Impact of COVID-19 Pandemic on Tuberculosis Preventive Services and Their Post-Pandemic Recovery Strategies: A Rapid Review of Literature

Abstract

Background Coronavirus disease 2019 (COVID-19) pandemic has disrupted tuberculosis (TB) care and prevention around the world. The aim of this study is to review literature on the impact of COVID-19 on TB preventive services and discuss their policy options during and after the pandemic. Methods We conducted a rapid review of scientific literature on the impact of COVID-19 on TB preventive services and their recovery strategies. After conducting a line-by-line open coding, their codes were applied in the descriptive theme building process, which was guided by the End TB strategy. TB preventive measures were selected and classified into five analytical categories: 1) vaccination against TB, 2) detection and treatment of latent TB infection (LTBI), 3) screening and diagnostics, 4) active case finding and contact tracing, and 5) surveillance. Results We identified 93 articles, of which 65 were research articles. During the pandemic, we observed decrease in Bacillus Calmette-Guérin (BCG) coverage, TB diagnostic services, case finding activities, and LTBI management. TB case detection was declined, which was not resumed to the pre-pandemic level after loosening the lock-down. Several recommendations were highlighted: 1) secure BCG stocks and its supply chains, 2) consider catch-up activities of routine immunization and LTBI screening, 3) maintain minimal TB health services, infection prevention and control, and surveillance, 4) leverage laboratory capacity and contact tracing mechanisms, 5) consider simultaneous testing for TB and COVID-19, and 6) Incorporate digital health technologies. Conclusions Our findings and lessons learnt from the pandemic can aid in the development of future national TB control program.

The Global Impact of COVID-19 on Tuberculosis: A Thematic Scoping Review, 2020-2023

“…In a 2023 rapid review from South Korea, Jeong et al [83] reported that global detection and treatment of TB infection were among the most negatively impacted steps in the TB cascade across low-, middle-, and high-income countries (LMHC). Two retrospective data analyses comparing TB preventive treatment initiation before and during the pandemic reported a 44.7% decline in Addis, Ethiopia [76] and 30% and 66% in Montreal and Toronto, Canada [77], respectively.…”

“…Several publications, across all themes, offered recommendations for combatting a wide range of TB issues [7, 54, 74, 83, 90, 108, 117, 127, 137, 139, 142, 153, 157, 172, 174, 180–181]. Some recommendations took a “glass half-full” approach by addressing the potential for positive, post-pandemic impacts on TB––leveraging and retrofitting aspects of the pandemic response, such as new developments in case-finding, diagnostics, and health education.…”

Health and illness beliefs in adults with tuberculosis infection during the COVID-19 pandemic in the UK

“…The WHO European Region was on track to reach 2020 targets, with a 19% reduction of TB incidence between 2015 and 2019 [ 1 ]. However, the COVID-19 pandemic has caused significant disruptions to healthcare systems globally, impacting on TB control in many countries [ 4 ]. For example, TB case notifications have decreased between 31% to 48%, indicating nondetection of cases in the European region between 2019 and 2020 [ 5 ], including countries with a low TB incidence.…”

Unsuccessful tuberculosis treatment outcomes across Brazil's geographical landscape before and during the COVID-19 pandemic: are we truly advancing toward the sustainable development/end TB goal?

“…The reallocation of human, material, and financial resources within healthcare services, as well as mobility restrictions, fear of contracting COVID-19, and the socioeconomic impact of the pandemic, have created barriers to accessing TB diagnosis. This has hindered programmatic efforts for active case finding of respiratory symptoms and contact tracing, as well as the monitoring and adherence to treatment [ 3 – 5 ].…”