Interrupted time-series analysis of active case-finding for tuberculosis during the COVID-19 pandemic, Zambia
Bull. W.H.O. (Online)
;
100(3): 205-215, 2022. figures, tables
Artigo
em Inglês
| AIM
| ID: biblio-1367030
ABSTRACT
Objective To evaluate the impact of the coronavirus disease 2019 (COVID-19) pandemic and the subsequent implementation of tuberculosis response measures on tuberculosis notifications in Zambia. Methods We used an interrupted time-series design to compare monthly tuberculosis notifications in Zambia before the pandemic (January 2019 to February 2020), after implementation of national pandemic mitigation measures (April 2020 to June 2020) and after response measures to improve tuberculosis detection (August 2020 to September 2021). The tuberculosis response included enhanced data surveillance, facility-based active case-finding and activities to generate demand for services. We used nationally aggregated, facility-level tuberculosis notification data for the analysis. Findings Pre-pandemic tuberculosis case notifications rose steadily from 2890 in January 2019 to 3337 in February 2020. After the start of the pandemic and mitigation measures, there was a −22% (95% confidence interval, CI −24 to −19) immediate decline in notifications in April 2020. Larger immediate declines in notifications were seen among human immunodeficiency virus (HIV)-positive compared with HIV-negative individuals (−36%; 95% CI −38 to −35; versus −12%; 95% CI −17 to −6). Following roll-out of tuberculosis response measures in July 2020, notifications immediately increased by 45% (95% CI 38 to 51) nationally and across all subgroups and provinces. The trend in notifications remained stable through September 2021, with similar numbers to the predicted number had the pandemic not occurred. Conclusion Implementation of a coordinated public health response including active tuberculosis case-finding was associated with reversal of the adverse impact of the pandemic and mitigation measures. The gains were sustained throughout subsequent waves of the pandemic.
Texto completo:
DisponíveL
Índice:
AIM (África)
Assunto principal:
Tuberculose
/
Epidemiologia
/
SARS-CoV-2
/
COVID-19
Tipo de estudo:
Estudo observacional
/
Estudo prognóstico
Limite:
Feminino
/
Humanos
/
Masculino
Idioma:
Inglês
Revista:
Bull. W.H.O. (Online)
Ano de publicação:
2022
Tipo de documento:
Artigo
Instituição/País de afiliação:
Centre for Infectious Disease Research in Zambia/ZM
/
Division of HIV, Infectious Diseases and Global Medicine, University of California San Francisco/US
/
Eradicate Tuberculosis Project, United States Agency for International Development/ZM
/
Ministry of Health/ZM
/
National Tuberculosis and Leprosy Control Programme, Ministry of Health, Ndeke House, Haile-Selaise Road, PO Box 30205/ZM
/
United States Agency for International Development/ZM
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