Relationship between TB and Covid-19

People ill with Covid-19 and TB show similar symptoms.
People ill with Covid-19 and TB show similar symptoms.
Image: 123RF/lightwise

Tuberculosis remains the number one killer in SA.

In 2018, the World Health Organisation's (WHO) 2019 Global TB report showed that 301,000 people had succumbed to the disease in SA alone.

This is why the WHO is imploring governments to ensure TB services are maintained during the Covid-19 outbreak.  

The WHO Global TB Programme, along with WHO regional and country offices, has developed an information note, in collaboration with stakeholders. This note is intended to assist national TB programmes and health personnel to urgently maintain continuity of essential services for people affected with TB during the  pandemic.

The WHO has developed a checklist for those treating TB patients. Some of the key points are:  

Are people with TB likely to be at higher risk of Covid-19 infection, illness and death?

People ill with Covid-19 and TB show similar symptoms such as cough, fever and difficulty in breathing. Both diseases attack the lungs. Although both are transmitted mainly via close contact, the waiting period in TB is often longer. People with both TB and Covid-19 may have poorer treatment outcomes, especially if the  TB treatment is interrupted.

What should health authorities do to support essential TB services during the Covid-19 pandemic?

All essential TB services should be maintained throughout the Covid-19 emergency. People-centred delivery of TB prevention, diagnosis, treatment and care services should be ensured in tandem with the Covid-19 response.

  • Prevention: Measures must be put in place to limit transmission of TB and Covid-19 in places where people gather and healthcare facilities, as per WHO guidelines. Though modes of transmission of the two diseases are slightly different, administrative and personal protection measures apply to both. Provision of TB preventive treatment should be maintained as much as possible.
  • Diagnosis: Accurate diagnostic tests are essential for both TB and Covid-19. Tests for the two conditions are different and both should be made available for individuals with respiratory symptoms, which may be similar for the two diseases.
  • Treatment and care: TB programme staff, with their experience and capacity, including in active case-finding and contact-tracing, can share crucial expertise and provide technical and logistical support. Adequate stocks of TB medicines should be provided to all patients to take home to ensure treatment completion without having to visit treatment centres unnecessarily to collect medicines.
  • Proactive planning, procurement, supply and risk management: WHO is monitoring medicine supply at a global level. Countries are advised to place their orders for 2020 delivery as soon as possible given anticipated delays in transport and delivery mechanisms.
  • Human resources: Respiratory physicians, pulmonology staff of all grades, TB specialists and health workers at the primary healthcare level may be points of reference for patients with pulmonary complications of Covid-19.
  • Capacity building: The response to Covid-19 can benefit from the capacity building efforts developed for TB over many years of investment by national authorities and donors.