Abstract
BackgroundThe COVID-19 pandemic has caused major disruption to healthcare services globally and has impacted on tuberculosis (TB) patients and TB diagnosis and treatment services both in low- and high-income countries. We therefore explored the perspectives of members of regional and international TB control and research networks to further understand TB service disruptions and compared the experiences of members from West African and European countries.MethodsThis cross-sectional, explorative descriptive study was conducted from May to July 2020 using an open online survey with target respondents from both West African and European countries. The survey comprised discrete questions exploring challenges faced with TB screening, diagnosis, treatment, prevention, and changes implemented. Additionally, respondents were asked to provide recommendations for remedial actions.ResultsWe analysed responses from 124 respondents based in 29 countries located in Europe and West Africa. About half of the respondents reported challenges in delivering routine TB services during the COVID-19 pandemic, with over one third reporting having some form of guidance issued regarding maintaining delivery of routine TB services. Respondents emphasised the need for strengthening TB services especially in light of COVID-19 pandemic. Considerable similarities were found between the challenges experienced by TB professionals in both West African and European settings. Responses also highlighted the hidden challenges faced in some countries prior to the COVID-19 pandemic, especially in some West African settings where staff shortages and laboratory issues predated COVID-19.Conclusions TB control and research professionals in West African and European settings experienced similar challenges to the delivery of TB diagnosis and treatment services due to the COVID-19 pandemic, and highlighted the need for clear communication of guidelines, prioritisation of routine TB service delivery, ongoing health education, and possible integration of TB and COVID-19 services to ensure that TB services are more resilient against the impact of the pandemic.
Highlights
The COVID-19 pandemic has caused major disruption to healthcare services globally and has impacted on tuberculosis (TB) patients and TB diagnosis and treatment services both in low- and high-income countries
TB control and research professionals in West African and European settings experienced similar challenges to the delivery of TB diagnosis and treatment services due to the COVID-19 pandemic, and highlighted the need for clear communication of guidelines, prioritisation of routine TB service delivery, ongoing health education, and possible integration of TB and COVID-19 services to ensure that TB services are more resilient against the impact of the pandemic
A higher proportion of respondents from West Africa, relative to Europe, reported increased difficulty for presumptive TB cases to access TB diagnosis and care services (36.1% vs. 21.1%), and for patients on TB treatment to receive their TB drug supply including by direct observation of treatment (DOT) (25% vs.17.3%)
Summary
The COVID-19 pandemic has caused major disruption to healthcare services globally and has impacted on tuberculosis (TB) patients and TB diagnosis and treatment services both in low- and high-income countries. COVID-19 has caused extensive disruption to routine services for the control of both communicable and noncommunicable diseases worldwide. This disruption, which could have far-reaching consequences, has continued well into 2021 and will most likely extend beyond [2, 3]. Low-income and high-income countries have been impacted by the pandemic, but the extent and pattern of the impact on routine health service delivery is still unfolding. Many low- and middle-income countries (LMIC) who were already battling high burdens of infectious diseases such as tuberculosis (TB) are likely to feel the impact of this disruption to a greater extent due to disruption of their health services [4, 5]. Many high-income countries (HIC) have experienced severely disrupted laboratory services due to the COVID-19 pandemic [6]
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