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Indian Pediatr 2020;57: 1082 |
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Tuberculosis During Covid-19 Pandemic: Challenges and
Opportunities
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Prawin Kumar and Jagdish P Goyal*
Department of Pediatrics, All India Institute of
Medical Sciences, Jodhpur, Rajasthan, India.
Email:
[email protected]
Published Online: September 05,
2020;
PII: S097475591600241
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Both novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)
and Mycobacterium tuberculosis involve the lungs and share
symptoms like cough, fever, and respiratory difficulty. The transmission
for both agents is through aerosol and close contact, although the
incubation period for tuber-culosis is relatively longer. There is
limited experience of COVID-19 infection in tuberculosis (TB) patients,
but it is estimated that there may be a catastrophic impact of COVID-19
on TB [1]. This pandemic of COVID-19 has elicited social stigmata and
discriminatory behaviour, coupled with pre-existed TB related stigmata
[2,3]. Together, it is likely to increase the burden on the family as
well as on limited resources in developing countries.
Currently, GeneXpert is the primary diagnostic tool
for TB; however, its equipment is shifted and being used for COVID-19
testing, which is seriously jeopardizingthe testing capacities for TB
[4]. Moreover, the protection of health care staff involved in the TB
program is a big concern, as sputum production is considered as an
aerosol generating procedure [5]. Further-more, access to health care
facilities is also hampered due to lockdown.This may lead to
interruption of treatment and increase the possibility of drug
resistance TB (DR-TB). All stakeholders should ensure that gene expert
machines during the COVID-19 pandemic should be used in such a manner
that there should be fractional testing for both COVID-19 and TB. Health
care workers (HCW) and other personnel involved in TB care should be
retrained on the importance of universal safety precautions and
infection prevention control. The mechanism of the door to door drug
delivery needs to be developed and strengthened in such an extent that
the treatment of TB will not be hampered. The universal use of masks in
COVID-19 will also help in reducing the incidence of TB, and considering
the high TB burden in India, this practice should be continued in the
post-COVID era too, especially in crowded areas.
We feel that lessons learned from this pandemic can
be fruitfully be used for tuberculosis eradication in future.
REFERENCES
1. Boffa J, Mhlaba T, Sulis G, et al. COVID-19
and tuberculosis in South Africa: A dangerous combination. S Afr Med J.
110:2020. Published online 2020 March 27.
2. Alagna R, Besozzi G, Codecasa LR, et al.
Celebrating World Tuberculosis Day at the time of COVID-19. Eur Respir
J. 2020;55:2000650.
3. Adepoju P. Tuberculosis and HIV responses
threatened by COVID-19 [published online ahead of print, 2020 Apr 8].
Lancet HIV.
4. World health Organization (WHO) Information Note
onTuberculosis and COVID-19. Accessed May 6, 2020. Available from:
https://www.who.int/tb/COVID_19 consi-derations_ tuberculosis_
services.pdf
5. Tuberculosis and Covid 19. Accessed May 23, 2020.
Available from:
https://www.who.int/docs/default-source/documents/tuberculosis/infonote-tb-covid-19.pdf
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