Covid screening for all diagnosed TB patients made mandatory

Amid a surge in tuberculosis (TB) cases, the Union Health Ministry on Saturday directed   its recommendations on TB screening for all Covid-19 positive patients and Covid-19 screening for all diagnosed TB patients.

States/UTs have been asked for convergence in efforts for better surveillance and case finding of TB and Covid-19, as early as August 2020, it added.

However, the Health Ministry has also clarified that so far there is not enough evidence to suggest that there has been an increase in TB cases due to Covid-19.

The Centre has further issued multiple advisories and guidance that reiterate the need for bi-directional screening of TB-Covid and TB-ILI/SARI.

Due to the impact of Covid-19 related restrictions, case notifications for TB had decreased by about 25 per cent in 2020 but special efforts are being made to mitigate this impact through intensified case finding in OPD settings as well as through active case finding campaigns in the community by all States, the directive stated.

The dual morbidity of TB and Covid-19 can be further highlighted through the facts that both the diseases are known to be infectious and primarily attack the lungs, presenting similar symptoms of cough, fever and difficulty in breathing, although TB has a longer incubation period and a slower onset of disease, it adds

Furthermore, TB bacilli can be present in humans in a dormant state and has the potential to start multiplying when the individual’s immunity is compromised for any reason.

The same is applicable in post Covid scenario, when an individual may develop decreased immunity due the virus itself or due to the treatment, especially immune-suppressants like steroids, it also added.

SARS-CoV-2 infection can make an individual more susceptible to developing active TB disease, as TB is an opportunistic infection like black fungus, further states.

With an estimated 2.69 million new cases every year, India has the world’s highest burden of tuberculosis, according to the WHO report 2019. Every fourth Multi Drug Resistant-TB patient is from India.

According to the WHO, tuberculosis and COVID-19 are both infectious diseases that attack primarily the lungs. Both diseases have similar symptoms such as cough, fever and difficulty breathing. TB, however, has a longer incubation period with a slower onset of disease. Incubation period refers to the time gap between contracting an infection and experiencing its symptoms.

“While experience on COVID-19 infection in TB patients remains limited, it is anticipated that people ill with both TB and COVID-19 may have poorer treatment outcomes, especially if TB treatment is interrupted,” the WHO had warned.

Last year, the health ministry had informed that the prevalence of TB among COVID19 patients was found to be 0.37 per cent to 4.47 per cent in different studies.