Every March 24, pulmonologists remember that tuberculosis is still there, without a vaccine to prevent it. The incidence of it has gone down, but you should not let your guard down. We must not forget that there was a time, not so long ago, when there were tuberculosis hospitals, such as the one in Los Llanos de Albacete, which has now disappeared, but with patients and professionals who still testify to its existence.
Pulmonologists ask not to let your guard down
World Tuberculosis Day is commemorated every March 24. This date, sponsored by the World Health Organization (WHO), recalls Robert Koch’s famous speech in 1882 in which he announced that the Mycobacterium tuberculosis was the causative agent of tuberculosis. Since then, enormous advances have been made in the fight against the disease, with a progressive decrease in the number of cases and an improvement in treatments; that have made tuberculosis a disease with an excellent cure rate.
However, the Spanish Society of Pneumology (SEPARATE) insists that, despite being such an old disease, we still do not have effective vaccines to prevent it.
The impact of the SARSCoV2 pandemic on health care services has meant that, for the first time in two decades, the WHO reported in its annual report an increase in the number of patients and deaths from tuberculosis.
It is estimated that in 2021 worldwide there were 10.6 million new patients and 100,000 more deaths. In total, 1,600,000 people died from tuberculosis. The number of cases increased by 4.5% and deaths by 6.6%.
Currently, the tuberculosis situation in Spain “is satisfactory, with an incidence of about 7.6 cases per 100,000 inhabitants per year. However, this does not mean that the disease has disappeared or that the level of surveillance can be lowered” in the words of Dr. Eva Tabernero, director of the Integrated Research Program (PII) in Tuberculosis of the Spanish Society of Pneumology and Thoracic Surgery ( SEPARATE).
The disease of the immunosuppressed and immigrant elderly
Tuberculosis continues to be a potentially serious problem, with a long treatment that also causes side effects. In our environment it is concentrated in vulnerable populations: the elderly, the immunosuppressed and immigrants from highly endemic countries”, added Dr. Sarai Quirós, coordinator of the area of tuberculosis and respiratory infections of the scientific society.
drug shortages
Despite the good evolution of tuberculosis in our country thanks to the control programs, “we must point out some difficulties that arise in daily practice, such as the periodic shortage of essential anti-tuberculosis drugs, and the increase in cases of multi-resistant tuberculosis , for whose treatment we have for the first time this year funding for some of the drugs currently considered first-line, both by the WHO and by the Spanish Society of Pneumology and Thoracic Surgery (SEPAR), such as bedaquiline. However, we still do not have rifapentine, a drug that is necessary for the new shorter treatment regimens and formally recommended by the WHO”, stated the pulmonologist Eva Tabernero.
“Don’t stop thinking about tuberculosis”
On the other hand, we must bear in mind that the decrease in the number of tuberculosis cases in our country means that it is consulted later and is less suspected; which entails a significant delay in diagnosis and the consequent increased risk of dissemination in the community. “For all these reasons, it is still necessary, especially after the Covid-19 pandemic, not to stop thinking about tuberculosis and to continue investing in research and control programs,” concluded Dr. Francisco García Río, president of SEPAR.
