For Your Health: World Tuberculosis Day: The disproportionately affected populations  

By Aniselle MacRenato, Special to the Daily Republic

Declared by the World Health Organization, World Tuberculosis Day is observed each year on March 24 to increase awareness about tuberculosis and the barriers to diagnosis, treatment and prevention of the disease. The theme for World TB Day 2022 is “Invest to End TB. Save Lives,” urging investment of resources to improve equitable access to care that will save lives.

This is especially critical in the context of the global Covid-19 pandemic that has stalled efforts to end TB.

On March 24, 1882, Dr. Robert Koch discovered the mycobacterium that causes TB, allowing for the development of a cure for this deadly disease. TB is transmitted by the inhalation of infectious TB droplets from an infected person. The bacterium, called mycobacterium tuberculosis, attacks the lungs and different locations of the body. An infected person may not have symptoms during the latent phase of TB infection, but a person can transition to symptomatic infectious TB when the bacteria activate and multiply.

This can happen especially in those who are immunocompromised or have certain chronic health conditions such as diabetes.

Racial and ethnic disparities exist for TB. Nearly nine out of 10 (89%) TB cases reported in the United States occurred among those who identify as Hispanic/Latino, Black/African American, and Asian, according to the Centers for Disease Control and Prevention. Those experiencing homelessness and the incarcerated were also identified to face an increased risk of TB disease. These are the same groups that have historically been marginalized and experienced disadvantages to accessing health care.

Due to the Covid-19 pandemic, TB case rates declined throughout the nation, including for California and Solano County. In 2020, the California TB case rate was 4.3 cases per 100,000 people, representing close to a 19% drop from 2019. Solano County’s TB case rate was 6.4 cases per 100,000 and 9.7% lower than 2019. Despite the decrease, the Solano County TB case rate was nearly three times the national rate of 2.2 cases per 100,000 and double the state rate.

Local data indicate a continued drop in case reports in 2021 and an overall 41.9% downturn in reported cases during the past two years of the pandemic. The specific causes of the decline are unknown. Some of the decreases are likely due to pandemic-related travel restrictions, decreased immigration and economic conditions. The drop may also reflect an actual decreased detection of TB, possibly from fewer TB diagnoses made when people sought care, decreased TB transmissions because of masking and reduced movement outside of households.

Solano Public Health and state TB experts expect to see increases in TB cases as the pandemic conditions recede.

Ongoing efforts to address disparities in TB include collaborations with national and public health organizations to improve screening, diagnosis and treatment, such as improving TB screening of immigrants and refugees and offering education and treatment for those who test positive for TB. Ending TB requires coordinated action across all sectors – the individual, communities, businesses, health care, governments and other agencies.

Each year, March 24 serves as a reminder of the need to stay vigilant about our own health and our personal risk factors that may increase the chance of contracting TB and developing infectious TB after infection. This spring, we urge everyone to ask their doctors about their TB risk, how to get the appropriate test and how to be treated if infected.

More information is available at www.cdc.gov/tb or http://tbfreecalifornia.org.

Aniselle MacRenato is a college intern at Solano County Public Health.

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