Tuberculosis prevalence relation to COVID-19: mortality in malaria free countries

Abstract

Background: Both malaria and latent tuberculosis (TB) are possible factors related to decreased COVID-19 mortality. Malaria endemicity variable is a possible confounder when conducting a study on the correlation of latent TB prevalence to COVID-19 mortality. Studies regarding latent TB prevalence" according to different studies" did not adjust malaria endemicity as a possible confounder. Many malaria-endemic countries are high TB prevalent. Malaria-free countries could be: high, moderate, or low in TB prevalence. The main aim of this study is to look for the influence of TB prevalence on COVID-19 mortality. TB prevalence reflects latent TB prevalence in the absence of malaria endemicity as a possible confounding factor in TB studies.Methods: The total chosen countries were sixty-nine non-malaria endemic countries. Countries were classified according to TB prevalence groups into low, moderate, and high prevalent groups. Covid-19 deaths/Million (M) inhabitant were taken as reported on September 2, 2020. "Kendall's-τ Correlation Coefficient", "Kruskal-Wall is test, and Mann-Whitney test were used in statistical analyses.Results: We found inverse relationships between TB prevalence and COVID-19 deaths/ (M) inhabitant and a highly positive significant correlation coefficient was reported (0.008) in Kendall's-τ correlation coefficient test. Kruskal-Wall is test showed a significant relationship within studied groups. Furthermore, the low TB prevalent group had significant reverse associations with both high and moderate TB prevalent groups in the Mann-Whitney test.Conclusions: In the absence of possible malaria confounding, TB prevalence in malaria free countries is inversely related to COVID-19 mortality in a highly significant association.