Tuberculosis amidst COVID-19 in Pakistan: a massive threat of overlapping crises for the fragile healthcare systems

Abstract

Mycobacterium tuberculosis is the cause of tuberculosis (TB), a granulomatous illness that mostly affects the lungs. Pakistan is one of the eight nations that accounts for two-thirds of all new cases of developing TB. TB has long been an endemic disease in Pakistan. According to the World Health Organization (WHO) estimates, the nation has over 500 000 incident TB infections per year, with a rising number of drug-resistant cases. Recently, the coexistence of COVID-19 and TB in Pakistan has provided doctors with a problem. Fever or chills, cough, shortness of breath or difficulty breathing are all signs of COVID-19. After SARS-CoV-2 infection, cough might persist for weeks or months and it is frequently accompanied by persistent tiredness, cognitive impairment, dyspnoea or paina group of long-term consequences known as post-COVID syndrome or protracted COVID. Coughing with mucus or blood, and coughing that continues over 2 months are indications of TB. The same clinical presentation features make it difficult for healthcare personnel to effectively evaluate the illness and prevent the spread of these fatal diseases. Pakistan lacks the necessary healthcare resources to tackle two contagious diseases at the same time. To counteract the sudden increase in TB cases, appropriate management and effective policies must be implemented. Thus, in order to prevent the spread of these infectious diseases, it is critical to recognise and address the problems that the healthcare sector faces, as well as to create an atmosphere in which the healthcare sector can function at its full potential.

The role of IL-1 family of cytokines and receptors in pathogenesis of COVID-19

“…SARS-CoV-2, the causative agent of the ongoing pandemic of COVID-19, has become a health threat since December 2019 and is responsible for over 500 million infected cases and 6 million deaths as of 6th May 2022. This pandemic has posed catastrophic impacts on nations' healthcare resources, especially in regions with fragile healthcare infrastructures, such as Africa [ 1 ], Afghanistan [ 2 ], and Bangladesh [ 3 ], and overloaded healthcare systems due to the coexisting contagious disease, like Zika [ 4 ] and Tuberculosis [ 5 ].…”

Monkeypox virus: A future scourge to the Pakistani Healthcare system

“…Even though Pakistan hasn't reported its first confirmed case of monkeypox yet, the spread of the virus to the country is almost inevitable. Considering the burden that has been inflicted by the COVID-19 pandemic on Pakistan's already struggling healthcare system [ [6] , [7] , [8] , [9] , [10] ], several precautionary measures need to be ensured to prevent its continuous decimation. In the past, co-epidemics and co-occurrences of viral diseases such as dengue fever, zika, chikungunya, Crimean Congo hemorrhagic fever, measles, and poliomyelitis along with the COVID-19 infection have resulted in numerous casualties that could've been prevented by taking the advanced precautionary measures [ 8 , 11 , 12 ].…”

Poliovirus returns to Pakistan: A rising concern

“…The COVID-19 pandemic has not helped the polio situation in Pakistan either [ [5] , [6] , [7] , [8] , [9] ] and has instead made polio vaccination drives harder than usual owing to the inability of healthcare workers to travel to rural areas amidst imposed lockdowns which might explain the post-COVID surge in polio cases [ 10 ]. The cherry on top is the distrust that most people in rural areas harbor towards healthcare workers which contributes to their reluctance to get their children the vaccine.…”