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Impact of the COVID-19 pandemic on TB services at ART programmes in low- and middle-income countries: a multi-cohort survey

dc.rights.licenseopenen_US
dc.contributor.authorMARTI, Mariana
dc.contributor.authorZURCHER, Kathrin
dc.contributor.authorENANE, Leslie A.
dc.contributor.authorDIERO, Lameck
hal.structure.identifierBordeaux population health [BPH]
hal.structure.identifierGlobal Health in the Global South [GHiGS]
dc.contributor.authorMARCY, Olivier
hal.structure.identifierBordeaux population health [BPH]
hal.structure.identifierGlobal Health in the Global South [GHiGS]
dc.contributor.authorTIENDREBEOGO, Kiswend-Sida Thierry
dc.contributor.authorYOTEBIENG, Marcel
dc.contributor.authorTWIZERE, Christelle
dc.contributor.authorKHUSUWAN, Suwimon
dc.contributor.authorYUNIHASTUTI, Evy
dc.contributor.authorREUBENSON, Gary
dc.contributor.authorSHAH, N. Sarita
dc.contributor.authorEGGER, Matthias
dc.contributor.authorBALLIF, Marie
dc.contributor.authorFENNER, Lukas
dc.date.accessioned2022-12-16T13:21:44Z
dc.date.available2022-12-16T13:21:44Z
dc.date.issued2022-10
dc.identifier.issn1758-2652 (Electronic) 1758-2652 (Linking)en_US
dc.identifier.urihttps://oskar-bordeaux.fr/handle/20.500.12278/171549
dc.description.abstractEnINTRODUCTION: COVID-19 stretched healthcare systems to their limits, particularly in settings with a pre-existing high burden of infectious diseases, including HIV and tuberculosis (TB). We studied the impact of COVID-19 on TB services at antiretroviral therapy (ART) clinics in low- and middle-income countries. METHODS: We surveyed ART clinics providing TB services in the International Epidemiology Databases to Evaluate AIDS (IeDEA) consortium in Africa and the Asia-Pacific until July 2021 (TB diagnoses until the end of 2021). We collected site-level data using standardized questionnaires. RESULTS: Of 46 participating ART clinics, 32 (70%) were in Africa and 14 (30%) in the Asia-Pacific; 52% provided tertiary care. Most clinics (85%) reported disrupted routine HIV care services during the pandemic, both in Africa (84%) and the Asia-Pacific (86%). The most frequently reported impacts were on staff (52%) and resource shortages (37%; protective clothing, face masks and disinfectants). Restrictions in TB health services were observed in 12 clinics (26%), mainly reduced access to TB diagnosis and postponed follow-up visits (6/12, 50% each), and restrictions in TB laboratory services (22%). Restrictions of TB services were addressed by dispensing TB drugs for longer periods than usual (7/12, 58%), providing telehealth services (3/12, 25%) and with changes in directly observed therapy (DOT) (e.g. virtual DOT, 3/12). The number of TB diagnoses at participating clinics decreased by 21% in 2020 compared to 2019; the decline was more pronounced in tertiary than primary/secondary clinics (24% vs. 12%) and in sites from the Asia-Pacific compared to Africa (46% vs. 14%). In 2021, TB diagnoses continued to decline in Africa (-8%) but not in the Asia-Pacific (+62%) compared to 2020. During the pandemic, new infection control measures were introduced or intensified at the clinics, including wearing face masks, hand sanitation and patient triage. CONCLUSIONS: The COVID-19 pandemic led to staff shortages, reduced access to TB care and delays in follow-up visits for people with TB across IeDEA sites in Africa and the Asia-Pacific. Increased efforts are needed to restore and secure ongoing access to essential TB services in these contexts.
dc.language.isoENen_US
dc.rightsAttribution 3.0 United States*
dc.rights.urihttp://creativecommons.org/licenses/by/3.0/us/*
dc.subject.enTuberculosis
dc.subject.enCOVID-19
dc.subject.enHIV clinic
dc.subject.enAntiretroviral therapy
dc.subject.enLow- and middle-income countries
dc.subject.enDifferentiated service delivery
dc.title.enImpact of the COVID-19 pandemic on TB services at ART programmes in low- and middle-income countries: a multi-cohort survey
dc.typeArticle de revueen_US
dc.identifier.doi10.1002/jia2.26018en_US
dc.subject.halSciences du Vivant [q-bio]/Santé publique et épidémiologieen_US
dc.identifier.pubmed36285602en_US
bordeaux.journalJournal of the International AIDS Societyen_US
bordeaux.volume25en_US
bordeaux.hal.laboratoriesBordeaux Population Health Research Center (BPH) - UMR 1219en_US
bordeaux.issue10en_US
bordeaux.institutionUniversité de Bordeauxen_US
bordeaux.institutionINSERMen_US
bordeaux.teamGHIGS_BPHen_US
bordeaux.teamIeDEAen_US
bordeaux.peerReviewedouien_US
bordeaux.inpressnonen_US
hal.identifierhal-03903538
hal.version1
hal.date.transferred2023-07-05T13:20:08Z
hal.exporttrue
dc.rights.ccPas de Licence CCen_US
bordeaux.COinSctx_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.jtitle=Journal%20of%20the%20International%20AIDS%20Society&rft.date=2022-10&rft.volume=25&rft.issue=10&rft.eissn=1758-2652%20(Electronic)%201758-2652%20(Linking)&rft.issn=1758-2652%20(Electronic)%201758-2652%20(Linking)&rft.au=MARTI,%20Mariana&ZURCHER,%20Kathrin&ENANE,%20Leslie%20A.&DIERO,%20Lameck&MARCY,%20Olivier&rft.genre=article


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