Changing Trends in the Diagnosis of Genitourinary Tuberculosis in Post Covid-19 Pandemic Era

Main Article Content

Sriram Krishnamoorthy, MS, MCh, DNB, FRCS (Glasgow) Kalpana Ramachandran, MS, DNB, FRCS (Glasgow), FAIMER FELLOW

Abstract

Introduction: Tuberculosis continues to be a global threat to humankind. Every year, more than a million deaths occur across the globe due to this disease. The Global plan to eradicate and eliminate tuberculosis took off very well with the launch of the End-Tuberculosis campaign until the COVID-19 pandemic created a severe dent in the efforts to achieve a tuberculosis-free-world by 2030.


Impact of the COVID-19 pandemic: Health professionals and the health care support team suffered a major setback in reaching out to patients due to various restrictions imposed on them during this pandemic period. Patients found it difficult to reach out to the health care team, owing largely to the fear factor and also due to inaccessibility to health care services. The delay in tuberculosis notifications, the emergence of drug-resistant strains and restrictions in the supply chain further added to the difficulties faced.


Government efforts: India is a nation with one of the largest numbers of tuberculosis victims. The strategic measures taken by the Government of India took a sudden jolt with the onset of the COVID-19 pandemic. The Tuberculosis elimination measures reverted to tuberculosis containment measures. Various African countries recorded a massive fall out of more than 75% during the various lockdown measures imposed. However, India took collateral measures to combat this setback. Its National Tuberculosis Elimination Programme involved private players to combat the tuberculosis epidemic, recruited Patient-provider support agencies and actively engaged Private Sectors through innovative patient-provider incentives to bring down numbers of the tuberculosis victims.


Changing trends in diagnostics: The diagnostic methods that took about 4 to 6 weeks to confirm the diagnosis of tuberculosis had earlier put the diagnosis and management of tuberculosis into the back seat. However, recent innovations in molecular biology, immunology and genomic sequencing techniques have greatly aided an earlier and more accurate diagnosis of tuberculosis. One individual, one health agency or one Government cannot achieve tuberculosis elimination by 2030. A global effort is the basic pre-requisite, incorporating advanced molecular diagnosis and appropriate treatment would ensure achieving a tuberculosis-free world by 2030.

Keywords: tuberculosis, gene expert, Covid-19, pandemic, drug resistance

Article Details

How to Cite
KRISHNAMOORTHY, Sriram; RAMACHANDRAN, Kalpana. Changing Trends in the Diagnosis of Genitourinary Tuberculosis in Post Covid-19 Pandemic Era. Medical Research Archives, [S.l.], v. 11, n. 8, aug. 2023. ISSN 2375-1924. Available at: <https://esmed.org/MRA/mra/article/view/4318>. Date accessed: 21 july 2024. doi: https://doi.org/10.18103/mra.v11i8.4318.
Section
Research Articles

