Lesotho TB burden remains

Ntsoaki Motaung

Lesotho still remains at the top of a list of countries with highest Tuberculosis (TB) cases amongst countries that are categorized as high burdened countries.

This was said by the TB Monitoring and Evaluation Officer of the Ministry of Health Thato Raleting-Letsie in an introspection meeting, on progress made on issues of TB held in Maseru earlier this week.

Raleting-Letsie indicated that for the year 2016 and 2020 Lesotho is amongst countries that have high TB cases and HIV co-infected cases.

She said Lesotho’s strategic guidance says that the goal of the Lesotho National TB Programme is to reduce the TB mortality, mobility and disease transmission to a level that no longer constitute as public health problem.

“This translates to 14,000 new cases of TB in the year 2020. The case detection which is the treatment coverage was only 33% as we were able to diagnose and treat only 4,500 cases of TB as an estimate,” she said.

She said this means there are 67% of TB cases that were not found and by not found, meaning they were not diagnosed hence not put on treatment.

She indicated that, about 50% of TB patients visit the facility three times before they are diagnosed with TB.

According to the Global Tuberculosis Report 2021, COVID-19 pandemic has reversed years of progress in providing essential TB services and reducing the TB disease burden.

“The most obvious impact is a large global drop in the number of people newly diagnosed with TB and reported. This fell from 7.1 million in 2019 to 5.8 million in 2020, an 18% decline back to the level of 2012 and far short of the approximately 10 million people who developed TB in 2020.”

The report says reduced access to TB diagnosis and treatment has resulted in an increase in TB deaths.

“Best estimates for 2020 are 1.3 million TB deaths among HIV-negative people, up from 1.2 million in 2019 and an additional 214 000 among HIV-positive people, up from 209 000 in 2019, with the combined total back to the level of 2017.”

“Declines in TB incidence achieved in previous years have slowed almost to a halt. These impacts are forecast to be much worse in 2021 and 2022. Other impacts include reductions between 2019 and 2020 in the number of people provided with treatment for drug-resistant TB -15%, from 177 100 to 150 359, about 1 in 3 of those in need and TB preventive treatment -21%, from 3.6 million to 2.8 million, and a fall in global spending on TB diagnostic, treatment and prevention services from US$ 5.8 billion to US$ 5.3 billion, less than half of what is needed.”

According to the report, actions to mitigate and reverse these impacts are urgently required. It says immediate priority is to restore access to and provision of essential TB services such that levels of TB case detection and treatment can recover to at least 2019 levels, especially in the most badly-affected countries.