Abstract
The COVID-19 pandemic has adversely affected tuberculosis (TB) care delivery in high burden countries. We therefore conducted a retrospective study to assess the impact of COVID-19 on TB case detection and treatment outcomes at the Chest Clinic at Connaught Hospital in Freetown, Sierra Leone. Overall, 2300 presumptive cases were tested during the first three quarters of 2020 (intra-COVID-19) versus 2636 in 2019 (baseline), representing a 12.7% decline. Testing declined by 25% in women, 20% in children and 81% in community-initiated referrals. Notwithstanding, laboratory-confirmed TB cases increased by 37.0% and treatment success rate was higher in 2020 (55.6% vs. 46.7%, p = 0.002). Multivariate logistic regression analysis found that age < 55 years (aOR 1.74, 95% CI (1.80, 2.56); p = 0.005), new diagnosis (aOR 1.69, 95% CI (1.16, 2.47); p = 0.007), pulmonary TB (aOR 3.17, 95% CI (1.67, 6.04); p < 0.001), HIV negative status (aOR 1.60, 95%CI (1.24, 2.06); p < 0.001) and self-administration of anti-TB drugs through monthly dispensing versus directly observed therapy (DOT) (aOR 1.56, 95% CI (1.21, 2.03); p = 0.001) independently predicted treatment success. These findings may have policy implications for DOTS in this setting and suggest that more resources are needed to reverse the negative impact of the COVID-19 pandemic on TB program activities in Sierra Leone.
Highlights
The outbreak of the coronavirus disease 2019 (COVID-19) pandemic in late December of 2019 has led to an unprecedented global health emergency, resulting in millions of deaths, and placing a severe strain on healthcare systems around the world [1]
We aimed to examine the impact of the COVID-19 pandemic on TB case detection and treatment outcomes at the largest TB treatment center in Freetown, Sierra Leone
This study assessed the impact of the COVID-19 pandemic on TB service delivery and treatment outcomes at the largest treatment center in Sierra Leone
Summary
The outbreak of the coronavirus disease 2019 (COVID-19) pandemic in late December of 2019 has led to an unprecedented global health emergency, resulting in millions of deaths, and placing a severe strain on healthcare systems around the world [1]. Recent reports have indicated that the pandemic is accelerating in SSA, the region has reported fewer confirmed COVID-19 cases (less than 2% of the global COVID-19 burden) and a significantly lower mortality rate compared with developed countries [1–3]. According to a recent provisional report by the World Health Organization (WHO), an estimated 1.4 million fewer TB cases went undetected and untreated in 2020—a 21% decrease from 2019 that is predicted to result in an additional half a million TB-related deaths in 2020 [11] In response to this sobering forecast, the WHO has declared the restoration and strengthening of essential TB prevention, case detection and treatment services in endemic settings as a priority global health agenda [11]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
