Impact of the COVID-19 Pandemic on Tuberculosis: A Retrospective Analytical Study of Morbidity Profiles, Trends, and Patient Care in a Primary Tuberculosis Treatment Unit in India

TL;DR

The study shows that the COVID-19 pandemic significantly reduced tuberculosis case detection and disrupted patient care in India.

Contribution

The study provides empirical evidence of the pandemic's impact on TB management in a primary treatment unit in India.

Findings

TB case detection dropped by 41.8% during the pandemic compared to pre-COVID-19 levels.

Follow-up assessments were significantly disrupted, with only 26.8% of patients followed up after treatment phases.

The prevalence of diabetes and HIV among TB patients increased post-COVID-19.

Abstract

Background

Tuberculosis (TB) control in India faces significant challenges, exacerbated by the COVID-19 pandemic, which disrupted healthcare services. This study assesses the pandemic's impact on TB case trends, patient characteristics, and program effectiveness in a primary TB treatment unit in Andhra Pradesh.

Objectives

The aim was to study and analyze the trends and morbidity profiles of tuberculosis patients in the target population during the pandemic years.

Methodology

A retrospective analysis was conducted on 727 TB patients registered at an urban tuberculosis unit from 2018-2023. Data from a digital portal and patient records were statistically analyzed for socio-demographic details, diagnostic information, treatment outcomes, and follow-up assessments. Tests of significance were used for parametric and nonparametric data. The chi-square test and Fisher's exact test were used to assess qualitative variables. Trend analysis was done by an interrupted time series analysis and graphically. A p-value< 0.05 was considered a significant association.

Results

A decline of 41.8% (pre-COVID-19: 318 cases, COVID-19: 185 cases) occurred in TB case detection during the COVID-19 period compared to pre-COVID-19 levels, with only partial recovery post-COVID-19. The prevalence of diabetes mellitus (54, 24.2%) and HIV reactivity (11, 4.91%) among TB patients increased post-COVID-19. Follow-up assessments were significantly disrupted, with only 195 (26.8%) patients followed up after both intensive and continuous phases of treatment overall.

Conclusion

The COVID-19 pandemic had a substantial negative impact on TB case notification, patient follow-up, and potential treatment outcomes. Strengthening the implementation of the TB program, improving follow-up monitoring, and addressing challenges faced by healthcare staff and patients are crucial to mitigating the long-term effects and improving future pandemic preparedness.

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