Diseases A-Z List

Preventive TB Treatment Could Avert Close To 1 Million Deaths, Study Finds

 

Most COVID-19 cases in Danish K-9 schools in fall 2021 didn't trigger clusters, but when they did, they were large, suggests a study published today in Epidemiology & Infection.

A team led by Serum Institut researchers in Copenhagen conducted a register-based, observational study linking student-level data on COVID-19 test results and vaccination status of children aged 6 to 15 years with grade-level and school-specific information from August 9 to December 19, 2021.

The SARS-CoV-2 Delta variant was dominant throughout the study, public health restrictions were minimal, and school COVID-19 testing was in place. The researchers defined clusters as three or more cases in a grade within 14 days of a primary case.

42% of cases tied to clusters

By study end, 2.5% of children in grades 0 to 4 and 63.1% in grades 5 to 9 were vaccinated. Almost all children (94.4%) were tested at least once.

A total of 75,225 COVID-19 infections were detected among 75,168 children (12.1% of all children). Overall, 5.7% of children were infected before the study. One or more infections were detected in 96.2% of schools, and 76.5% of 1,300 schools reported at least one cluster.

Overall, 21,497 case introductions and 7,518 clusters consisting of 55,912 cases were identified. More cases and clusters were identified in lower (4,239) than in higher grades (3,281). Of 21,497 case introductions, 41.6% produced a cluster. Overall, 74.4% of cases were linked to clusters of 3 to 65 infections.

Overall, more cases and clusters had been seen in the lower class levels, where children were mainly unvaccinated.

A higher assumed within-grade immunity level due to vaccination or previous infection appeared to significantly lower the likelihood of a link between a case introduction and a cluster (eg, immunity of at least 80% vs less than 20%; odds ratio [OR], 0.28). A previous infection in the primary case protected against clusters (OR, 0.58).

"Overall, more cases and clusters had been seen in the lower class levels, where children were mainly unvaccinated, than in higher class levels," the study authors wrote. "It further indicates that vaccination of children markedly reduces the risk of secondary infections."

Namibia Hosts Workshop On Combating Tuberculosis In Mining Communities

WINDHOEK, July 31 (Xinhua) -- Namibia's Ministry of Health and Social Services (MHSS), in collaboration with the East, Central and Southern Africa Health Community, is hosting a workshop on tackling tuberculosis (TB) and enhancing health and safety standards in the mining sector.

Speaking at the opening ceremony on Monday, MHSS Executive Director Ben Nangombe said the workshop aims to address the persistent TB epidemic in the mining communities of Southern Africa and develop country-wide implementation of standard operating procedures on mine health and safety.

The key objectives of the workshop include educating and training relevant organizations, developing advocacy plans, and communicating key strategies to prioritize prevention, screening, and treatment of TB in mining communities, Nangombe said.

In Namibia, TB remains a burden, particularly among mineral miners and people living with HIV, he said.

"One group at exceptionally high risk of contracting TB is mineral miners. Working conditions inside mines create a high-risk environment for TB transmission, resulting from confined and poorly ventilated environments conducive to transmission," Nangombe said. "The TB incidence among miners is estimated to be as much as 10 times higher than in the populations from which they originate."

"Prioritization of TB services in the mining communities is of paramount importance," he said.

Nangombe said addressing the social determinants of health in the mining sector, such as poor working conditions, inadequate housing, and limited access to healthcare, will be critical to stemming the spread of TB.

In 2022, Namibia was ranked as the ninth-highest in the world for TB incidence, with a rate of 460 cases per 100,000 people, according to the World Health Organization.

Still The Highest In The World, The Government Continues To Accelerate The Elimination Of Tuberculosis

The following article was translated using both Microsoft Azure Open AI and Google Translation AI.

KRIS - BIRO PERS SEKRETARIAT PRESIDEN

The limited meeting on tuberculosis (TBC) led by President Joko Widodo was held in the Merdeka Palace, Jakarta, on Tuesday, July 18, 2023. Indonesia still remains the second largest country in the world in terms of TBC sufferers after India, with an estimated number of cases reaching 969,000 per year.

JAKARTA, KOMPAS - Indonesia remains the second largest country in the world with tuberculosis or TB sufferers after India, with an estimated number of cases reaching 969,000 annually. The government continues to accelerate the elimination of TB in the country through various measures, ranging from intensifying surveillance or detection, treatment, to vaccination.

"Until before Covid-19, the most that could be identified was around 545,000 cases. So the remaining 400,000 cases were not detected, even though this is a contagious disease that can spread everywhere," said Minister of Health Budi Gunadi Sadikin at the Presidential Palace Complex in Jakarta, after attending a limited meeting on tuberculosis chaired by President Joko Widodo at the Istana Merdeka in Jakarta on Tuesday (18/7/2023)."

