Worrying drop in the number of reported cases of tuberculosis. It has to do with COVID-19

In Poland, the incidence of tuberculosis is systematically decreasing year by year. As Medexpress writes, however, this year, due to the COVID-19 pandemic, the sharp drop in reported cases is not good news.

1. Every year in Poland there is a decrease in reported cases of tuberculosis. Each case of the disease should be entered in the Tuberculosis Registry
2. The sharp decline in tuberculosis cases is related to the COVID-19 pandemic. In all countries, tuberculosis usually affects people from less privileged segments of society, who during a pandemic have even more difficult access to diagnosis than usual
3. The most common symptoms of tuberculosis are dry cough or sputum production. The cough may be accompanied by fever and night sweats. The symptoms of tuberculosis can resemble COVID-19

Principles of tuberculosis prevention in Poland

In Poland, activities related to the prevention and combating of infectious diseases, including tuberculosis, are regulated by law. The Act of 5 December 2008, specifying the principles and procedure for preventing and combating infections and infectious diseases in humans, obliges doctors and medical assistants to report tuberculosis cases.

Cases are reported to state sanitary inspectors, and finally the application forms are sent to the Institute of Tuberculosis and Lung Diseases, where the National Tuberculosis Registry has been kept since 1957. The register is a database that enables the analysis of the epidemiological situation of tuberculosis in Poland and the changes taking place.

A significant decrease in the number of new cases of tuberculosis

In the first months of 2020, there was a significant, incomparably greater than in previous years, decrease in the number of reported cases of tuberculosis in the country. This is a worrying change, most likely a consequence of the difficult access of patients to doctors during the coronavirus pandemic. In all countries, including Poland, tuberculosis mainly affects people from less privileged segments of society who are more vulnerable in a pandemic.

Furthermore, symptoms of tuberculosis are similar to those of COVID-19. It may happen that the exclusion of COVID-19 reduces the vigilance of doctors and patients themselves, who no longer take into account other causes of the ailments. Untreated tuberculosis is progressive and can be fatal, and the patient is a long-term source of infection for those around him.

How is tuberculosis detected in society?

The main method of detecting tuberculosis in the community is passive detection. This procedure is recommended by the World Health Organization (WHO). Passive detection is the search for the disease in people who have self-reported to a medical facility because of symptoms.

In risk groups, mainly those in contact with patients with tuberculosis tuberculosis and those with medical tuberculosis risk factors, tuberculosis is actively detected by screening. Active case detection also occurs when the healthcare professional is alerting himself to symptoms that may be related to tuberculosis.

The most common symptom of tuberculosis is a dry or sputum cough; hemoptysis is less frequent. Coughing occurs in many respiratory diseases, including acute infections, but if it persists for more than 2-3 weeks without improvement, it indicates tuberculosis.

Respiratory symptoms may be associated with fever, night sweats and weight loss. Sometimes a person with tuberculosis does not have obvious symptoms, especially if he is immunosuppressed. It is important to refer to tuberculosis when conducting a medical interview.

Chest X-ray is performed in people suspected of having tuberculosis. Visualization of changes in the lungs is an indication for microbiological tests to detect mycobacteria tuberculosis. Rapid molecular tests (Xpert MTB / RIF or newer Xpert MTB / RIF Ultra), available in mycobacterial laboratories, are important. A positive result of a bacterioscopic sputum test and confirmation with the Xpert MTB / RIF test that the visualized mycobacteria are tuberculosis mycobacteria require immediate treatment. Xpert MTB / RIF detects the genetic material of the Mycobacterium tuberculosis complex and possible resistance of mycobacteria to rifampicin.

In most cases, detecting tuberculosis is not a difficult task. The most important thing is not to forget about tuberculosis when patients return to medical facilities.

The editorial board recommends:

1. Measles vaccine as a hope for an effective weapon against coronavirus?
2. Tuberculosis vaccine tested to fight coronavirus
3. Millions will develop tuberculosis as a result of the coronavirus pandemic

dr hab. n. med. Maria Korzeniewska-Koseła