Tuberculosis (TB), once considered a disease associated with poverty and overcrowded living conditions, remains one of India’s most persistent public health challenges. According to the WHO Global TB Report, 2023, India accounts for nearly 27 percent of the world’s tuberculosis cases, making it the largest contributor to the global TB burden.
Despite decades of medical progress, national control programmes and global efforts to eliminate TB, the infection continues to affect millions of people every year, cutting across economic, geographic and social boundaries. In 2025, TB is no longer a concern limited to vulnerable communities; it has become a widespread threat driven by weakened immunity, lifestyle-related illnesses, and increased exposure in crowded environments.
To understand why TB continues to thrive in modern India, and what must change to reduce its burden, MedBound Times connected with Dr. Pranay Sai Chandragiri, Consultant Interventional Pulmonologist at Yashoda Hospitals, Malakpet, Hyderabad (M.B.B.S; M.D Pulmonary Medicine; D.M AIIMS New Delhi Pulmonary, Critical Care & Sleep Medicine). In this in-depth discussion, Dr. Pranay shares insights on risk factors, treatment challenges, misconceptions, drug resistance, and community support.
“TB has been long recorded as a disease of the poor. The recent WHO statement has stated that crowding and poorly ventilated areas are high risk for transmission. Poor are usually at higher risk and because of the undernourishment also, there is a high chance of conversion of this transmitted disease into an active form," Dr. Pranay said.
He mentioned that nowadays due to lifestyle modifications and many changes around the world, which has to do a lot of things with nutrition and immunity, TB has spread to all other classes of people too.
He added:
“People are getting a lot of comorbidities like diabetes, like COVID and every other viral infection which partly depletes your immunity. So due to such reasons, now everyone in the community is bearing that disease.”
“Adherence issues are more with TB medication because it’s a long course, minimum 6 months for drug-susceptible TB and nearly 18 to 20 months for drug-resistant TB,” he said.
Patients often discontinue treatment after early relief:
He added, “Rapid growers die within two weeks and the slow growers take six months. When the rapid growing bacilli die, patient will feel symptomatically better, that is where they lose this track of time and become non-adherent.”
He explained that stopping tuberculosis medication early results in the infection being restarted. The dormant bacilli are still present, and once the treatment is stopped, the cycle is repeated and becomes vicious. He emphasized that adherence is tied to awareness and education, adding that consistent patient feedback on how the therapy has progressed is also important.
Dr. Pranay explained that TB is generally a bacteria and the medicine which is given, is an antibiotic intended to kill the bacteria. But the bacteria has its own rescue in the form of developing drug resistance. It is nothing but antibiotic resistance.
On treatment variations:
“If the bacilli become resistant to the core drugs, isoniazid and rifampicin, it becomes multi-drug resistant TB. For multi-drug resistant TB, we have 18 months regime which is minimum, but in a suitable patient, it can be 6 months and can also extend up to 20 months.”
Dr. Pranay explained that Tuberculosis is often referred to as “consumption” because it consumes the body from within. According to him, the key symptoms to watch for include:
Loss of appetite – often one of the earliest indicators
Gradual weight loss as the disease progresses
Persistent cough that does not go away
Sputum production while coughing
Blood in cough (hemoptysis) in more advanced stages
Low-grade fever, commonly occurring in the evenings
Dr. Pranay highlighted key facts about TB:
“It is a myth that only poor people get TB… Any age group can get TB.”
→ TB can affect individuals regardless of socioeconomic background or age.
“TB can affect the whole body. There are only countable organs which TB will not penetrate.”
→ It is not limited to the lungs; extrapulmonary TB can impact various organs.
"People with TB are infectious for long time."
→ With proper medication adherence, transmission drastically reduces within two weeks.
Dr. Pranay stressed the importance of self-education and trusting medical guidance, saying that understanding the treatment process helps patients feel more confident and in control.
Speaking about home care and support, he advised that during the first two weeks, close and prolonged contact should be avoided — for example, not staying in the same room for 12–13 hours. The patient should be kept in a well-ventilated room, and proper nutrition is essential, including protein-rich foods such as meat, eggs, and pulses.
Addressing stigma, he emphasized that patients on treatment should not be isolated or judged. After the initial infection period has passed, they are fit to return to work and daily life. He highlighted the importance of community awareness, noting that understanding when TB is actually transmissible helps eliminate unnecessary fear.
Tuberculosis continues to challenge public health systems, but awareness, early detection, and strict treatment adherence remain the strongest tools in reducing its spread. As Dr. Pranay highlights, empowering communities through education and reducing stigma is essential to achieving long-term control of TB in India.
References:
1. World Health Organization. “Tuberculosis”. Global Health Observatory. Accessed November 22, 2025. https://www.who.int/data/gho/data/themes/tuberculosis.
Edited by M Subha Maheswari
