COVID-19 Hampered Diagnosis of TB Infection in France, Italy, Spain and the United Kingdom

García-García, José-María; Blanc, F.–X.; Buonsenso, Danilo; Centis, Rosella; Codecasa, Luigi Ruffo; D’Ambrosio, Lia; Goletti, Delia; Gualano, Gina; Kunst, Heinke; Pontali, Emanuele; Tadolini, Marina; Tiberi, Simon; Ong, Catherine W.M.; Sotgiu, Giovanni; Migliori, Giovanni Battista

doi:10.1016/j.arbres.2022.07.013

Cited by 7 publications

(3 citation statements)

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“…However, in absolute numbers, there was a decrease by half in the number of cases. These findings are in line with the 2021 WHO Global Report [ 26 ] that describes a drop in case notifications of new diagnosis worldwide [ 27 , 28 ]. The data, combined with the poor adherence and linkage to care observed, with 21% of patients not even starting treatment and around 40% of patients lost to follow-up over time, are extremely worrisome and endanger the control of transmission.…”

Section: Discussionsupporting

confidence: 89%

Impact of Coronavirus Pandemic on Tuberculosis and Other Imported Diseases Screening among Migrant Minors in Spain

et al. 2022

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Background: In recent decades, the increase in population movements has turned the focus to imported diseases. The COVID-19 pandemic has negatively impacted the access to health care systems, especially in highly vulnerable populations. We address the effects of the pandemic on the health screening of migrant unaccompanied minors (UM) in Spain. Method: Retrospective cross-sectional study including UM screened for imported diseases with a unified protocol at a pediatric reference unit for tropical and infectious diseases in Madrid, Spain. We compared the pre-pandemic (2018–2019) and post-pandemic periods (2020–2021). Results: A total of 192 minors were screened during the study period, with a drop in UM’s referral to our center in the post-pandemic years (140 in 2018–2019 vs. 52 in 2020–2021). Out of 192, 161 (83.9%) were diagnosed with at least one medical condition. The mean age was 16.8 years (SD 0.8) and 96.9% were males. Most cases were referred for a health exam; only 38% of children were symptomatic. Eosinophilia was present in 20.8%. The most common diagnosis were latent tuberculosis infection (LTBI) (72.9%), schistosomiasis (15.1%), toxocariasis (4.9%) and strongyloidiasis (4.9%). The prevalence of LTBI did not vary significantly (69.3% vs. 82.7%, p = 0.087). A total of 38% of the patients diagnosed with LTBI never started treatment or were lost to follow-up, as were two out of three patients with active pulmonary tuberculosis. Conclusions: In this series, the number of UM referred for health screening has dropped dramatically after the COVID pandemic, and two years after the beginning of the pandemic, access to care is still limited. Lost to follow-up rates are extremely high despite institutionalization. Specific resources, including multidisciplinary teams and accessible units are needed to improve diagnoses and linkage to care in this vulnerable population.

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Section: Discussionsupporting

confidence: 89%

Impact of Coronavirus Pandemic on Tuberculosis and Other Imported Diseases Screening among Migrant Minors in Spain

et al. 2022

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“… 5 The COVID-19 pandemic compounded these challenges, causing a sharp reduction in the number of people with TB seeking care, a drop in diagnoses and diagnostic capacity and less care being available if sought. 6 , 7 Pandemic-related disruption is estimated to have resulted in an additional 100,000 global TB deaths in 2020 compared to 2019. 1 Continued disruption to services and increased biopsychosocial vulnerabilities of people living in high-burden settings has reversed progress and pushed global TB targets off track.…”

Section: Introductionmentioning

confidence: 99%

Psychosocial support interventions to improve treatment outcomes for people living with tuberculosis: a mixed methods systematic review and meta-analysis

Maynard¹,

Tariq²,

Sotgiu

et al. 2023

eClinicalMedicine

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“…The COVID-19 pandemic may have harmed TB control in Ireland [11]. In other low-incidence countries, during the pandemic, testing for TB decreased, TB diagnoses were delayed, patients had more severe disease at diagnosis and more household contacts had TB infection (suggesting increased transmission) [12][13][14][15]. There will probably be an increase in TB nationally, particularly drug-resistant TB, related to the arrival of people from Ukraine (where the incidence of TB was 73 cases per 100,000 prior to the war [1]) [11].…”

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confidence: 99%

Ending tuberculosis: the cost of missing the World Health Organization target in a low-incidence country

et al. 2022

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Background Ending tuberculosis (TB) is a global priority and targets for doing so are outlined in the World Health Organization (WHO) End TB Strategy. For low-incidence countries, eliminating TB requires high levels of wealth, low levels of income inequality and effective TB programmes and services that can meet the needs of people who have not benefited from these and are still at risk of TB. In Ireland, numerous reports have noted a need for more funding for TB prevention and control. Aim The aim of this research was to estimate the cost of not meeting the WHO End TB target of a 90% reduction in TB incidence in Ireland between 2015 and 2035. Methods The cost of projected TB cases between 2022 and 2035 is estimated based on trends in surveillance data for the period 2015 to 2019 and outcomes reported in the literature. Results Between 2022 and 2035, it is projected that a failure to meet the WHO End TB Strategy target will result in an additional 989 cases of TB, 577.3 disability-adjusted life years and 35 deaths with TB in Ireland. The cost of this is estimated to be €70.779 million. Conclusion Given the estimated cost, Ireland’s current prospects of eliminating TB and the tendency towards programmatic funding internationally, greater investment in TB prevention and control in Ireland is justifiable. A national elimination strategy with actions at the levels of the social determinants of health, the health system and the TB programme should be funded.

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COVID-19 Hampered Diagnosis of TB Infection in France, Italy, Spain and the United Kingdom

Cited by 7 publications

References 10 publications

Impact of Coronavirus Pandemic on Tuberculosis and Other Imported Diseases Screening among Migrant Minors in Spain

Impact of Coronavirus Pandemic on Tuberculosis and Other Imported Diseases Screening among Migrant Minors in Spain

Psychosocial support interventions to improve treatment outcomes for people living with tuberculosis: a mixed methods systematic review and meta-analysis

Ending tuberculosis: the cost of missing the World Health Organization target in a low-incidence country

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