Lung health conference: Failure to achieve end TB targets will have devastating economic impact
Pretoria - Failure to achieve the end TB targets by 2030 will have a devastating economic impact on countries with high prevalence of HIV and TBl, researchers reveal.
This was communicated during the virtual 51st Union World Conference on Lung Health where researchers indicated that the cost of not ending TB by 2030 will be over $3 trillion US dollars and over 28 million deaths.
The conference had the participation of the South African Medical Research Council and looked at new data that provides insights with potential real-world implications for people living with TB including a one-third reduction in treatment time.
This included the promising results from an inaugural trial in South Africa of targeted universal testing for TB and new data from a clinical trial demonstrating that treatment time for people living with TB can be reduced by a third.
Sachin Silva of Harvard University said the Covid-19 pandemic has certainly made 2045 the more likely scenario, suggesting that even a brief shut down in TB programmes is likely to have calamitous epidemiologic and economic consequences.
The conference, however, revealed that a high-dose of rifapentine with or without moxifloxacin can shorten treatment time by a third for people with pulmonary TB.
A randomised, open-label, controlled Phase III trial enrolled a total of 2 516 participants from 33 sites in 13 countries to determine whether one or two four-month regimens of TB treatment are as effective as a standard six-month regimen for treatment of pulmonary TB.
All three regimens were administered daily, seven days each week, with direct observation of each dose by a health-care worker at least five of the seven days of each week.
Susan Dorman of the Medical University of South Carolina said participants were TB free after a regiment of four months, effectively reducing their treatment time by a third, down from six months.
In women both pregnancy and HIV increase the risk of TB. Antiretroviral therapy and isoniazid preventive therapy can reduce mortality rates among HIV-positive pregnant women.
A total of 1 215 HIV-positive consenting pregnant women in their second or third trimester were prospectively enrolled from six facilities across three provinces in South Africa, between October 2017 and May 2019.
The birth outcomes were assessed for those with isoniazid preventive therapy exposure and those with non-exposure.
Sikhethiwe Masuku of the South African Medical Research Council said findings suggested that isoniazid preventive therapy can be safely used during the second and third trimester of pregnancy.
However, with recent changes in TB and HIV treatment regimens, more research is needed to determine the safety of these therapies during each trimester of pregnancy and to evaluate pregnancy outcomes.