Diagnosed with TB in the era of COVID-19: patient perspectives in Zambia

Abstract

Introduction: Delayed TB diagnosis and treatment perpetuate the high burden of TB-related morbidity and mortality in resource-constrained settings. We explored the potential of COVID-19 to further compromise TB care engagement in Zambia.Methods: From April to May 2020, we purposefully selected 17 adults newly diagnosed with TB from three public health facilities in Lusaka, Zambia, for in-depth phone interviews. We conducted thematic analyses using a hybrid approach.Results: The majority of participants were highly concerned about the impact of lockdowns on their financial security. Most were not worried about being diagnosed with COVID-19 when seeking care for their illness because they felt unwell prior to the outbreak; however, they were very worried about contracting COVID-19 during clinic visits. COVID-19 was perceived as a greater threat than TB as it is highly transmittable and there is no treatment for it, which provoked fear of social isolation and of death among participants in case they contracted it. Nonetheless, participants reported willingness to continue with TB medication and the clinic visits required to improve their health.Conclusion: The COVID-19 pandemic did not appear to deter care-seeking for TB by patients. However, messaging on TB in the era of COVID-19 must encourage timely care-seeking by informing people of infection control measures taken at health facilities.

Assessing the Impact of COVID-19 on TB and HIV Programme Services in Selected Health Facilities in Lilongwe, Malawi: Operational Research in Real Time

“…There is little information in the literature to explain these findings, so the reasons have to be speculative. A qualitative study in neighbouring Zambia found that patients recently diagnosed with TB during the COVID-19 pandemic were very concerned about contracting COVID-19 during clinic visits, perceiving the disease to be highly transmissible, deadly, and without effective treatment [27]. It is possible that these concerns were felt more keenly amongst mothers and their children, thus reducing the desire of the family unit to attend health facilities.…”

Operational Research to Assess the Real-Time Impact of COVID-19 on TB and HIV Services: The Experience and Response from Health Facilities in Harare, Zimbabwe

“…The use of aggregate quantitative data made it impossible to understand the cascade of care for TB case detection and HIV testing during COVID-19. Further mixed-methods research with both quantitative and qualitative analysis amongst TB patients themselves, as has been conducted in Zambia [ 38 ], are needed to obtain a better idea of why patient access to health services and health service delivery was so badly affected. We only assessed referrals of HIV-positive persons to ART and did not document the initiation or retention on ART.…”

Digital communication in health promotion in handling tuberculosis sputum

“…15 When someone with a cough for more than 2-3 weeks comes to the MRC and is referred to a BTA sputum examination, they should receive education on how to collect purulent sputum, how to collect it in a pot. 1,16,17 Online communication using digital communication is a current solution that can be taken as a bridge between officers and sufferers. 18 This can be seen from the increase in respondents' knowledge and understanding after watching VisKomLAM 1 with a significance of 0.000 (table 1).…”

“…In the current era of the Covid-19 pandemic, handling tuberculosis (TB) must remain a concern. 1,2,3 The World Health Organization (WHO) reports that Indonesia is in the third position with the highest cases of tuberculosis (TB) in the world. While the first and second positions are currently India and China.…”