About

About the Book

While much progress has been made with tuberculosis (TB) control, the WHO estimates that 9 million people developed TB in 2013, and 1.5 million died of TB. India accounts for 25% of the global TB burden, and for a third of the ‘missing cases’ that do not get diagnosed or notified. The emergence of severe forms of drug-resistance has further complicated the picture. More than 50% of India’s TB patients seek care in the private sector, and private providers and GPs are often the first point of care even for patients treated in the public sector. Unfortunately, private practitioners rarely adhere to national and international standards, and there is plenty of evidence that quality of TB care is often suboptimal. This results in emergence of drug-resistance, and also explains the high TB mortality rate in India.

This supplement to GP Clinics is an effort to engage and educate GPs and private practitioners in India, and to share with them the current best practices on TB diagnosis and treatment. It is a compilation of a series of articles published in GP Clinics over the past two years.

I am grateful to my co-authors who contributed their valuable expertise and time to this project. I am particularly grateful to Dr Anupam Aggarwal, Editor and Publisher of GP Clinics. His enthusiasm and support for TB control is exceptional, and his desire to educate GPs about evidence-based clinical practices is commendable. I am also grateful to the Clinton Health Access Initiative (CHAI) for their support in publishing this TB series. Their leadership role in IPAQT is important and impactful. Lastly, I am thankful to several partners for their support, including The Union, PATH, REACH, World Health Partners, Global Health Strategies, McGill International TB Centre, and McGill Global Health Programs. I am also grateful to Bijoyeta Das (www.bijoyetadas.com) for designing the book cover.

Dr Madhukar Pai, MD, PhD
Montreal, Canada
madhukar.pai@mcgill.ca
@paimadhu

About the Editor

Madhukar Pai, MD, PhD
Madhukar Pai is a TB researcher. He is a professor of epidemiology at McGill University in Montreal. He serves as the Director of Global Health Programs, and as an Associate Director of the McGill International TB Centre. He holds visiting faculty positions at Christian Medical College, Vellore; Manipal University; Mahatma Gandhi Institute of Medical Sciences, Sevagram; and Translational Health Science and Technology Institute, Delhi.

About the Publisher

Anupam Aggarwal, MBBS, MD
Anupam Aggarwal, a postgraduate in Public Health from Maualana Azad Medical College, New Delhi, India, started Clinics India Press Pvt Ltd, a medical publishing and healthcare information company, in India in the year 2004. Clinics India publishes medical journals and develop medical content for customized literature for practicing doctors.

‘GP Clinics’ (www.gpclinics.in) is one of the flagship publications of Clinics India. Published monthly, and categorized as a CME journal for family physicians in India, ‘GP Clinics’ has a pan India circulation. ‘GP Clinics’ pulls together practical clinical articles from top international and national experts in many specialties in a convenient source for primary care practitioners. The journal provides articles on key topics encountered in clinical practice, as well as short, quick-reading features that emphasize diagnostic quizzes with high resolution color photographs. Among the most popular features are: “Drug Review”, “Court Room”, “Dermclinic“, “What’s Your Diagnosis?” “Photoclinic“, “What’s the ‘Take Home’?“, “Photo Quiz“, “Case In Point”, “Pearls of Wisdom”, “Nutritional Pearls” and much more.