Indonesia is the second largest country with TB sufferers after India. Following Indonesia, China is ranked third. TB is a contagious respiratory disease that is similar to Covid-19 and has a higher annual death rate than Covid-19. The number of deaths due to TB each year reaches 200,000 or higher than deaths due to Covid-19.

Since the end of 2022, the government has accelerated detection efforts, resulting in the ability to detect around 720,000 TB carriers, compared to only around 540,000 previously. The Minister of Health hopes that this number can increase to 90 percent of the estimated 969,000 TB carriers. "So, there are several things we need to know, this disease has existed for thousands of years and now only remains in several large countries," he added.

To increase the detection rate, President Joko Widodo directed the Minister of Health to collaborate with the Minister of Home Affairs and the Minister of Villages, Disadvantaged Regions, and Transmigration. "We hope that by 2024, 90 percent of the estimated number of 969,000 cases can be found or detected," he added.

Also read: Improve Access to Diagnosis of Tuberculosis in Children

KOMPAS/CYPRIANUS ANTO SAPTOWALYONO

Minister of Health Budi Gunadi Sadikin giving a press statement at the Presidential Palace complex in Jakarta on Tuesday (18/7/2023).

Once detected, other problems that arise are related to the treatment process for at least six months. Pills that must be taken in large quantities, namely 5-7 pills. "So lazy people don't have the discipline to take their medicine until it's finished. If he is not disciplined until finished because this is an antibiotic, later he can develop resistance, this is even more difficult, he can take the medicine for up to 20 months," said the Minister of Health.

Various community organizations must be mobilized to boost compliance in taking medicine until the disease is completely cured. "We have collaborated with several community organizations to help people take their medicine until the end. The medicine is available at the community health center, and the community just needs to take it until it is finished," said the Minister of Health.

Various community organizations must be mobilized to increase compliance in taking medication until the disease is completely cured.

Regarding the treatment, President Jokowi has instructed to prepare a special quarantine nearby the location where tuberculosis occurs for two months. In addition to preventing the disease from spreading to the patient's family, quarantine is also expected to make tuberculosis patients disciplined in taking their medication. Treatment for tuberculosis takes six months with a minimum of two full months for the medication to take effect.

"So for two months, he didn't transmit the virus to his family and was placed in special quarantine. I was instructed to work with the Minister of Public Works and Housing under the coordination of the Coordinating Minister for Human Development and Culture, so that he wouldn't transmit the virus and given medication, ensuring that he took medication continuously for two months," he said.

The government is currently conducting a study to bring in a new TB vaccine because the effectiveness of the BCG vaccine is considered low, at only 50 percent. According to the Minister of Health, Indonesia is currently actively participating with world organizations and there are three potential new vaccines that will be brought in by the government.

"The closest thing is the vaccine found by Glaxosmithkline (GSK), then taken over by the Bill and Melinda Gates Foundation, now it is in the process of conducting a clinical trial in Indonesia, in collaboration with the Ministry of Health and UI (University of Indonesia). ), and Padjadjaran University, with BPOM (Food and Drug Supervisory Agency)," said the Minister of Health.

Also read: Break the Tuberculosis Transmission Chain

KOMPAS/ERIKA KURNIA

Nurjanah and her child had a consultation with a nutritionist at the Cakung Barat Community Health Center, in the Cakung district of East Jakarta, on Tuesday (4/4/2023).

In addition, there are two mRNA vaccine candidates. "We are collaborating with foreign parties so that if it's mRNA, it will be faster like Pfizer and Moderna. So, there are three new TB vaccine candidates that we are currently studying their usage," added the Minister of Health.

Regarding budget allocation, the Health Minister mentioned that the Ministry of Health received donations from various parties, such as from USAID, which amounted to 70 million US dollars for the TB alleviation program. The budget is not only used by the government but also by community-based institutions to help eradicate TB among the people.

"Regarding tuberculosis, from a budget perspective, it is not a problem. In addition to the existing government budget, the donations are far greater than the government's own budget," he said.

Contacted separately, Global Health and Security Researcher from Griffith University Australia, Dicky Budiman, emphasized that the high incidence of TB reflects that Indonesia is still classified as a developing country, even a poor country. This is because TB arises from poor environmental and household ventilation conditions, as well as poor nutrition.

In addition, low literacy also has an impact on the high cases of tuberculosis (TB). TB patients also tend to feel ashamed to seek treatment. "Because having experienced this for decades, it means that this is a chronic case that I think is still being neglected and has not received adequate attention from the government," said Dicky.

The WHO data states that the number of TB cases in Indonesia are 391 per 100,000 population in 2020. TB affects all age groups, but is mostly found among adult male populations in Indonesia. The challenges faced in Indonesia are still related to diagnosis and therapy, drug resistance, and negative stigma.

---