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. 2022 Jun 29:13:891711.
doi: 10.3389/fphar.2022.891711. eCollection 2022.

Impact of the COVID-19 Pandemic on the Diagnosis of Tuberculosis in Brazil: Is the WHO End TB Strategy at Risk?

Mariana do Rosário Souza  1   2 , Wandklebson Silva da Paz  2   3 , Vinícius Barbosa Dos Santos Sales  4 , Gleidson Felipe Hilario de Jesus  4 , Débora Dos Santos Tavares  5 , Shirley V M Almeida Lima  6 , Álvaro Francisco Lopes Sousa  7 , Enaldo Vieira de Melo  4 , Rodrigo Feliciano do Carmo  8 , Carlos Dornels Freire de Souza  9 , Márcio Bezerra-Santos  1   2   10   11
Affiliations

Impact of the COVID-19 Pandemic on the Diagnosis of Tuberculosis in Brazil: Is the WHO End TB Strategy at Risk?

Mariana do Rosário Souza et al. Front Pharmacol. .

Erratum in

Abstract

Background: In 2014, the World Health Organization (WHO) launched the "post-2015 End TB strategy", that aims to end the global tuberculosis (TB) epidemic by 2030. However, the COVID-19 pandemic has severely impacted global public health and the strict measures to control the coronavirus spread can affect the management of other diseases, such as TB. Herein, we aimed to assess the impact of the COVID-19 pandemic on the diagnosis of TB in Brazil, during 2020. Methods: We carried out an ecological and population-based study, using spatial analysis techniques. The variables used were the new cases of TB, pulmonary tuberculosis (PTB), and also baciloscopy-positive (BP) cases in Brazil between 2015 and 2020. The percentage of changes (% change) was calculated to verify if there was an increase or decrease of TB cases in 2020, along with time trend analyses given by Joinpoint regression model. Also, interrupted time series analyses were used to assess the trend of TB diagnosis before and after the onset of the COVID-19 in Brazil. Spatial distribution maps were elaborated, considering the % change of each Brazilian state. Findings: Data analyses showed a reduction in the diagnosis of TB (-8.3%) and PTB (-8.1%) in Brazil after the irruption of the COVID-19 pandemic. Likewise, 22 states depicted a reduction in TB diagnosis. An expressive reduction of BP cases (-17.1%) was also observed. Interestingly, interrupted time series analysis showed decline in TB and PTB diagnoses from March 2020. Spatial analyses revealed that all states had a progressive reduction of TB, PTB and PB cases, from March on, with the highest percentages of reduction in December (-100% to -75%). Interpretation: Taken together, our analyses demonstrated a reduction in TB diagnosis after the irruption of the COVID-19 pandemic in Brazil and its regions, signaling a serious impact on the WHO "End TB Strategy" global plan.

Keywords: COVID-19; COVID-19 pandemic; end TB strategy; global healh; tuberculosis.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
The percentage of change of tuberculosis cases, according to data from Brazil (green bars), Brazilian regions (orange bars), and states. (A) % change in the new TB cases; (B) % change in the new PTB cases; (C) % change in the new baciloscopy-positive (AARB+) cases.
FIGURE 2
FIGURE 2
Interrupted time series analysis of tuberculosis cases in Brazil: (A) New cases of tuberculosis (TB); (B) New cases of pulmonary tuberculosis (PTB); (C) Baciloscopy-positive (AARB+) cases. The line that cuts each time series indicates the intervention in the series, in this case, the onset of the COVID-19 pandemic in Brazil in March 2020.
FIGURE 3
FIGURE 3
Spatial distribution of the monthly percentage of change in the TB cases in Brazil, between January and December 2020: (A) New cases of tuberculosis (TB); (B) New cases of pulmonary tuberculosis (PTB); (C) Baciloscopy-positive (AARB+) cases.
See this image and copyright information in PMC

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