Dr Lucica Ditiu
Executive Director, Stop TB Partnership
Around 1.5 million people are dying from TB every year. For this reason, the World Health Organization finds clear evidence in favour of systematic testing and treatment for Latent Tuberculosis (LTBI). However, if the prospect of COVID means reduced hospital resources, traditional TB testing (which requires multiple hospital visits) could be compromised.
The World Health Organization (WHO) was half-way through its four-year End TB Strategy when the current coronavirus crisis emerged, and the death toll started to rise.
However, Dr Lucica Ditiu, Executive Director of the Stop TB Partnership, reminds us that “TB remains the biggest infectious disease killer, killing around 1.5million people around the world every year.
“The high-level UN meeting in September 2018 set some very bold targets, including getting 40 million people onto treatment. Two years later, we had very high hopes for our work being successful.”
“Coronavirus is affecting us in a variety of ways,” said Dr Dititu, explaining that TB shared its most common symptom – a dry cough – with COVID-19.
“At the individual level, if you go to a hospital with a cough, you will now be tested for COVID-19. If you don’t have it, you will be sent back out into the community. Every person with TB who does not get diagnosed or treated can infect 15 other people and 10% will go on to develop disease,” said Dr Dititu.
“The more cases that we do not detect, the more infections we will have and problems we will face in the future.”
What’s currently involved in testing for TB?
If a nation declares a public lockdown, or a patient tests positive for COVID-19, they may be asked to immediately isolate. However, if the patient also requires a TB test, or is mid-way through the traditional, multiple-visit TB skin test, their testing will be interrupted as they would not be able to return to the hospital.
A solution could lie in an alternative test for TB. Interferon gamma release assays (IGRAs) are blood tests that produce a more accurate test result – crucially – in a single visit. This ensures that treatment can be started swiftly, and people can isolate as soon as possible if required.
The World Health Organization recognises the vital role that IGRAs play and has endorsed IGRA testing in their guidelines as a critical component of the fight to eradicate TB.
Find out more about a new channel of support for testing and treatment in countries with a high incidence of tuberculosis (TB).
We must listen to the WHO’s advice on TB testing
The availability, cost and access to testing for COVID-19 remains wanting. Let us not take for granted the access we have to testing for TB, like IGRAs. While the world is paying more attention than ever to the guidance of the WHO, we must act on their views that:
- There is clear evidence for the benefit of systematic testing and treatment of LTBI
- We should support IGRA (interferon-gamma release assay) testing globally for at-risk populations
“These are very complicated challenges to overcome,” says Dr Dititu, “but I am 100% sure that if we don’t tackle them, we will lag behind on reaching our targets. We have to make people aware of this risk.”