TUBERCULOSIS TRENDS DURING CRISES AND CONFLICTS: IMPLICATIONS FOR EPIDEMIC MANAGEMENT

Tuberculosis (TB) remains a major global health challenge, causing significant morbidity and mortality despite advances in diagnostics, treatment, and prevention. In 2022, an estimated 10.6 million people developed TB worldwide, and approximately 1.3 million died, making it the second leading cause of death from a single infectious agent after COVID-19. Multidrug-resistant TB (MDR-TB) and rifampicin-resistant TB (RR-TB) remain critical concerns, with over 410,000 reported cases in the same year, highlighting persistent gaps in health systems, particularly in low- and middle-income countries. TB is closely linked to socio-economic determinants, including poverty, overcrowding, inadequate nutrition, poor ventilation, and limited access to healthcare, which collectively facilitate transmission and disease progression. Crisis-affected populations are especially vulnerable, often experiencing multiple overlapping risk factors. Biological and behavioral determinants—such as HIV infection, diabetes, smoking, alcohol use, and immunosuppressive conditions—further compromise immune defenses, increasing the likelihood of latent infections progressing to active disease. Understanding the interplay of social, environmental, and biological factors is critical for effective TB control, particularly in emergency and conflict settings, where healthcare access and preventive measures are severely disrupted. This study underscores the need for integrated interventions that address both the clinical and socio-economic dimensions of TB to reduce its burden globally