Covid-19’s Devastating Effect on Tuberculosis Care — A Path to Recovery

Pai, Madhukar; Kasaeva, Tereza; Swaminathan, Soumya

doi:10.1056/nejmp2118145

Cited by 195 publications

(202 citation statements)

References 4 publications

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“…The situation has been further exacerbated with unequitable distribution and access to health services and vaccines. The rapid increase in COVID-19 cases has led to TB services being severely impacted due to the cancellation of essential health services in high burden TB countries [5][6][7]. The pivoting of health services infrastructure and workforce towards COVID-19 has not helped either [5,8].…”

Section: Introductionmentioning

confidence: 99%

Integrated Tuberculosis and COVID-19 Activities in Karachi and Tuberculosis Case Notifications

Malik

Hussain²,

Maniar

et al. 2022

TropicalMed

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As the COVID-19 pandemic surged, lockdowns led to the cancellation of essential health services. As part of our Zero TB activities in Karachi, we adapted our approach to integrate activities for TB and COVID-19 to decrease the impact on diagnosis and linkage to care for TB treatment. We implemented the following: (1) integrated COVID-19 screening and testing within existing TB program activities, along with the use of an artificial intelligence (AI) software reader on digital chest X-rays; (2) home delivery of medication; (3) use of telehealth and mental health counseling; (4) provision of PPE; (5) burnout monitoring of health workers; and (6) patient safety and disinfectant protocol. We used programmatic data for six districts of Karachi from January 2018 to March 2021 to explore the time trends in case notifications, the impact of the COVID-19 pandemic, and service adaptations in the city. The case notifications in all six districts in Karachi were over 80% of the trend-adjusted expected notifications with three districts having over 90% of the expected case notifications. Overall, Karachi reached 90% of the expected case notifications during the COVID-19 pandemic. The collaborative efforts by the provincial TB program and private sector partners facilitated this reduced loss in case notifications.

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Section: Introductionmentioning

confidence: 99%

Integrated Tuberculosis and COVID-19 Activities in Karachi and Tuberculosis Case Notifications

Malik

Hussain²,

Maniar

et al. 2022

TropicalMed

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“…The successful management and treatment of pediatric patients with TBI is of paramount importance in ending the TB epidemic in the United States and globally, especially during the COVID-19 pandemic [11]. The pandemic has exacerbated the TB epidemic, as for the first time since 2005, the World Health Organization (WHO) has seen a year-over-year increase in global TB mortality caused primarily by decreased access to care [11]. Other pandemic-related setbacks include a 15% reduction in the number of patients treated for TB and a 21% decrease in individuals receiving preventative treatment for TBI [11].…”

Section: Discussionmentioning

confidence: 99%

“…The pandemic has exacerbated the TB epidemic, as for the first time since 2005, the World Health Organization (WHO) has seen a year-over-year increase in global TB mortality caused primarily by decreased access to care [11]. Other pandemic-related setbacks include a 15% reduction in the number of patients treated for TB and a 21% decrease in individuals receiving preventative treatment for TBI [11]. Therefore, it is more urgent than ever to address the social determinants of TBI treatment incompletion and consider options such as increased telehealth services to reduce barriers to TBI care.…”

Section: Discussionmentioning

confidence: 99%

“…The COVID-19 pandemic has presented healthcare systems globally with unprecedented obstacles, including the safe care of populations while reducing the risk of SARS-CoV-2 transmission. For example, there has been a decrease in the identification of patients with TB and an increase in TB-related mortality [11]. One approach to improve access to care is the implementation of telehealth services in hospitals and clinics [12].…”

Section: Introductionmentioning

confidence: 99%

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Telehealth Reduces Missed Appointments in Pediatric Patients with Tuberculosis Infection

et al. 2022

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Pediatric patients with untreated tuberculosis infection (TBI), also called latent TBI, are at risk of progression to active TB disease. The primary aim of this study was to identify factors associated with higher rates of missed appointments and failure to complete therapy for pediatric patients with TBI. A secondary aim was to determine the impact of the COVID-19 pandemic and the rise of telehealth on TBI missed appointment rates. We first performed a retrospective chart review of 129 pediatric patients referred to the free Yale Pediatric Winchester Chest Tuberculosis Clinic from 2016–2019. Associations between demographic/clinical variables and missed appointments/failure to complete therapy were analyzed using univariate and bivariate chi-square tests. Language, lack of primary provider, and distance to clinic were the main contributors to missed appointments and poor treatment adherence. There was an association between the number of missed appointments and failure to complete treatment (p = 0.050). A second cohort of 29 patients was analyzed from January–December 2021 when telehealth was offered for follow-up appointments. Of these follow-up visits, 54% were conducted via telehealth, and the clinic’s missed appointment rate dropped significantly from 16.9% to 5.8% during this time frame (p = 0.037). These data demonstrate that telehealth is accepted as an alternative by patients for follow-up TBI visits.

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“…[5][6][7] Although it has been noted that many of the preventive measures implemented to reduce SARS-CoV-2 incidence also have a clear benefit on reducing Mycobacterium tuberculosis (Mtb) transmission, 2020 saw the first year-over-year increase in TB deaths from 2005, regardless of physical distancing and PPE (personal protective equipment) wearing measures. 2,8 In Canada, the pandemic significantly affected latent TB infection (LTBI) and active TB treatment, leading to ineffective measures for TB elimination. 9 In Spain, newly diagnosed TB patients had more extended pulmonary disease, moreover there was a rise in household transmission probably due to anti-COVID-19 measures.…”

mentioning

confidence: 99%

The Dark Side of the Covid-19 Treatments on Mycobacterium Tuberculosis Infection

Maio

Bianco

Delogu

2022

Mediterr J Hematol Infect Dis

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Since the emergence of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) at the end of 2019, a number of medications have been used to treat the infection and the related Coronavirus disease – 19 (COVID-19). Some of the administered drugs were tested or used in practice only on the basis of biological plausibility; a promising strategy was to target the host immune response, with host directed therapies (HDTs), to reduce systemic hyperinflammation and hypercytokinemia responsible for additional tissue damage. We summarize the treatments against SARS-CoV-2 and underline their possible effects on Mycobacterium tuberculosis (Mtb) infection. Both SARS-CoV-2 and Mtb respiratory infections impair the host’s immune response. Furthermore, little research has been conducted on the impact of medicaments used to counteract COVID-19 disease in patients with Latent Tuberculosis Infection (LTBI). A number of these drugs may modulate host immune response by modifying LTBI dynamic equilibrium, favoring either the host or the bacteria. Keywords: SARS-CoV-2, Mycobacterium tuberculosis, COVID-19, Tuberculosis, Host directed therapies

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Covid-19’s Devastating Effect on Tuberculosis Care — A Path to Recovery

Cited by 195 publications

References 4 publications

Integrated Tuberculosis and COVID-19 Activities in Karachi and Tuberculosis Case Notifications

Integrated Tuberculosis and COVID-19 Activities in Karachi and Tuberculosis Case Notifications

Telehealth Reduces Missed Appointments in Pediatric Patients with Tuberculosis Infection

The Dark Side of the Covid-19 Treatments on Mycobacterium Tuberculosis Infection

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