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Table of Contents
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
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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 2021 Dec 4];6:49. Available from: https://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.

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Conflicts of interest

There are no conflicts of interest.

  References Top

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
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]  
World Health Organization. Global Tuberculosis Report 2017. Geneva: WHO Press; 2017. p. 1-26.  Back to cited text no. 3
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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