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Reducing Tuberculosis Globally and the Impact of COVID-19
Author(s)
Patricio Escalante, MD, MSc, FCCP
Paige K. Marty, MD

Click to view more from Pulmonology Data Trends 2022.

References

1. Tuberculosis fact sheet. World Health Organization. Updated October 14, 2021. Accessed May 24, 2022. https://www.who.int/ news-room/fact-sheets/detail/tuberculosis

2. Tuberculosis deaths rise for the first time in more than a decade due to the COVID-19 pandemic. World Health Organization. Published October 14, 2021. Accessed May 24, 2022. https://www. who.int/news/item/14-10-2021-tuberculosis-deaths-rise-for-thefirst-time-in-more-than-a-decade-due-to-the-covid-19-pandemic

3. Wilson JW, Kissner DG, Escalante P. Cascade of care in the management of latent tuberculosis infection in the United States: a lot to improve and to scale up. Ann Am Thorac Soc. 2021;18(10):1620-1621. doi:10.1513/AnnalsATS.202106-722ED

4. Pedrazzoli D, Wingfield T. Biosocial strategies to address the socioeconomic determinants and consequences of the TB and COVID-19 pandemics. Am J Trop Med Hyg. 2021;104(2):407- 409. doi:10.4269/ajtmh.20-1641

5. Hogan AB, Jewell BL, Sherrard-Smith E, et al. Potential impact of the COVID-19 pandemic on HIV, tuberculosis, and malaria in low-income and middle-income countries: a modelling study. Lancet Glob Health. 2020;8(9):e1132- e1141. doi:10.1016/S2214-109X(20)30288-6. Erratum in: Lancet Glob Health. 2021;9(1):e23. doi:10.1016/S2214- 109X(20)30433-2

6. Harries AD, Kumar AMV, Satyanarayana S, et al. The growing importance of tuberculosis preventive therapy and how research and innovation can enhance its implementation on the ground. Trop Med Infect Dis. 2020;5(2):61. doi:10.3390/ tropicalmed5020061

7. Ugarte-Gil C, Carrillo-Larco RM, Kirwan DE. Latent tuberculosis infection and non-infectious co-morbidities: diabetes mellitus type 2, chronic kidney disease and rheumatoid arthritis. Int J Infect Dis. 2019;80S:S29-S31. doi:10.1016/j.ijid.2019.02.018

8. Frascella B, Richards AS, Sossen B, et al. Subclinical tuberculosis disease–a review and analysis of prevalence surveys to inform definitions, burden, associations, and screening methodology. Clin Infect Dis. 2021;73(3):e830-e841. doi:10.1093/cid/ciaa1402

9. Nathavitharana RR, Garcia-Basteiro AL, Ruhwald M, Cobelens F, Theron G. Reimagining the status quo: how close are we to rapid sputum-free tuberculosis diagnostics for all? EBioMedicine. 2022;78:103939. doi:10.1016/j.ebiom.2022.103939

10. Cattamanchi A, Reza TF, Nalugwa T, et al. Multicomponent strategy with decentralized molecular testing for tuberculosis. N Engl J Med. 2021;385(26):2441-2450. doi:10.1056/NEJMoa2105470

11. Gebreselassie N, Kasaeva T, Zignol M. A global strategy for tuberculosis research and innovation. Eur Respir J. 2020;56(5):2003539. doi:10.1183/13993003.03539-2020

12. Visca D, Ong CWM, Tiberi S, et al. Tuberculosis and COVID19 interaction: a review of biological, clinical and public health effects. Pulmonology. 2021;27(2):151-165. doi:10.1016/j. pulmoe.2020.12.012

13. Saunders MJ, Evans CA. COVID-19, tuberculosis and poverty: preventing a perfect storm. Eur Respir J. 2020;56(1):2001348. doi:10.1183/13993003.01348-2020

14. Sy KTL, Haw NJL, Uy J. Previous and active tuberculosis increases risk of death and prolongs recovery in patients with COVID-19. Infect Dis (Lond). 2020;52(12):902-907. doi:10.1080 /23744235.2020.180635

15. Pai M, Kasaeva T, Swaminathan S. Covid-19’s devastating effect on tuberculosis care — a path to recovery. N Engl J Med. 2022;386(16):1490-1493. doi:10.1056/nejmp2118145

16. Dheda K, Perumal T, Moultrie H, et al. The intersecting pandemics of tuberculosis and COVID-19: population-level and patient-level impact, clinical presentation, and corrective interventions. Lancet Respir Med. 2022;10(6):603-622. doi:10.1016/S2213-2600(22)00092-3

Publications
CHEST Physician
Author(s)
Patricio Escalante, MD, MSc, FCCP
Paige K. Marty, MD
Author(s)
Patricio Escalante, MD, MSc, FCCP
Paige K. Marty, MD

Click to view more from Pulmonology Data Trends 2022.

Click to view more from Pulmonology Data Trends 2022.

