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Tuesday, December 17, 2024

Protracted Wars Hike Cases of Tuberculosis in Africa

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About 70% of tuberculosis (TB) cases in the African region are now being diagnosed and treated, marking the highest case-detection rate in the region ever.

WHO estimates the incidence of tuberculosis (TB) in South Sudan to be at 79 per 100 000 for new sputum smear-positive TB and 140 per 100 000 for all forms of TB cases, and it is apparent that lack of data has made regular estimates for South Sudan difficult.

Tuberculosis, leprosy, and Buruli ulcer control programme, in collaboration with its partners, coordinates, monitors, and supervises the implementation of TB-related activities.

Protracted armed conflict in South Sudan is likely to present the same scenario for the Great Lakes region of Africa.

South Sudan has been going through years of civil wars leaving the healthcare centers across the country dependent on humanitarian organizations.

The government could not allocate sufficient finances to rebuild the health facilities destroyed by conflict and devastating floods in areas like Jonglei, Upper Nile, and Unity states.

Although the case detection rate has been on the rise since 2018, the region saw a significant increase between 2020 and 2022, rising from 60% to 70% of cases being detected, according to the World Health Organization (WHO) Global Tuberculosis Report 2023.

There has also been a notable reduction in the region in the number of people with TB who miss diagnosis. 

An estimated 700,000 people missed diagnosis in 2022, a 10% reduction compared with 2021. To further rally efforts to end the disease through concerted global efforts to advance detection, diagnosis, and treatment, World TB Day was celebrated across Africa and South Sudan this month under the theme “Yes! We can end TB”.

In the African region, a range of factors have helped boost TB diagnosis rates. During the COVID-19 pandemic, many countries maintained TB notification services, ensuring that cases were detected and treated. 

In Nigeria, which has a huge TB burden, case notifications nearly tripled over the past five years to 285,000 cases in 2022 from 106,000 cases in 2018. 

Improvement in the management of HIV infection, a significant driver of TB, has also bolstered TB detection rates in the region.

“More efforts are still needed to reduce the devastating impacts of this disease on families and communities. As WHO we continue working closely with governments to address the barriers to effective response and speed up the momentum to make TB history,” said Dr Matshidiso Moeti, WHO Regional Director for Africa.

The region, which accounts for 23% of TB cases and 33% of deaths globally, is making steady progress towards ending the disease.  For example, Cabo Verde, Eswatini, and South Africa have achieved at least a 50% reduction in TB cases. 

The WHO End TB Strategy calls for countries to reduce TB deaths by 75% and cases by 50% by 2025 compared with the 2015 levels.

Across the region, TB deaths fell by 38% and new cases declined by 23% in 2022 compared with 2015. High-burden TB countries have surpassed the 2025 milestone to lower TB deaths.

Despite the progress, further efforts are needed to meet the 2030 global End TB Strategy targets to cut TB deaths by 90% and cases by 80%. These include increased investments in TB control programmes. 

In 2022, in the African Region, the Global Plan to End TB 2018-2022 estimated that US$ 3.9 billion was required annually to achieve the targets, but only around US$ 890 million was mobilized for TB prevention, diagnosis, and treatment.

Domestic funding represented about 46% of total funding for TB (54% from international funding) in 2022.

Limited access to health services, inadequate health infrastructure, insufficient quality of care, inadequate human resources for health, and inadequate social protection are also impeding progress in ending TB.

Globally TB continues to claim millions of lives annually.

In the African region Africa, TB was the second leading cause of death from a single infectious agent, with nearly 2.5 million people falling ill and 424,000 lives lost in 2022.

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