MHF TOP PICKS FOR NOVEMBER
Every month, we at the Mueller Health Foundation like to showcase interesting news and updates in the field of tuberculosis. Below are our top 3 picks for November:
- Study on Tuberculosis Testing and Latent Tuberculosis Infection Treatment Practices Among Health Care Providers in the United States, 2020–2022
To assess TB-related practices among health care providers (HCPs) in the United States, the CDC analyzed data from the 2020–2022 Porter Novelli DocStyles surveys. They found that approximately only one half (53.3%) of HCPs reported routinely testing non–U.S.-born patients for TB, and of those who did, 35.7% exclusively ordered recommended blood tests, 44.2% exclusively ordered skin tests, and 20.2% ordered TB skin tests and blood tests. One third (33.0%) of HCPs reported prescribing recommended short-course treatment regimens for latent TB infection (LTBI), and 4.0% reported doing none of the treatment practices available for patients with LTBI (i.e., prescribing short-course regimens, longer course regimens, or referring patients to a health department). Further efforts are needed to identify and overcome barriers for providers to test for and treat persons at risk for TB. To learn more, you can access the full study at: https://www.cdc.gov/mmwr/volumes/72/wr/mm7244a2.htm?s_cid=mm7244a2_w
- New TB Treatments Could Tackle the Disease Without Wrecking the Microbiome
In this study, the researchers conducted a retrospective analysis of the impact of tuberculosis treatment regimens on the respiratory microbiome by analyzing longitudinally collected sputum samples obtained as part of two clinical trials that evaluated the efficacy of six experimental tuberculosis treatment regimens against that of the standard tuberculosis treatment regimen. The findings showed that the standard treatment regimens for tuberculosis, consisting of isoniazid, pyrazinamide, rifampicin, and ethambutol, had a marginal impact on the respiratory microbiome and did not significantly impact the diversity. Additionally, the study found that the abundance and diversity of the respiratory microbiome underwent a pattern of fall and recovery that was similar to predator-prey interactions, indicating the initial sensitivity and developing resistance of the microbiome to the antibiotics. The inclusion of moxifloxacin into the regimen and increasing the rifampicin dosage substantially impacted the microbiome, specifically the Mycobacterium levels.
DID YOU KNOW?
The World Health Organization (WHO) released the new Global Tuberculosis Report for 2023, which contains the latest global data on tuberculosis for the year 2022. Below, we have summarized key findings from the report:
- In 2022, tuberculosis was the world’s second leading cause of death from a single infectious agent, after coronavirus disease (COVID-19), and caused almost twice as many deaths as HIV/AIDS.
- The reported global number of people newly diagnosed with TB was 7.5 million in 2022. This is the highest number since WHO began global TB monitoring in 1995, above the pre-COVID baseline (and previous historical peak) of 7.1 million in 2019, and up from 5.8 million in 2020 and 6.4 million in 2021. The number in 2022 likely includes a sizeable backlog of people who developed TB in previous years, but whose diagnosis and treatment were delayed by COVID related disruptions that affected access to and provision of health services
- The net reduction in the global number of deaths caused by TB from 2015 to 2022 was 19%, far from the WHO End TB Strategy milestone of a 75% reduction by 2025. Progress is much better in the WHO African and European regions, and 47 countries achieved reductions of at least 35%.
- Globally, an estimated 410,000 people developed multidrug-resistant or rifampicin- resistant TB (MDR/RR-TB) in 2022. The number of people diagnosed and started on treatment was much lower: 175,650 people in 2022, equivalent to about two in five of those in need and still below the pre-pandemic level of 181,533 people in 2019.
- Treatment success rates have improved in 2022 to 88% for people treated for drugsusceptible TB and 63% for people with MDR/RR-TB.
- About 50% of TB patients and their households face total costs (direct medical expenditures, non-medical expenditures and indirect costs such as income losses) that are catastrophic (>20% of annual household income), far from the WHO End TB Strategy target of zero. This shows that there are major economic and financial barriers to accessing and completing TB treatment.