The aftermath of COVID-19 pandemic on the diagnosis of TB at a tertiary care hospital in India

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

“…A review of data from several countries indicated decreases in TB testing and delays in diagnosis in some high burden TB settings as a result of the pandemic [ 21 ]. Data from two studies in public health facilities in Karnataka and Haryana indicate significant drops in TB specimens received for testing [ [35] , [36] ], similar to our data indicating that both clinical and microbiological TB screening had decreased. Additionally, there were reports, especially during the earlier months of the pandemic, that several GeneXpert machines procured for TB testing had been reassigned to COVID-19 testing [ [37] , [38] ], in line with the WHO rapid advice [ 39 ].…”

Impact of COVID-19 on the cascade of care for tuberculosis: A systematic review

“…Two reviewers independently assessed the risk of bias in the included studies. The tool described by Hoy et al (15) was used to assess the risk of bias of the included studies. They resolved conflicts through consensus, and a third reviewer when consensus was not reached.…”

“…Out of the 4480 records, 4343 records were excluded using the title and abstract only. The remaining 135 records were screened using the full text and 109 excluded, resulting in 27 included studies [15,17, (Figure 1). The reasons for the exclusions were studies that did not include relevant outcomes (n=54), letters to the editor (n=50), qualitative studies (n=2), one was a newsletter and one review (Figure 1).…”

“…The study designs of the included studies were as follows; one study was described as a surveillance report [45], 12 studies were longitudinal before and after time series [15,24,[30][31][32][34][35][36][37][38][39][40], 12 were cohort studies [17,[20][21][22][27][28][29]33,[41][42][43] and the remaining three were cross-sectional studies [23,25,44]. Ten studies [17,25,26,29,31,32,34,36,37,39] had nationally representative data while others were provincial, and community based.…”

“…Not only were human resources diverted to the COVID-19 response, but TB infrastructure, due to the similarities of the two respiratory diseases, was also used. For example, centres for TB management in some countries were changed to COVID-19 testing and treatment centres [13] Several studies [14][15][16][17] have documented the effects of the COVID-19 pandemic on some components of the TB cascade of care but estimates of the effect of COVID-19 vary, perhaps because of the different ways that the countries were affected by COVID-19 and how and when they responded. For example, a very small (1%) decrease in numbers screened for TB from 12 months prior to COVID-19 was reported in Vietnam [14], while in India, TB screening went down by 50% [14].…”