References

1. Fukunaga R, Glaziou P, Harris JB, Date A, Floyd K, Kasaeva T. Epidemiology of Tuberculosis and Progress Toward Meeting Global Targets - Worldwide, 2019. MMWR Morb Mortal Wkly Rep. 2021;70(12):427-430. doi:10.15585/mmwr.mm7012a4.
2. Bhalla AS, Goyal A, Guleria R, Gupta AK. Chest tuberculosis: Radiological review and imaging recommendations. Indian J Radiol Imaging. 2015;25(3):213-225. doi:10.4103/0971-3026.161431.
3. Satyanarayana S, Thekkur P, Kumar AMV, et al. An Opportunity to END TB: Using the Sustainable Development Goals for Action on Socio-Economic Determinants of TB in High Burden Countries in WHO South-East Asia and the Western Pacific Regions. Trop Med Infect Dis. 2020;5(2):101. Published 2020 Jun 18. doi:10.3390/tropicalmed5020101.
4. Das D, Satapathy P, Murmu B. First Line Anti-TB Drug Resistance in an Urban Area of Odisha, India. J Clin Diagn Res. 2016;10(11):DC04-DC06. doi:10.7860/JCDR/2016/20289.8846.
5. Seung KJ, Keshavjee S, Rich ML. Multidrug-Resistant Tuberculosis and Extensively Drug-Resistant Tuberculosis. Cold Spring Harb Perspect Med. 2015;5(9):a017863. Apr 27. doi:10.1101/cshperspect.a017863.
6. Kiazyk S, Ball TB. Latent tuberculosis infection: An overview. Can Commun Dis Rep. 2017;43(3-4):62-66. Published 2017 Mar 2. doi:10.14745/ccdr. v43i34a01.
7. M Marti M, Zürcher K, Enane LA, et al. Impact of the COVID-19 pandemic on TB services at ART programmes in low- and middle-income countries: a multi-cohort survey. J Int AIDS Soc. 2022;25(10):e26018. doi:10.1002/jia2.26018.
8. Tadolini M, Codecasa LR, García-García JM, et al. Active tuberculosis, sequelae and COVID-19 co-infection: first cohort of 49 cases. Eur Respir J. 2020;56(1):2001398. Published 2020 Jul 9. doi:10.1183/13993003.01398-2020.
9. Motta I, Centis R, D'Ambrosio L, et al. Tuberculosis, COVID-19 and migrants: Preliminary analysis of deaths occurring in 69 patients from two cohorts. Pulmonology. 2020;26(4):233-240. doi:10.1016/j.pulmoe.2020.05.002.
10. Golandaj JA. Insight into the COVID-19 led slow-down in TB notifications in India. Indian J Tuberc. 2021;68(1):142-145. doi:10.1016/j.ijtb.2020.12.005.
11. Dheda K, Perumal T, Moultrie H, et al. The intersecting pandemics of tuberculosis and COVID-19: population-level and patient-level impact, clinical presentation, and corrective interventions. Lancet Respir Med. 2022;10(6):603-622. doi:10.1016/S2213-2600(22)00092-3.
12. Iyengar KP, Jain VK. Tuberculosis and COVID-19 in India- double trouble!. Indian J Tuberc. 2020;67(4S):S175-S176. doi:10.1016/j.ijtb.2020.07.014.
13. Cilloni L, Fu H, Vesga JF, et al. The potential impact of the COVID-19 pandemic on the tuberculosis epidemic a modelling analysis. EClinical Medicine. 2020;28:100603. Published 2020 Oct 24. doi:10.1016/j.eclinm. 2020.100603.
14. Muniz-Salazar R, Le T, Cuevas-Mota J, et al. Impact of COVID-19 on tuberculosis detection and treatment in Baja California, México. Front Public Health. 2022;10:921596. Published 2022 Jul 22. doi:10.3389/fpubh.2022.921596.
15. Rosser JI, Phiri C, Bramante JT, et al. Impact of the COVID-19 Pandemic on Tuberculosis Testing and Treatment at a Tertiary Hospital in Zambia. Am J Trop Med Hyg. 2023;108(5):911-915. Published 2023 Mar 13. doi:10.4269/ajtmh.22-0689.
16. Ray D, Subramanian S. India's lockdown: an interim report. Indian Econ Rev. 2020;55(Suppl 1):31-79. doi:10.1007/s41775-020-00094-2.
17. Zimmer AJ, Heitkamp P, Malar J, et al. Facility-based directly observed therapy (DOT) for tuberculosis during COVID-19: A community perspective. J Clin Tuberc Other Mycobact Dis. 2021;24:100248. Published 2021 Jun 25. doi:10.1016/j.jctube. 2021.100248.
18. Kabbur S, Patil B, Angolkar M, Narasannavar A. Effect of pandemic on DOTS treatment during COVID-19 lockdown- A cross-sectional study [published online ahead of print, 2022 Sep 10]. Indian J Tuberc. 2022;doi:10.1016/j.ijtb.2022.09.001.
19. Jaiswal S, Sharma H, Joshi U, Agrawal M, Sheohare R. Non-adherence to anti-tubercular treatment during COVID-19 pandemic in Raipur district Central India. Indian J Tuberc. 2022;69(4):558-564. doi:10.1016/j.ijtb. 2021.08.033.
20. Chiang CY, Islam T, Xu C, et al. The impact of COVID-19 and the restoration of tuberculosis services in the Western Pacific Region. Eur Respir J. 2020;56(4):2003054. Published 2020 Oct 22. doi:10.1183/13993003.03054-2020.
