Clinical impact of COVID-19 on tuberculosis

Zamparelli, Stefano Sanduzzi; Mormile, Mauro; Zamparelli, Alessandro Sanduzzi; Guarino, Amedeo; Parrella, Roberto; Bocchino, Marialuisa

doi:10.53854/liim-3004-3

Cited by 8 publications

(6 citation statements)

References 27 publications

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“…In conclusion, we suggest that TB should be actively ruled out when confronting migrants with recurrent insidious headache, abdominal pain, or back pain, with or without nonspecific chronic symptoms or unexplained weight loss and several prior visits. This is now especially relevant, since it is expected that the major impact of COVID-19 on TB incidence and mortality would be much larger in 2022 and beyond ( 32 ). Supplementary Figure S1 in Appendix 2 includes a chart for clinicians describing the prototypical profiles of patients studied which might help them to screen extra-pulmonary of dTB.…”

Section: Discussionmentioning

confidence: 99%

Disseminated tuberculosis and diagnosis delay during the COVID-19 era in a Western European country: a case series analysis

Roure,

Vallès,

Sopena

et al. 2023

Front. Public Health

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BackgroundDisseminated tuberculosis is frequently associated with delayed diagnosis and a poorer prognosis.ObjectivesTo describe case series of disseminated TB and diagnosis delay in a low TB burden country during the COVID-19 period.MethodologyWe consecutively included all patients with of disseminated TB reported from 2019 to 2021 in the reference hospital of the Northern Crown of the Metropolitan Area of Barcelona. We collected socio-demographic information, clinical, laboratory and radiological findings.ResultsWe included all 30 patients reported during the study period—5, 9, and 16 in 2019, 2020, and 2021 respectively—20 (66.7%) of whom were male and whose mean age was 41 years. Twenty-five (83.3%) were of non-EU origin. The most frequent system involvement was central nervous system (N = 8; 26.7%) followed by visceral (N = 7; 23.3%), gastro-intestinal (N = 6, 20.0%), musculoskeletal (N = 5; 16.7%), and pulmonary (N = 4; 13.3%). Hypoalbuminemia and anemia were highly prevalent (72 and 77%). The median of diagnostic delay was 6.5 months (IQR 1.8–30), which was higher among women (36.0 vs. 3.5 months; p = 0.002). Central nervous system involvement and pulmonary involvement were associated with diagnostic delay among women. We recorded 24 cured patients, two deaths, three patients with post-treatment sequelae, and one lost-to-follow up. We observed a clustering effect of patients in low-income neighborhoods (p < 0.001).ConclusionThere was a substantial delay in the diagnosis of disseminated TB in our study region, which might impacted the prognosis with women affected more negatively. Our results suggest that an increase in the occurrence of disseminated TB set in motion by diagnosis delay may have been a secondary effect of the COVID-19 pandemic.

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Section: Discussionmentioning

confidence: 99%

Disseminated tuberculosis and diagnosis delay during the COVID-19 era in a Western European country: a case series analysis

Roure,

Vallès,

Sopena

et al. 2023

Front. Public Health

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“…There are studies that reported a positive trend of TB has been reversed due to the COVID-19 pandemic outbreak. They expected that the unintended consequences of COVID-19 preventive measures such as restriction and reduced access to healthcare resulted in a drop in access to TB services [ 25 ]. The predictive models have also reported that the negative impact of COVID-19 on TB is much larger [ 26 ].…”

Section: Discussionmentioning

confidence: 99%

The Predicted Potential Impact of COVID-19 Pandemic on Tuberculosis Epidemic in Tamil Nadu, South India