About the Authors

Kavita Ayyagari, MA Kavita Ayyagari is the Project Director for Challenge TB India project at The Union South East Asia Office, New Delhi. She is an expert in strategic communication, policy advocacy and brand building. She has worked on issues such as child rights, reproductive health, WASH, and nutrition at several organizations. She holds a Master’s degree in Economics and is a post graduate in Mass Communications from Indian Institute of Mass Communications, New Delhi. Indira Behara, MBBS, MPH Indira is a senior manager at Global Health Strategies. She holds a Bachelor’s degree in Medicine and Surgery from the Sri Ramachandra Medical College in Chennai, India and a Master’s degree in Public Health from the Columbia University Mailman School of Public Health. She works in health policy, advocacy and communications with a focus on TB. Anurag Bhargava MD, MSc Anurag Bhargava is a professor of Medicine at Yenepoya Medical College, Mangalore received his clinical training at AIIMS, New Delhi, and did a Masters in Epidemiology at McGill University. He helped set up and run a non-profit organisation, Jan Swasthya Sahyog, in rural Chhattisgarh, for 10 years. His research interests include TB, acute febrile illnesses, and non-communicable diseases. He coordinated the development of the RNTCP’s Guidance document for nutritional care and support for patients with TB in India, as well as the Standard Treatment Guideline for Hypertension in India, and contributed to the ICMR guideline for rickettsial infections in India. Madhavi Bhargava, MBBS, DLO, MD Madhavi Bhargava is an Assistant Professor in the department of Community Medicine at Yenepoya Medical College, Mangalore. She has a background of training and experience in medical and surgical care at primary and secondary level. She spent a decade helping run clinical and outreach services, in rural Chhattisgarh at Jan Swasthya Sahyog. She enjoys teaching as well as mentoring young students in research projects, and her research interests include interactions of nutrition and diseases, and in environmental health. She also contributed to Guidance document for nutritional care and support for patients with TB in India by RNTCP. Deepti Chavan Musale, Patient advocate Deepti Chavan, a survivor of MDR TB, now actively works towards creating awareness about TB prevention so that others do not suffer the way she did. Deepti was forced to drop out of her engineering degree when her health deteriorated. Today, she regularly counsels people with TB and speaks about her experiences on radio, print and TV to inspire patients to keep fighting. Her husband, Neeraj Musale, has been a big support in her battle against TB and encourages her to fight for this cause. Pamela Chedore, MLT Pamela Chedore is a medical laboratory technologist. She was formerly the head of the Mycobacteriology Laboratory, Public Health Laboratory (PHL), Ontario Agency for Health Promotion and Protection, Toronto. She is currently a consultant at the Respiratory Epidemiology and Clinical Research Unit, Montreal Chest Institute, Montreal. Amrita Daftary, PhD, MPH Amrita is an Assistant Professor of Research in the Department of Epidemiology & Biostatistics at McGill University, and an Investigator at the McGill International TB Centre. She studies the social and behavioural contexts of tuberculosis in diverse global settings, and contributes to the design and evaluation of interventions that address the social determinants of health care seeking and caregiving practices in tuberculosis, drug-resistant tuberculosis and TB-HIV coinfection. Amrita is an expert in qualitative methods, and experienced in mixed methods and implementation science research. Faiz Ahmad Khan, MD MPH Faiz Khan is a consultant respirologist at the McGill University Health Centre in Montreal, Canada. He is an Assistant Professor in the Department of Medicine at McGill University, Montreal. He completed his MPH in Epidemiology at Columbia University’s Mailman School of Public Health, and a research fellowship at Harvard Medical School’s Department of Global Health and Social Medicine. He is Director of Clinical Services of the Montreal Chest Institute TB Clinic.     Aasit G. Nanavati, MPH Aasit is a senior programme associate at Global Health Strategies. He holds a Master’s degree in Public Health, studying epidemiology and biostatistics from Temple University located in Philadelphia, Pennsylvania. At GHS, Aasit works on implementing advocacy and communication strategies to strengthen the tuberculosis landscape in India. Previous to this, Aasit was working as a monitoring and evaluation associate with a USAID implementing partner based in East Africa. Ruvandhi Nathavitharana, MD, MPH Ruvandhi Nathavitharana is a Clinical Infectious Diseases Fellow at Beth Israel Deaconess Medical Center and Harvard Medical School in Boston, USA. Trained in Medicine at Imperial College London, she subsequently won a Kennedy Scholarship to pursue her MPH at Harvard School of Public Health. Dr. Nathavitharana has a particular interest in tuberculosis and has worked in Kenya, Peru, Thailand, Brazil, India, and also with the WHO Stop TB division in Geneva. Lancelot M. Pinto, MD, MSc Lancelot Pinto is a consultant pulmonologist at the PD Hinduja Hospital and Medical Research Centre in Mumbai. He is also a clinical epidemiologist, with a Master’s degree from McGill University, Montreal. Barry Rabinovitch, MD, FRCP(C) Barry Rabinovitch is an assistant