Gauging the impact of the COVID-19 pandemic on tuberculosis services: a global study

Migliori, Giovanni Battista; Thong, Pei Min; Alffenaar, Jan-Willem; Denholm, Justin; Tadolini, Marina; Alyaquobi, Fatma; Blanc, François-Xavier; Buonsenso, Danilo; Cho, Jin-Gun; Codecasa, Luigi; Danila, Edvardas; Duarte, Raquel; García-García, José-María; Gualano, Gina; Rendón, Adrián; Silva, Denise Rossato; Souleymane, Mahamadou Bassirou; Tham, Sai Meng; Thomas, Tania A; Tiberi, Simon; Udwadia, Zarir F; Goletti, Delia; Centis, Rosella; D’Ambrosio, Lia; Sotgiu, Giovanni; Ong, Catherine W. M.

doi:10.1183/13993003.01786-2021

Cited by 112 publications

(104 citation statements)

References 17 publications

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“…Since the beginning of 2020, the coronavirus disease 2019 (COVID-19) pandemic has caused a significant disruption in all areas of healthcare worldwide. 1 , 2 , 3 The functioning and response of many health services, including tuberculosis (TB) services, were profoundly affected by the policies adopted to respond to the pandemic, such as country lockdowns, reallocation of health professionals, materials, and diagnostic tools, and reduction of outpatient care. 4 , 5 , 6 , 7 , 8…”

Section: Introductionmentioning

confidence: 99%

Impact of the COVID-19 pandemic on tuberculosis services

et al. 2022

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Section: Introductionmentioning

confidence: 99%

Impact of the COVID-19 pandemic on tuberculosis services

et al. 2022

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“…One prospective study demonstrated that patients at a primary and specialty care clinic had a significantly lower no show rate for telehealth visits compared with no show rates for in-office visits both before and during the pandemic [14]. Although this adoption of telehealth is still nascent and actively evolving based on the needs of patients and health system resources, there is a history of telehealth use for video-based direct observed therapy (vDOT) for patients with active TB disease [15,16]. VDOT is a convenient and cost-effective alternative to daily in-person observation that is especially valuable during the COVID-19 pandemic [17].…”

Section: Introductionmentioning

confidence: 99%

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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“…16 During the COVID-19 pandemic, newly treated TB patients face additional barriers to seeking health care, so many patients go undiagnosed, and a long time has passed before starting treatment. 17 If these patients are unfortunate enough to contract COVID-19 while seeking care, this will undoubtedly worsen their illness. 18 Blindly seeking and delaying treatment not only lead to antibiotic overuse but also may delay the start of effective treatment and cause TB transmission in the community.…”

Section: Introductionmentioning

confidence: 99%

Cut-off Points of Treatment Delay to Predict Poor Outcomes Among New Pulmonary Tuberculosis Cases in Dalian, China: A Cohort Study

Ji¹,

Xu²,

Wu³

et al. 2021

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Purpose: Despite increasing literature on the association between treatment delay and outcomes, cut-off point (1 month or median) selection in almost all studies for treatment delay is too subjective. This study explored more scientific cut-off points of treatment delay for poor treatment outcomes and death at the clinical level. Patients and Methods: A total of 18,100 newly confirmed pulmonary tuberculosis (TB) cases in Dalian, China were used in the final analysis. A 3-knotted restricted cubic spline (RCS) fitted for Cox proportional hazard regression models is used to analyse the effects of cut-off points of treatment delay on incident poor treatment outcomes. To explore the moderating effects of age, gender and diabetes, we added the interaction terms of these moderating variables and treatment delay to Cox proportional hazard regression models. Results:The median time of treatment initiation was 30 days (IQR: 14-59 days). The risk of incident poor treatment outcomes increased when the time was greater than cut-off point 1 (53 days; adjusted HR: 1.26; 95% CI: 1.00-1.60) of treatment delay, and the risk of incident death events increased when the time was greater than cut-off point 2 (103 days; adjusted HR: 1.56; 95% CI: 1.00-2.44) of delay. In addition, treatment delay was associated with an increased risk of incident poor treatment outcomes and death, and older age, male sex, and diabetes may increase the risk of treatment delay for poor outcomes. Conclusion:This study is the first to identify scientific cut-off points of treatment delay for poor treatment outcomes and death, and this method of exploration should be popularized. In addition, the knowledge of tuberculosis must be spread to every adult. Moreover, the tuberculosis diagnosis level of community level health workers should be enhanced.

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Gauging the impact of the COVID-19 pandemic on tuberculosis services: a global study

Cited by 112 publications

References 17 publications

Impact of the COVID-19 pandemic on tuberculosis services

Impact of the COVID-19 pandemic on tuberculosis services

Telehealth Reduces Missed Appointments in Pediatric Patients with Tuberculosis Infection

Cut-off Points of Treatment Delay to Predict Poor Outcomes Among New Pulmonary Tuberculosis Cases in Dalian, China: A Cohort Study

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