Community-based TB testing as an essential part of TB recovery plans in the COVID-19 era

Zokufa, Nompumelelo; Lebelo, Keitumetse; Hacking, Damian; Tabo, L; Runeyi, Pumeza; Malabi, Nikiwe; Sibanda, Sinothando; Cassidy, Tali; Makanda, Gilbert; Norman, Bryan A.; Khuzani, S; Furin, Jennifer; Jonker, Cornelis; Nkasana, B; Scott, Vera; Pfaff, Colin

doi:10.5588/ijtld.21.0077

Cited by 4 publications

(5 citation statements)

References 12 publications

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“…This ‘door-to-door’ approach of collecting sputum samples enabled 92% of individuals that provided a sample to be tested for TB. 55 …”

Section: Personalmentioning

confidence: 99%

“…This 'door-to-door' approach of collecting sputum samples enabled 92% of individuals that provided a sample to be tested for TB. 55 Because COVID-19 and TB share similar symptoms, community outreach and screening activities for both diseases need to be integrated. 56 57 While such bidirectional screening activities have already been applied in many countries burdened by both diseases, including India and Nigeria, the extent of the scale-up of such initiatives is unknown.…”

Section: Screening For Infection and Diseasementioning

confidence: 99%

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Tuberculosis in times of COVID-19

Zimmer

Klinton

Oga‐Omenka

et al. 2021

J Epidemiol Community Health

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The COVID-19 pandemic has caused widespread disruptions to tuberculosis (TB) care and service delivery in 2020, setting back progress in the fight against TB by several years. As newer COVID-19 variants continue to devastate many low and middle-income countries in 2021, the extent of this setback is likely to increase. Despite these challenges, the TB community can draw on the comprehensive approaches used to manage COVID-19 to help restore progress and mitigate the impact of COVID-19 on TB. Our team developed the ‘Swiss Cheese Model for Ending TB’ to illustrate that it is only through multisectoral collaborations that address the personal, societal and health system layers of care that we will end TB. In this paper, we examine how COVID-19 has impacted the different layers of TB care presented in the model and explore how we can leverage some of the lessons and outcomes of the COVID-19 pandemic to strengthen the global TB response.

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“…This ‘door-to-door’ approach of collecting sputum samples enabled 92% of individuals that provided a sample to be tested for TB. 55 …”

Section: Personalmentioning

confidence: 99%

Section: Screening For Infection and Diseasementioning

confidence: 99%

Tuberculosis in times of COVID-19

Zimmer

Klinton

Oga‐Omenka

et al. 2021

J Epidemiol Community Health

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“…Health systems across the world were challenged by COVID-19 12 and had to rapidly adapt to mitigate negative impacts. Whilst various strategies were put in place for TB infection control, retention in care and case finding, 13 , 14 reports on the adoption of integrated TB and COVID-19 testing to improve case finding are very limited. 15 Our literature search revealed one study from India in which an integrated TB/COVID-19 algorithm was adopted.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of a model integrating tuberculosis testing into COVID-19 services in South Africa

Mutyambizi

Wilkinson²,

Rees³

et al. 2022

African Journal of Primary Health Care & Family Medicine

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The coronavirus disease 2019 (COVID-19) pandemic led to a reordering of healthcare priorities. Health resources were turned to the screening and diagnosis of COVID-19, leading to a reduction in tuberculosis (TB) testing and treatment initiation. An innovative model that integrated TB and COVID-19 services was adopted at primary care facilities in Johannesburg Health District, Gauteng. This short report illustrates results from this model’s implementation in two facilities. Patients were screened for COVID-19 at a single point of entry and separated according to screening result. Self-reported human immunodeficiency virus (HIV) status, symptom, and symptom duration were then used to determine TB risk amongst those screening positive for COVID-19. Data from clinical records were extracted. Approximately 9% of patients with a positive symptom screen (n = 76) were sent for a TB test and 84% were sent for a COVID-19 test. Amongst those sent for a TB test, 8% (n = 6) had TB detected, and amongst those sent for a COVID-19 test, 18% (n = 128) were positive. Amongst those with COVID-19-related symptoms, 15% (n = 130) presented with a cough or fever and were known HIV positive and 121 (93%) of these were sent for a COVID-19 test and 31 (24%) were sent for a TB test. Given the HIV prevalence and symptoms in our study, our results show lower-than-expected TB tests conducted.Contribution: Our study documents the outcomes of an innovative way to combine operational workflows for TB and COVID-19. This provides a starting point for countries seeking to integrate TB and COVID-19 screening and testing.

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“…A recent study showed the feasibility and usefulness of targeting neighbourhoods with a high TB burden for TB screening 31. The ‘Targeted Universal Testing for TB’ (TUTT) study and a modelling study showed the added value of targeting people with a previous episode of TB as one of the risk groups for TB screening 32 33.…”

Section: Discussionmentioning

confidence: 99%

“…Our study and that of Marx et al 23 contribute to the evidence that living in a neighbourhood with a high TB burden increases the risk of recurrent TB, indicating that it should be targeted in screening. The best strategy for this, community-based as in the ‘Tuberculosis Neighbourhood Expanded Testing’31 or clinic-based approach as in the TUTT study, is unknown. Future research could focus on comparing these strategies.…”

Section: Discussionmentioning

confidence: 99%

Neighbourhood risk factors of recurrent tuberculosis in Cape Town: a cohort study using geocoded notification data

Molemans

Leth

McKelly

et al. 2022

J Epidemiol Community Health

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BackgroundIndividuals with a history of tuberculosis (TB) disease are at higher risk of developing a subsequent episode than those without. Considering the role of social and environmental factors in tuberculosis, we assessed neighbourhood-level risk factors associated with recurrent tuberculosis in Cape Town, South Africa.MethodsThis cohort consisted of patients who completed treatment for their first drug-sensitive TB episode between 2003 and 2015. Addresses were geocoded at neighbourhood level. Data on neighbourhood-level factors were obtained from the Census 2011 (household size, population density) and the City of Cape Town (Socio-Economic Index). Neighbourhood-level TB burden was calculated annually by dividing the number of notified TB episodes by the population in that neighbourhood. Multilevel survival analysis was performed with the outcome recurrent TB, defined as a second episode of TB, and controlling for individual-level risk factors (age, gender and time since first episode in years). Follow-up ended at the second episode, or on 31 December 2015, whichever came first.ResultsThe study included 173 421 patients from 700 neighbourhoods. Higher Socio-Economic Index was associated with a lower risk of recurrence compared with average Socio-Economic Index. An increased risk was found for higher household size and TB burden, with an increase of 20% for every additional person in mean household size and 10% for every additional TB episode/100 inhabitants. No association was found with population density.ConclusionRecurrent TB was associated with increased household size and TB burden at neighbourhood level. These findings could be used to target TB screening activities.

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Community-based TB testing as an essential part of TB recovery plans in the COVID-19 era

Cited by 4 publications

References 12 publications

Tuberculosis in times of COVID-19

Tuberculosis in times of COVID-19

Outcomes of a model integrating tuberculosis testing into COVID-19 services in South Africa

Neighbourhood risk factors of recurrent tuberculosis in Cape Town: a cohort study using geocoded notification data

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