Prevention of tuberculosis in the developing countries

JUNE 22, 2022

Table of Contents

Prevention of Tuberculosis in Developing Countries........................................................2

Abstract.................................................................................................................................2
Introduction..........................................................................................................................3
Local and Global Impact of Tuberculosis..........................................................................5
Barriers and challenges in fighting Tuberculosis..................................................................7
Emergence of drug-resistant organisms.............................................................................7
Poor patient compliance with therapy................................................................................8
Failure to carefully control drug supplies and therapy....................................................8
HIV and TB co-morbidity....................................................................................................8
Prolonged period of Treatment...........................................................................................9
Outdated diagnosis methods and devices...........................................................................9
Demographic factors............................................................................................................9
Knowledge and education about TB, the illness, and the available treatments...........10
Perception—perception of public health services and self-condition............................10
Social factors—stigmatization and a lack of parental support......................................11
Potential solutions..................................................................................................................11
Upgrade lab networks and Practical Approach to Lung Health into practice (PAL). 12
Encourage action on the social determinants of health..................................................12
Utilize Public-Private Mix (PPM) strategies....................................................................12
Partnerships that strengthen communities and TB patients..........................................13
Social Mobilization.............................................................................................................13
Promote and enable research............................................................................................13
Vaccination..........................................................................................................................13
Maintaining immunity strength........................................................................................14
Maintaining hygiene:..........................................................................................................14
Adherence to medication:..................................................................................................14
Stay away from those who have active TB.......................................................................15
Identify whether you are "at-risk."..................................................................................15
Engaging in regular exercise.............................................................................................16
Going for test.......................................................................................................................16
Developing a case management strategy..........................................................................17
Discussion................................................................................................................................18
References...............................................................................................................................19
 Prevention of Tuberculosis in Developing Countries.

Abstract

With molecular evidence dating back to more than 17,000 years, tuberculosis (TB) is one of

human’s ancient diseases. Tuberculosis is one of the topmost infectious diseases that is fatal

worldwide, despite of the technological advances in detection and its treatment. The World

Health Organization claims that tuberculosis is an international pandemic. Among individuals

with HIV, Tuberculosis is the main cause of death. In developing countries, the battle against

tuberculosis faces challenges due to; poor primary health care infrastructure especially in

rural areas of many countries, unregulated private healthcare leading to widespread irrational

use of first and second-line anti-TB drugs, the spread of HIV infection, insufficient political

will, corrupt administrations across the developing countries and the emerging danger of

multidrug-resistant tuberculosis (MDR-TB) which is a result of inadequate or failing TB

control programs (Gursimrat, 2021).

Tuberculosis continues to be a challenge to most developing countries since it is an infection

associated with poverty, low sanitation, or hygiene standards, or easy person-to-person

transmission. However, TB is also more widespread and common in low- and middle-income

countries and even high-income countries are also affected (Gursimrat, 2021). In addition, it

is commonly known that poverty and TB are related, and the poorest areas of the town have

the highest TB rates. Those with poor incomes, those who live in congested conditions, and

those with little formal education are more likely to contract Tuberculosis. Poor nutrition

because of poverty may change the way the immune system functions. On the other hand,

poverty that results in crowded housing, inadequate ventilation, and poor hygiene practices is

probably going to enhance the risk of TB transmission (Zaman, 2016).

Introduction

Tuberculosis is a contagious infection caused by bacteria known as Mycobacterium

tuberculosis that mainly affects the lungs and other organs including the bones, brain, and the

spine. According to Peter J, Courtney M , Charalambos, James A , & Helen E , 2017, the

most common infectious cause of death worldwide is tuberculosis, a bacterial infection that

spreads through the air. Although tuberculosis is treatable, due to problems in acquiring

samples and low bacillary loads, tuberculosis diagnostic tests are ineffective and perform

poorly among the young people (Dr Peter J, Courtney M , Charalambos, James A , & Helen

E , 2017). Tuberculosis (TB) is spread through the air by people who are already infected

with the bacteria.

Un-affected person can be infected with the bacteria once he/she gets into contact with fluids

i.e., Mucus and saliva droplets originating from infected person. Other ways include getting

into contact with cough from an infected individual, sneeze from infected person, saliva from

an infected person while speaking, singing or spit. Up to 40,000 droplets can be produced by

a single sneeze. According to Yan, Mang, Ximei, Yong and Lei, tuberculosis has a relatively

low infectious dosage, each of these droplets could spread the disease the inhalation of fewer

than 10 bacteria may cause an infection (Yan, Mang , Ximei , Yong , & Lei , 2020). Roughly

one-fourth of the world's population, according to the World Health Organization, is infected

with Mycobacterium tuberculosis and may be at risk of contracting the disease (Gursimrat,

2021).