21. Hopewell PC, Reichman LB, Castro KG. Parallels and Mutual Lessons in Tuberculosis and COVID-19 Transmission, Prevention, and Control. Emerg Infect Dis. 2021;27(3):681-686. doi:10.3201/eid2703.203456.
22. Mathew M, Mathew T, Joseph E. First case of primary appendiceal tuberculosis presented as stump appendicitis. J Surg Case Rep. 2023;2023(6):rjad373. Published 2023 Jun 27. doi:10.1093/jscr/rjad373.
23. Arinaminpathy N, Batra D, Maheshwari N, et al. Tuberculosis treatment in the private healthcare sector in India: an analysis of recent trends and volumes using drug sales data. BMC Infect Dis. 2019;19(1):539. Published 2019 Jun 19. doi:10.1186/s12879-019-4169-y.
24. Suseela RP, Shannawaz M. Engaging the Private Health Service Delivery Sector for TB Care in India-Miles to Go!. Trop Med Infect Dis. 2023;8(5):265. Published 2023 May 4. doi:10.3390/tropicalmed8050265.
25. Satpati M, Burugina Nagaraja S, Shewade HD, et al. TB Notification from Private Health Sector in Delhi, India: Challenges Encountered by Programme Personnel and Private Health Care Providers. Tuberc Res Treat. 2017;2017:6346892. doi:10.1155/2017/6346892.
26. Dong B, He Z, Li Y, Xu X, Wang C, Zeng J. Improved Conventional and New Approaches in the Diagnosis of Tuberculosis. Front Microbiol. 2022;13:924410. Published 2022; May 31. doi:10.3389/fmicb.2022.924410.
27. Hasan M, Munshi SK, Banu Momi MS, Rahman F, Noor R. Evaluation of the effectiveness of BACTEC MGIT 960 for the detection of mycobacteria in Bangladesh. Int J Mycobacteriol. 2013;2(4):214-219. doi:10.1016/j.ijmyco. 2013.09.001.
28. Espasa M, Salvadó M, Vicente E, et al. Evaluation of the VersaTREK system compared to the Bactec MGIT 960 system for first-line drug susceptibility testing of Mycobacterium tuberculosis. J Clin Microbiol. 2012;50(2):488-491. doi:10.1128/JCM.06432-11.
29. Lee JJ, Suo J, Lin CB, Wang JD, Lin TY, Tsai YC. Comparative evaluation of the BACTEC MGIT 960 system with solid medium for isolation of mycobacteria. Int J Tuberc Lung Dis. 2003;7(6):569-574.
30. Bodmer T, Ströhle A. Diagnosing pulmonary tuberculosis with the Xpert MTB/RIF test. J Vis Exp. 2012;(62):e3547. Published 2012 Apr 9. doi:10.3791/3547.
31. Nyaruaba R, Mwaliko C, Kering KK, Wei H. Droplet digital PCR applications in the tuberculosis world. Tuberculosis (Edinb). 2019;117:85-92. doi:10.1016/ j.tube.2019.07.001.
32. Nagai K, Horita N, Yamamoto M, et al. Diagnostic test accuracy of loop-mediated isothermal amplification assay for Mycobacterium tuberculosis: systematic review and meta-analysis. Sci Rep. 2016;6:39090. Published 2016 Dec 13. doi:10.1038/srep39090.
33. Mehta PK, Dahiya B, Sharma S, et al. Immuno-PCR, a new technique for the serodiagnosis of tuberculosis. J Microbiol Methods. 2017;139:218-229. doi:10.1016/j.mimet.2017.05.009.
34. Sigal GB, Pinter A, Lowary TL, et al. A Novel Sensitive Immunoassay Targeting the 5-Methylthio-d-Xylofuranose-Lipoarabinomannan Epitope Meets the WHO's Performance Target for Tuberculosis Diagnosis. J Clin Microbiol. 2018;56(12):e01338-18. Published 2018 Nov 27. doi:10.1128/JCM. 01338-18.
35. Hira J, Uddin MJ, Haugland MM, Lentz CS. From Differential Stains to Next Generation Physiology: Chemical Probes to Visualize Bacterial Cell Structure and Physiology. Molecules. 2020;25(21):4949. Published 2020 Oct 26. doi:10.3390/molecules25214949.
36. Ai JW, Zhou X, Xu T, et al. CRISPR-based rapid and ultra-sensitive diagnostic test for Mycobacterium tuberculosis. Emerg Microbes Infect. 2019;8(1):1361-1369. doi:10.1080/22221751.2019.1664939.
37. Seng P, Rolain JM, Fournier PE, La Scola B, Drancourt M, Raoult D. MALDI-TOF-mass spectrometry applications in clinical microbiology. Future Microbiol. 2010;5(11):1733-1754. doi:10.2217/fmb.10.127.
38. Hatherell HA, Colijn C, Stagg HR, Jackson C, Winter JR, Abubakar I. Interpreting whole genome sequencing for investigating tuberculosis transmission: a systematic review. BMC Med. 2016;14:21. Published 2016 Mar 23. doi:10.1186/s12916-016-0566-x.
39. Gupta AK, Singh A, Singh S. Diagnosis of Tuberculosis: Nanodiagnostics Approaches. NanoBioMedicine. 2019;261-283. Published 2019 Sep 25. doi:10.1007/978-981-32-9898-9_11.