Impact of National Lockdown for Sars-Cov-2 Pandemic on Incident Tuberculosis and Transmission

ABSTRACT

Introduction The nationwide lockdown for COVID-19 and ongoing mitigation measures are having a significant impact on healthcare delivery for other disease including tuberculosis (TB). Leicester has faced a particularly prolonged period of disruption after imposition of local lockdown measures within 7 weeks of the national lockdown. Objectives To evaluate the impact of the national lockdown and post-lockdown periods on tuberculosis presentation and transmission in Leicester, UK. Methods We performed retrospective analysis of all notified tuberculosis cases and their contacts comparing the pre-lockdown period (January 2019-March 2020) with lockdown and post-lockdown periods (April-Sept 2020). AFB smear status, Xpert DNA load, culture status, time to culture positivity, CXR severity scores, hospital admission rate and proportion of screened contacts identified with latent tuberculosis infection (LTBI) were reviewed. Data was extracted from hospital systems. Statistical analyses used SPSS (v.26). Results 307 index cases (146 pulmonary) and 460 family contacts of pulmonary TB were included for analysis. Overall, TB incidence in 2020 has been lower than 2019 (144 vs. 129 cases from Jan-Sept). There has been a marked fall in cases during the lockdown with no comparable rebound increase Introduction The nationwide lockdown for COVID-19 and ongoing mitigation measures are having a significant impact on healthcare delivery for other disease including tuberculosis (TB). Leicester has faced a particularly prolonged period of disruption after imposition of local lockdown measures within 7 weeks of the national lockdown. Objectives To evaluate the impact of the national lockdown and post-lockdown periods on tuberculosis presentation and transmission in Leicester, UK. Methods We performed retrospective analysis of all notified tuberculosis cases and their contacts comparing the pre-lockdown period (January 2019-March 2020) with lockdown and post-lockdown periods (April-Sept 2020). AFB smear status, Xpert DNA load, culture status, time to culture positivity, CXR severity scores, hospital admission rate and proportion of screened contacts identified with latent tuberculosis infection (LTBI) were reviewed. Data was extracted from hospital systems. Statistical analyses used SPSS (v.26). Results 307 index cases (146 pulmonary) and 460 family contacts of pulmonary TB were included for analysis. Overall, TB incidence in 2020 has been lower than 2019 (144 vs. 129 cases from Jan-Sept). There has been a marked fall in cases during the lockdown with no comparable rebound increase.