An individual who can spread TB that is considered to be "active" and they can spread the

bacteria through their respiratory fluids once they cough or sneeze. Latent TB is a kind of TB

that is dormant, but it can still be spread to many people. The disease-causing bacterium is

known as Mycobacterium tuberculosis has a distinct cell wall with a waxy coating made

mostly of mycolic acids that enables the bacteria to remain dormant for a long period of time
therefore, the immune system of the body may be able to control the disease, it cannot

eradicate it. While some carriers of this latent infection never experience active TB, five to

ten percent of them will get sick at some point later in their lives.

In this research paper, the writer is going to bring into light the nature and the scope of the

infection as a global health issue and its importance, the local impact of the infection, barriers

in addressing the issue, the potential solutions with respective advantages and disadvantages

and recommendations for action.

Nature and Scope of the infection as a global issue.

According to World Health Organization (WHO), in the twenty-first century, HIV officially

overtook tuberculosis as the leading infectious killer of adults globally (Nardell, 2015).

However, after research and analysis done by the same organization it was reported that most

TB-related deaths among HIV-infected people in TB-endemic areas are mistakenly assigned

to HIV. Annually, developing countries member states report TB data to World Health

Organization, which is reviewed and validated in collaboration with reporting entities

(MacNeil, Glaziou, Sismanidis, Maloney, & Floyd, 2019). Special studies, such as TB

prevalence surveys or inventory studies, contributed to incidence estimates in countries where

case notifications did not capture all incident cases that occurred within a year based on a

standardized checklist (MacNeil, Glaziou, Sismanidis, Maloney, & Floyd, 2019).

Estimates of TB mortality among HIV-negative people were based on cause of death data

from civil registration and vital statistics, mortality surveys, or the product of TB incidence

and case fatality. TB mortality among HIV-infected people was calculated as the product of

HIV infection incidence and case fatality (MacNeil, Glaziou, Sismanidis, Maloney, & Floyd,

2019). Although TB transmission may theoretically occur outside of buildings, this is

significantly less likely because to the practically infinite dilution and generally less
congested surroundings outside. Due to its prevalence in poorly ventilated houses, public

gathering places of all many people, including vehicles like minibuses, trains, and ships,

tuberculosis is possibly has emerged as most significant building-associated disease in the

world. Other than TB, few illnesses are virtually entirely airborne (Nardell, 2015).

According to the analysis and findings of the World Health Organization, Tuberculosis is a

mere infectious disease and a threat to developing countries and the world as well. As a

result, it is very meaningful and advantageous to the developing countries to come up in one

accord to fight the deadly and fierce infection. Understanding the latency of tuberculosis

infection and the persistence of infection after treatment is critical. The discovery of new

markers for high and low risk individuals in terms of TB development and treatment

adequateness would allow for evidence-based decisions about who to treat, how to treat, and

how long to treat for both prevention and cure. In fighting the disease is it will help reduce

the spread rate of the infection, grant health for future generations, strengthen immunity

among the nationalities (Mermin, 2020).

Local and Global Impact of Tuberculosis

The world is in grave danger of devastating regional or global disease epidemics or

pandemics, which not only kill people but also disrupt economies and cause social dis-

organization. Many financial, human, infrastructure, surveillance, and laboratory health

resources already exist in countries that can directly support preparedness efforts. However,

resources for disease-specific programs for tuberculosis frequently do not include or

sustainably support preparedness. High-impact respiratory pathogens, such as a particularly

lethal strain of influenza, pose global risks in the modern era. The tuberculosis causing

bacteria spread through respiratory droplets; they can infect many people quickly and, with

today's transportation infrastructure they aid in spreading of the bacteria more quickly across

multiple geographies (World Health Organization, 2021).

According to the World Health Organization, Mycobacterium tuberculosis, the bacteria that

causes TB, is present in 1.8 billion people, or about one-fourth of the world's population. Ten

million people contracted TB last year, and 1.5 million died (World Health Organization,

2021). The most common infectious disease in the world is tuberculosis. It is to blame for the

economic destruction and the vicious cycle of illness and poverty that has masked up many

families in developing countries, communities, and even whole nations. Women, kids, and

people with HIV/AIDS are among the most susceptible. The disease is getting increasingly

fatal and challenging to cure because of increasing treatment resistance.

