WHO GLOBAL TB REPORT

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Context: The WHO Global TB Report for 2022 highlights a concerning trend in the fight against tuberculosis. Despite progress made in the past years, the impact of COVID-19 disruptions on healthcare systems has hampered efforts to combat the disease effectively.

Key points from the report

Increase in New Cases

• In 2022, there were 7.5 million newly diagnosed cases of TB globally. This marked the highest number since the WHO began monitoring TB cases in 1995.
• In 2020, there were 5.8 million TB cases globally.
• In 2021, the number of TB cases increased to 6.4 million.

COVID-19 Disruptions

• The COVID-19 pandemic strained healthcare systems worldwide, diverting resources, personnel, and infrastructure away from routine health services, including TB diagnosis and treatment.
• Lockdowns, travel restrictions, and fear of exposure to COVID-19 deterred individuals from seeking medical care, resulting in delayed access to healthcare facilities for TB screening and diagnosis.
• The surge in COVID-19 cases overwhelmed healthcare facilities, making it challenging for them to maintain the same level of TB diagnosis and treatment services, leading to a backlog.
• Disruptions in global supply chains affected the availability of TB diagnostic tests and medications, making it even more difficult to provide timely care to TB patients.
• Many healthcare workers were reassigned to COVID-19-related tasks, leaving a shortage of personnel for TB diagnosis and treatment services.
• The fear of contracting COVID-19 in healthcare settings made many individuals reluctant to visit hospitals or clinics, resulting in delayed diagnosis and treatment of TB cases.
• Mass screening and active case-finding programs were scaled back or halted during the pandemic, allowing TB cases to go undetected.
• Some TB patients face interruptions in their treatment due to lockdowns, quarantine requirements, or difficulties in obtaining medication, which can lead to drug resistance and prolonged illness.
• Economic challenges resulting from the pandemic made it harder for individuals to afford healthcare services, further delaying TB diagnosis and treatment.
• Efforts and resources focused on COVID-19 took precedence, leading to a temporary neglect of TB control and prevention measures, exacerbating the TB backlog.

Global TB Targets

• Despite efforts to combat TB, global targets set by the WHO have either been missed or are off track.
• The net reduction from 2015 to 2022 was 8.7%, falling far short of the WHO's End TB Strategy milestone of a 50% reduction by 2025.

High Impact Countries

• India, Indonesia, and the Philippines, which had previously made significant progress in reducing TB cases, experienced setbacks in 2022.
• These countries collectively accounted for nearly 60% of the reduction in newly diagnosed TB cases in 2020 and 2021 but saw an increase in cases in 2022.

Impact on Mortality

• TB caused an estimated 1.30 million deaths in 2022, approaching the level seen in 2019.
• COVID-19 disruptions are estimated to have resulted in nearly half a million excess deaths from TB between 2020 and 2022.

Treatment Success Rates

• Despite challenges, there was an improvement in treatment success rates.
• 88% of people treated for drug-susceptible TB and 63% of people with multidrug-resistant TB (MDR-TB) or rifampicin-resistant TB (RR-TB) had successful outcomes.

Call to Action

• The report emphasizes the need for translating the commitments made at the 2023 UN high-level meeting on TB into action to effectively combat the global TB epidemic.

Tuberculosis (TB)

• Tuberculosis (TB) is a bacterial infection caused by Mycobacterium tuberculosis.
• It primarily affects the lungs but can also affect other parts of the body, such as the kidneys, brain, spine, and skin.
• TB is spread through the air when an infected person coughs, sneezes, or spits, and someone else inhales the bacteria.

Symptoms

• People with latent TB infection do not show symptoms and are not contagious.
• People with active TB may experience symptoms such as prolonged cough (sometimes with blood), chest pain, weakness, fatigue, weight loss, fever, and night sweats.

Risk Factors

• Individuals with weakened immune systems, such as those with HIV/AIDS, are at higher risk.
• Diabetes, malnutrition, and tobacco use can increase the risk of developing TB.

Prevention

• The Bacille Calmette-Guérin (BCG) vaccine is given in some countries to prevent severe forms of TB in children.
• Seeking medical attention for symptoms like prolonged cough, fever, and unexplained weight loss is crucial.
• Practising good hygiene, wearing masks, and avoiding close contact with infected individuals can help prevent transmission.

Diagnosis

• Rapid molecular diagnostic tests like Xpert MTB/RIF Ultra and Truenat assays are recommended for diagnosing TB.
• Tuberculin skin tests (TST) and interferon-gamma release assays (IGRA) can identify TB infection.

Treatment

• TB disease is treated with antibiotics such as isoniazid, rifampin, pyrazinamide, ethambutol, and streptomycin.
• Multidrug-resistant TB (MDR-TB) requires specialized treatment due to resistance to standard drugs.

Conclusion

• These findings of the report highlight the urgent need for continued efforts and resources to combat TB globally and address the challenges exacerbated by the disruptions caused by the COVID-19 pandemic.

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TUBERCULOSIS: https://www.iasgyan.in/daily-current-affairs/tuberculosis