COVID-19 in Africa: community and digital technologies for tuberculosis management

Koura, Kobto Ghislain; Harries, Anthony; Fujiwara, Paula I.; Dlodlo, Riitta A; Sansan, E K; Kampoer, B; Affolabi, Dissou; Combary, Adjima; Mbassa, Vincent; Gando, H; Bangoura, Adama Marie; Assao, M.; Gning, Barnabé; Dogo, Mohammed Fall; Fiogbé, A A; Bridgen, G

doi:10.5588/ijtld.20.0412

Cited by 7 publications

(4 citation statements)

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“…Although this increase was relatively lower in Africa and LMICs, several reports emerged on its use during the pandemic, 17 , 18 , 19 , 20 whereas others gave recommendations for its use. 21 , 22 , 23 , 24 A recent study in Mexico, also an LMIC, reported the implementation of a novel outpatient teleneurology service utilizing primarily WhatsApp video calls, with only 8.5% of visits conducted exclusively by telephone, that resulted in high patient satisfaction. 25 In contrast, our teleneurology clinic relied almost exclusively on telephone calls.…”

Section: Discussionmentioning

confidence: 99%

Implementation of a Teleneurology Clinic in Zambia during the COVID‐19 Pandemic

Asukile

Chishimba

Chomba

et al. 2022

Annals of Neurology

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Objective: The objective of this study was to assess the feasibility, acceptability, and benefits of a teleneurology clinic serving adults usually attending a neurology outpatient clinic in Lusaka, Zambia during the coronavirus disease 2019 (COVID-19) pandemic. Methods: Televisits were offered to patients scheduled for neurology appointments between March and July 2020 using the telephone, WhatsApp video, or Zoom calls based on patient accessibility. Visit outcomes were documented, and patient and neurologist satisfaction surveys were completed. Results: Of 323 patients, 195 (60%) were reachable by telephone, 179 of these were alive, and 74% (133/179) of those alive agreed to a televisit. Stroke (30%), seizures (20%), and headache (16%) were the most common diagnoses seen via televisit. Most televisits (80%) were by telephone call, 14% by WhatsApp video call, and 6% by Zoom. Nearly onethird (30%) of the patients were stable and discharged from the clinic, 32% only required medication refills, and 19% required an in-person visit. Sixty patients (out of 85 reachable and 71% response rate) and 7 of 9 neurologists (78% response rate) completed satisfaction surveys. Neurologists reported greater assessment confidence with Zoom, but confidence was high for all modalities. Patients preferring televisits (75%, 45/60) noted reduced expense and time requirements, whereas those preferring in-person visits (22%, 13/60) cited the desire for physical examinations. Overall, 98% of patients and 100% of neurologists were satisfied with televisits. Interpretation: Teleneurology visits were acceptable and feasible for adults attending an outpatient neurology clinic in Zambia and their neurologists. They offer a promising supplement to in-person visits in resource-limited settings, even when video-conference capabilities and electronic medical records are absent.

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Section: Discussionmentioning

confidence: 99%

Implementation of a Teleneurology Clinic in Zambia during the COVID‐19 Pandemic

Asukile

Chishimba

Chomba

et al. 2022

Annals of Neurology

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“…Twelve publications [100][101][102][103][104][105][106][107][108][109][110][111] discussed how LMIC swiftly implemented telehealth interventions to offset COVID-19 disruptions in TB services. Various digital tools enabled virtual case identification, TB care, treatment, and adherence [4].…”

Section: Telemedicine/telehealthmentioning

confidence: 99%

The Global Impact of COVID-19 on Tuberculosis: A Thematic Scoping Review, 2020-2023