In most developing countries such as Algeria, Brazil, Liberia, Kenya, Poland just a few but to

mention, individuals infected with tuberculosis do not get the care and assistance they

require. In communities that are vulnerable to low economic development, a lot of infected

people suffer because of both the individuals themselves and the state are not able to provide

the following:

i. Required health facilities i.e., the hospitals.

ii. Required surroundings, whether at home and at work for the patients

iii. Good social, economic, or legal standing in society

iv. An environment where the patients will not face discrimination

v. A spacious and distance cells and prisons for the jailed

In failure and challenging state of meeting the above-mentioned requirements, untreated TB

patients have a higher risk of spreading the disease to others. Significant groups at risk of

being infected as a result thereby include persons with low income, persons who are

underweight, those suffering from HIV/AIDS, those who have immunodeficiency diseases or

other co-morbid conditions, miners, prisoners, women and young people, minority ethnic
groups especially those arriving from countries with high burdens, refugees and migrants, the

homeless, those who are dependent on drugs and other substances.

The above case in many developing countries share many the same traits as those that

enhance the risk of contracting COVID-19. For Example, is when a person's access to

medical care is restricted, it is very serious. Before the COVID-19 pandemic, the rates of

Tuberculosis infection, death, and TB-related illnesses were decreasing internationally and

locally nevertheless, the COVID-19 pandemic now poses a threat to drive back this

advancement globally. Resources that were directed towards the TB care have been

redistributed to the COVID-19 response in many developing nations and globally. COVID-19

pandemic may result to driving higher the rate of tuberculosis infection.

Barriers and challenges in fighting Tuberculosis

Prevention and control of tuberculosis is a major challenge for health care workers, patients

funding agencies, communities, and families in developing countries. Issues that pose

challenges in these countries differ from those in the developed world and must thus be

addressed differently. Key challenges include, high prevalence of tuberculosis, particularly

drug resistant tuberculosis, Multidrug Resistant Tuberculosis (MDR-TB) and extensively

drug resistant tuberculosis (XDR-TB), HIV and TB co morbidity, local, social, and structural

factors which vary from one country to another, economic constraints, and poor diagnostic

facilities. To meet these challenges, developing a case management strategy, maintaining

high quality of care, and preventing drug resistance, increasing human resource capacity,

improving diagnosis, and fostering operation research in the area are all necessary.

Despite the availability of anti-TB drugs, TB treatment programs in most developing

countries have not succeeded due to (Laura , Rodrigues, & Peter, 2018).

Emergence of drug-resistant organisms

In most cases, TB is treatable and curable; however, people with TB can die if they do not get

proper treatment. Sometimes drug-resistant TB occurs when bacteria become resistant to the

drugs used to treat TB. This means that the drug can no longer kill the tuberculosis bacteria.

Drug-resistant TB (DR TB) is spread the same way that drug-susceptible TB is spread. TB is

spread through the air from one person to another. The TB bacteria are put into the air when a

person with TB disease of the lungs or throat coughs, sneezes, speaks, or sings. People

nearby may breathe in these bacteria and become infected.

Poor patient compliance with therapy.

This is where most patients do not take the medication and treatment clinics seriously. In a

number of cases, some patients fail to take the drugs prescribed by the doctor and their health

and life is more endangered.

Failure to carefully control drug supplies and therapy.

This occurs as a result of low economic standards of the developing countries. The states due

to the situation, are not in a position to purchase the required therapeutic devices, medication

and experienced personnel i.e., Doctors and Nurses.

HIV and TB co-morbidity

In cases of HIV infection complications arise in both accurate diagnosis and adequate

treatment. People with HIV or AIDS have a faster deterioration of their immune systems, and

they are more likely to have active TB during their lifetime than HIV-negative people. People

with advanced HIV infection can have active TB that is smear-negative or lacks typical chest

radiography features, resulting in untreated coexisting TB infections. HIV-positive

individuals have higher recurrence rates when using certain anti-TB medications.
Antiretroviral drug interactions and clinically significant toxicity can occur when

antiretroviral medications of both Tuberculosis and HIV are taken concurrently. The clinical

picture in patients with co-infections is further becomes complex since patients using

antiretroviral medications may develop an immunological reconstitution syndrome, which

resembles TB infection in many ways.

Prolonged period of Treatment

The main issue with these most Tuberculosis medications is the requirement for long period

therapy. The medications are currently advised for a period of 6–9 months, and failure to

follow lengthy therapy courses leads to resistant strains and recurrence of the infection.

