Can high private cough syrup sales act as a proxy for missed TB notifications in TB surveillance?
Year: 2025
Type: article
Abstract: BACKGROUND: Rajasthan in India, is a high TB burden state with a high prevalence to notification ratio. This gap calls for alternative strategies to find the non-notified people with TB. Because cough is the most prominent symptom of TB and cough syrups are one of the highest over the counter drugs in India, its sale might be used as a proxy for missed TB cases. METHODS: This was an ecological study to assess the correlation between cough syrup sales and missed TB notifications in the private sector. We calculated the missed TB notification rate as the difference between the estimated people on TB treatment and TB notification in the private sector from January 2021 to March 2023, across all districts of Rajasthan (n = 33). We analysed district level mean quarterly cough syrup sales and TB notification rates/100,000 population. RESULTS: We found positive correlation between cough syrup sales and TB notification [overall (r = 0.43), private (r = 0.63) and missed private TB notification (r = 0.39)]. Based on this analysis, missed TB notification rates were 7x more than the reported notifications in the private sector. CONCLUSION: We recommend a private sector-based TB surveillance system with TB screening for people who approach pharmacies for cough syrup.
Source: Public Health Action
DOI: 10.5588/pha.25.0033
Authors: K. Gupta, H.D. Shewade, P. Manickam, P. Soni, V.N. Baig, R. Dagar, M. Parmar, Y. Saxena, S. Charan, H. Abdullah, A.K. Bhardwaj
Language: English
Subfield: Infectious Diseases
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4417019226