There have been some media reports alleging that asudden rise in cases of Tuberculosis (TB) has been noticed among patients who were infected with COVID-19 recently, leaving the doctors worried on receiving around a dozen similar cases every day.
It is clarified that Tuberculosis (TB) screening for all COVID-19 positive patients and COVID-19 screening for all diagnosed TB patients has been recommended by Ministry of Health and Family Welfare (MoHFW).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.
Apart from this, multiple advisories and guidance have also been issued by MoHFW to reiterate the need for bi-directional screening of TB-COVID and TB-ILI/SARI. The States/ UTs have been implementing the same.
Due to the impact of COVID-19 related restrictions,case notifications for TB had decreased by about 25% in 2020 but special efforts arebeing made to mitigate this impact through intensifiedcase finding in OPD settings as well as through active case finding campaigns in the community by all States.
Moreover, there is not enough evidence currently to suggest that there has been an increase in TB cases due to COVID-19or due to increased case finding efforts.
The dual morbidity of Tuberculosis (TB) and COVID-19 can be further highlighted through the facts that both the diseasesare 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.
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.
SARS-CoV-2 infection can make an individual more susceptible to developing active TB disease, as TB is an opportunistic infection like black fungus.