They, however, had little clue it could spell doom, at least health-wise. When the couple visited the tuberculosis (TB) centre at Lok Nayak Hospital last week with complaints of persistent cough and fatigue, they were amused at the series of tests prescribed. “Hum to hamesha se swasth rahe hain; kabhi soche nahin thhey kuch gambhir hoga (I have been healthy all these years; never thought anything serious could happen),” Yadav said, waiting for his turn at the clinic.

The test results were shocking, though: once known as ‘raj rog’, or a rich man’s disease, tuberculosis of the lungs had gripped Yadav. His wife contracted the disease from Yadav, doctors said.

Since then, Yadav has not reported for work; his wife, who works as a domestic help in a Trilokpuri household, fears being sacked once she tells her employers about the disease.

Delhi State Tuberculosis Officer Dr R P Vashist, in charge of the most successful DOTS (Directly Observed Treatment, Short course) programme in the country, said the burgeoning migrant population helps spread the TB virus faster. And more people it affects, the financial burden gets heavier on the state. Currently an annual Rs 10 crore is spent on the DOTS programme in Delhi alone.

Affects in productive years

Dr Vashist said the economic ramifications of TB on a patient’s family are disastrous since it affects most people in their productive years. “It puts an extraordinary burden on patients, their family, community, and the government’s budgets,” Dr Vashist said.

A study by the Indian Council of Medical Research says 2 lakh women are evicted from their houses each year after they contract the disease, and 1 lakh children drop out of school annually because of the stigma attached with TB and its contagious nature. On an average, medical expenses can be 8-20 per cent of the total household income. Without treatment, two-thirds of positive cases die within 5-8 years; most die within 18 months, say experts.

Dr Vashist said, “About 40 per cent of our population is already infected with TB germs. Many in rural areas continue untreated and pass on the infection.”

About 10 per cent of people infected with the germ are likely to develop TB in their lifetime, and these are mostly young people, doctors warn.

Indraprastha Apollo Hospital, for example, had predominantly young patients out of 856 who came for treatment in 2006 and 2007. But the big picture appears grimmer: 80 per cent of 50,000 TB patients in Delhi being treated under the DOTs programme are in the age group of 18-50 years, Dr Vashist says.

“Ten per cent of them are children; the remaining ten per cent comprises old people,” he said.

Doctors at private hospitals say the disease primarily affects people from poor socio-economic backgrounds. “When I was at (government-run) Maulana Azad Memorial Hospital, we got much more TB cases than in a private hospital,” Dr Suranjit Chatterjee said.

TBtruths
Outside LN Hospital. Photo: Prem Nath Pandey

3,618
deaths in Delhi (2005-06)

60,000
TB patients in Delhi

50,000
covered by DOTS programme