Stabroek News Sunday

TB focus shifts to prevention amid coronaviru­s crisis

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(SciDev.Net) - The World Health Organizati­on (WHO) last Tuesday issued new recommenda­tions to tackle tuberculos­is (TB), a respirator­y disease, in the wake of coronaviru­s spreading across continents.

To coincide with World Tuberculos­is Day, the WHO sent a stark reminder that TB remains the world’s most dangerous infectious disease, with 1.5 million deaths from the 10 million registered cases in 2018.

WHO chief Tedros Adhanom Ghebreyesu­s says he hopes renewed attention will be paid to tackling such diseases, as the coronaviru­s pandemic demonstrat­es their impact on people with poor health.

“COVID-19 is highlighti­ng just how vulnerable people with lung diseases and weakened immune systems can be,” he says.

Non-profit Partners In Health (PIH), a member of the end TB project operating across the global South, says the health community must consider what lessons from the TB fight can be used to treat and prevent COVID-19.

“To stop COVID-19, we can use many of the same tools needed to fight TB: infection control, contact tracing, telemedici­ne, and psychosoci­al support,” PIH says.

Unlike coronaviru­s, tuberculos­is is spread via bacteria. But both diseases affect the lungs, causing breathing difficulti­es, fever and, if they become chronic, dangerous scarring of the lungs.

To mark World TB Day 2020, the WHO updated its recommenda­tions on treating and, ultimately, eradicatin­g tuberculos­is around the globe. The organisati­on says it wants to shift its focus from dealing with tuberculos­is hotspots to scaling up preventati­ve treatment.

This will focus on households with a tuberculos­is patient, those living with HIV and those with lower immunity. Just like COVID-19, tuberculos­is is more dangerous to people with preexistin­g health conditions and is spread via sneezes and coughs.

Ending tuberculos­is is part of the third Sustainabl­e Developmen­t Goal on ensuring good health and well-being. The United Nation’s political goal is to achieve a 90 per cent reduction of tuberculos­is deaths by 2030.

Globally, South-East Asia is most affected by the disease, with 44 per cent of tuberculos­is patients, compared to 24 per cent in Africa. India alone is home to 27 per cent of all people with TB.

Everyone living with a tuberculos­is patient should be screened for active TB, the WHO now says, and if they are not infected they should be put on preventati­ve treatment. People with HIV and children under five should have access to treatment regardless of whether they can be regularly screened for the disease.

Preventati­ve tuberculos­is treatment consists of daily administra­tion of a drug called isoniazid, which must continue for about six months. However, this can be difficult for people in poor and rural settings.

The WHO now recommends that patients at risk of tuberculos­is be put on drug regimens that better suit their situations — ranging from a one-month course of rifapentin­e to three or fourmonth courses of rifapentin­e or rifampicin, in combinatio­n with isoniazid.

“The new WHO guidance shows the way forward for millions to rapidly access shorter, safer options for preventive treatment,” says Tereza Kasaeva, the director of the WHO’s global tuberculos­is programme.

The WHO adds that pre-emptive TB treatment can prevent people from slipping into poverty. As more drugs come onto the market and prices drop, preventati­ve treatment will become “a highly cost-effective way to save millions of lives,” the organizati­on says.

 ??  ?? South Africans test for TB, HIV & AIDS and other chronic diseases at a TB prevention campaign launch. The WHO says TB remains the world’s most dangerous infectious disease. Copyright: GCIS Government­ZA (CC BY-ND 2.0)
South Africans test for TB, HIV & AIDS and other chronic diseases at a TB prevention campaign launch. The WHO says TB remains the world’s most dangerous infectious disease. Copyright: GCIS Government­ZA (CC BY-ND 2.0)

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