Tuberculosis cases and deaths predicted to spike due to COVID-19

Date:
June 24, 2020
Source:
London School of Hygiene & Tropical Medicine
Summary:
A new study estimates that at least 110,000 additional deaths
from tuberculosis in China, India and South Africa unless health
services maintained and strengthened.



FULL STORY ==========================================================================
The global COVID-19 pandemic could significantly increase the global
burden of tuberculosis (TB) due to disruptions to health services, and
delays to diagnosis and treatment, according to new estimates published
in the European Respiratory Journal.


========================================================================== Before COVID-19, over 4,000 people were dying from TB every day. In
countries where health services are strained, there is a fear that TB
cases and deaths could rise significantly.

Researchers from the London School of Hygiene & Tropical Medicine (LSHTM)
and Lancaster University estimated additional TB deaths and cases in
China, India and South Africa over the next five years. They examined
the impact of various reductions in social contacts and impacts on health services due to COVID-19.

The researchers hypothesised that social distancing might reduce TB
incidence as Mycobacterium tuberculosis, the bacteria which causes
the disease, is transmitted via droplets in the air -- similar to the coronavirus.

However, even after taking into account this potential reduced TB
transmission, the most likely scenario was estimated to result in more
than 110,000 additional TB deaths.

In the worst case scenario where the impact of COVID-19 on health services
is severe, this number could rise to up to 200,000 additional deaths.



========================================================================== First author Dr Finn McQuaid, Assistant Professor in Infectious Disease Epidemiology at LSHTM, said: "There is concern that the COVID-19 pandemic
is resulting in decreased TB clinic attendance, delayed diagnosis and treatment.

This is especially so in low- and middle-income countries where health services, or access to them, might be substantially disrupted. Early
anecdotal information from China, India and South Africa suggests that
the number of people being diagnosed and treated for TB has fallen significantly." The team measured the effect of these factors on TB
incidence and deaths in China, India and South Africa, three countries
which make up approximately 40% of the global TB cases. They modelled
different scenarios with various implementations of social distancing
measures and health service disruption lasting for six months to estimate
the impact of COVID-19 on global TB burden.

They found that if there is substantial health service disruption,
such as a 50% reduction in TB cases detected and successfully treated,
there would be an increase in both incidence and deaths from TB over
the subsequent five years, regardless of the level of social contact.

The most probable scenario, based on the current information and
distancing measures, suggests 6,000 additional deaths could occur in
China, 95,000 in India and 13,000 in South Africa.

However, if social distancing measures are minimal and there is
substantial health care disruption -- based on 80% reduction in case
detection and treatment success -- the model predicts an 8-14% increase
in cumulative deaths from TB over the next five years.



==========================================================================
Dr McQuaid explained: "We need to act now to ensure innovative approaches
to people-centric TB care are the focus, so that the fight to end this
pandemic doesn't overwrite the hard-won gains made against this disease.

"Given that health service disruption far outweighs the benefit of social distancing, it is crucial to maintain and strengthen TB-related health
services during, and after, COVID-19.

"It is also important to note that the decline of health services is
likely to have a greater impact on drug-resistance TB patients, as
they often require longer treatment. Additionally, we examined social distancing measures over a six month period, but with the potential
of subsequent waves of the virus, the impact could last longer."
The authors acknowledge limitations of their work including that it did
not take into account setting-specific differences within the countries,
while the effect on service delivery needs to be investigated in greater detail. It also did not incorporate external factors of the COVID-19
pandemic, including increased poverty or reduced access to antiretroviral treatments in areas of high HIV prevalence.

Further research is required to examine these factors, as well as whether
TB patients are at higher risk of severe COVID-19.


========================================================================== Story Source: Materials provided by London_School_of_Hygiene_&_Tropical_Medicine. Note: Content may be edited
for style and length.


========================================================================== Journal Reference:
1. C. Finn McQuaid, Nicky McCreesh, Jonathan M. Read, Tom Sumner,
Rein M. G.

J. Houben, Richard G. White, Rebecca C. Harris. The potential impact
of COVID-19-related disruption on tuberculosis burden. European
Respiratory Journal, 2020; 2001718 DOI: 10.1183/13993003.01718-2020 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2020/06/200624103257.htm

--- up 22 weeks, 1 day, 2 hours, 34 minutes
* Origin: -=> Castle Rock BBS <=- Now Husky HPT Powered! (1337:3/111)