TB Screening For All Covid Patients, And Vice Versa: Health Ministry Guidelines

As per the guidelines, people who have influenza-like illness (ILI) or severe acute respiratory infections (SARI) will also be screened for TB.

The Union Ministry of Health and Family Welfare (MoHFW) has issued new guidelines for people who are suffering from either tuberculosis (TB) or Covid-19.

It is highly likely that many people may be suffering from both diseases, hence under the new guidelines, all TB patients will be screened for Covid-19 and those infected with Covid-19 will be screened for TB.

As per the guidelines, people who have influenza-like illness (ILI) or severe acute respiratory infections (SARI) will also be screened for TB. These two illnesses have symptoms similar to TB and COVID-19.

Influenza-like illness (ILI) is defined as the presence of fever of greater than or equal to 100°F, with additional symptoms like cough or sore throat, in the absence of an alternative cause. After an incubation period of 1–4 days, there is an abrupt onset of constitutional and respiratory signs and symptoms which generally lasts 5–7 days.

Since the Covid-19 outbreak, there has been a steady decline in reportage of TB cases in India.

“There has been an overall decline in TB notification by 26 per cent during January-June 2020, as compared to the previous year, due to the COVID-19 pandemic,” the guidelines said.

This has alarmed the health ministry as various studies suggest that there may be significant prevalence of TB among COVID-19 patients. The prevalence of TB among COVID-19 patients ranges between 0.37-4.47 per cent, studies have shown.

Although the health ministry’s latest guidelines has not mentioned any specific study, but it says that history of active as well as latent TB is an important risk factor for SARS-CoV-2 infection”. Tuberculosis is associated with a 2.1-fold increased risk of severe COVID-19 disease, the guidelines document said.

For TB patients who are found COVID-19 positive, the treatment for both would be taken up. Similarly, COVID-19 patients screened for TB would undergo the same treatment for both.

The note also says that the lungs are the primary targets of both TB and Covid-19.

In addition, TB patients also tend to have co-morbid or living conditions (malnutrition, diabetes, smoking, HIV etc) that increase their vulnerability,” the note said.

“If masks become routine in India, just like they are in Japan, then we could well meet our target of eliminating TB by 2025,” pulmonologist Dr Sanjeev Mehta, was quoted  as saying this by The Times of India.

In order to ensure that uninterrupted care is provided to all tuberculosis patents during the pandemic, WHO’s Global TB Programme has developed open access databases for research publications, clinical trials and ongoing research projects at the interface of TB and COVID-19.

Does TB increase the risk of getting COVID-19?

Any damage to the lungs from a pre-existing condition like pulmonary tuberculosis makes people vulnerable to COVID-19. However, there is no data or studies about this association. Irrespective of this, health experts across the world have warned that people with a lung condition like TB need special protection and care during the pandemic.

If a TB patient gets infected from Covid, there is a higher risk that he will suffer from severe Covid illness which will be extremely difficult to treat. As per the WHO notification, we still have a limited data on Covid infection in people with tuberculosis.

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