A lingering epidemic in the face of a pandemic: The tuberculosis dilemma in a high burden region
Considering the accelerated approach to the control of the leading cause of death from a single infectious agent (Mycobacterium tuberculosis) with a goal at ending the epidemic by 2030, this study aimed to evaluate how effective these concerted efforts have been as well as the feasibility of the End TB goals by observing the prevalence trends in a high tuberculosis burden country (Nigeria- Plateau State as a case study) in the past nine years (2012-2020) noting the progress made and the impact of the current pandemic
A 9-year retrospective cross-sectional clinical and laboratory data of patients who presented at the secondary health care facility with clinical symptoms suggestive of tuberculosis infection or have been in close, prolonged contacts with confirmed tuberculosis patients were collated. The initial six years relied on sputum smear microscopy, before the inclusion of GeneXpert in recent years that provided results of resistance to the first-line drug when present.
Of the total 3,093 patients recruited, 412 (13.3%) tested positive with the highest spike in 2016. Reports from 2017 showed a steady decline in the number of reported cases per year. Age, sex and HIV status were found to be significantly associated with infection in the region. Drug-resistant tuberculosis was however low; the highest rifampicin resistance reported (4 cases) was in 2019. Among those infected with TB, 6.6% were co-infected with HIV.
Remarkably, there has been a continuous decline in reported cases within the first 9 months of the pandemic year. However, there was a concurrent reduction in the number of people tested. The slight rise in prevalence recorded could be an early indicator of a resurgence in cases.
We thus conclude that the TB infection requires more attention during the current pandemic to consolidate previous gains and the actualization of the 2030 SDG goals.