Impact of wars and disasters on tuberculosis epidemiology
1Provincial Health Directorate of Ankara, Republic of Türkiye Ministry of Health, Ankara, Türkiye
2Department of Medical Microbiology, Medical Faculty, University of Economics and Technology, Ankara, Türkiye
3Department of Clinical Microbiology and Infectious Diseases, Medical Faculty, University of Ankara Yildirim Beyazit, Ankara, Türkiye
J Clin Pract Res - DOI: 10.14744/cpr.2024.39082

Abstract

Tuberculosis (TB) remains one of the major public health problems globally. Poverty and living conditions including the density of overcrowding, and the presence and prevalence of major biological/behavioral risk factors which impair the immune system or give rise to forth biological risk factors are the major key risk factors for TB. Wars and disasters increase the risk of development of TB mainly due to population movement and displacement into overcrowded camps and temporary shelters, destruction of infrastructure, breakdown of health services, or discontinuation of the ongoing treatment for HIV co-infection that leads a higher risk of TB transmission, reactivation of latent TB infection or worsening of active disease and increased risk of vulnerabilities. Any causal factor leading to an increase in risk factors for TB is the main driver of alteration in TB epidemiology in wars and disasters. A TB preparedness plan including the coordination mechanism, pre-assessment of data such as TB prevalence and incidence and drug-resistance status, prevailing major biological/behavioral risk factors for TB, resource requirements, the contingency plan for procurement and supply chain, surveillance, monitoring and evaluation tools, health facility details, effective TB infection control measures, testing, and screening protocols should be developed. Strategies to enable the continuity of the National TB Control Program and strategies to decrease the vulnerabilities and risk factors for TB should be developed. Since most of the wars and disasters, causing refugees to travel across borders, affect more than one country the development of an international data-sharing system would be useful.