Abstract
The incidence of extensively drug-resistant tuberculosis (XDR-TB) has been rising consistently in Pakistan, and the country is likely to experience another surge of cases in the midst of the COVID-19 crisis. It is imperative to consider how the rising proportion of XDR-TB is best tackled during the pandemic; this includes finding a solution to the problem of non-adherence at the level of community-based healthcare, the utility and practicality of simultaneous testing for COVID-19 and TB, and reconciliation of the World Health Organization's recommendation of home-based treatment with the need for frequent monitoring of anti-tubercular therapy in XDR-TB. Operational research is needed expeditiously to bypass these limitations.
Highlights
The incidence of extensively drug-resistant tuberculosis (XDR-TB) has been rising consistently in Pakistan, and the country is likely to experience another surge of cases in the midst of the COVID-19 crisis
Ongoing efforts to control the spread of TB, consistent, have been hindered by a lack of patient awareness, unemployment or underpaid labor resulting in financial constraints, and the social stigma of tuberculosis itself, all of which collectively discourage patients from adhering to treatment.[1]
A recent report by the Stop TB Partnership suggested that efforts against TB may be set back even further during the coronavirus disease 2019 (COVID-19) crisis, with 6.3 million new cases and 1.4 million deaths expected worldwide between and 20253; for Pakistan, it is imperative to consider how the rising proportion of XDR-TB may require a unique approach to this situation
Summary
The incidence of extensively drug-resistant tuberculosis (XDR-TB) has been rising consistently in Pakistan, and the country is likely to experience another surge of cases in the midst of the COVID-19 crisis. A disproportionate 95% of these deaths are restricted to middle-income/ low-income countries, one of which is Pakistan.
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