# Access to tuberculosis care in South Africa during the COVID-19 pandemic: A scoping review

## TL;DR

This study reviews how the COVID-19 pandemic worsened access to tuberculosis care in South Africa, revealing disruptions like reduced diagnostics and healthcare closures.

## Contribution

The paper provides a scoping review of how the pandemic impacted TB care access in South Africa, identifying new insights into systemic challenges.

## Key findings

- TB service delivery faced significant disruptions, including reduced diagnostic capacity and facility closures.
- Patients experienced delayed diagnoses and increased stigma during the pandemic.
- Healthcare workers encountered resource shortages and operational challenges.

## Abstract

Tuberculosis (TB) remains a major public health issue in South Africa, a high-burden TB country. The coronavirus disease 2019 (COVID-19) pandemic has exacerbated challenges in accessing essential TB services. This scoping review explores how access to TB care was impacted during the pandemic.

This research aimed to review original studies on access to TB care in South Africa during the COVID-19 pandemic using a scoping review methodology.

A scoping review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews (PRISMA-ScR) guidelines. Five databases were systematically searched for original peer-reviewed research published between 2020 and 2022. Data were extracted and synthesised using the Penchansky and Thomas framework of healthcare access.

Three studies met the inclusion criteria. The review identified significant disruptions in TB service delivery during the pandemic, including reduced diagnostic capacity, healthcare facility closures and economic barriers. Patients reported delayed diagnoses and increased stigma, while healthcare workers faced resource shortages and operational challenges.

The COVID-19 pandemic has exacerbated pre-existing barriers to TB care in South Africa, highlighting critical gaps in healthcare delivery. This review provides insights into the challenges faced and emphasises the need for resilient health systems to sustain TB care during future health crises.

This article highlights the impact of the COVID-19 pandemic on TB care access in South Africa, identifying key barriers across healthcare access dimensions and offering recommendations to improve TB care delivery during public health emergencies.