The Union health ministry on Wednesday recommended that tuberculosis patients should be tested for the coronavirus and vice versa.

In a document titled “Guidance note on Bi-directional TB-Covid screening and screening of TB among ILI/SARI cases”, the ministry said tuberculosis is associated with a 2.1-fold increased risk of severe coronavirus infection and that the prevalence of the disease among those infected by Covid-19 has been found to be 0.37% – 4.47% in different studies.

“Studies have shown that history of active as well as latent TB [tuberculosis] is an important risk factor for SARS-CoV-2 [severe acute respiratory syndrome coronavirus 2] infection,” the document said. “This not only results in increased susceptibility but also rapid and severe symptom development and disease progression with poor outcomes.”

The ministry added that tuberculosis patients also tend to have comorbidities and their living conditions such as malnutrition, diabetes, a smoking habit, human immunodeficiency virus, among others, increases their vulnerability.

To deal with the dual morbidity of the coronavirus and tuberculosis, the ministry said that bi-directional tuberculosis-coronavirus [TB-Covid] screening, tuberculosis screening for influenza-like illness [ILI] cases and tuberculosis screening for severe acute respiratory illness [SARI] cases should be done.

Under the bi-directional tuberculosis-coronavirus screening, Covid screening for all diagnosed tuberculosis patients as well as tuberculosis screening for all coronavirus positive patients should be carried out. The coronavirus patients would be screened using a 4-system complex and checked if they have a history of tuberculosis or had been in contact with a tuberculosis case. The 4-system complex refers to diagnosis based on coughing and persistent fever for more than two weeks, significant weight loss and night sweats. A chest X-ray and upfront Nuclear Acid Amplification Test should be offered to those found symptomatic, the document said.

The same eligibility criteria is to be followed for the influenza-like illness and severe acute respiratory illness cases besides checking if the patients have symptoms for the respective illnesses for more than 10 days.

As of Thursday, India’s overall case count has risen to 33,10,234 after 75,760 new infections were reported in 24 hours. The country’s toll went up by 1,023 to 60,472. As many as 25,23,771 people have recovered from the infection in the country.