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Med: Commentary - Integrated testing for TB and COVID-19

Mary Wilson

Well-known member
Available online 11 February 20

https://doi.org/10.1016/j.medj.2022.02.002

Emily L.MacLean[SUP]1[/SUP][SUP]2[/SUP]LuzVilla-Castillo[SUP]3[/SUP]MortenRuhwald[SUP]4[/SUP]CésarUgarte-Gil[SUP]3[/SUP][SUP]5[/SUP]MadhukarPai[SUP]1[/SUP][SUP]2[/SUP]

Integrated testing for TB and COVID-19 may help find those TB patients who are not accessing care in the context of the COVID-19 pandemic. Some molecular platforms with assays for both diseases are already commercially available; however, integrated testing approaches need to be systematically evaluated to ensure their appropriate implementation.

Main text

The COVID-19 pandemic is wreaking havoc on all realms of global health and tuberculosis (TB) care and services are no exception.[SUP]1[/SUP][SUP],[/SUP][SUP]2[/SUP] After one year of the pandemic, high TB burden countries were reporting drops in TB case notifications ranging from 16% to 41% (mean 23%)—levels not seen since 2008 (https://www.stoptb.org/news/12-month...t-tuberculosis). Of the approximately 10 million people who developed TB in 2020, only 5.8 million people were diagnosed and reported to national TB programs, an 18% decrease compared to 2019.[SUP]1[/SUP] Reduced access to medical care and TB services as well as the reallocation of existing public health tools, personnel, and infrastructure to COVID-19 efforts could explain this reduction.[SUP]3[/SUP] Predictably, the decline in people seeking TB care has led to an increase in TB-related deaths: in 2020, at least 1.5 million people died of TB, a figure not seen since 2017. Evidently, we are off track to meet many of the End TB goals, and without redoubled efforts and innovative strategies to reach those who need testing and treatment, we risk missing these milestones by even larger margins.[SUP]1[/SUP]

Additionally, emerging data suggest that people with TB who develop COVID-19 are at a higher risk of severe disease and mortality compared to those without COVID-19. As well, a recent systematic review reported that COVID-19 patients with TB were at almost twice the risk of mortality compared to individuals with COVID-19 alone.[SUP]4[/SUP] Therefore, reaching people with TB and ensuring they receive appropriate care is urgent. Increasing TB testing and case notifications is a critical and pressing priority. ...

https://www.sciencedirect.com/science/article/pii/S266663402200085X?dgcid=author
 
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