South Africa saw large drop in the number of people diagnosed with Tuberculosis (TB), between January and June this year. It could be a sign of how the pandemic has affected health services. Globally the Covid-19 pandemic has disrupted TB services, which could lead to an increase in TB deaths.

According to the World Health Organisation (WHO) Global Tuberculosis Report 2020 released last week, the Covid-19 pandemic threatens to reverse recent progress in reducing the global burden of TB.

Disrupting treatment and healthcare

The global number of TB deaths could increase by around two to four hundred thousand in 2020. This would happen if the pandemic disrupts health services so that the number of people diagnosed with and treated for TB falls by 25-50% over a specific period of three months.

“The economic impact of the pandemic is predicted to worsen at least two of the key determinants of TB incidence: GDP per capita and undernutrition,” says the report. “Modelling has suggested that the number of people developing TB could increase by more than 1 million per year in the period 2020-2025.”

The pandemic has led to the reallocation of human, financial and other resources from TB to the emergency Covid-19 response. For example, many countries have reported using the GeneXpert molecular test for TB to diagnose Covid-19 instead. While this has helped make testing for Covid-19 more efficient, it has come at the expense of TB testing.

The advantage of face masks

Covid-19 created a culture of wearing face masks to help stop the spread of the disease in public areas. Experts say masks in sectors like mining could not only protect workers from the novel coronavirus but also minimize the spread of TB.

Speaking on the impact  of Covid-19 on health systems in southern Africa during the Minerals Council’s Masoyise Health Programme last week Dr Willy Amisi said the use of face masks could bear fruit in preventing the spread of the viruses in mines.

“TB and Covid-19 are all airborne diseases which are spread by droplets, when people are coughing and speaking. So if someone wears a mask there is already a barrier between you and the next person. The mask is a good measure to apply in the mining sector, especially this time because the benefits will be double as you will be preventing Covid-19 and TB as well,” says Amisi, who is Senior Program officer for health and nutrition at SADC.

The rising risk of TB

TB is one of the top ten causes of death worldwide and the leading cause of death in South Africa. Globally, 7,1 million people with TB were reported to have been newly diagnosed and notified in 2019. This was an increase from 7 million in 2018 and a large increase from 6.4 million in 2017. Between 2009 and 2012, the number of new infections were between 5,7 million and 5,8 million.

South Africa’s health minister, Dr Zweli Mkhize has also expressed his concerns over the decrease of TB testing.

“Without a doubt 2020 will go down in history as one of the greatest tests ever endured by humanity. We are very concerned to see that HIV testing fell by nearly half and TB testing and primary health care access by carers and children fell by between 9% and 25%,” says Mkhize.

The Covid-19 pandemic has highlighted the importance of infection prevention and control in health care facilities for both health care workers and people seeking care, says the WHO. — Health-e News