References

1. Tuberculosis fact sheet. World Health Organization. Updated October 14, 2021. Accessed May 24, 2022. https://www.who.int/ news-room/fact-sheets/detail/tuberculosis

2. Tuberculosis deaths rise for the first time in more than a decade due to the COVID-19 pandemic. World Health Organization. Published October 14, 2021. Accessed May 24, 2022. https://www. who.int/news/item/14-10-2021-tuberculosis-deaths-rise-for-thefirst-time-in-more-than-a-decade-due-to-the-covid-19-pandemic

3. Wilson JW, Kissner DG, Escalante P. Cascade of care in the management of latent tuberculosis infection in the United States: a lot to improve and to scale up. Ann Am Thorac Soc. 2021;18(10):1620-1621. doi:10.1513/AnnalsATS.202106-722ED

4. Pedrazzoli D, Wingfield T. Biosocial strategies to address the socioeconomic determinants and consequences of the TB and COVID-19 pandemics. Am J Trop Med Hyg. 2021;104(2):407- 409. doi:10.4269/ajtmh.20-1641

5. Hogan AB, Jewell BL, Sherrard-Smith E, et al. Potential impact of the COVID-19 pandemic on HIV, tuberculosis, and malaria in low-income and middle-income countries: a modelling study. Lancet Glob Health. 2020;8(9):e1132- e1141. doi:10.1016/S2214-109X(20)30288-6. Erratum in: Lancet Glob Health. 2021;9(1):e23. doi:10.1016/S2214- 109X(20)30433-2

6. Harries AD, Kumar AMV, Satyanarayana S, et al. The growing importance of tuberculosis preventive therapy and how research and innovation can enhance its implementation on the ground. Trop Med Infect Dis. 2020;5(2):61. doi:10.3390/ tropicalmed5020061

7. Ugarte-Gil C, Carrillo-Larco RM, Kirwan DE. Latent tuberculosis infection and non-infectious co-morbidities: diabetes mellitus type 2, chronic kidney disease and rheumatoid arthritis. Int J Infect Dis. 2019;80S:S29-S31. doi:10.1016/j.ijid.2019.02.018

8. Frascella B, Richards AS, Sossen B, et al. Subclinical tuberculosis disease–a review and analysis of prevalence surveys to inform definitions, burden, associations, and screening methodology. Clin Infect Dis. 2021;73(3):e830-e841. doi:10.1093/cid/ciaa1402

9. Nathavitharana RR, Garcia-Basteiro AL, Ruhwald M, Cobelens F, Theron G. Reimagining the status quo: how close are we to rapid sputum-free tuberculosis diagnostics for all? EBioMedicine. 2022;78:103939. doi:10.1016/j.ebiom.2022.103939

10. Cattamanchi A, Reza TF, Nalugwa T, et al. Multicomponent strategy with decentralized molecular testing for tuberculosis. N Engl J Med. 2021;385(26):2441-2450. doi:10.1056/NEJMoa2105470

11. Gebreselassie N, Kasaeva T, Zignol M. A global strategy for tuberculosis research and innovation. Eur Respir J. 2020;56(5):2003539. doi:10.1183/13993003.03539-2020

12. Visca D, Ong CWM, Tiberi S, et al. Tuberculosis and COVID19 interaction: a review of biological, clinical and public health effects. Pulmonology. 2021;27(2):151-165. doi:10.1016/j. pulmoe.2020.12.012

13. Saunders MJ, Evans CA. COVID-19, tuberculosis and poverty: preventing a perfect storm. Eur Respir J. 2020;56(1):2001348. doi:10.1183/13993003.01348-2020

14. Sy KTL, Haw NJL, Uy J. Previous and active tuberculosis increases risk of death and prolongs recovery in patients with COVID-19. Infect Dis (Lond). 2020;52(12):902-907. doi:10.1080 /23744235.2020.180635

15. Pai M, Kasaeva T, Swaminathan S. Covid-19’s devastating effect on tuberculosis care — a path to recovery. N Engl J Med. 2022;386(16):1490-1493. doi:10.1056/nejmp2118145

16. Dheda K, Perumal T, Moultrie H, et al. The intersecting pandemics of tuberculosis and COVID-19: population-level and patient-level impact, clinical presentation, and corrective interventions. Lancet Respir Med. 2022;10(6):603-622. doi:10.1016/S2213-2600(22)00092-3

References

1. Tuberculosis fact sheet. World Health Organization. Updated October 14, 2021. Accessed May 24, 2022. https://www.who.int/ news-room/fact-sheets/detail/tuberculosis

2. Tuberculosis deaths rise for the first time in more than a decade due to the COVID-19 pandemic. World Health Organization. Published October 14, 2021. Accessed May 24, 2022. https://www. who.int/news/item/14-10-2021-tuberculosis-deaths-rise-for-thefirst-time-in-more-than-a-decade-due-to-the-covid-19-pandemic

3. Wilson JW, Kissner DG, Escalante P. Cascade of care in the management of latent tuberculosis infection in the United States: a lot to improve and to scale up. Ann Am Thorac Soc. 2021;18(10):1620-1621. doi:10.1513/AnnalsATS.202106-722ED

4. Pedrazzoli D, Wingfield T. Biosocial strategies to address the socioeconomic determinants and consequences of the TB and COVID-19 pandemics. Am J Trop Med Hyg. 2021;104(2):407- 409. doi:10.4269/ajtmh.20-1641

