Covid-19 to fuel number of TB cases globally, say experts

Friday, May 8th, 2020 00:00 |
Stop TB Partnership executive director Dr Lucica Ditiu. Photo/COURTESY

The Covid–19 disease caused by the pathogen will fuel  number of tuberculosis  (TB) cases  globally by an additional 6.3 million cases in the next five years.

At the same time, there will be an additional 1.4 million TB deaths during the same period.

The grim picture is  contained in a  modeling analysis released by the Stop TB Partnership, a unique United Nations hosted entity based in Geneva, Switzerland, committed to revolutionising TB space to end the disease by 2030.

The prediction is based on an under three-month lockdown and a protracted 10-month restoration of services period.

“Length of quarantine, movement restrictions and disruption of TB services could spell disaster for hundreds of thousands at risk,” said Stop TB Partnership executive director Dr  Lucica Ditiu.

The modeling focused on three high burden countries—Kenya, India and Ukraine—and extrapolated estimates from those countries to create global estimates of the impact of COVID-19 on TB.

Financial requests

The authors note that the model can be replicated in any other country and that the findings can be used by countries for data-driven decisions and financial requests.

TB is the world’s biggest killer among infectious diseases, claiming more than 4,000 lives each day.

In Kenya, a survey released in 2017 stated there are more cases in Kenya than previously estimated, with a prevalence of 558 per 100,000 people.

TB was found to be higher in men between the ages of 25 and 34 years, urban dwellers, and women over the age of 65.

The majority (83 percent) of cases were HIV negative, suggesting that broad efforts at controlling it in people with and without HIV are needed.

The unprecedented coronavirus pandemic seriously impacts people with pre-existing health conditions.

People who have TB are usually more vulnerable to other infections, including the novel coronavirus, due to pre-existing lung damage. They are at a higher risk of developing complications from Covid-19.

 “We never learn from mistakes. For the past five years, TB, a respiratory disease, has remained the biggest infectious disease killer because the ‘TB agenda’ consistently became less visible in front of other priorities,” said Ditiu.

 “Today, governments face a torturous path, navigating between the imminent disaster of Covid-19 and the long-running plague of TB.

But choosing to ignore TB again would erase at least half a decade of hard-earned progress against the world’s most deadly infection and make millions more people sick,” he added.

The new study was commissioned by the Stop TB Partnership in collaboration with the Imperial College, Avenir Health and Johns Hopkins University, and was supported by USAID.

The modeling was constructed on assumptions drawn from a rapid assessment done by The Stop TB Partnership on the impact of the COVID-19 pandemic and related measures on the TB response in 20 high-burden TB countries—representing 54 per cent  of the global TB burden.

TB is a forgotten respiratory disease that still kills 1.5 million people each year, more than any other infectious disease.

Incidence and deaths due to TB have been declining steadily over the last several years as a result of intensified activities by high burden countries to find people with TB early and provide appropriate treatment.

In 2018, during the UN General Assembly (UNGA) High-Level Meeting on TB, Heads of States and governments committed to significantly scale up the TB response.

Mitigation measures

In 2018, this resulted in identifying an additional 600,000 people who could access TB care. In 2019, we also saw very promising progress.

The Covid-19 pandemic, especially considering the mitigation measures put in place, has proven to be a major setback in achieving the UNGA targets, as TB case detection has dramatically fallen, treatments have often been delayed and the risk of interruption of treatment and potential increase of people with drug-resistant TB has increased.

According to the new study, with a three-month lockdown and a protracted 10-month restoration of services, global TB incidence and deaths in 2021 would increase to levels last seen in between 2013 and 2016 respectively, implying a setback of at least five to eight years in the fight against TB.

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