The long-term impact of the COVID-19 pandemic on tuberculosis care and infection control measures in anti-retroviral therapy (ART) clinics in low- and middle-income countries: a multiregional site survey in Asia and Africa

• DOI: 10.1136/bmjgh-2024-017828
• Publication Date: 2025-03-25T03:06:45Z
• Authors: Marie Ballif; Nicolas Banholzer; Lisa Perrig; Anchalee Avihings...; Dominique Mahambu...; Sarah Obatsa; Guy Muula; Eric Komena; Haruka Uemura; Patricia Lelo; Brian Otaalo; Jacqueline Huwa; Patrice Gouéssé; Nagalingeswaran K...; Ellen Brazier; Denna Michael; Idiovino Rafael; Richard Ramdé; I Ketut Agus Somia; Marcel Yotebieng; Lameck Diero; Jonathan Euvrard; Oliver Ezechi; Lukas Fenner
• Keywords: Pandemic; Telehealth

Background The COVID-19 pandemic challenged healthcare systems, particularly in settings with high infectious disease burden. We examined the postpandemic long-term impacts of on tuberculosis (TB) services at anti-retroviral therapy (ART) clinics lower-income countries. Methods Using standardised online questionnaires, we conducted a cross-sectional site survey among ART providing TB Africa and Asia from July to September 2023 (site-level information number diagnoses tests). Results Of 45 participating clinics, 32 (71%) were 13 (29%) Asia. During (2020–2022), 43 (96%) reported implementing social distancing or separation measures, 39 (87%) personal protections for staff members patients. Infection control measures place 45% before (until 2019), 23% introduced during 15% maintained them after (after 2022). Service provision was affected 33 (73%) including 22 (49%) clinics. service restrictions addressed by introducing changes directly observed 8 (18%) multimonth drug dispensing 23 (51%), telehealth 25 (56%) differentiated delivery 19 (42%). These sustained 4 (9%), 11 (24%), 17 (38%) 12 (27%) respectively. Compared 2018–2019, decreased sharply 2020–2021 improved pandemic. Conclusions care This paralleled reduction diagnoses, which partly resumed alternative modes adopted only partially maintained. Efforts should be made sustain lessons learnt pandemic, approaches that reduce risk transmission diseases, TB,