We may see a spike in TB deaths by the end of the year
–
The COVID pandemic is a major challenge for health systems. Prophylactic check-up programs were discontinued almost all over the world, and for the first time in the world in many countries, including Russia, activities related to the prevention of tuberculosis were suspended. Today experts are sounding the alarm: by the end of the year we may get a new surge in mortality from infectious killer number one – tuberculosis. The World Health Organization (WHO) predicts an increase in mortality from “consumption” to 1.9 million people (usually 1.5 million die a year).
–
Experts note that the tuberculosis epidemic, which is constantly increasing its pace, is hundreds of times more dangerous than the coronavirus epidemic. For example, mortality with it is much higher – despite the fact that everyone knows about its causative agent. According to the chief phthisiatrician of the Ministry of Health of the Russian Federation, professor, director of the National Medical Research Center of Phthisiopulmonology and Infectious Diseases Irina Vasilyeva, 10 million people fall ill with tuberculosis in the world every year. “We know everything about this infection: how it is transmitted, how to carry out prevention, how to treat it. However, tuberculosis continues to maintain its high positions in the world. And Russia is on the list of 30 WHO countries with a high burden of tuberculosis, and is also included in the list of three countries for which accounts for half of all cases of multidrug-resistant tuberculosis, so only 55% of our patients are cured, while in Europe 70%. “
Until the late 1940s, tuberculosis was classified as an incurable disease. Then drugs appeared – and mortality began to decline. Russia achieved the best results by 1990, while the country had a well-built system of assistance, diagnostics and treatment. But after the collapse of the USSR, the system collapsed and the rates of morbidity and mortality began to rise. “An epidemic has begun,” says Professor Vasilyeva. “Growth was recorded for ten years, during which both morbidity and mortality increased by 3 times.
For example, the coronavirus is spreading rapidly, but the mycobacterium tuberculosis multiplies slowly, which is why the epidemic has been developing for so long. Another 10 years were spent on the plateau. And only in recent years has a slow decline started. From 13th place on the WHO list in 2013, we went to 20th in 2018. But we are very far behind Europe. Over the past 6 years, the incidence in Russia has decreased by 35%. “
However, the pandemic has badly damaged all indicators and is about to nullify all the painstaking achievements of many years. So, according to Vasilyeva, in the first half of 2020, half of the number of patients with tuberculosis was detected in the country than in previous years. “But the reason is not that there are fewer of them. Prophylactic screening measures were simply suspended – and many patients were simply not identified. However, by the end of the year, a surge in growth in both morbidity and mortality is possible. We are very much afraid of the growth of tuberculosis and must do everything possible. to keep the epidemic in our hands, but today it is spiraling out of control. “
As noted by the WHO Special Representative in Russia Melita Vujnovich, since the beginning of the year in the countries of the WHO European Region, the number of notifications of tuberculosis has decreased by 50%: “The system has stopped due to the pandemic. But if we do not diagnose tuberculosis now, the situation will worsen significantly. Even in countries and regions of Russia, where today the situation with coronavirus is tense, you need to pay attention to patients with tuberculosis – today you can use the possibilities of telemedicine for this. Today there is nothing difficult in treating tuberculosis at home, if you organize monitoring of the patient using modern equipment ” …
Teresa Kasaeva, Director of the WHO Tuberculosis Control Department, notes that the number one infectious killer in the world continues to attack, and by the end of the year, a sharp increase in mortality due to it is predicted: “Before the pandemic, many countries have made some progress. But tuberculosis goes hand in hand with social shocks – and after any crisis, outbreaks of tuberculosis are recorded in all countries.The pandemic was precisely this shock, the provision of care for these patients in many countries was stopped, as a result, an increase and more aggressive spread of antibiotic-resistant forms of tuberculosis began. To return to normal, it will take decades. “
Valentina Aksenova, the chief freelance pediatric TB specialist of the Ministry of Health of the Russian Federation, urged to resume the system of immunodiagnostics of children and adolescents as soon as possible, which was also discontinued. (However, new instructions were issued to cover 90% of the child population by the end of the year). “In recent years, we have almost achieved a decrease in the incidence rate of the child population to the level of the early 1990s, however, during the pandemic, our inpatient and sanatorium services have practically ceased to work – we now have uncontrolled treatment of patients and uncontrolled observation of risk groups, canceled immunodiagnostics and fluorographic examination of the child population. Children’s tuberculosis manifests itself differently than in adults – without sputum, without special symptoms, and patients can be identified only by immunodiagnostic methods. “
Experts expressed hope that the situation will be dealt with. “It’s time for health systems to resume their normal work,” said Melita Vujnovic.
– .
