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. 2021 Aug 19;6(3):154.
doi: 10.3390/tropicalmed6030154.

Impact of COVID-19 on Tuberculosis Case Detection and Treatment Outcomes in Sierra Leone

Sulaiman Lakoh  1   2 , Darlinda F Jiba  2 , Mamadu Baldeh  2 , Olukemi Adekanmbi  3   4 , Umu Barrie  5 , Alhassan L Seisay  6 , Gibrilla F Deen  1   2 , Robert A Salata  7   8 , George A Yendewa  7   8   9
Affiliations

Impact of COVID-19 on Tuberculosis Case Detection and Treatment Outcomes in Sierra Leone

Sulaiman Lakoh et al. Trop Med Infect Dis. .

Abstract

The COVID-19 pandemic has adversely affected tuberculosis (TB) care delivery in high burden countries. We therefore conducted a retrospective study to assess the impact of COVID-19 on TB case detection and treatment outcomes at the Chest Clinic at Connaught Hospital in Freetown, Sierra Leone. Overall, 2300 presumptive cases were tested during the first three quarters of 2020 (intra-COVID-19) versus 2636 in 2019 (baseline), representing a 12.7% decline. Testing declined by 25% in women, 20% in children and 81% in community-initiated referrals. Notwithstanding, laboratory-confirmed TB cases increased by 37.0% and treatment success rate was higher in 2020 (55.6% vs. 46.7%, p = 0.002). Multivariate logistic regression analysis found that age < 55 years (aOR 1.74, 95% CI (1.80, 2.56); p = 0.005), new diagnosis (aOR 1.69, 95% CI (1.16, 2.47); p = 0.007), pulmonary TB (aOR 3.17, 95% CI (1.67, 6.04); p < 0.001), HIV negative status (aOR 1.60, 95%CI (1.24, 2.06); p < 0.001) and self-administration of anti-TB drugs through monthly dispensing versus directly observed therapy (DOT) (aOR 1.56, 95% CI (1.21, 2.03); p = 0.001) independently predicted treatment success. These findings may have policy implications for DOTS in this setting and suggest that more resources are needed to reverse the negative impact of the COVID-19 pandemic on TB program activities in Sierra Leone.

Keywords: COVID-19; Sierra Leone; resource-limited settings; services utilization; tuberculosis.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Comparison of presumptive TB cases during the pre- and intra-COVID-19 periods.
Figure 2
Figure 2
Trends in monthly presumptive TB cases during the pre- and intra-COVID-19 periods.
Figure 3
Figure 3
Trends in monthly laboratory-confirmed TB cases during the pre- and intra-COVID-19 periods.
See this image and copyright information in PMC

References

    1. World Health Organization WHO Coronavirus Disease (COVID-19) Dashboard. [(accessed on 10 June 2020)];2020 Available online: https://covid19.who.int/
    1. Thornton J. COVID-19: Africa’s case numbers are rising rapidly, WHO warns. BMJ. 2020;369:m2394. doi: 10.1136/bmj.m2394. - DOI - PubMed
    1. Lawal Y. Africa’s low COVID-19 mortality rate: A paradox? Int. J. Infect. Dis. 2021;102:118–122. doi: 10.1016/j.ijid.2020.10.038. - DOI - PMC - PubMed
    1. Mwananyanda L., Gill C.J., MacLeod W., Kwenda G., Pieciak R., Mupila Z., Lapidot R., Mupeta F., Forman L., Ziko L., et al. COVID-19 deaths in Africa: Prospective systematic postmortem surveillance study. BMJ. 2021;372:n334. doi: 10.1136/bmj.n334. - DOI - PMC - PubMed
    1. Bell D., Hansen K.S., Kiragga A.N., Kambugu A., Kissa J., Mbonye A.K. Predicting the Impact of COVID-19 and the Potential Impact of the Public Health Response on Disease Burden in Uganda. Am. J. Trop. Med. Hyg. 2020;103:1191–1197. doi: 10.4269/ajtmh.20-0546. - DOI - PMC - PubMed

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