Impact of COVID-19 on TB active case finding in Nigeria.

Abstract

Active TB case finding (ACF) is a key strategy employed by the National Tuberculosis and Leprosy Control Programme (NTBLCP) to address the increasing gap in TB case finding in Nigeria. KNCV TB foundation Nigeria rolled out two high-impact ACF interventions; TB Surge and the Wellness on Wheels (WoW) campaigns from January 2020. The TB Surge intervention supports the engagement of ad hoc staff for TB ACF. The WoW campaign employs a mobile diagnostic unit to deliver care to the doorstep of people at risk of TB. Data along the TB cascade are recorded for all clients using the CommCare app. Cochran-Armitage χ2 test for linear trend was used to assess the significance declining trends along the TB cascade. There was a progressive decrease of respectively 63%, 64%, 73% and 72% in clinic attendance, presumptive TB identification, TB cases detected and treatment initiation for the TB Surge ACF intervention since the emergence of coronavirus; a similar decrease was noted for the WoW intervention. Trend analysis showed a significant decline in trends for both interventions for all variables (P < 0.001). The COVID-19 epidemic has impacted negatively on TB services in Nigeria. The TB programme could leverage some resources used to combat the epidemic such as digital health technology and funds, and work towards strengthening patient-centred approach to care to limit the challenges that COVID-19 presents to TB control.