Tuberculosis healthcare service disruptions during the COVID-19 pandemic in Brazil, India and South Africa: A model-based analysis of country-level data

• DOI: 10.1371/journal.pgph.0003309
• Publication Date: 2025-01-07T18:31:11Z
• Authors: Abigail K. de Vil...; Muhammad Osman; Claudio J. Struch...; Anete Trajman; Dheeraj Tumu; Vaibhav V. Shah; Guilherme L. Werneck; Layana C. Alves; Megha Choudhary; Sunita Verma; Sanjay K. Mattoo; Sue-Ann Meehan; Urvashi B. Singh; Anneke C. Hesseling; Florian M. Marx
• Keywords: Pandemic; Healthcare service

Tuberculosis (TB) is the leading infectious disease cause of death worldwide. In recent years, stringent measures to contain spread SARS-CoV-2 have led considerable disruptions healthcare services for TB in many countries. The extent which these affected testing, treatment initiation and outcomes has not been comprehensively assessed. We aimed estimate service occurring during COVID-19 pandemic Brazil, India, South Africa. obtained country-level programme laboratory data used autoregressive integrated moving average (ARIMA) time-series models with respect initiation, outcomes. quantified as percentage difference between indicator observed compared values a hypothetical no-COVID scenario, predicted through forecasting trends three-year pre-pandemic period. Annual estimates 2020–2022 were derived from aggregated monthly data. estimated that 2020, number bacteriological tests conducted diagnosis was 24.3% (95% uncertainty interval: 8.4%;36.6%) lower 27.8% (19.8;3 4.8%) 32.0% (28.9%;34.9%) Africa scenario. initiations 17.4% (13.9%;20.6%) than 43.3% (39.8%;46.4%) 27.0% (15.2%;36.3%) Reductions 2021 less severe 2020. deaths 13.7% (8.1%; 19.7%) higher 1.7% (-8.9%;14.0%) India 21.8% (7.4%;39.2%) Our analysis suggests occurred early phase Africa, at least partial recovery following years. Sustained efforts mitigate detrimental impact on are needed.