Muniyandi,

Nagarajan,

Mathiyazhagan

et al. 2024

TropicalMed

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Objective: To estimate the prevalence and incidence of TB before and during the COVID-19 pandemic in Tamil Nadu, south India. Methods: In the present study, the effect of COVID-19 epidemiology on the TB epidemic was assessed by the SEIR (Susceptible-Exposed-Infected-Recovered), a compartmental epidemiological model. The model input parameters on compartments of TB and incidence of COVID-19 were collected from the published literature. Based on the data collected, point prevalence and incidence of TB per 100,000 population is calculated with and without COVID-19. A prediction was conducted up to 2025, trend analysis was performed, and a trend chi-square test and chi-square test of independence were used to test the difference between the prevalence with and without COVID-19. R software 2000 (R 4.0.0) was used for analysis. Results: The TB prevalence without and with COVID-19 decreases from 289 in 2020 to 271 in 2025 and from 289 in 2020 to 269 in 2025, respectively. Similarly, the incidence of TB was decreasing from 144 in 2020 to 135 in 2025 without COVID-19 and 143 in 2020 to 134 in 2025 with COVID-19. Though the TB burden is decreasing over the years, the trend was not statistically significant (p > 0.05). With respect to the district level, the prevalence and incidence of TB with and without COVID-19 is also found to be decreasing over the years. It was also found that the difference in the prevalence and incidence of TB with and without COVID-19 was not statically significant. Conclusion: The results of our study shows that there was an annual decline of around 2% from 2020 to 2025 in the trend of the prevalence and incidence of TB with and without COVID-19. Overall, there is a reduction, but it was not significant, and there is no significant effect of COVID-19 on TB in Tamil Nadu.

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“…Tuberculosis (TB) remains a major public health problem and ranks second as the leading cause of death by a single infectious disease globally after COVID-19 [ 1 ]. In 2021 alone, an estimated 10.6 million new cases and 1.6 million deaths were attributed to TB globally [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Stigma and Associated Sex Disparities Among Patients with Tuberculosis in Uganda: A Cross-Sectional Study

Sekandi,

Quach,

Olum

et al. 2024

Preprint

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Background Tuberculosis (TB) is one of the leading causes of death from a single infectious agent globally. Stigma associated with TB encompassing self-, anticipated-, and public-stigma has significant negative effects on treatment adherence. In Uganda, limited data exist on the prevalence of stigma and its relationship with sex among patients with TB. We evaluate prevalence of three types of stigma and their relationship with the sex of patients undergoing TB treatment. Methods This cross-sectional study was conducted between July 2020 to March 2021 at selected TB clinics in Kampala, Uganda. Eligible participants were aged 18-65 with confirmed TB and starting their prescribed treatment. We collected data on socio-demographics and used 13 items to capture the self-, anticipated-, and public-stigma from which we composed the dependent variables. The primary independent variable was sex. We employed multivariable logistic regression analysis to evaluate the association between sex and the three stigma types. Additionally, we considered potential confounders such as age, HIV, and employment status. Statistical significance was defined as p<0.05. Results In this study we enrolled 144 participants with a mean age of 35.8 years (standard deviation = 12). Half of the participants (50%, n=72) were female, 44% had a secondary education, 37.5% were unemployed, and 32.6% were co-infected with HIV. The prevalence of self-stigma was 71.1%, anticipated stigma was 75.7%, and public stigma was 41.7%. Significant factors were associated with self-stigma were female sex (adjusted odds ratio (AOR): 2.35 95% CI: 1.02-5.74) and unemployment (AOR: 2.95 95% CI: 1.16-8.58). HIV-positive status was significantly associated with anticipated stigma (AOR: 3.58 95% CI: 1.38-11.23). However, none of the variables we evaluated showed a significant association with public stigma. Conclusions Our study showed a high prevalence of self, anticipated and public stigma among TB patients. Notably, females and unemployed individuals were at a higher risk of self-stigma, while those with HIV/AIDS and TB were more likely to report anticipated stigma. To combat stigma effectively, interventions should be tailored to cater to sex-specific needs and persons living with HIV. Future research should delve further in determinants of TB-related stigma in high-burden settings.

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Clinical impact of COVID-19 on tuberculosis

Cited by 8 publications

References 27 publications

Disseminated tuberculosis and diagnosis delay during the COVID-19 era in a Western European country: a case series analysis

Disseminated tuberculosis and diagnosis delay during the COVID-19 era in a Western European country: a case series analysis

The Predicted Potential Impact of COVID-19 Pandemic on Tuberculosis Epidemic in Tamil Nadu, South India

Stigma and Associated Sex Disparities Among Patients with Tuberculosis in Uganda: A Cross-Sectional Study

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