Care pathways of individuals with tuberculosis before and during the COVID-19 pandemic in Bandung, Indonesia

• DOI: 10.1371/journal.pgph.0002251
• Publication Date: 2024-01-02T18:38:08Z
• Authors: Lavanya Huria; Bony Wiem Lestari; Eka Saptiningrum; Auliya Ramanda Fikri; Charity Oga-Omenka; Mohammad Abdullah...; Benjamin Daniels; Nathaly Aguilera ...; Angelina Sassi; Jishnu Das; Ira Dewi Jani; Madhukar Pai; Bachti Alisjahbana
• Keywords: Pandemic; Cross-sectional study

The COVID-19 pandemic is thought to have undone years’ worth of progress in the fight against tuberculosis (TB). For instance, Indonesia, a high TB burden country, case notifications decreased by 14% and treatment coverage 47% during COVID-19. We sought better understand impact on detection using two cross-sectional surveys conducted before (2018) after onset (2021). These allowed us quantify delays that individuals with who eventually received at private providers faced while trying access care for their illness, journey obtain diagnosis, encounters had healthcare factors associated patient delay total number provider encounters. found some worsening seeking pathways multiple dimensions. Median increased from 28 days (IQR: 10, 31) 32 14, 90) median 5 4, 8) 7 5, 10), but doctor remained relatively unchanged. Employed experienced shorter compared unemployed (adjusted medians: -20.13, CI -39.14, -1.12) whose initial consult was hospitals less those visiting public providers, primary informal (-4.29 encounters, -6.76, -1.81). Patients visited >6 times longer than 6 visits 59.40, 95% CI: 35.04, 83.77). Our findings suggest need ramp up awareness programs reduce strengthen provide engagement particularly sector.