49       | 51.24     | 47.39       | 43.26     | 49.39          | 51.45                      | 27.07       |
| 9        | Daman & Diu              | 8.45      | 17.98       | 24.80     | 19.58       | 11.70     | 20.85          | 32.66                      | 11.5        |
| 10       | Delhi                    | 619.10    | 1084.46     | 1049.23   | 947.88      | 1338.87   | 844.75         | 1196.54                    | 630.89      |
| 11       | Goa                      | 43.19     | 70.59       | 91.74     | 107.48      | 90.19     | 60.37          | 58.25                      | 45.97       |
| 12       | Gujarat                  | 1583.98   | 1902.32     | 1890.13   | 2262.15     | 1826.61   | 2901.59        | 1665.80                    | 1527.72     |
| 13       | Haryana                  | 755.59    | 599.70      | 451.61    | 643.73      | 545.90    | 839.73         | 755.45                     | 352.15      |
| 14       | Himachal Pradesh         | 259.71    | 399.57      | 421.06    | 405.03      | 603.31    | 299.02         | 438.09                     | 233.05      |
| 15       | Jammu & Kashmir          | 359.51    | 452.09      | 591.32    | 556.11      | 573.00    | 404.48         | 703.91                     | 144.9       |
| 16       | Jharkhand                | 743.73    | 817.83      | 886.63    | 784.94      | 424.00    | 1152.75        | 1087.07                    | 331.76      |
| 17       | Karnataka                | 846.68    | 1738.52     | 1695.53   | 2028.04     | 1943.99   | 1543.06        | 1303.43                    | 1071.31     |
| 18       | Kerala                   | 536.77    | 745.65      | 996.98    | 811.18      | 814.55    | 821.56         | 928.91                     | 271.07      |
| 19       | Lakshadweep              | 15.45     | 18.45       | 19.56     | 15.19       | 22.85     | 8.02           | 28.01                      | *           |
| 20       | Madhya Pradesh           | 1046.78   | 1407.95     | 1449.59   | 1738.69     | 1382.86   | 2793.36        | 2029.83                    | *           |
| 21       | Maharashtra              | 4040.00   | 4080.51     | 4983.68   | 5193.83     | 5043.57   | 5050.80        | 4728.71                    | 2059.01     |
| 22       | Manipur                  | 218.44    | 251.31      | 255.87    | 311.96      | 332.49    | 283.73         | 310.06                     | 57.53       |
| 23       | Meghalaya                | 138.24    | 207.24      | 266.88    | 288.11      | 433.73    | 205.45         | 152.18                     | 161.41      |
| 24       | Mizoram                  | 277.56    | 291.65      | 295.92    | 358.58      | 334.23    | 332.86         | 261.08                     | 115.02      |
| 25       | Nagaland                 | 291.74    | 286.12      | 233.18    | 290.43      | 250.84    | 237.32         | 286.06                     | 121.2       |
| 26       | Orissa                   | 947.72    | 1015.63     | 1031.72   | 1161.32     | 1562.03   | 1387.03        | 1247.84                    | 603.69      |
| 27       | Puducherry               | 85.70     | 106.57      | 156.71    | 146.23      | 133.84    | 157.48         | 134.71                     | 67.13       |
| 28       | Punjab                   | 401.55    | 742.37      | 881.29    | 882.49      | 871.10    | 968.42         | 792.48                     | 301.52      |
| 29       | Rajasthan                | 959.81    | 1076.22     | 1395.76   | 1441.93     | 1056.04   | 1475.22        | 1536.85                    | 554.12      |
| 30       | Sikkim                   | 95.73     | 117.82      | 176.59    | 194.73      | 164.46    | 104.97         | 151.80                     | 79.68       |
| 31       | Tamilnadu                | 737.26    | 1427.87     | 1666.16   | 1902.53     | 2121.49   | 2349.56        | 1800.55                    | 915.95      |
| 32       | Tripura                  | 118.94    | 111.24      | 156.03    | 137.5       | 105.66    | 139.78         | 181.90                     | 78.41       |
| 33       | Uttar Pradesh            | 0.00      | 4320.65     | 3817.66   | 5209.21     | 5628.85   | 8558.02        | 4853.47                    | 623.09      |
| 34       | Uttrakhand               | 300.80    | 433.53      | 381.01    | 414.18      | 538.67    |                |                            | 350.13      |
|          | West Bengal              | 1986.36   | 2105.81     | 1808.91   | 2698.00     | 1891.18   | 564.46         | 428.85 2156.70             | 703.75      |
| 35 36    | Telangana                |           |             |           |             | 1139.24   | 1952.50 158.84 | 0.00                       | 377.98      |
| Total    | Total                    | 22472.02  | 31678.22    | 32352.30  | 37047.61    | 37387.12  | 40127.29       | 34359.84                   | 13426.98    |

*SOE not submitted