2K Covid patients also tested +ve for TB between Oct-Dec 2020

PUNE Out of the 0

PUNE Out of the 0.133 million Covid-19 cases reported in state between October and December 2020, 2,163 also tested positive for tuberculosis (TB). To keep a check on the drop in notifications of tuberculosis cases in the state, the state health department had started bi-directional testing among Covid1-9 patients who would also be tested for tuberculosis in case of specific symptoms.

Out of the 0.133 million Covid-19 cases reported in state between October and December 2020, 2,163 also tested positive for tuberculosis (TB) (HT FILE PHOTO)

The drastic drop in the notifications of TB which is also a respiratory disease with similar symptoms forced the administration to take stern steps as Tuberculosis is one of the leading causes of deaths in the state.

Dr RS Adkekar, joint director of TB and Leprosy Maharashtra said, “During the pandemic, the health infrastructure was involved in reporting, treating and later vaccinating the Covid-19 patients. However, prior to Covid-19 tuberculosis was one of the main leading causes of deaths in the state. In October we started diagnosing Covid-19 patients with specific symptoms for tuberculosis and over 2,000 tested positive for both the infections. When a patient tested positive for TB as well we got them isolated in a separate room and continued with treatment for both the infections. Tuberculosis can aggravate the symptoms in Covid-19 patients. While both TB and Covid-19 are primarily respiratory infectious diseases and patients show similar symptoms of cough, fever and difficulty breathing, but TB has a longer incubation period and a slower onset of disease.”

The state guidelines stated that the prevalence of TB among Covid-19 patients has been found to be 0.37 – 4.47% in different studies. Studies have shown that history of active as well as latent TB is an important risk factor for SARS-CoV-2 infection. This not only results in increased susceptibility, but also rapid and severe symptom development and disease progression with poor outcomes. Tuberculosis is associated with a 2.1-fold increased risk of severe COVID-19 disease. In addition, TB patients also tend to have co-morbid or living conditions (malnutrition, diabetes, smoking, HIV) that increase their vulnerability.

The state had issued guidelines that for intensive management of TB-Covid co-morbid patients, linkages of TB service facilities with Covid isolation facilities should be established. All Covid positive TB patients, will be admitted to a dedicated centre, if required.

For TB and Covid-19 patients

-Between October and December 2020, of the 133,319 Covid-19 positive patients, 2,163 were diagnosed with Tuberculosis

-Out of 2,163; 487 were from rural parts of the state and 1,676 were from urban areas.

The following activities should be carried out:

-Bi-directional TB-Covid screening: All Covid cases should be screened for TB symptoms using the 4-symptom complex (Cough for > 2 weeks, persistent fever for > 2 weeks, significant weight loss, night sweats), history of contact with TB case, history of TB and those symptomatic should be offered Chest X ray and upfront Nuclear Acid Amplification Test (NAAT) – CBNAAT/TrueNat) for diagnosis of Tuberculosis.

-TB screening for ILI cases: Any ILI case with 4-symptom complex, history of contact with TB case, history of TB, ILI symptoms persisting >10 days

-TB screening for SARI cases: Any SARI case with 4-symptom complex history of contact with TB case, history of TB, SARI symptoms persisting >10 days.