Tuberculosis and malaria in the age of COVID-19
Medikoe Wellness Expert
80 feet road indira nagar, Bengaluru Jul 29, 2021
With the world still facing the COVID-19 outbreak and hoping for vaccine rollout, 2020 world health organisation worldwide reports on TB and malaria are timely reminders that these infections remain two of the three most lethal infectious diseases. A pivotal question in early 2020 was how the added strains of the pandemic on healthcare systems would influence their management, with some dreadful early conjectures. So, where are we now?
TB elimination is on the correct track, but progress is more inactive than necessary to reach the 2030 Sustainable Development Goals target of decreasing the rate by 80% and death rate by 90% from the levels of the year 2015. By 2020, this rate has fallen by 9% (target 20%) and death rate by 14% (target 25%). Approximately 3% of 2019 cases and 18% of former cases were found to be rifampicin-resistant. There is still a huge between-region variability, with the low-burden European nations already at the SDG milestones and the high-burden African Region advancing well. However, the three highest-burden nations (China, Indonesia, and India) are lagging, emphasising the need for additional investment in testing, prevention, treatment, and research capabilities.
By June 2020, TB screening and notifications of new diagnoses decreased sharply due to the repurposing of diagnostic machines, budgets, health facilities and workers, and lapses in the data reporting. Disruptions of a similar kind of nature have affected malaria-endemic nations, especially delayed deliveries of chemoprophylaxis and bed-nets before seasonal peaks (affecting prevention) as well as stay-at-home orders for people suffering from fever (affecting diagnosis and treatment access).
From experience so far, maybe the worst predictions have not yet materialised. There are still diseases that do not exist in isolation, and one COVID-19 management scenario might work well for tuberculosis but intensify the malaria burden, creating the need for extremely complex policy decisions. The bottom line is that while healthcare workers in endemic countries have battled exceptionally hard on three fronts, policymakers cannot forget that tuberculosis and malaria are greater long-term threats than COVID-19. Planning of resource allocation must account for that.
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