As a result of the above challenges the healing rates in developing countries are frequently

less than 50%; however, cure rates of greater than 90% can be achieved when short-course

chemotherapy regimens are given under supervision. A major obstacle to the more

widespread use of these short-course treatment regimens is the higher cost of the drugs,

especially Rifampin and Pyrazinamids.

Outdated diagnosis methods and devices.

The current diagnostic methods for TB are dated and frequently unsuccessful. Sputum-smear

microscopy, which was invented in 1882, is less efficient in treating children and HIV-

positive individuals, whose smear findings are frequently negative, and it cannot detect

extrapulmonary or smear-negative TB. Additionally, most laboratories lack the tools

necessary to recognize Multidrug Resistant Tuberculosis (MDR-TB).

Demographic factors.

This becomes a challenge where a patient must commute a long distance in order to access a

hospital or public health facility. Regular trips to the medical institution are necessary since

individuals on the patients under medication must get injectable medications (Murray, 2017).
Unfortunately, most patients I developing countries are not able to afford the transport costs

and, they cannot manage to walk for long distances to the health facilities.

Knowledge and education about TB, the illness, and the available treatments

Most patients and patient caregivers in developing countries have insufficient awareness

regarding Tuberculosis because there are few or no education sessions offered to the public

concerning tuberculosis. Most people have insufficient knowledge about TB, about the

infection, how it is spread, how to take care of TB patients (home-Based care). When most

patients begin the TB treatment, most of them stop at a certain point because they are unable

to pay the medical bills up until the end of the course of treatment. Furthermore, the absence

of communication between commercial and public health service facilities made the

ignorance of TB programs worse (Gautam, Karki, & Khanam R., 2021).

Referring TB patients to public health centre where the condition of treatment is even worse

is a common issue in most developing countries. Some private health institutions refer TB

patients to public hospital to evade failure of payment of the hospital bills of most TB

patients. In the public health facilities, most Tuberculosis required medications may not be

available (GoogleScholar.com, 2020).

Perception—perception of public health services and self-condition

Some patient’s belief that qualified medication and treatment should be expensive and not

free.

Due to a bad perspective of their situation, TB patients begin to have psychological issues.

Due to their health situation, they experience shame, despondency, and rejection. Another

case is the existence of belief that TB only affects those with poor living conditions, so the

rich are not affected and therefore, they may tend to not bother much about being infected.
 Social factors—stigmatization and a lack of parental support

In the sense that some patient’s belief that the community has disapproved them and is afraid

to come in close contact with them, stigmatization of TB patients has been a challenge in the

community. Additionally, close relatives and healthcare professionals as well as the broader

public stigmatization. Patients with TB experience discrimination and isolation due to the

stigma that comes from close kin (Murray, 2017).

In some cases, immediate family members abandon their patients leaving them without any

help as they battle the illness. When stigmatization is also seen in the community and the

workplace, the problem becomes more complicated because this can affect the patients'

capacity to receive access to skilled TB care and to make the daily financial help which they

need to survive. Additionally, social security is not available to TB patients in most

developing countries, despite the government's announcement of a free TB care program,

most patients incur large amount of expenses as they undergo the treatment process.

Three themes were used to group the obstacles socio-demographic factors and the economy;

knowledge and perception; and TB treatment. There are five significant treatment hurdles

that cut across those challenges, not knowing much about TB, being stigmatized, traveling a

considerable distance to a health institution, experiencing a negative drug reaction, and losing

one's job. To improve patient-centered care for TB patients in developing countries, it is

important to take into account the primary treatment hurdles. To increase the success of TB

therapy, a multifaceted approach involving TB patients, healthcare professionals, the general

community, and policymakers is necessary (Murray, 2017).

Potential solutions

The requirements of TB connections, as well as those from poor and vulnerable groups
strengthen the health system in developing countries by emphasizing the following measures:

Primary healthcare aid in the creation of health policy, human resources, funding, resources,

service provision, and information about infection prevention in homes, other communal

spaces, and health care facilities. This will help in educating people about the illness and

about the health measures and medication requirements for the patient. The disadvantage of

this measure is that most people may not be willed in learning about tuberculosis because

they belief that this should only concern the affected patients and their families or close

relative.

Upgrade lab networks and Practical Approach to Lung Health into practice (PAL).

This will make a great milestone in diagnosis of the infection in its most early stages which

will make it easier for treatment. The only disadvantage is that, most developing countries

have limited income to implement and set up this lab networks (GoogleScholar.com, 2020).

