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Tuberculosis, world day 24 March: screening for Ukrainian refugees ready

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Tuberculosis, world day 24 March: screening for Ukrainian refugees ready

After Covid, the war in Ukraine: it is a sad World Tuberculosis Day this year, March 24, 2022. Ukraine and Russia are among the countries in the world with the most worrying levels of drug-resistant tuberculosis (MDR -TB) and also with higher HIV / TB prevalence. It is no coincidence that in Italy the monitoring and screening plan with TB tests was immediately launched for Ukrainian refugees, in addition to that for Covid. And that the Italian Society of Pediatrics (SIP) itself has issued a specific vademecum. Pediatricians invite “screening for tuberculosis, given the high incidence of this disease in Ukraine”, with tests (Mantoux or Igra intradermal reaction), and “in patients with persistent cough for more than 2 weeks, an x-ray of the chest and subsequent in-depth diagnostic tests “.

Children fleeing the war in Ukraine: the pediatricians’ handbook for reception


The day

March 24 is the date on which the World Health Organization celebrates the announcement, in 1882, 140 years ago, by Robert Koch to the scientific community of the discovery of the mycobacterium that causes this disease still today among the deadliest in the world. With an alarming figure reported by the Global Report (WHO) on TB for 2020-21: for the first time in ten years, global mortality is increasing, returning to 2017 levels. It is estimated that over 1.3 million deaths against previous 1,2, with an increase also in HIV-positive co-infected deaths. 3,600 deaths every day, 150 every hour. The interruption or stop and go of health services due to Covid has also led to a reduction in the number of diagnosed cases: from 7.1 million to 5.8 million, suddenly bringing us back to 2012 figures, against an estimate of cases that goes beyond 10 million.

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Covid: Scientists investigate the link between variants and compromised immune system


No treatment for half of the sick in the world

So no treatment or prevention for almost half of the cases in the world. A health disaster: access to services and treatments are in free fall. And we are moving away from the 2030 Sustainable Development Goals (SDGs), that 80% reduction in incidence and 90% reduction in deaths. When we talk about TB patients we mean active disease, but a quarter of the world‘s population is affected by tuberculosis, latent bacteria trapped by our immune systems. Latent TB which, once identified, could be cured. It is no coincidence that in the last congress of the Italian Clinical Microbiologists Association (AMCLI) greater attention was paid to screening with advanced DNA tests for a “threat that is believed to be extinct but also circulates in Italy”.

Music and hope

Despite the thickening black clouds, the TBC day will see for all 24 hours (from 00.00 on 24 March until 24.00 on the same day) the traditional, we are in the thirteenth year, live concert in stages with internet connections from all continents ( live streaming here). It is ToBeContinued with 48 musical groups in continuous flow, from 42 countries, under the sign of the Global Health Workshop of Topolò Station (Topolovo), a tiny Italian village on the border with Slovenia, part of the municipality of Grimacco, province of Udine. An imaginative and extraordinary initiative that sees medicine (Mario Raviglioneformer director of the WHO Stop Tb program and now professor of Global Health at various universities), music and technology (Antonio Della Marina and Moreno Miorelli) allies beyond every barrier, border, wall. From the Ukrainian rubble no sound and from Russia, present last year with two bands, just a message: “I don’t have the energy to do something in these dark times. I’m sorry!”

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Global Health

“Covid made us forget HIV, TB and malaria, but we are reacting”

at Peter Sands


Online talk show

For its part, the WHO is preparing an “Online Talk show” aimed at fundraising: Invest to End TB. Save Lives. Ministers, heads of international agencies, partners and civil society are called to speak. All on the WHO interactive platform. Possible live questions. You need to register. Very institutional by the will of the director of the TB Department in Geneva who has been the Russian since 2018, Tereza Kasaeva, “an unknown Russian official” (wrote Politico) elected with “preferential lane” by the Ethiopian Tedros Adhanom Ghebreyesus among many controversies (appeals of civil society and a Lancet editorial). The Stop Tb Italia Association organizes on March 25 in Pavia (Collegio Fratelli Cairoli, piazza Cairoli 1) the conference entitled “Back to the future”, underlining the intertwining between CoVid and Tbc: “Tuberculosis could be an excellent training ground for at best the Covid-19 pandemic, but it did not happen “. Similarities and differences: TB is cured, CoVid is not. Yet more people die of tuberculosis. Thus indicating sanitary nonsense. The winners of the Virchow Prize, 2021 edition, tales and stories about tuberculosis by patients and healthcare professionals will also be awarded.

TB, the treatments are lacking for cynicism

by Carolina Zanoni


Cases in Italy

The notifications of tuberculosis (not the estimate, which is stable at around 5 thousand cases) in Italy date back to data from 2019: 3346, they were 3912 the year before, with a decrease between 2015 and 2019 of 2.8% l year on average. 56.2% of the total concerns foreign citizens. Average age of Italians 52.9, of foreigners 37.2. Only 80 cases among children under 5, 96 cases between 5 and 14 years. Italy is the only country in the European region where there are more women among the new cases. Tuberculosis is an infectious disease that is transmitted by air and 70-80% affects the lungs. Unfortunately, even in Italy cases of resistance to treatment (MDR-TB) and also of extended resistance (XDR-TB) are developing, making it increasingly difficult to cure and with higher mortality. Recently the Medicines Agency (AIFA) approved Dovprela (pretomanid), the only drug approved exclusively for extensive drug resistance pulmonary tuberculosis.

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Treatment up to six months long

Pharmacological treatments, which generally vary between 4 and 6 months, also become one or two years long and with heavy side effects in the case of MDR or XDR-TB. Those in treatment suffer from the many pills to take (even 16 per day!), Peripheral nerve malfunction, pain, acne, anemia, nausea, vomiting, headache, increased liver enzymes (transaminase and gamma-glutamyltransferase), indigestion (dyspepsia), rash, increased pancreatic enzymes (hyperamylasemia), visual impairment, low blood sugar (hypoglycaemia), and diarrhea. Then there is the long isolation with relative psychological crisis. Within the European Union – for now – less than half (46.8%) of patients suffering from multidrug-resistant TB achieve confirmed success, and only 34.9 of cases of extended resistance (XDR-TB).

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