A Study to Determine The Incidence of Pulmonary Tuberculosis in Urban Slum Areas of Ram Nagar (North Belagavi) - An Observational Study

 Introduction

Tuberculosis is a chronic infectious disease caused by tubercle bacilli (Mycobacterium tuberculosis). The disease primarily affects the lungs and causes pulmonary tuberculosis. It can also affect meninges, intestines, and bones.¹ In 1882, Robert Koch proved the specific cause of the disease nearly 125 years ago. But we are struggling to control the disease despite developments in science, technology, and effective chemotherapy.² Tuberculosis most often affects the lungs and the pleura. Once the bacteria are inside the lungs, they multiply and cause inflammation, which stimulates neutrophils and macrophages to migrate to the area and engulf the bacteria to prevent their spread The bacteria remain dormant for life if the immune system is not impaired. However, impaired immunity may enable the bacteria to escape into the blood and lymph to infect other organs. In many people, symptoms such as fatigue, weight loss, lethargy, anorexia, a low-grade fever, night sweats, cough, dyspnea, chest pain, and hemoptysis do not develop until the disease is advanced.³ According to WHO, 20%–50% of the urban population residing in slum areas were found to be suffering from tuberculosis when incidence was seen in 5 countries.⁴ Tuberculosis can be tackled in its early stages. A dietetic and vitality building program along natural lines is the only method to overcome the disease. People should be educated strictly to follow the guidance given at the health center regarding drugs and motivated to take simple hygienic precautions such as covering the face while sneezing or coughing. To achieve tangible results in our fight against tuberculosis, medical professionals and health workers must shed their indifferent attitude and take an activist stance.⁵

Objective

To determine the incidence of pulmonary tuberculosis in urban slum areas of Ram Nagar (North Belagavi).

Observation

Ram Nagar, Belagavi, is a semi-slum area where some people are inferior in socio-economic status while other parts of people are well settled with good socio-economic status. People of this slum area are poorly nourished, don’t have a good house to stay in, and cannot afford nutritious food.

Materials and methods

Source of data: All age groups and sexes residing in the urban slum area of Ram Nagar.

Type of Research: Observational survey study S

Sample size: 70 families (325 subjects)

Duration of the study: 5 months (1st April 2022 to 31st July 2022)

Tools used for the study: Self- structured tuberculosis questionnaire was used to screen tuberculosis; if three or more questions were answered as ‘YES’, then the subjects were considered suspects, and their sputum was collected and sent to the laboratory for confirmation of tuberculosis (Table 1).

Selection criteria

a. Inclusion criteria: All age groups and sexes residing in the urban slum area of Ram Nagar, Belagavi, were included in the study.

b. Exclusion criteria:

a) People who were not present in their houses when the survey was conducted.

b) People who were well settled with good socio economic status and not residing in the slum areas of Ram Nagar, Belagavi.

Results

We conducted a survey in the urban slum areas of Ram Nagar for the incidence of tuberculosis. Statistical data wass analyzed for suspected cases, positive cases, and cases who were already on tuberculosis medication. Table 2 explains the distribution of suspected cases in the selected population of Ram Nagar. A total of 70 families with 325 members were surveyed. Among them, suspected cases in these families were 7(2%). 

Figure 1 explains the distribution of positive cases among suspected cases of tuberculosis. Of the 7 (70%) subjects suspected of tuberculosis, 3 (30%) were positive for the disease. 

Figure 2 explains the distribution of cases already on medication for tuberculosis. It was reported that of the 3 positive tuberculosus cases, 1 case was already on medication.

Discussion

This study was conducted to know the incidence of tuberculosis in urban slum areas of Ram Nagar due to low socio-economic status and poorly nourished people. A survey method was prepared by interrogating people staying in such areas. Self-structured questionnaire was asked according to the symptoms of tuberculosis to gather the data of suspected individuals. Seventy families (325 subjects) were taken into consideration who were poorly nourished and low in socioeconomic status. Seven individuals were suspected of tuberculosis after interrogation. Those 7 individuals were considered for the following study where they were told to send their sputum sample for investigation., Three out of them were confirmed with tuberculosis. Those three subjects were again interrogated and convinced to take medication for tuberculosis, out of which one subject was already on medication.

Conclusion

The incidence of tuberculosis in the urban slums of Ram Nagar, Belagavi, is around 2%. In those, one subject was already on medication. This study included a small group of low socio-economic subjects, giving the platform to conduct the multi-centric survey to determine tuberculosis incidence.

Conflict of interest

None