5. Hogan AB, Jewell BL, Sherrard-Smith E, et al. Potential impact of the COVID-19 pandemic on HIV, tuberculosis, and malaria in low-income and middle-income countries: a modelling study. Lancet Glob Health. 2020;8(9):e1132- e1141. doi:10.1016/S2214-109X(20)30288-6. Erratum in: Lancet Glob Health. 2021;9(1):e23. doi:10.1016/S2214- 109X(20)30433-2

6. Harries AD, Kumar AMV, Satyanarayana S, et al. The growing importance of tuberculosis preventive therapy and how research and innovation can enhance its implementation on the ground. Trop Med Infect Dis. 2020;5(2):61. doi:10.3390/ tropicalmed5020061

7. Ugarte-Gil C, Carrillo-Larco RM, Kirwan DE. Latent tuberculosis infection and non-infectious co-morbidities: diabetes mellitus type 2, chronic kidney disease and rheumatoid arthritis. Int J Infect Dis. 2019;80S:S29-S31. doi:10.1016/j.ijid.2019.02.018

8. Frascella B, Richards AS, Sossen B, et al. Subclinical tuberculosis disease–a review and analysis of prevalence surveys to inform definitions, burden, associations, and screening methodology. Clin Infect Dis. 2021;73(3):e830-e841. doi:10.1093/cid/ciaa1402

9. Nathavitharana RR, Garcia-Basteiro AL, Ruhwald M, Cobelens F, Theron G. Reimagining the status quo: how close are we to rapid sputum-free tuberculosis diagnostics for all? EBioMedicine. 2022;78:103939. doi:10.1016/j.ebiom.2022.103939

10. Cattamanchi A, Reza TF, Nalugwa T, et al. Multicomponent strategy with decentralized molecular testing for tuberculosis. N Engl J Med. 2021;385(26):2441-2450. doi:10.1056/NEJMoa2105470

11. Gebreselassie N, Kasaeva T, Zignol M. A global strategy for tuberculosis research and innovation. Eur Respir J. 2020;56(5):2003539. doi:10.1183/13993003.03539-2020

12. Visca D, Ong CWM, Tiberi S, et al. Tuberculosis and COVID19 interaction: a review of biological, clinical and public health effects. Pulmonology. 2021;27(2):151-165. doi:10.1016/j. pulmoe.2020.12.012

13. Saunders MJ, Evans CA. COVID-19, tuberculosis and poverty: preventing a perfect storm. Eur Respir J. 2020;56(1):2001348. doi:10.1183/13993003.01348-2020

14. Sy KTL, Haw NJL, Uy J. Previous and active tuberculosis increases risk of death and prolongs recovery in patients with COVID-19. Infect Dis (Lond). 2020;52(12):902-907. doi:10.1080 /23744235.2020.180635

15. Pai M, Kasaeva T, Swaminathan S. Covid-19’s devastating effect on tuberculosis care — a path to recovery. N Engl J Med. 2022;386(16):1490-1493. doi:10.1056/nejmp2118145

16. Dheda K, Perumal T, Moultrie H, et al. The intersecting pandemics of tuberculosis and COVID-19: population-level and patient-level impact, clinical presentation, and corrective interventions. Lancet Respir Med. 2022;10(6):603-622. doi:10.1016/S2213-2600(22)00092-3

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Reducing Tuberculosis Globally and the Impact of COVID-19
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In 2020, more than 1.5 million people died of tuberculosis (TB), and 10 million people contracted the illness globally.1 The World Health Organization (WHO) End TB Strategy aimed to reduce the number of deaths by 35% between 2015 and 2020, yet reduction was just 9.2% (one-quarter of the goal) during this period.2

TB remains the 13th leading cause of death worldwide and is second only to COVID-19 in terms of pathogen-related mortality.1 In fact, due to a significant shift in attention and resources to COVID-19, the death toll for TB has risen for the first time in over a decade.2,3 This disruption has led experts to take a closer look at the characteristics and disparities surrounding those deaths. Areas of focus are the health and socioeconomic consequences of TB and COVID-19 as they relate to TB-related deaths and biosocial inequities in access to essential care. These factors are predicted to lead to a 20% increase in TB death in high-burden countries.4,5

TB management needs to improve at the clinical and public health levels. Adults and children exposed to patients with TB or subclinical pulmonary TB, open with their own conditions that affect their immune response, are at a particularly high risk for acquiring latent tuberculosis infection (LTBI) and developing active TB. Thus, improved prevention, screening, and treatment strategies are urgently needed.6-8 While efforts are ongoing to improve TB vaccines, recent discoveries and technical developments have shown the potential to substantially improve TB prevention efforts through rapid and accurate diagnostic management and innovation that can benefit people at risk of developing TB in resource-limited settings.9-11 Despite this recent progress, multiple challenges remain, including suboptimal investment in global TB control efforts and innovation, increasing rates of drug-resistant TB, as well as lack of and unequal access to services to patients and individuals in need in many countries across the world.1-3,11

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