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How Has COVID-19 Affected the Global Fight Against Tuberculosis?
Series | COVID-19 and other pandemics
Authors: Isabelle Munyangaju, Alberto García-Basteiro, Elisa López-Varela and Anna Saura Lázaro (ISGlobal)* [ This document is a one of a series of discussion notes addressing fundamental questions about the global health. Its purpose is to transfer scientific knowledge to the public conversation and decision-making process. The papers are based on the best information available and may be updated as new information comes to light. ]
Tuberculosis (TB) remains one of the oldest and leading infectious causes of death in the world; with modern strains of the causative agent, Mycobacterium tuberculosis, dating some 15,000 years back.1 TB was the first infectious disease to be declared a public health emergency in 1993.2 Since then, it has continued to be a public health priority particularly in low and middle income countries (LMIC) which endure the highest burden of disease. TB is usually described as a disease of poverty, as poor income settings across
the globe account for a disproportionately high disease burden. Poor populations are at higher risk of TB infection, progression to disease, and mortality due to povertyrelated risk factors such as living conditions, undernutrition, and comorbidities, among others. The vicious cycle between poverty and TB is well reported in several studies, showing that TB incidence and mortality are closely linked to socioeconomic indicators. Families experience a marked loss of their income and fall further in the grip of poverty.3
* Isabelle Munyangaju, a predoctoral researcher at ISGlobal, is a public health professional based in Mozambique working in the field of infectious diseases (mainly tuberculosis and TB/HIV coinfections). Alberto Garcia-Basteiro is a research associate professor at ISGlobal and coordinator of the tuberculosis research area at the Centro de Investigação em Saúde de Manhiça (CISM) in Mozambique. Elisa Lopez-Varela is a pediatrician and researcher at ISGlobal, where she leads several studies focused on pediatric tuberculosis, HIV and COVID-19 in sub-Saharan Africa. Anna Saura Lázaro is a predoctoral researcher at ISGlobal.
9 June 2022 Photo: Ross Road Community Health Center in Freetown, Sierra Leone. Dominic Chavez / World Bank
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Kefyalew Addis Alene, Kinley Wangdi, and Archie C A Clements, ‘Impact of the COVID-19 Pandemic on Tuberculosis Control: An Overview’, Tropical Medicine and Infectious Disease 5, no. 3 (24 July 2020): 123, https://www.mdpi.com/2414-6366/5/3/123; Thomas M. Daniel, ‘The History of Tuberculosis’, Respiratory Medicine 100, no. 11 (1 November 2006): 1862–70, https://doi.org/10.1016/j. rmed.2006.08.006. 2
Thomas M. Daniel, ‘The History of Tuberculosis’, Respiratory Medicine 100, no. 11 (1 November 2006): 1862–70, https://doi. org/10.1016/j.rmed.2006.08.006; WHO, ‘Global Tuberculosis Report 2021’, 2021, https://www.who.int/teams/global-tuberculosis-programme/tb-reports/global-tuberculosis-report-2021. 3
Devra M. Barter et al., ‘Tuberculosis and Poverty: The Contribution of Patient Costs in Sub-Saharan Africa – a Systematic Review’, BMC Public Health 12, no. 1 (14 November 2012): 980, https://doi.org/10.1186/1471-2458-12-980; Olivia Oxlade and Megan Murray, ‘Tuberculosis and Poverty: Why Are the Poor at Greater Risk in India?’, PLoS ONE 7, no. 11 (19 November 2012): e47533, https://doi. org/10.1371/journal.pone.0047533; The Lancet, ‘Tackling Poverty in Tuberculosis Control’, The Lancet 366, no. 9503 (17 December 2005): 2063, https://doi.org/10.1016/S0140-6736(05)67862-2.
www.isglobal.org
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