An Oxford Immunotec spotlight
Tuberculosis (TB) remains a serious, global public health problem
Until the coronavirus (COVID-19) pandemic, TB was the leading cause of death from a single infectious agent, ranking above HIV/AIDS. To drive the efforts to end the global epidemic of TB, the World Health Organization (WHO) publishes a global TB report every year. This report provides us with an up-to-date overview of the status of the TB epidemic, with a focus on progress towards the global commitments, strategies and targets that have been outlined as key in the fight against TB.
The Global TB Report 2022 was published in October, and it has provided an opportunity for Oxford Immunotec to understand the ever changing global TB picture, and reassess how we can best support global efforts. The 2022 report highlights the continued damaging impact of the COVID-19 pandemic, and urges those leading the fight to end TB to intensify our efforts. In light of this, we wanted to share our thoughts on how accessible and effective testing for TB is more important now than ever before.
Latent TB screening plays a critical role in controlling the TB burden
It is no surprise that the COVID-19 pandemic has led to a reduction in access to TB diagnosis and treatment, and this has subsequently worsened the global burden of TB disease. The diagnosis of latent TB has been recognised as a key pillar in the fight against TB for many years now. If TB can be accurately detected, diagnosed and treated while the infection is in its latent stage, then this can prevent infected individuals from developing active TB, and spreading the bacteria to others. As such latent TB screening plays a critical role in controlling the TB burden. In the Global TB Report 2021, it was reported that there had been a large drop in TB case notifications, as a result of people not being able to access testing.
In 2022 we have heard that the number of TB notifications is starting to recover but we are still not back to pre-COVID levels. This is thought to be due to:
·???????ongoing reductions in health system capacity
·???????reduced ability to seek care
·???????concerns over accessing healthcare settings
·???????stigma associated with the similar symptoms of TB and COVID
A sharp reversal in the progress to end TB
Reductions in the reported number of individuals who have been newly diagnosed with TB in the 2021 and 2022 reports suggest that more people who have acquired TB infections are going undiagnosed and untreated. This is confirmed by the reported increases in the number of TB deaths globally.
The 2022 report states that whilst the COVID-19 pandemic has made measuring TB burden and associated deaths more challenging, the WHO estimates that there were 1.6 million TB deaths in 2021, an increase from the estimated 1.5 million in 2020. This has reversed the trend seen in the years leading up to 2019 which had seen year-on-year reductions in the number of TB deaths due to the global efforts to end TB.
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In addition to this, the 2022 report estimated that 10.6 million people fell ill with TB in 2021, an increase from 10.1 million in the 2021 report. This again has reversed many years of slow decline in the number of people developing active TB, and represents a sharp reversal in the progress that has been made towards reducing the burden of TB.?
This is also alarming as there is generally a lag that occurs between latent TB being missed, and people developing active TB, meaning that we may not yet be seeing the full effect of the reduced testing and treatment that occurred during the COVID-19 pandemic.
The importance of finding TB
The 2022 report highlights several areas for concern, it also includes some positive findings.
1.?????The success rate for people treated for TB remained high in 2020, suggesting that the quality of care was maintained despite the COVID-19 pandemic
2.?????The number of people being provided with TB preventive treatment has recovered to close to 2019 levels
These findings highlight how important accurate and accessible latent TB screening is in the fight to end TB by showing us when TB is accurately identified, it can be successfully treated which leads to a reduction in illness, onward transmission, and death. The drops in TB notifications, together with the increases in the incidences of TB illness and deaths tell us that finding latent TB truly is more important than ever.
The Global TB Report 2022 has helped us to understand the status of the TB epidemic, and has highlighted how hard we will have to work to get TB management back on track. Every year the WHO reports remind us how important global collaboration is when tackling global health threats. At Oxford Immunotec, we are moving into 2023 with a renewed sense of purpose – together, we can end TB.
What would more accurate and accessible latent TB testing mean to you?
Resources
Global tuberculosis report 2022. Geneva: World Health Organization; 2022. Licence: CC BY-NC-SA 3.0 IGO.