Encourage action on the social determinants of health

By adapting effective strategies from other fields and sectors including, engaging all medical

personnel in decision making processes. The advantage of this being that reasoning together

by people from different sectors will provide a more concrete solving ideas than when one

sector is involved. The disadvantage of this is that the members from different sectors may

not be willing to offer support if required or they do not want to be involved in the decision-

making processes and they might be in fear of incurring expenses (GoogleScholar.com,

2020).

Utilize Public-Private Mix (PPM) strategies

This means to include all public, nonprofit, corporate, and private providers. This will aid in

coming up with strategies, ways of funding Tuberculosis prevention programs as well as

joining financial strengths in fighting the disease. The disadvantage of this solution being that

self will or the private sectors to be incorporated may be negative.

Partnerships that strengthen communities and TB patients

This incorporates the health and government servants of health sector, by encouraging

patients who have started the medication to continues, introducing television and social

media channels to encourage patients and all people on fighting TB. The disadvantage may

be that most people especially the un-affected may not be willing to learn about Tuberculosis.

The public health sector personnel may not be willing to go out and encourage patients and

people on ways to deal with the infection and continue with medication (GoogleScholar.com,

2020).

Social Mobilization

Advocacy, communication, and social mobilization to be encouraged as well as community

involvement in TB treatment. This can be achieved through organizing public education

programs, creating public awareness about the infection control ways, the early symptoms of

the infection and ways of handling the TB patients at home. The disadvantage of this being

that; The educating personnel may not be available, and it may take time to educate a good

number of people (Murray, 2017).

Promote and enable research

This is where program-based operational research should be done, and new methods should

be used. This will enable the health sectors to be open to diverse ways of implanting new

drugs, vaccines, and methods of treatment. The disadvantage of this, is that it requires

funding to implement and put in practice where funds are challenge to most developing

countries.

Vaccination
All newborn and infants should be given the Bacillus Calmette-Guerin (BCG) vaccine to

protect them against TB. The vaccine enables the child to develop antibodies against the

causative organism (Mycobacterium tuberculosis) of TB (Laura , Rodrigues, & Peter, 2018).

Maintaining immunity strength

Most people who have ever received TB vaccination may not have developed strong defense

to the disease because the protection offered by vaccination received in childhood reduces its

strength with time. Therefore, the vaccine cannot provide life-long protection. Therefore, a

healthy lifestyle is important to prevent TB. Including fresh fruits and vegetables in diet. Eat

a complete meal that includes carbohydrates, proteins and fats. Avoiding smoking and

alcohol, exercise regularly and staying fit by exercises. The disadvantage is that in

developing countries some families may not manage to provide a balanced diet for all

members and there are cases of drug addiction i.e., smoking and alcohol taking which are

challenging to handle.

Maintaining hygiene:

This include sanitary measures like covering the mouth when coughing and refraining from

spitting in public areas are still overlooked by people, including those who are infected with

TB. Prevention is greatly aided by good hygiene. So, making sure that hands are washed

regularly and before eating and drinking plenty of fresh and safe water. When around TB

patients, hospital workers one should wear protective masks and gloves. Avoid going to

crowded, dirty locations. Although, in most developing countries, access to clean and safe

drinking water is a challenge including the access to masks and gloves for everyone.

Adherence to medication:

The emergence of drug-resistant TB is one of the main causes of the rise in the number of

fatalities. As a result, those who have the illness are the true disease carriers. When people
don't follow the instructions, the TB bacteria have a chance to become resistant to the

medications. These resistant bacteria can be inhaled by healthy people when they are released

into the air resulting in an increasing number of fatalities. Therefore, TB patients under

medication should be encouraged and motivated to continue with treatment until they heal.

Despite it being important for the patients, some may not be willing because they are

subjected to long period of treatment and drug taking which they may not like (Xing, et al.,

2021).

Stay away from those who have active TB

The most crucial step in TB prevention is to stay away from those who have the disease

because it is extremely contagious, especially if you have already tested positive for TB.

Particularly if they have only recently begun treatment (less than two weeks), avoid spending

extended periods of time with somebody who has an active TB infection. It's crucial to stay

away from TB patients in warm, stuffy places. However, the TB patients may develop

psychological problem as to why are people avoiding staying and spend time them and this

may affect them psychologically as they will feel isolated.

Identify whether you are "at-risk."

