Mumbai: When an eight-year-old boy with a persistent cough for over 45 days was brought to the state-run JJ Hospital’s TB clinic on Saturday, routine history-taking by doctors threw up some strange points.The child, since birth, had suffered three to four major respiratory infections requiring hospitalisations every year. He also had discharge from his ears, and his fingers were clubbed, meaning the tips were enlarged and the nails curved downwards to give a spoon-like appearance. “We realised that even if he did have TB, he most possibly also had a rare respiratory disease called ciliary dyskinesia,” said paediatrician Dr Sushant Mane. Luckily for the child, the hospital’s paediatrics department, through govt funding and CSR donations, developed a paediatric pulmonary centre with high-tech equipment to help diagnose the condition. There is now no need to send him or others to an outstation research lab or an expensive private lab for tests. “Besides, our costs will be a fraction of those for advanced respiratory tests in the private sector,” said Dr Mane. In Worli, pharma company Cipla Ltd inaugurated a lung wellness centre offering only respiratory tests, some for the first time in India. “There is an unmet need in India for respiratory diagnostics. India has a high burden of COPD (chronic obstructive pulmonary disease) and asthma, but barely 1% of the patients get timely diagnosis,” said Cipla MD Achin Gupta. The idea of focusing on the lung is to reduce the delay of 6 months-2 years it now takes to correctly diagnose patients with a chronic respiratory disease, such as COPD. The patient pool of chronic respiratory diseases in India is huge. According to Global Burden of Diseases 2023, over 6.89 crore people in India lived with chronic respiratory diseases, driven by high rates of COPD and asthma, with air pollution and smoking as primary risks. It said 3.77 crore Indians lived with COPD and 3.23 crore with asthma. “Around 40% of the patients, both paediatric and adult, who come to the daily OPD at JJ Hospital have respiratory illness, ranging from cough, tonsillitis, lower respiratory tract infection to pneumonia. The disease burden is high, but chronic respiratory diseases never got the attention like, say, cardiac diseases,” said Dr Mane. Indeed, while there are multiple diagnostic labs offering multiple heart tests, most hospitals only offer basic lung tests. Due to poor access to specific lung function tests, children lived with a wrong diagnosis for up to four years before coming to the JJ paediatric department. This prompted the decision to carve out a sub-specialty of paediatric pulmonology. “We get cases from across Maharashtra and neighbouring states. We are in the process of developing other paediatric sub-specialties in pulmonology, nephrology and rheumatology,” said head of paediatrics Dr Chhaya Valvi. The hospital is going to start a fellowship in paediatric pulmonology soon. Pulmonologist Dr Sujeet K Rajan from Bhatia Hospital, Tardeo, believes growing awareness about respiratory diseases has resulted in more diagnostic infrastructure. “There is more awareness about lung problems now, with people downloading apps for air quality index,” he said. However, there is a need for more awareness and infrastructure, he added.
