Tuberculosis on the rise for first time in decades: Research

Before SARSCoV2 the virus that causes Covid19 spread across the world in 2020 tuberculosis was responsible for more deaths globally than any other infectious disease But thanks to targeted public health efforts in the US and globally tuberculosis cases had been steadily falling for decadesI am an infectious disease clinician and public health practitioner who has been caring for underserved communities in the US for more than two decadesDuring the pandemic it at first appeared that as with many other common illnesses like the flu Covid19 prevention efforts reduced tuberculosis cases tooBut tuberculosis numbers have quickly climbed back up to prepandemic levels marking the first time in decades that cases and deaths have risen globallyThe pandemic not only interrupted important health interventions for tuberculosis it also caused a decrease in social and economic opportunities for marginalised people around the globeTogether these effects appear to have put a serious dent in the fight against tuberculosisTuberculosis before and during Covid19 Tuberculosis is a contagious bacterial infection of the lungs that is normally spread through the air Most tuberculosis infections are asymptomatic and not contagiousAbout 5 per cent to 10 per cent of infected individuals develop active tuberculosis which is characterised by cough fever decreased appetite and weight lossIf left untreated tuberculosis is a very contagious and dangerous disease that can result in deathAlso readMumbai weather update Moderate to heavy spells of rain likely todayTotal estimated tuberculosis infections globally have been falling for years The lowest number 101 million cases occurred in 2020 according to the World Health Organisation2021 saw a significant increase in infections to 105 million the first rise in more than a decadeGlobal tuberculosis deaths followed a similar pattern reaching a low point of an estimated 14 millions deaths in 2019 then rising to 15 million in 2020 and 16 million in 2021The number of confirmed cases of tuberculosis iquest infections detected through direct testing tells a different part of the storyAs testing efforts have improved confirmed cases have been rising globally to a peak in 2019As the coronavirus disrupted lives in 2020 confirmed cases of tuberculosis fell significantly before quickly rising again in 2021A similar pattern played out in the US There was a sharp drop in confirmed cases in 2020 mostly driven by lack of testing followed by a sharp rise back to prepandemic levelsTuberculosis is a social diseaseTuberculosis is a preventable disease thanks to effective vaccines testing and treatmentsBut millions of people around the world still suffer from this disease not because of a lack of medical knowledge but because of persistent social inequitiesUnequal access to economic opportunities limited health care poor sanitation crowded living conditions malnutrition and illnesses such as diabetes or HIV are all associated with increased risk of tuberculosisIn the US in 2021 racial and ethnic minority groups accounted for more than 85 per cent of tuberculosis cases with 71 per cent of cases occurring in persons born outside the USIncreased inequality causing more tuberculosisEven as the world witnessed a rapid decline in confirmed cases in 2020 experts were worried that interruption of prevention and treatment efforts might result in a rise in tuberculosisThese fears were warranted Many health experts along with the US Centres for Disease Control and Prevention have confirmed the pandemic disrupted access to tuberculosis testing and diagnosisIt is likely that many cases were missed because of the interruption of tuberculosis control activities since funding resources and staff were reassigned to assist in COVID19 control effortsAdditionally during health encounters similarities in symptoms between COVID19 and tuberculosis may have led to missed diagnosesThe drop in confirmed cases seems to be in large part driven by a lack of testing The rapid increase since the pandemic and especially the rise in deaths confirms that progress made in tuberculosis control over the past 20 years has stalled slowed or reversedThese two troubling trends are also almost certainly connected to the increase in inequality brought about by the pandemicThe existence of multigenerational households overcrowding in lowincome neighborhoods lack of paid sick leave inability to shield from the pandemic use of public transportation and lack of health insurance all converged to heighten the risk of both COVID19 and tuberculosis among the most vulnerable peopleOf course the pandemic is not the only factor that has increased human hardship iquest and therefore tuberculosis iquest in recent yearsFor example Ukraine now has one of the worlds highest tuberculosis disease burdens as a result of Russias invasion and the resulting harm to Ukraines medical social and economic systemsOngoing conflicts in other parts of the world energy shortages and the effects of climate change and associated impacts on food security are expected to worsen the broader social and political determinants of tuberculosisThere are many neglected diseases of poverty and tuberculosis is a great example of how social forces produce human diseaseWith an estimated onethird of the worlds population at risk for tuberculosis today fostering social justice interventions to reduce health inequities is a critically important step to relieving the global medical burden of this relentless disease The Conversation via PTI