The Need For TB Prevention Choice
TB Prevention Choice: Before the emergence of COVID-19, the most lethal infectious diseases were HIV and tuberculosis (TB).
Although HIV still persists, the decreasing number of cases can be attributed to the availability of numerous HIV prevention methods.
According to the World Health Organization (WHO), new HIV infections have decreased by 49% and HIV-related deaths by 61% over the past two decades.
This progress is due to new treatments that minimize the infection and prevent its spread, saving an estimated 18.6 million lives.
Various prevention options for HIV exist, including the dapivirine vaginal ring, oral Pre-Exposure Prophylaxis (PrEP), harm reduction for drug users, condoms for both men and women, voluntary medical male circumcision, and recently approved long-acting cabotegravir, with other options in development.
The availability of multiple options allows individuals to choose the prevention method that aligns with their lifestyle.
TB Prevention Choice
In contrast, TB prevention lacks such diverse choices, despite the urgent need to address the disease and achieve the “End TB targets,” aiming to reduce TB deaths by 90% by 2030.
TB remains a significant threat, with an estimated 1.6 million deaths in 2021, and an alarming number of undiagnosed and untreated cases in Africa.
Although the COVID-19 pandemic disrupted surveillance efforts, some countries like Zambia have seen a slow decline in TB incidence over recent years.
Unlike HIV, there is no effective vaccine to prevent TB in adults.
However, various prophylactic regimens can help prevent TB in individuals potentially exposed to the infection.
Masking, particularly in clinical settings or when a family member is sick, serves as an initial preventive measure.
Shorter regimens like 1HP and 3HP, combining rifapentine and isoniazid, are now available, offering patients more choices in treatment duration.
Despite the success of TB prevention programs, there is a need to ensure access to the full range of prevention options.
A study suggests that tracing the contacts of TB patients and providing prevention treatment could save numerous lives, both financially and medically.
It is essential for healthcare facilities and outreach programs to embrace a variety of preventive options and ensure that patients have a choice.
Although supply chain limitations may initially hinder choice, demand from healthcare providers can drive the expansion of supply chains.
The success achieved in HIV prevention through scientific advancements and resource dedication demonstrates the need for TB prevention to catch up.
It is time for medicine to utilize its advancements to combat TB effectively, just as it has done for HIV.
About the Author
Violet Chihota is an Adjunct Associate Professor and Chief Specialist Scientist at the Aurum Institute.
She has been a researcher in global health for over 10 years, designing and managing the conduct of clinical research studies in South Africa, Zimbabwe, Botswana, Cameroon, Georgia, India and Malaysia.