Doctors told me I'd be 'very unlucky' to have TB in Australia. A week later I tested positive

Increased Tuberculosis Risk In Individuals With Diabetes And Past COVID-19

Photo Credit: VectorMine

The following is a summary of "Interaction between type 2 diabetes and past COVID-19 on active tuberculosis," published in the December 2024 issue of Infectious Disease by Calles-Cabanillas et al. 

The global setback in tuberculosis (TB) prevalence and mortality post-COVID-19 is partly due to healthcare disruptions, with the biological impact of COVID-19 on TB remained unclear.  

Researchers conducted a retrospective study to analyze the association between COVID-19 in the past 18 months and new TB episodes and the role of type 2 diabetes mellitus (DM) comorbidity.  

They included 112 new patients with active TB and 373 non-TB controls identified between June 2020 and November 2021 in communities along the Mexican border with Texas. Past COVID-19 was determined by self-report or positive serology. Bivariable and multivariable analyses were employed in new individuals with TB to estimate the odds with past COVID-19 and/or type 2 diabetes mellitus (DM).  

The results showed that the odds of new TB were higher in individuals with past COVID-19 compared to controls, but this was significant only among those with type 2 DM (aOR 2.3). In participants with DM, the odds of TB were 2.7 times higher in those without past COVID-19 and increased to 7.9 times higher in those with past COVID-19.  

Investigators concluded the DM and previous COVID-19 infection synergistically increased the risk of TB, suggesting the need for latent TB screening and prophylactic treatment in this high-risk population, with larger longitudinal studies required to validate the findings. 

Source: bmcinfectdis.Biomedcentral.Com/articles/10.1186/s12879-024-10244-z 

Tuberculosis R&D Funding Is Up, But Still Short Of Goals And Dominated By A Few Players, Report Finds

By Ed Silverman

Dec. 13, 2024

Pharmalot Columnist, Senior Writer

Although research and development funding for tuberculosis reached new heights last year, the total fell substantially short of goals set by the United Nations and most of the increase came from just two organizations, according to a new report.

Specifically, the amount spent on basic research, new treatments, vaccines, and diagnostics was $1.2 billion, the highest level since tracking of funding began in 2005 and 20% more than what was seen in 2022. Yet this amounted to only one quarter of the $5 billion annual goal that was adopted last year at a United Nations High-Level Meeting on TB as part of a plan to end the epidemic by 2030.

Meanwhile, the U.S. National Institutes of Health and the Bill & Melinda Gates Foundation contributed 53% of all R&D funds, and the 20 top funders were responsible for 86% of total spending. Looked at another way, the public sector provided 62% of the $1.2 billion in funding, followed by philanthropies that contributed 24%. Just 9% came from the private sector, such as pharmaceutical companies.

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Fighting The Tuberculosis Scourge

TUBERCULOSIS, a disease once thought to be under control, remains one of the most significant health challenges in Nigeria. With over 467,000 cases recorded in 2023, Nigeria is now ranked as the sixth-highest TB-burdened country in the world and the first in Africa. This is a troubling statistic for a disease that is both preventable and curable.

The call by the wife of the President, Oluremi Tinubu, for united action to end TB resonates with all stakeholders. Governments at all levels, the private sector, civil society, and individuals must play their part in the fight against TB.

TB is caused by Mycobacterium tuberculosis, a bacterium that most commonly affects the lungs but can spread to other parts of the body. It is airborne, transmitted through droplets when an infected person coughs, sneezes or even speaks.

The symptoms are persistent coughing, fever, night sweats, weight loss, and fatigue. It thrives in conditions of poverty, overcrowding, and poor healthcare access, making low and middle-income countries particularly vulnerable.

Globally, TB claimed 1.6 million lives in 2023, with 10.8 million new cases reported. Alarmingly, 12 per cent of the global burden affects vulnerable populations, including children and adolescents.

Nigeria has a burden of 245,000 annual TB deaths.

The WHO Global Tuberculosis Report 2024 says TB remains a leading cause of death in Nigeria. The prevalence of drug-resistant TB and the overlap with HIV exacerbate the problem, presenting new challenges for treatment and containment.

The Nigerian government, over the years, has made some efforts to combat TB, including implementing the National Tuberculosis and Leprosy Control Programme. This programme has focused on early detection, treatment, and prevention.

International partnerships have played a significant role. Support from global organisations like the Stop TB Partnership and the WHO has facilitated awareness campaigns, provision of diagnostic tools, and supply of medications.

The private sector, too, has shown commitment, with a recent pledge of $25 million towards Nigeria's TB response. These efforts have yielded some progress: the country recorded a 24 per cent decline in TB incidence rates between 2015 and 2023.

However, the pace of progress is grossly insufficient. The high number of undiagnosed cases—estimated to be over 40 per cent of those affected—indicates a gap in access to healthcare, awareness, and community engagement. The lack of sustained domestic funding, poor integration of TB services into primary healthcare, and inadequate use of technology have hindered the fight against TB.

Several factors contribute to the persistence of tuberculosis in Nigeria. First, there is a significant lack of awareness about the disease. Many people do not know the symptoms of TB, how it is transmitted, or if it can be cured.

Second, the stigma associated with TB discourages individuals from seeking medical help. In many communities, TB is erroneously viewed as a disease of the poor or as a punishment for immoral behaviour.

Third, Nigeria's healthcare system is underfunded and overstretched. Diagnostic tools, such as GeneXpert machines used to detect TB and drug-resistant strains, are often unavailable or concentrated in urban centres, leaving rural populations underserved. The same applies to medications and trained healthcare workers.

To effectively tackle tuberculosis in Nigeria, a multi-pronged approach is required, involving government agencies, private sector actors, community leaders, and international partners. Public education must be a cornerstone of Nigeria's TB strategy.

Awareness campaigns should target rural and urban areas, using local languages and culturally relevant messaging.

Also, early diagnosis is critical to controlling TB. The government must invest in diagnostic tools and ensure they are widely available, particularly in underserved rural areas. Mobile testing units and community health outreach programmes can help bridge the gap in access.

With decisive leadership, adequate funding, and collective effort, the scourge of TB can be eradicated.

The time to act is now.

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