Marco,

Ahmedov,

Castro

2024

Preprint

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Background: This thematic scoping review of publications sought to understand the global impact of COVID-19 on tuberculosis (TB), interpret the scope of resonating themes, and offer policy recommendations to stimulate TB recovery and future pandemic preparedness. Data Sources: Publications were captured from three search engines, PubMed, EBSCO, and Google Scholar, and applicable websites written in English from January 1, 2020, to April 30, 2023. Study Selection: Our scoping review was limited to publications detailing the impact of COVID-19 on TB. Original research, reviews, letters, and editorials describing the deleterious and harmful––yet sometimes positive–– impact of COVID-19 (sole exposure) on TB (sole outcome) were included. The objective was to methodically categorize the impacts into themes through a comprehensive review of selected studies to provide significant health policy guidance. Data Extraction: Two authors independently screened citations and full texts, while the third arbitrated when consensus was not met. All three performed data extraction. Data Synthesis/Results: Of 1,755 screened publications, 176 (10%) covering 39 countries over 41 months met the inclusion criteria. Ten principal themes were established, which encompassed TB’s care cascade, patient-centered care, psychosocial issues, and health services: 1) case-finding and notification (n=45; 26%); 2) diagnosis and laboratory systems (n=19; 10.7%) 3) prevention, treatment, and care (n=22; 12.2%); 4) telemedicine/telehealth (n=12; 6.8%); 5) social determinants of health (n=14; 8%); 6) airborne infection prevention and control (n=8; 4.6%); 7) health system strengthening (n=22; 13%); 8) mental health (n=13; 7.4%); 9) stigma (n=11; 6.3%); and 10) health education (n=10; 5.7%). Limitations: Heterogeneity of publications within themes. Conclusions: We identified ten globally generalizable themes of COVID-19’s impact on TB. These thematic areas will guide evidence-informed policies to strengthen comprehensive global responses, recovery for TB, and future airborne pandemic preparedness.

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“…The project has also highlighted the lack of coordination between child health and TB services, as well as the refusal of some parents to agree to TPT for their healthy child. Finally, the COVID-19 pandemic has reduced attendance to clinics for referral assessment or follow-up [77].…”

Section: French-speaking African Countries: a Focus On Child Contact ...mentioning

confidence: 99%

“…In terms of future perspectives, the implementation of a simple clinical algorithm suitable for use by community healthcare workers and nurses would help to detect or eliminate active TB in child contacts. The activity should be digitalized in real time, and the use of digital chest X ray with computer-aided detection should be evaluated [77]. Many countries recommend a test for infection before TPT initiation, as does the WHO, for older child contacts who are HIV-negative; therefore, a rapid test for infection would be a real advantage.…”

Section: French-speaking African Countries: a Focus On Child Contact ...mentioning

confidence: 99%

Priority Activities in Child and Adolescent Tuberculosis to Close the Policy-Practice Gap in Low- and Middle-Income Countries

et al. 2022

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Over the past 15 years, and despite many difficulties, significant progress has been made to advance child and adolescent tuberculosis (TB) care. Despite increasing availability of safe and effective treatment and prevention options, TB remains a global health priority as a major cause of child and adolescent morbidity and mortality—over one and a half million children and adolescents develop TB each year. A history of the global public health perspective on child and adolescent TB is followed by 12 narratives detailing challenges and progress in 19 TB endemic low and middle-income countries. Overarching challenges include: under-detection and under-reporting of child and adolescent TB; poor implementation and reporting of contact investigation and TB preventive treatment services; the need for health systems strengthening to deliver effective, decentralized services; and lack of integration between TB programs and child health services. The COVID-19 pandemic has had a significant negative impact on case detection and treatment outcomes. Child and adolescent TB working groups can address country-specific challenges to close the policy–practice gaps by developing and supporting decentral ized models of care, strengthening clinical and laboratory diagnosis, including of multidrug-resistant TB, providing recommended options for treatment of disease and infection, and forging strong collaborations across relevant health sectors.

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COVID-19 in Africa: community and digital technologies for tuberculosis management

Cited by 7 publications

References 0 publications

Implementation of a Teleneurology Clinic in Zambia during the COVID‐19 Pandemic

Implementation of a Teleneurology Clinic in Zambia during the COVID‐19 Pandemic

The Global Impact of COVID-19 on Tuberculosis: A Thematic Scoping Review, 2020-2023

Priority Activities in Child and Adolescent Tuberculosis to Close the Policy-Practice Gap in Low- and Middle-Income Countries

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