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Tuberculosis healthcare service disruptions during the Covid-19 pandemic in Brazil, India and South Africa

A model-based analysis of country-level data

Bibliographic Data

ID19590760
AuthorsAbigail K de Villiers (0000-0003-0888-1087, Desmond Tutu HIV Foundation, corresponding author), Muhammad Osman (0000-0003-3818-9729, Desmond Tutu HIV Foundation, corresponding author), Cláudio José Struchiner (0000-0003-2114-847X, Fundação Getulio Vargas, corresponding author), Anete Trajman (0000-0002-4000-4984, Universidade Federal do Rio de Janeiro, corresponding author), Dheeraj Tumu (0000-0003-3741-2298, Government of India, corresponding author), Vaibhav V Shah (Government of India, corresponding author), Guilherme Loureiro Werneck (0000-0003-1169-1436, Universidade do Estado do Rio de Janeiro, corresponding author), Layana Costa Alves (0000-0003-3512-7872, Universidade Federal da Bahia, corresponding author), Megha Choudhary (0000-0002-6068-5983, All India Institute of Medical Sciences, corresponding author), Sunita Verma (0000-0002-5514-6360, All India Institute of Medical Sciences, corresponding author), Sanjay K Mattoo (0000-0001-9711-321X, Government of India, corresponding author), Sue-Ann Meehan (0000-0002-0826-1833, Desmond Tutu HIV Foundation, corresponding author), Urvashi B Singh (0000-0001-8753-9743, All India Institute of Medical Sciences, corresponding author), Anneke C Hesseling (0000-0001-9399-9834, Desmond Tutu HIV Foundation, corresponding author), Florian M Marx (0000-0003-4630-4598, Desmond Tutu HIV Foundation, corresponding author)
EditorsIsabella Faria (0000-0002-3073-5636)
Year2025
Volume5
Issue1
Pagese0003309
Publication date2025-01-07
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenuePLOS Global Public Health (JOURNAL)
Journal identifiersISSN: 2767-3375 • E-ISSN: 2767-3375
PublisherPublic Library of Science (PLoS) (PUBLISHER)
DOI10.1371/journal.pgph.0003309
PMID39774490
OpenAlexW4406151834
LanguageEN
Citations received1
References cited27

Tuberculosis (TB) is the leading infectious disease cause of death worldwide. In recent years, stringent measures to contain the spread of SARS-CoV-2 have led to considerable disruptions of healthcare services for TB in many countries. The extent to which these measures have affected TB testing, treatment initiation and outcomes has not been comprehensively assessed. We aimed to estimate TB healthcare service disruptions occurring during the COVID-19 pandemic in Brazil, India, and South Africa. We obtained country-level TB programme and laboratory data and used autoregressive integrated moving average (ARIMA) time-series models to estimate healthcare service disruptions with respect to TB testing, treatment initiation, and treatment outcomes. We quantified disruptions as the percentage difference between TB indicator data observed during the COVID-19 pandemic compared with values for a hypothetical no-COVID scenario, predicted through forecasting of trends during a three-year pre-pandemic period. Annual estimates for 2020–2022 were derived from aggregated monthly data. We estimated that in 2020, the number of bacteriological tests conducted for TB diagnosis was 24.3% (95% uncertainty interval: 8.4%;36.6%) lower in Brazil, 27.8% (19.8;3 4.8%) lower in India, and 32.0% (28.9%;34.9%) lower in South Africa compared with values predicted for the no-COVID scenario. TB treatment initiations were 17.4% (13.9%;20.6%) lower than predicted in Brazil, 43.3% (39.8%;46.4%) in India, and 27.0% (15.2%;36.3%) in South Africa. Reductions in 2021 were less severe compared with 2020. The percentage deaths during TB treatment were 13.7% (8.1%; 19.7%) higher than predicted in Brazil, 1.7% (-8.9%;14.0%) in India and 21.8% (7.4%;39.2%) in South Africa. Our analysis suggests considerable disruptions of TB healthcare services occurred during the early phase of the COVID-19 pandemic in Brazil, India, and South Africa, with at least partial recovery in the following years. Sustained efforts to mitigate the detrimental impact of COVID-19 on TB healthcare services are needed

Autoregressive integrated moving average · Disease · Economic growth · Economics · Environmental health · Health care · Healthcare service · Pandemic · Statistics · Time series · Tuberculosis · COVID-19 diagnosis using AI · COVID-19 epidemiological studies · Demography · Medicine · Tuberculosis Research and Epidemiology

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    Open Access•Norma A Téllez-Navarrete, Jesús Romero-Tendilla et al.•Frontiers in Public Health•2025

  • Automatic Time Series Forecasting

    Open Access•Rob J Hyndman, Yeasmin Khandakar•Journal of Statistical Software•2008

Unique citing works1
Citations per year1
Citation span2025 - 2025 (1)
Citation velocityrecent
Highly citedNo
Citation typesNeutral: 1
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