Tuberculosis pressure worldwide

The World Health Organization (WHO) has just announced that tuberculosis has replaced Covid-19 as the leading infectious disease causing death by 2023.

According to WHO, last year there were about 8.2 million new TB diagnoses, the highest number recorded since WHO began tracking TB globally in 1995, up from 7.5 million reported in 2022.

The World Health Organization (WHO) has just announced that tuberculosis has replaced Covid-19 to become the leading infectious disease causing death by 2023.

Eradicating tuberculosis remains a distant goal as the fight against the disease faces persistent challenges such as significant funding shortages, the report said.

According to WHO, key milestones and global targets to reduce the burden of disease are off track and significant progress is needed to achieve other targets set by 2027.

Low- and middle-income countries, which bear 98% of the burden of the disease, are facing significant funding shortfalls.

In 2023, the gap between estimated new TB cases and reported cases will have narrowed to around 2.7 million, down from around 4 million during the Covid-19 pandemic in 2020 and 2021.

Vietnam is currently a country with a high burden of tuberculosis. In 2018, from 16th out of 30 countries with a high burden of tuberculosis and 15th out of 30 countries with the highest burden of multidrug-resistant tuberculosis in the world, Vietnam moved up to 11th out of 30 countries with the highest number of tuberculosis patients globally, and 11th out of 30 countries with the highest burden of multidrug-resistant tuberculosis in the world.

The country has the highest burden of tuberculosis globally, and ranks 11th among the 30 countries with the highest burden of multidrug-resistant tuberculosis in the world.

In 2023, it is estimated that Vietnam will have 172,000 more people with tuberculosis in 2022 and about 13,000 people will die from tuberculosis, higher than the number of deaths from traffic accidents.

Multidrug-resistant tuberculosis is estimated at 9,200 cases, accounting for 4.5% of new tuberculosis patients and 15% of previously treated patients. HIV-coinfected tuberculosis is estimated at 4,300 cases, accounting for 2.5% of detected tuberculosis patients.

Compared to the North and Central regions, the tuberculosis epidemic in the South is much more severe. In some provinces in the Southwest region such as An Giang and Can Tho, the number of detected tuberculosis cases and the tuberculosis incidence rate per population in 2023 were 5,467 (270/100,000 people) and 2,713 (218/100,000 people), respectively, and in some areas, high-risk groups have very high tuberculosis incidence rates, around 400-500/100,000 people.

The number of tuberculosis patients detected annually in Vietnam only accounts for about 60% of the estimated number of tuberculosis patients (in 2023, 106,086 tuberculosis patients of all types were detected).

Thus, there will be >40% of TB patients in the community who have not been detected and treated. During the 2 years of the Covid-19 pandemic, TB prevention work in Vietnam has been seriously affected.

The number of detected TB patients in 2021 decreased by 22% compared to 2020 and decreased by 24.5% compared to 2019, making Vietnam one of the countries with the highest reduction in TB detection globally due to the impact of the pandemic.

To detect tuberculosis, the Xpert MTB/RIF test is a molecular biological test for diagnosing tuberculosis and multidrug-resistant tuberculosis recommended by the World Health Organization since December 2010. To date, about 140 countries and territories worldwide have performed this test.

In Vietnam, the Xpert MTB/RIF test has been deployed by the National Tuberculosis Control Program (NTP) since 2011 at the National Standard Tuberculosis Laboratory. To date, Vietnam has installed, put into use and managed 332 GeneXpert machines at 182 deployment points nationwide.

The number of tests nationwide increases gradually every year. In 2023, 452,279 tests were performed nationwide, an increase of more than 113% compared to 2022.

Dr. Dinh Van Luong, Director of the Central Lung Hospital, Head of the Executive Board of the National Tuberculosis Control Program, the MTB/RIF external control program of the Central Lung Hospital has provided external control samples to countries such as Laos, Myanmar, Philippines, Bangladesh, Papua New Guinea in recent years.

In 2024, the Central Lung Hospital will continue to maintain two activities of providing external sample sets for Bangladesh and Papua New Guinea with more than 200 sample sets and providing technology consulting support for sample set production for the Philippines.

In addition, with the support of CDC-US Vietnam, the program is on track to expand and develop into a regional external control center with new molecular tests such as Xpert MTB/XDR, Truenat MTB/RIF and provide domestic services in 2024 and is expected to be able to provide services to foreign units in the following years.

The TB external audit program - Xpert MTB/RIF & Xpert MTB/RIF Ultra molecular testing is organized for all Xpert implementing units nationwide with financial support from the Global Fund for the period 2024-2026.

The Xpert MTB/RIF & MTB/RIF ULTRA external audit program was officially launched in 2017. After 7 years of implementation, 14 rounds of external audits have been successfully organized for units implementing Xpert MTB/RIF & Xpert MTB/RIF Ultra nationwide. The number of participating units has increased over the years with 35 units since 2017, and now there are nearly 180 participating units.

The rate of units with inconsistent results through the rounds ranges from 1% to 10%. Through organizing 2 rounds of annual external inspections for units implementing Xpert nationwide, the National Tuberculosis Control Program has been and is continuing to serve the goal of ensuring and improving the quality of Xpert testing for diagnosing tuberculosis and multidrug-resistant tuberculosis.

The Director of the Central Lung Hospital said that to increase the rate of tuberculosis detection in the coming time, the Vietnam National Tuberculosis Control Program is focusing resources on expanding access to rapid molecular tests for diagnosing tuberculosis recommended by the World Health Organization.

Along with strengthening and expanding the scope and quantity of TB testing, the Vietnam National Tuberculosis Control Program also focuses on ensuring the quality of testing as a key factor in early detection of TB cases and effective treatment monitoring.

Vietnam's model and experience in implementing external audit programs will be shared at this workshop, with the hope of supporting the implementation and improvement of TB testing quality assurance methods in the region," said Mr. Luong.

However, according to Dr. Dinh Van Luong, the implementation of these external audit programs still faces many limitations due to high costs and limited service availability.

Source: https://baodautu.vn/ap-luc-benh-lao-tren-toan-the-gioi-d229055.html