Impact of COVID-19 on tuberculosis services: an experience from a tertiary care hospital.

ABSTRACT

Introduction. India is home to the most significant number of tuberculosis (TB) cases around the globe. The COVID-19 crisis has massively affected TB healthcare services in the country.Hypothesis/Gap Statement. Are we sufficiently equipped to fight against TB during emergencies?Aim. Our study aims to provide a true insight into the disruption of TB care during the pandemic period at a tertiary care hospital in India.Methods. A retrospective observational cohort analysis was conducted on 6491 patients who accessed the TB diagnostics at the tertiary care hospital during the study period, i.e. the COVID-19 pandemic period (March 2020 to March 2021) compared with 14 665 in the control period (March 2019 to Feb 2020).Results. Out of the total tested, 3136 patients were notified as new TB cases in the study period than 4370 in the control period (P-value=0.0000001), i.e. 28.23 % decline in notifications. A drastic decline of 69 % in notifications was observed during the lock down months in the pandemic period, i.e. March to June 2020 (P-value=0.00001). A reduction of 44 % in treatment accession by 3690 TB patients in the control period compared with 2062 in the study period (P-value=0.0000001) was noted. Lost to follow-up patients increased by 65 % from 460 in the control period to 760 in the study period (P-value=0.0000001). Also, an increased death rate by 43 % from control to study period (P-value=0.0000001) was reported.Conclusion. There is an urgent need to maintain the continuity of essential TB services to reduce the rising burden in vulnerable populations. The need of the hour is to undertake novel strategies for tuberculosis control to combat such emergencies in the coming future.