Paradojas que limitan un conocimiento real de la tuberculosis y pueden favorecer su expansión durante la COVID-19
Resumen
Antecedentes: La tuberculosis es la pandemia que más muertes ha causado a la humanidad. Objetivo. alertar sobre incongruencias que limitan la aproximación al conocimiento real de la tuberculosis y pueden favorecer su expansión durante la COVID-19. Desarrollo: seis incongruencias limitan el conocimiento real de la enfermedad: a) su subestimación, b) considerarla exclusiva de la pobreza, c) desestimar los integrantes zoonóticos del complejo Mycobacterium tuberculosis, d) subvalorar a los animales como reservorios, e) ignorar la relación enfermedad - ecología y f) el desfasaje entre la taxonomía molecular actual y las anteriores limitantes. Factores que la descontextualizan, distorsionan su estado real y retardaron las decisiones para su erradicación hasta 2018. Desde 2020, la casi absoluta subordinación de los sistemas salud a la COVID-19, interfieren este propósito y pueden provocar un retroceso de la tuberculosis a escenarios similares a los de 2012. Los estudios sobre posibles sinergias entre ambas pandemias, aunque escasos, pronostican que los coinfectados tienen 2,21 - 2,27 veces más probabilidades de morir o desarrollar una enfermedad grave. Conclusiones: la tuberculosis es la pandemia más antigua y letal para la humanidad; también la más ignorada. A ello han contribuido los excesos de confianza, subestimar: las áreas menos favorecidas del planeta, la participación de animales, el entorno y no adecuar los conocimientos taxonómicos de avanzada en función de estas limitantes. Situación que se agrava ante la prioridad que demanda la COVID-19. Valorar las incongruencias que limitaron un conocimiento más objetivo de la tuberculosis sería un primer paso para su futura erradicación.
Palabras claves: complejo Mycobacterium tuberculosis, pandemia, subnotificación, tuberculosis, zoonosis (Fuente MeSH)
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