A new study by researchers from the London School of Hygiene & Tropical Medicine (LSHTM) and Lancaster University estimates that about 110,000 additional deaths from tuberculosis (TB) will be expected in China, India, and South Africa within the next five years.
Furthermore, they find that the COVID-19 pandemic could naturally increase the global burden of TB because of delays to diagnosis, treatment, and interruptions to health services. Their study's findings were published in the clinical journal European Respiratory Journal on June 8, 2020.
Even before the worldwide spread of the coronavirus, over 4,000 people were already dying from TB every day. In developing countries where health services are tight, experts fear that TB cases could increase consequently.
In their paper, the researchers analyzed the impact of distinct reductions in social connections and their effects on health services due to COVID-19. They found that although social distancing might reduce the droplet transmission of Mycobacterium tuberculosis, the pandemic could still cause TB-related deaths to reach more than 110,000.
In the worst-case scenario, the authors say the tally could reach up to 200,000 additional deaths if the impacts of COVID-19 severely affect the health services in the said countries.
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Increased Tuberculosis Death Rates Due to Poor Health Services
According to the first author of the study, Dr. Finn McQuaid, early anecdotal data from China, India, and South Africa suggest that the number of people being screened and treated for TB has significantly decreased since the coronavirus pandemic.
The three countries are said to make up 40 percent of TB cases worldwide. The researchers modeled different schemes with different implementations of social distancing and health service disruptions lasting about six months. This was done to estimate the impact of COVID-19 on the worldwide TB burden.
The researchers have found that if there were about a 50 percent reduction of TB cases identified and treated, there would be a surge in both TB cases and deaths regardless of their social contact level.
Based on current information and distancing measures in each country, the researchers have come up with probable figures leading to approximately 95,000 deaths in India, 13,000 in South Africa, and 6,000 additional deaths in China.
However, in the scenario that social distancing is minimal, and there is significant health care disruption, the model predicts an eight to 14 percent increase in TB-related deaths over the next five years.
Tuberculosis Treatment and Detection Still a Priority
According to Dr. McQuaid, quick action must be done to address the problem and to make sure that the pandemic does not overwrite the hard-won achievements made against tuberculosis.
He adds that it is vital to maintain and enhance TB-related health services even during and after the COVID-19 pandemic. He cautions health providers to note that a slump in health services is likely to have a greater impact on drug-resistance TB patients. This is because these patients would often need a longer duration for their treatment.
The researchers acknowledge the limitation of their study, in such a way that they did not take into account the setting-specific differences among the countries. They say that the effect on medical health service delivery needs to be examined thoroughly.
Moreover, it also failed to incorporate external factors of the coronavirus pandemic, such as increased poverty or insufficient access to antiretroviral treatments in areas with prevalent HIV cases. The researchers say that further research is needed to examine the factors and determine whether TB patients are more at risk of severe coronavirus infections.