It is believed that some demographic groups are more susceptible to contracting TB than

others. If you belong to one of these categories, you need to be more watchful about guarding

against TB exposure. The following are some of the major at-risk groups:

i. Those with compromised immune systems, such as HIV/AIDS patients.

ii. Those who care for or live with someone who has active TB, such as a close

relative, a physician, or a nurse.

iii. Those in the medical and social fields who deal with patients at high risk, like the

homeless.
iv. People who have recently immigrated from regions with a high TB rate as well as

anyone who was born in an area where TB is prevalent, including children.

v. Individuals who reside in crowded, constrained settings, such as jails, nursing

homes, or shelters for the destitute.

vi. Individuals who misuse drugs and alcohol or who have limited or no access to

quality medical treatment.

vii. those who reside in or visit nations where active TB is widespread.

Engaging in regular exercise.

Trying to include cardiovascular exercises like jogging, swimming, or rowing and getting

enough rest and sleep. This will help in strengthening people immunity and maintaining

general body strength. Despite it being an advantage to health, most people do not like

exercise, and they think that it is tiresome and unnecessary to commit themselves in it.

Going for test

when someone has been around to a person who has tuberculosis. It is crucial to contact

healthcare practitioner right away if someone has recently come into contact with

someone who has active TB and think there's a risk that he/she might have caught the

illness. This can be done in two ways of testing test for tuberculosis:

1. The skin test A protein solution must be injected anywhere between 8 and 10 weeks

after contact with an infected person as part of the Tuberculin Skin Test (TST). Two

or three days later, the patient must go back to the doctor to have the skin reaction

explained.

2. Blood test: which just needs one medical visit and is less likely to be misinterpreted

than the skin test. However, most people once they visit or come close to persons with

Tuberculosis, they tend to assume that they never caught the infection which is a
 wrong assumption. Another disadvantage is that the testing hospital or devices may be

found in long distance places where it might require some commuter expenses which

is a challenge (Ho, Feng, Narita, Stout, & Chen, 2022).

Developing a case management strategy.

This involves all the states and other tuberculosis fighting organizations to come on board

and develop a strategy whose aim is mainly eradicating tuberculosis spread. The World

Health Organization for Example, has already developed a strategy known as the TB STOP

STRATEGY whose Targets, Objectives, and Vision are as follows:

Vision: a TB-free world

To significantly reduce the worldwide burden of TB in accordance with the Stop TB

Partnership's and Millennium Development Goals targets.

Objectives:

Realize widespread accessibility to superior diagnostic and patient-centered care.

Reduce the TB-related human suffering and socioeconomic burden.

TB, TB/HIV, and drug-resistant TB should be prevented in poor and vulnerable populations.

Encourage the creation of new tools and make them available for efficient and timely use

Targets: Get rid of tuberculosis as a public health issue such that there is less than one case

per million population.

The World Health Organization Stop TB Strategy constitute of the following parts.

a) Directly Observed Therapy Short-Course (DoTS) expansion and improvement of the

highest caliber dependable political commitment, sufficient and ongoing funding.

 This Strategy is meant to ensure that the patients under medication are observed by a

selected health personnel and the taking of medicine is recorded.

b) Ensure accurate, quality-assured bacteriology diagnosis and the correct directive to be

given for early case detection and diagnosis.

c) Offer standardized care accompanied with patient support and oversight.

d) Ensure efficient drug management and supply tracking and assessing results and

effects. This is accompanied by improvisation and implementation of better data

capturing health and medical software’s for the medical personnel to capture every

data and make record of the management as well as producing accurate results of the

same.

e) Emphasizing on the needs of underprivileged and prone groups to the tuberculosis

causing bacteria, as well as TB-HIV and Multi Drug Resistance-TB

f) Increase prevention and treatment of multidrug-resistant TB.

g) Increase joint TB/HIV initiatives (MDR-TB) (Xing, et al., 2021).

Discussion

Fighting against tuberculosis in developing countries calls for joined task force by the

governments, health organizations, private sectors and other potential sectors. It requires

everyone commitment in aid of eradicating the infection. In accordance with the Geneva

World convention on fighting against TB, New World Health Organization (WHO)

recommendations will assist nations in accelerating efforts to provide preventive therapy to

people infected with tuberculosis (TB) (World Health Organization, 2020). TB is still the

leading cause of death among HIV patients. To prevent TB and save lives, TB preventive

treatment works in tandem with antiretroviral therapy. Governments, health services,

partners, donors, and civil society will need to redouble their efforts to achieve the desired

levels of access to TB prevention treatment.

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