The COVID-19 pandemic has currently overtaken every other health issue throughout the world. There are numerous ways in which this will impact existing public health issues. Here we reflect on the interactions between COVID-19 and tuberculosis (TB), which still ranks as the leading cause of death from a single infectious disease globally. There may be grave consequences for existing and undiagnosed TB patients globally, particularly in low and middle income countries (LMICs) where TB is endemic and health services poorly equipped. TB control programmes will be strained due to diversion of resources, and an inevitable loss of health system focus, such that some activities cannot or will not be prioritised. This is likely to lead to a reduction in quality of TB care and worse outcomes. Further, TB patients often have underlying co-morbidities and lung damage that may make them prone to more severe COVID-19. The symptoms of TB and COVID-19 can be similar, with for example cough and fever. Not only can this create diagnostic confusion, but it could worsen the stigmatization of TB patients especially in LMICs, given the fear of COVID-19. Children with TB are a vulnerable group especially likely to suffer as part of the "collateral damage". There will be a confounding of symptoms and epidemiological data through co-infection, as happens already with TB-HIV, and this will require unpicking. Lessons for COVID-19 could be learned from the vast experience of running global TB control programmes, while the astonishingly rapid and relatively well co-ordinated response to COVID-19 demonstrates how existing programmes could be significantly improved.

中文翻译：

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预测 COVID-19 大流行对结核病患者和结核病控制计划的影响。

COVID-19 大流行目前已经超过了全世界所有其他健康问题。这将通过多种方式影响现有的公共卫生问题。在这里，我们反思 COVID-19 与肺结核 (TB) 之间的相互作用，肺结核仍然是全球单一传染病的主要死因。全球现有和未确诊的结核病患者可能会受到严重后果，特别是在结核病流行且卫生服务设施薄弱的中低收入国家 (LMIC)。由于资源转移和卫生系统的重点不可避免的丧失，结核病控制计划将变得紧张，因此某些活动不能或不会被优先考虑。这可能会导致结核病护理质量下降和结果更差。进一步，结核病患者通常有潜在的合并症和肺损伤，这可能使他们更容易感染更严重的 COVID-19。结核病和 COVID-19 的症状可能相似，例如咳嗽和发烧。鉴于对 COVID-19 的恐惧，这不仅会造成诊断混乱，而且可能会加剧结核病患者的污名化，尤其是在 LMIC 中。患有结核病的儿童是一个弱势群体，特别容易成为“附带损害”的一部分。与 TB-HIV 一样，合并感染会导致症状和流行病学数据混杂，这需要剔除。COVID-19 的教训可以从运行全球结核病控制计划的丰富经验中吸取，