Tuberculosis control and care in the era of COVID-19

Malik, Amyn A.; Safdar, Nauman; Chandir, Subhash; Khan, Uzma; Khowaja, Saira; Riaz, Najam; Maniar, R; Jaswal, Maria; Khan, Aamir; Hussain, Hamidah

doi:10.1093/heapol/czaa109

Cited by 48 publications

(47 citation statements)

References 13 publications

(15 reference statements)

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“…Critical efforts to mitigate impacts on TB control could include integration of TB and COVID-19 services for infection control, contact tracing, community-based care, surveillance and monitoring. Innovative ways to deliver medicines and collect specimens for follow-up TB testing at home, and combine screening for TB and COVID-19, have already been demonstrated in South Africa [40, 69]. The socioeconomic inequities driving both TB and COVID-19 highlight the need for all countries to invest in universal health coverage and ensure equitable access to services.…”

Section: Resultsmentioning

confidence: 99%

Competing Health Risks Associated with the COVID-19 Pandemic and Early Response: A Scoping Review

Baral

Rao

Rwema

et al. 2021

Preprint

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BackgroundCOVID-19 has rapidly emerged as a global public health threat with infections recorded in nearly every country. Responses to COVID-19 have varied in intensity and breadth, but generally have included domestic and international travel limitations, closure of non-essential businesses, and repurposing of health services. While these interventions have focused on testing, treatment, and mitigation of COVID-19, there have been reports of interruptions to diagnostic, prevention, and treatment services for other public health threats. We conducted a scoping review to characterize the impact of COVID-19 on HIV, tuberculosis, malaria, sexual and reproductive health, and malnutrition.MethodsA scoping literature review was completed using searches of PubMed and preprint servers (medRxiv/bioRxiv) from January 1st to October 31st, 2020, using Medical Subject Headings (MeSH) terms related to SARS-CoV-2 or COVID-19 and HIV, tuberculosis, malaria, sexual and reproductive health, and malnutrition. Empiric studies reporting original data collection and mathematical models were included, and available data synthesized by region. Studies were excluded if they were not written in English.ResultsA total of 1604 published papers and 205 preprints met inclusion criteria, including 8.2% (132/1604) of published studies and 10.2% (21/205) of preprints: 7.3% (68/931) on HIV, 7.1% (24/339) on tuberculosis, 11.6% (26/224) on malaria, 7.8% (13/166) on sexual and reproductive health, and 12.1% (16/132) on malnutrition. Thematic results were similar across competing health risks, with substantial indirect effects of the COVID-19 pandemic and response on diagnostic, prevention, and treatment services for HIV, tuberculosis, malaria, sexual and reproductive health, and malnutrition.DiscussionCOVID-19 emerged in the context of existing public health threats that result in millions of deaths every year. Thus, effectively responding to COVID-19 while minimizing the negative impacts of COVID-19 necessitates innovation and integration of existing programs that are often siloed across health systems. Inequities have been a consistent driver of existing health threats; COVID-19 has worsened disparities, reinforcing the need for programs that address structural risks. Data reviewed here suggest that effective strengthening of health systems should include investment in public health with adequate funding to ensure continuity of care for emergent and existing public health threats.

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Section: Resultsmentioning

confidence: 99%

Competing Health Risks Associated with the COVID-19 Pandemic and Early Response: A Scoping Review

Baral

Rao

Rwema

et al. 2021

Preprint

View full text Add to dashboard Cite

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“… 3 Health system infrastructure, from diagnostic tools to the workforce, has pivoted towards COVID-19 and away from competing illnesses, including tuberculosis. 4 Health-care access has been constrained due to transport disruptions, restricted movement, reduced opening hours, depleted staffing levels, fear, and stigma. 5 …”

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confidence: 99%

“…For example, people with respiratory symptoms and illness should be able to receive community-based contact tracing, directly observed therapy, and isolation and quarantine support from trusted friends, family, or neighbours. 4 Such strategies could improve distribution and use of appropriate personal protective equipment, reduce nosocomial transmission of communicable respiratory diseases, and improve the value-for-money of trained health-care worker time. They will also be vital for longer term management of people with post-COVID or post-tuberculosis lung disease and complications, 8 conditions which require more coordinated research and intervention.…”

mentioning

confidence: 99%

“…In some countries, careful targeted use of artificial intelligence software and digital radiography has the potential to be used to support enhanced contact tracing and outreach strategies for communicable respiratory illnesses. 4 …”

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confidence: 99%

“…While potentially beneficial, virtual consultations and adherence support, including video observed therapy, is not available routinely in many LMICs. Moreover, there have been colossal challenges to delivering food, economic, and psychosocial support to tuberculosis-affected households during COVID-19 times, 4 which might increase their likelihood of incurring catastrophic tuberculosis-related costs ( figure ). 11 This serves to re-emphasise the crucial importance of social protection and universal health coverage to provide income security, enable health-care access, and reduce out-of-pocket health-care expenditure.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Challenges and opportunities to end tuberculosis in the COVID-19 era

Wingfield

Karmadwala

MacPherson

et al. 2021

The Lancet Respiratory Medicine

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Integrating health planning and primary care infrastructure for COVID‐19 and tuberculosis care in India: Challenges and opportunities

Yadav

Vohra

Gopalakrishnan

et al. 2021

Health Planning & Management

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Tuberculosis (TB) is the leading cause of death from a single infectious agent worldwide. The COVID‐19 pandemic has overburdened healthcare services around the world especially in resource constrained settings. It has shaken already unstable foundation of TB control programs in India and other high burden states. A 25% decline is expected in TB detection while estimates suggest 13% increase in TB deaths due to the impact of the pandemic. However, the significant intersections between the two diseases perhaps offer potential opportunities for consolidating the efforts to tackle both. The widespread implementation and acceptance of universal masking and social distancing in India has helped limit transmission of both diseases. Integrating the capacity building strategies for the two diseases, optimizing the existing the surveillance and monitoring systems which have been achieved over the years will result in a single vertically integrated national program addressing both, rather than multiple parallel program which utilize the already sparse primary care manpower and infrastructure. In this article, we explore the impact of the COVID‐19 pandemic on tuberculosis in India and offer suggestions on how effective health planning can efficiently integrate infrastructure and manpower at primary level to provide care for both COVID‐19 and tuberculosis.

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Tuberculosis control and care in the era of COVID-19

Cited by 48 publications

References 13 publications

Competing Health Risks Associated with the COVID-19 Pandemic and Early Response: A Scoping Review

Competing Health Risks Associated with the COVID-19 Pandemic and Early Response: A Scoping Review

Challenges and opportunities to end tuberculosis in the COVID-19 era

Integrating health planning and primary care infrastructure for COVID‐19 and tuberculosis care in India: Challenges and opportunities

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