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Table of Contents
LETTER TO EDITOR
Year : 2019  |  Volume : 6  |  Issue : 1  |  Page : 49

Ending the tuberculosis epidemic: Necessity to bridge the existing gaps


1 Department of Community Medicine, Member of the Medical Education Unit and Institute Research Council, Shri Sathya Sai Medical College and Research Institute, Kancheepuram, Sri Balaji Vidyapeeth, India
2 Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Kancheepuram, Sri Balaji Vidyapeeth, India

Date of Web Publication10-Jun-2019

Correspondence Address:
Dr. Saurabh RamBihariLal Shrivastava
3rd Floor, Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Ammapettai Village, Thiruporur-Guduvancherry Main Road, Sembakkam Post, Kancheepuram - 603 108, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ami.ami_64_18

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How to cite this article:
Shrivastava SR, Shrivastava PS. Ending the tuberculosis epidemic: Necessity to bridge the existing gaps. Acta Med Int 2019;6:49

How to cite this URL:
Shrivastava SR, Shrivastava PS. Ending the tuberculosis epidemic: Necessity to bridge the existing gaps. Acta Med Int [serial online] 2019 [cited 2019 Aug 19];6:49. Available from: http://www.actamedicainternational.com/text.asp?2019/6/1/49/257610

Dear Editor,

Tuberculosis (TB) is the most common infectious cause of death and is one among the first ten causes of deaths due to any reason across the globe.[1],[2] It is also the most common cause of death attributed to antimicrobial resistance and among people living with human immunodeficiency virus (HIV) infection.[1] The available global estimates for the year 2016 depict that in excess of 10 million new cases were detected (including 1 million children), while >1.6 million people lost their lives, of which >95% deaths were reported in developing nations.[1],[3] Further, 0.49 million cases of multidrug-resistant TB (MDR-TB) were also detected worldwide, which is again an alarming estimate for the health stakeholders to ponder.[2],[3]

Considering the magnitude of the disease, its global distribution, preponderance to affect poor and malnourished people, and the availability of effective first-line drugs, the global leaders have set the target to end the epidemic by 2030.[1],[4] Even though, due to the consistent efforts of the health workers and implementation of effective strategies, the lives of >50 million people have been saved since the start of the century, the incidence of disease is decreasing at about 2% each year, instead of the expected 5%.[3] This clearly reflects that the observed progress is not good enough to ensure that set global targets can be successfully achieved.[1],[3]

In other words, despite the commitment of national leaders to end the epidemic, actions and investments are not in accordance with the desired inputs.[3] The analysis of the situation has led to the identification of multiple gaps, which have to be addressed soon.[3] The gaps include underdetection and underreporting, especially in nations with unregulated private sector or weak health-care delivery system.[1] In fact, almost 40% of the estimated cases in the year 2016 were not notified to the health authorities.[3] Furthermore, only 20% of the MDR-TB cases were initiated on treatment, and the treatment success for the same is little above 50%.[3] Further, despite the guideline to put all HIV-TB coinfected patients on antiretroviral therapy, 15% were not initiated.[1],[3]

In addition, the chemoprophylaxis for the disease has been recommended for HIV patients and under-five children, but in reality, most of the eligible people are not availing the same.[3] Finally, there is a significant shortage in the financial support to carry out essential disease-related prevention and control activities, and both middle- and low-income nations are paying the price for less financial support.[2],[3] In order to have an effective response against the disease, there is a need to have sustained political action and efforts should be taken to ensure that quality-assured services are accessible to the people who are in maximum need of the same.[2],[4] Moreover, investments are required in the field of disease-related research activities, and health stakeholders should adopt all innovative strategies to improve the existing situation.[4]

To conclude, despite making major strides in the field of diagnosis and treatment of TB, there is still a lot needs to be done to improve the reach of the services.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
  References Top

1.
World Health Organization. Tuberculosis – Fact Sheet No. 104. World Health Organization; 2017. Available from: http://www.who.int/mediacentre/factsheets/fs104/en/. [Last accessed on 2018 Sep 11].  Back to cited text no. 1
    
2.
Shrivastava SR, Shrivastava PS, Ramasamy J. Where does the world stand in the battle against the tuberculosis? 2015 global update. Ann Trop Med Public Health 2016;9:405-6.  Back to cited text no. 2
  [Full text]  
3.
World Health Organization. Global Tuberculosis Report 2017. Geneva: WHO Press; 2017. p. 1-26.  Back to cited text no. 3
    
4.
Shrivastava SR, Shrivastava PS, Ramasamy J. Uniting the efforts of stakeholders to end tuberculosis globally by 2030. Ann Trop Med Public Health 2017;10:297-8.  Back to cited text no. 4
  [Full text]  




 

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