professor of medicine at McGill University, Montreal and a respirologist at the Montreal Chest Institute, McGill University Health Centre, Montreal. Sujeet Rajan, MD Sujeet Rajan is a practising respiratory physician and post-graduate teacher at Bombay Hospital Institute of Medical Sciences, Mumbai, India. He graduated from the Grant Medical College in Mumbai in 1989, and post-graduated in Respiratory Medicine thereafter, from the Seth. GS Medical College and KEM Hospital, Mumbai. Besides MDR-TB, his interests include idiopathic pulmonary fibrosis, airway disease and sleep-disordered breathing. He thoroughly enjoys teaching and research. Camilla Rodrigues, MD Camilla Rodrigues is a Consultant Microbiologist and Chair of the Infection Control Committee at the Hinduja Hospital, Mumbai. She is currently a member of the WHO Advisory Committee on MDR-TB in the South- East Asia Region from April 2012. She has authored 253 publications in International/National Journals as well as book chapters, and has conducted 85 research projects. She has received 18 awards/prizes and given over 460 faculty presentations internationally and regionally. Karishma Saran, MSc Karishma is a manager at Global Health Strategies. She holds a Master’s Degree in Global Health and Development from University College London (UCL). At GHS, Karishma works extensively on communications, advocacy and policy research for improved TB prevention and control in India. She worked closely with the Municipal Corporation of Greater Mumbai (MCGM) to conceptualize the TB campaign ‘TB Harega Desh Jeetega’. Srinath Satyanarayana, MD Srinath Satyanarayana is an MD in Community Medicine from the All India Institute of Medical Sciences, New Delhi. He has worked as a WHO-RNTCP-Medical Consultant from 2006-2011 supporting Monitoring and Evaluation, and Promoting Operations Research at the national Level. He has currently pursuing his PhD in Epidemiology at McGill University, Canada. He is also a Senior Operations research Fellow with the International Union Against Tuberculosis and Lung Disease, Paris, France. Jamhoih (Jamie) Tonsing, MBBS, DPM, MSc Jamie Tonsing is the Regional Director for The Union’s South-East Asia (USEA) Office in New Delhi overseeing operations of the organization’s largest regional office implementing projects on tobacco control, tuberculosis, operations research, trainings and capacity building in the region. She is a medical doctor with a MSc in Public Health from the London School of Hygiene and Tropical Medicine. Kavitha Saravu, MBBS, MD, DNB, DTM&H Kavitha Saravu is a Professor of Medicine and unit chief at the Kasturba Medical College, Manipal University, Manipal, India. She is a clinician with special interest in tropical infections and holds a diploma in Tropical Medicine and Hygiene from London School of Hygiene and Tropical Medicine. Dr Saravu has published in several international and national journals and has authored chapters on melioidosis and tuberculosis in text books of Medicine. Her areas of interest are tropical infectious diseases especially malaria, tuberculosis, and melioidosis. Ramnath Subbaraman, MD, MSc, FACP Ramnath is an assistant professor in the Department of Public Health and Community Medicine and an infectious diseases physician in the Division of Geographic Medicine and Infectious Diseases at the Tufts University School of Medicine. In addition to being a practicing infectious diseases physician, he conducts tuberculosis implementation science research focused on improving linkage to treatment and patient retention across the tuberculosis cascade of care in India. He also conducts research on social determinants of health and access to basic services in urban slum settlements in Mumbai. Zarir F Udwadia, D, DNB, FRCP (London.), FCCP (USA) is a consultant chest physician at the Hinduja Hospital, Breach Candy Hospital and Parsee General Hospitals in Mumbai. He has a special interest and expertise in drug resistant tuberculosis. About 7000 patients pass through his busy OPD annually, a number of whom are MDR-TB patients referred by colleagues from different parts of the country. Tuberculosis remains his over-riding passion. He is co-author of “Principles of Respiratory medicine published (2011) by Oxford International Publishers. His recent publication of the first Indian patients with Totally Drug Resistant TB attracted intense media and medical interest from across the globe. He was the sectional-editor for Tuberculosis for the journal Thorax.

About the Website Marzieh Ghiasi, MSc Marzieh, the website developer, is an MD/PhD trainee at Michigan State University. She completed her MSc in Epidemiology at McGill University studying TB in clinical settings. She holds a BSc Honours in Anatomy and Cell Biology and Environmental Health. Her interests include science communication and global health. Her current research focuses on tuberculosis infection control in clinical settings. Let’s Talk TB (http://www.letstalktb.org/) is a website designed to accompany GP Clinics‘ publication of the same name. We provide healthcare professionals with a platform to engage interactively with the materials in book, and discuss these materials with other professionals in the field. Responsively-designed and powered by WordPress and Colorlib, the website has been developed adhering to W3C standards, ensuring a smooth browsing experience on all modern browsers and multiple devices. For any enquiries, please contact us directly.