Tuberculosis Day

Every year on March 24, the world observes Tuberculosis Day to draw public attention to the devastating medical, social and economic consequences of the disease and to intensify efforts to eliminate the global tuberculosis epidemic.

According to estimates by the World Health Organization (WHO), about a quarter of the world’s population is infected with tuberculosis bacteria. Potentially there is a risk of developing tuberculosis in persons with reduced immune protection. In 2022, the WHO published an annual report on the fight against tuberculosis: for the first time since 1997, an increase in the number of patients was registered. Currently, about 10.6 million people in the world are suffering from tuberculosis, annually about 1.5 million people die as a result of this disease.

According to Tereza Kasaeva, director of the WHO Global Program to Fight Tuberculosis, the reasons for the increase in the European region are the COVID-19 pandemic and the war in Ukraine.

To eliminate the tuberculosis epidemic, Ukraine, the first in the European region, updated the national standards for providing medical care for tuberculosis in accordance with the latest WHO recommendations.

The updated standards of “Tuberculosis” medical care, which were developed with the active participation of specialists of the Center for Public Health, were approved on January 19, 2023 by Order No. 102 of the Ministry of Health of Ukraine.

Innovative BPaLM/BPaL treatment regimens have been implemented in our country as part of routine use. Thanks to the BPaL regimen, the duration of treatment for patients with drug-resistant tuberculosis is almost tripled: 6–9 months versus 18–24 months. Patients no longer need to receive painful injections for many months. In addition, this regimen provides a much higher chance of recovery (up to 90% according to the results of clinical studies).

In general, the implemented updates relate to six points of the Tuberculosis Medical Care Standards:

protection of public health and prevention of tuberculosis;
systematic screening for tuberculosis among groups at increased risk of developing the disease;
diagnosis of tuberculosis, including drug-resistant tuberculosis;
treatment of tuberculosis, including drug-resistant tuberculosis;
management of HIV infection and other concomitant diseases in people with tuberculosis;
management of tuberculosis in children and adolescents.

What’s new in the “Tuberculosis” Medical Care Standards:

management of tuberculosis in children and adolescents has been updated, including the issue of BCG vaccination among HIV-infected children;
modern approaches to the diagnosis of tuberculosis in children and adolescents have been introduced;
an integrated decision-making algorithm for the treatment of children under 10 years of age with suspected pulmonary tuberculosis was introduced, modern approaches to the formation of pediatric tuberculosis treatment schemes were described;
approaches to family-oriented medical care for children and adolescents, as well as aspects of pediatric palliative care, etc., have been regulated;
updated the standards of treatment of susceptible tuberculosis by age categories and severity of the disease: shortened 4-month regimens of treatment of susceptible tuberculosis using rifapentine were introduced instead of traditional 6-month regimens;
recommendations on the dosage of anti-tuberculosis drugs according to the patient’s weight have been updated;
the amount of recommended measures in the clinical management of patients due to treatment inefficiency, etc. is defined;
the standards for the treatment of drug-resistant tuberculosis have been updated — the standard provides for the regulation of issues regarding the choice of modern therapy regimens with priority given to completely oral treatment regimens.