Silico-tuberculosis amidst COVID-19 Pandemic: Global Scenario and Indian
Perspective
Abstract
Purpose: Inhalation of crystalline silica-rich dust particles
can result in the deadly occupational lung disorder called silicosis.
The risk of contracting tuberculosis and the potential for lung cancer
increase as a result of silicosis. This review article aims to bring to
light the state of Silicosis and TB scenario in the world and India for
evaluating hurdles in the present and future to achieve the elimination
road map, and assess these conditions in the backdrop of the COVID-19
pandemic. Methods: A PubMed Central search was conducted using
the keywords “silico-tuberculosis” and “prevalence” and the time
period of the last 20 years, which yielded 15 studies, out of which only
the following were found to be relevant in terms of exemplifying the
prevalence of Silico-tuberculosis at various geographical locations
around the world. Results: A patient with silicosis has a
2.8-2.9 times higher risk of developing pulmonary tuberculosis and 3.7
times that of extrapulmonary tuberculosis. Incidences of missed cases
when tuberculosis was misdiagnosed with silicosis due to indifferent
clinical manifestations of the two in the initial stages aren’t
uncommon. The duration of exposure to silica and the severity of
silicosis, have a direct relation with the propensity to develop
tuberculosis. As per a study, an average gap of 7.6 years has been
noticed in a South African population for Silico-tuberculosis to develop
post silicosis. In a study done on mine workers at Jodhpur, Rajasthan,
it was seen that there is no definitive relation between patient with
silicosis and possibility of having Covid-19. Conclusions: This
paper has focused on the coexistence of silicosis and tuberculosis. It
has been seen that the risk of tuberculosis is highly increased with
pre-existing silicosis. There is a big need for the integration of the
Silicosis control programme with Tuberculosis elimination programme for
the government. A few of the steps that can include assessing the
workplaces, periodic monitoring of the workers’ health, active case
surveillance, identification of hotspots, and introducing reforms to
curb the spread of dust and particulate matter from industrialized areas
be taken in this regard.