The Clock is Ticking: TB successes eroding amidst coronavirus pandemic

With the COVID-19 pandemic requiring much attention and efforts in the health sector both at the national and global fronts since last year, an estimated 1.

4 million fewer people received care for tuberculosis (TB) in 2020 than in 2019.

Preliminary data compiled by the World Health Organization (WHO) from over 80 countries showed a reduction of 21 per cent decline in TB care in 2020 as compared to 2019.

The countries with the biggest relative gaps were Indonesia (42%), South Africa (41%), the Philippines (37%) and India (25%).

Tuberculosis, although a preventable and curable disease, has taken a large number of lives around the globe.

Nearly 1.5 million people each year die due to this fatal health condition mostly in developing countries.

Before COVID-19 struck, the gap between the estimated number of people developing TB each year and the annual number of people officially reported as diagnosed with TB was about 3 million.

Dr Tedros Adhanom Ghebreyesus, Director-General of the WHO, says the effects of COVID-19 go far beyond the death and disease caused by the virus itself.

"The disruption to essential services for people with TB is just one tragic example of the ways the pandemic is disproportionately affecting some of the world’s poorest people, who were already at higher risk for TB,” he said.

In Ghana, the trends of National TB notification declined rapidly from 15601 in 2019 to 12,251 in 2020.

Dr Yaw Adusi-Poku, Programme Manager of the National TB Control Programme, attributed this to the long waiting time in initiating Drug-Resistant TB cases on Second Line TB treatment which varied widely between regions.

He said 90 per cent of TB patients reported in 2020 were tested for HIV with the Volta region achieving a 98 per cent testing rate while North East had a 67 per cent testing rate.

He told the Ghana News Agency that of TB patients co-infected with HIV, 90 per cent were enrolled on Anti-Retroviral Therapy and this varied from 25 per cent in North East to 100 per cent in Upper East.

"As of 9th February 2020, only 95 per cent of TB patients initiated on treatment in 2019 had their treatment outcomes evaluated," he said.

Similarly in 2020, 83 per cent of the patients whose treatment outcomes were evaluated, were successfully treated.
Treatment outcome evaluations for TB patients are done a year after treatment is initiated. The western region achieved 93 per cent while Upper West achieved 77 per cent.

Dr Adusi-Poku said presently, death rates for TB cases were rising high at 9 per cent while testing for TB patients remained low especially, in the Teaching Hospitals.

He said in 2020, 197 Rifampicin Resistant and or Multi-Drug Resistant TB (RR and or MDR-TB) cases were notified of which 96 per cent of the cases were enrolled on Second Line TB treatment.

The programme manager said despite the effects of the pandemic on TB care, the Upper West Region met its targets for the year while all other regions did not.

These sobering data point to the need for countries to make universal health coverage a key priority as they respond to and recover from the pandemic, to ensure access to essential services for TB and all diseases.

Building up health systems so that everyone can get the services they need is key.

Some countries have already taken steps to mitigate the impact of COVID-19 on service delivery, by strengthening infection control; expanding the use of digital technologies to provide remote advice and support, and providing home-based TB prevention and care.

The WHO says it fears that over half a million more people may have died from TB in 2020, simply because they were unable to obtain a diagnosis.

It said one way to address this is through restored and improved TB screening to rapidly identify people with TB infection or TB disease.

Ghana must make a renewed effort to ensure that TB Control interventions in all parts of the country are strong enough to detect and treat more cases during any future emergency, as it joins the rest of the world to observe World TB day today.

Now is the time for Ghana to also commit more resources to educating the public on TB and the need for the public to stop stigmatising persons with TB infections.

World TB Day is observed on 24 March each year to raise awareness and understanding about one of the world’s top infectious killers and catalyze action to address its devastating health, social, and economic impact around the world.

The theme for this year's World Tuberculosis Day 2021 is, “The clock is ticking”.

Tuberculosis (TB) is a potentially serious infectious disease caused by the Mycobacterium bacteria which mainly affects the lungs.

It spreads through the air and is contagious, people usually get TB when they are in close contact with a person who is already infected.

However, not everyone who has tuberculosis can spread the infection.

Symptoms of active TB infections include cough that lasts more than 3 weeks, chest pain, coughing up blood, feeling tired all the time, night sweats, chills, fever, loss of appetite and weight loss.

Persons infected with TB can develop complications like Joint damage, Lung damage, damage of the bones, spinal cord, brain, or lymph nodes, liver or kidney problems, as well as an inflammation of the tissues around the heart.

TB is curable and treated with medication when diagnosed early.