Care pathways of individuals with tuberculosis before and during the Covid-19 pandemic in Bandung, Indonesia

Bibliographic Data

ID19592193
AuthorsLavanya Huria (0000-0002-7835-0372, McGill University, corresponding author), Bony Wiem Lestari (0000-0002-6476-2034, Padjadjaran University, corresponding author), Eka Saptiningrum (Padjadjaran University, corresponding author), Auliya Ramanda Fikri (0000-0001-6078-9072, Padjadjaran University, corresponding author), Charity Oga‐Omenka (0000-0003-0779-570X, University of Waterloo, corresponding author), Mohammad Abdullah Heel Kafi (0000-0002-6437-0161, corresponding author), Benjamin Daniels (0000-0001-8617-6055, Georgetown University, corresponding author), Nathaly Aguilera Vasquez (0000-0002-1019-8597, McGill University, corresponding author), Angelina Sassi (0000-0002-5807-6388, McGill University, corresponding author), Jishnu Das (0000-0002-5909-3585, Georgetown University, corresponding author), Ira Dewi Jani (Dr. Hasan Sadikin General Hospital, corresponding author), Madhukar Pai (0000-0003-3667-4536, McGill University, corresponding author), Bachti Alisjahbana (0000-0003-3745-8229, Dr. Hasan Sadikin General Hospital, corresponding author)
EditorsSanjana Ravi (0000-0001-9769-6814)
Year2024
Volume4
Issue1
Pagese0002251
Publication date2024-01-02
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.0002251
PMID38165843
OpenAlexW4390497068
LanguageEN
Citations received5
References cited25

The COVID-19 pandemic is thought to have undone years’ worth of progress in the fight against tuberculosis (TB). For instance, in Indonesia, a high TB burden country, TB case notifications decreased by 14% and treatment coverage decreased by 47% during COVID-19. We sought to better understand the impact of COVID-19 on TB case detection using two cross-sectional surveys conducted before (2018) and after the onset of the pandemic (2021). These surveys allowed us to quantify the delays that individuals with TB who eventually received treatment at private providers faced while trying to access care for their illness, their journey to obtain a diagnosis, the encounters individuals had with healthcare providers before a TB diagnosis, and the factors associated with patient delay and the total number of provider encounters. We found some worsening of care seeking pathways on multiple dimensions. Median patient delay increased from 28 days (IQR: 10, 31) to 32 days (IQR: 14, 90) and the median number of encounters increased from 5 (IQR: 4, 8) to 7 (IQR: 5, 10), but doctor and treatment delays remained relatively unchanged. Employed individuals experienced shorter delays compared to unemployed individuals (adjusted medians: -20.13, CI -39.14, -1.12) while individuals whose initial consult was in the private hospitals experienced less encounters compared to those visiting public providers, private primary care providers, and informal providers (-4.29 encounters, CI -6.76, -1.81). Patients who visited the healthcare providers >6 times experienced longer total delay compared to those with less than 6 visits (adjusted medians: 59.40, 95% CI: 35.04, 83.77). Our findings suggest the need to ramp up awareness programs to reduce patient delay and strengthen private provide engagement in the country, particularly in the primary care sector

Cross-sectional study · Disease · Family medicine · Health care · Pandemic · Public health · Tuberculosis · Chronic Disease Management Strategies · COVID-19 Clinical Research Studies · Demography · Medicine · Nursing · Tuberculosis Research and Epidemiology · Internal Medicine