Adaptations to the first wave of the COVID-19 pandemic by private sector tuberculosis care providers in India

Mannan, Shamim; Oga‐Omenka, Charity; ThekkePurakkal, Akhil Soman; Huria, Lavanya; Kalra, Aakshi; Gandhi, Ravdeep; Kapoor, Tunisha; Gunawardena, Nathali; Raj, S.; Kaur, Manjot; Sassi, Angelina; Pande, Tripti; Vijayan, Shibu; Sarin, Sanjay; Chadha, Sarabjit; Heitkamp, Petra; Das, Jishnu; Rao, Raghuram

doi:10.1016/j.jctube.2022.100327

Cited by 10 publications

(15 citation statements)

References 44 publications

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“…Other detailed reports of facility closures, service disruptions, and increases in costs for patients have begun to be published [15,16,31,32]. The results of our study agree with results obtained in a previous rapid assessment by Klinton et al on the impact of the pandemic on TB services in the private sector in seven high-burden TB countries including Nigeria [16].…”

Section: Discussionsupporting

confidence: 90%

Tuberculosis service disruptions and adaptations during the first year of the COVID-19 pandemic in the private health sector of two urban settings in Nigeria—A mixed methods study

Oga‐Omenka

Sassi

Vasquez³

et al. 2023

PLOS Glob Public Health

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Nigeria has the second largest share of undiagnosed TB cases in the world and a large private health sector estimated to be the point of initial care-seeking for 67% of TB patients. There is evidence that COVID-19 restrictions disrupted private healthcare provision, but insufficient data on how private healthcare provision changed as a result of the pandemic. We conducted qualitative interviews and a survey to assess the impact of the pandemic, and government response on private healthcare provision, and the disruptions providers experienced, particularly for TB services. Using mixed methods, we targeted policymakers, and a network of clinical facilities, laboratories, community pharmacies, and medicine vendors in Kano and Lagos, Nigeria. We interviewed 11 policymakers, surveyed participants in 2,412 private facilities. Most (n = 1,676, 70%) facilities remained open during the initial lockdown period, and most (n = 1,667, 69%) offered TB screening. TB notifications dipped during the lockdown periods but quickly recovered. Clinical facilities reported disruptions in availability of medical supplies, staff, required renovations, patient volume and income. Few private providers (n = 119, 11% in Kano; n = 323, 25% in Lagos) offered any COVID-19 screening up to the time of the survey, as these were only available in designated facilities. These findings aligned with the interviews as policymakers reported a gradual return to pre-COVID services after initial disruptions and diversion of resources to the pandemic response. Our results show that COVID-19 and control measures had a temporary impact on private sector TB care. Although some facilities saw decreases in TB notifications, private facilities continued to provide care for individuals with TB who otherwise might have been unable to seek care in the public sector. Our findings highlight resilience in the private sector as they recovered fairly quickly from pandemic-related disruptions, and the important role private providers can play in supporting TB control efforts.

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Section: Discussionsupporting

confidence: 90%

Tuberculosis service disruptions and adaptations during the first year of the COVID-19 pandemic in the private health sector of two urban settings in Nigeria—A mixed methods study

Oga‐Omenka

Sassi

Vasquez³

et al. 2023

PLOS Glob Public Health

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“…The private provider engagement under the project was implemented through a human resource-intensive patient-provider support agency model, and a human resource-limited patient-provider support agency lite model. 17 The human resource-intensive model included senior field officers, field officers, hub agents, sample collection and transportation agents, and treatment coordinators. The resource-limited patient-provider support agency lite model had only one primary dedicated human resource ( Box 1 for operational definitions).…”

Section: Methodsmentioning

confidence: 99%

Implementation of a tuberculosis elimination project, India 2018–2019

Kalra¹,

ThekkePurakkal²,

Rao³

et al. 2023

Bull World Health Org

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“…6,15,16,22,61 Individual patients in tribal areas in India face major challenges due to poor socioeconomic conditions, socio-cultural variables, individual ignorance or discrimination, mental health challenges, limited resources or transportation, gender-specific education, a lack of basic understanding about the disease, and difficulty accessing the healthcare facility. 1,3,22,43,[60][61][62][63] According to studies by Rao et al 29 , Bhat et al 55 , and Thomas et al 16 , PTB exposures were more prevalent among tribal groups, and 2.8 times higher prevalent among males than females. 16,22,29,55,63 Drug-resistant tuberculosis According to current trends, drug-resistant tuberculosis (DR-TB), which is resistant to a variety of anti-tuberculosis drugs, is a serious problem in the Indian population, and as a result, it has become a new impediment to India's efforts to combat the illness.…”

Section: The Burden Of Tuberculosis In Different States Of Indiamentioning

confidence: 99%

“…1,3,4,[10][11][12]20,28,38,41,43,46,59 Furthermore, the COVID-19 reaction-induced lockdown has resulted in poverty and economic hardship, worsening food shortages and making it more difficult to provide various TB services such as prevention, surveillance, and treatment to the vulnerable segment. 13,22,31,44,60 Children with TB had significant implications or problems during the COVID epidemic, such as requiring more mechanical breathing, being hospitalized for longer periods of time, and having poorer outcomes. 11,13,14 Scheduled Tribes represent 8.6% of India's population with having high TB prevalence (703 per 1,00,000) as compared to national TB average cases (256 per 1,00,000).…”

Section: The Burden Of Tuberculosis In Different States Of Indiamentioning

confidence: 99%

Tuberculosis epidemic in India – a systematic review

Deotale,

Mondal

2023

Eur J Clin Exp Med

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Introduction and aim. India, accounting for approximately 26% of the global tuberculosis (TB) burden with a significant proportion of 0.11 million (6%) pediatric TB cases. The goal of this systematic review paper is to provide a thorough analysis of the TB epidemic in India, including information on the severity of the illness and challenges associated with diagnosis and treatment, the risk factors for transmission and progression of the disease, and the advancements and difficulties encountered in efforts to control at community level. Material and methods. The terms “Tuberculosis in India,” “Drug-Resistant Tuberculosis,” “Tuberculosis and Associated Co-morbidities,” “Diagnosis of Tuberculosis,” “Prevention of Tuberculosis,” and “Treatment of Tuberculosis’’, keywords were used to search in number of international electronic databases, including “Google Scholar,” “PubMed,” and “DOAJ.” Analysis of the literature. Diagnosis and treatment of TB are significantly complicated by co-morbid condition such includes alcoholism, diabetes, HIV, undernutrition, diabetes and HIV. In addition, there may be treatment delays, and the extra-pulmonary or drug-resistant TB due to ignorance, misunderstandings, and lack of education among TB patients, and medical professionals, which ultimately increases morbidity and mortality. Conclusion. Poverty, undernutrition, inadequate healthcare infrastructure, and co-morbidities, which frequently complicate TB diagnosis and treatment, must be addressed in addition to the critical need to prioritize TB research and development.

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Adaptations to the first wave of the COVID-19 pandemic by private sector tuberculosis care providers in India

Cited by 10 publications

References 44 publications

Tuberculosis service disruptions and adaptations during the first year of the COVID-19 pandemic in the private health sector of two urban settings in Nigeria—A mixed methods study

Tuberculosis service disruptions and adaptations during the first year of the COVID-19 pandemic in the private health sector of two urban settings in Nigeria—A mixed methods study

Implementation of a tuberculosis elimination project, India 2018–2019

Tuberculosis epidemic in India – a systematic review

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