Impact of COVID-19 Pandemic on Pulmonary Tuberculosis Care in Secondary and Tertiary Care Centers of Thailand
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Abstract
Introduction
Historically, a pandemic usually disrupted a country’s public health systems. COVID-19 pandemic, as well, has disrupted the care of several tropical infectious diseases, including tuberculosis (TB). In the past years, the pace of TB elimination has lagged behind the goal of End TB Strategy. It remains to be seen whether the COVID-19 pandemic will hamper this process.
Objective
The purpose of this study was to address the effects of COVID-19 pandemic and its consequences on pulmonary TB care, as well as risk factors of unsuccessful TB treatment outcomes during the pandemic.
Methods
Retrospective cohort study was conducted on 1,500 TB patients receiving treatment during 2012 to 2021. Collected data included treatment dates, demographic data, sputum collection for acid fast bacilli smear and culture, directly observed therapy (DOT), follow-ups, and treatment outcomes. Incidence was calculated using person-time function. Risk factors were calculated by Cox proportional hazard model.
Results
A total of 188 cases received treatment during COVID-19 pandemic (2020-2021). Patients who had no facility-based DOT during the pandemic were markedly higher than before the pandemic.
Incidence rates of unsuccessful pulmonary TB treatment in 2020 was 24.3 per 100 PY and 8.0 per 100 PY in 2021. Monthly notification of new pulmonary TB cases had downward trend. Risk factors of unsuccessful treatment during COVID-19 pandemic were tobacco use (AHR 6.12, 95%CI 1.31-28.56) and having history of missing follow-up or no doctor’s appointment at any point during the treatment course (AHR 3.63, 95% CI 1.44-9.17)
Conclusion
This study described the effects of the pandemic and its consequence toward pulmonary TB care. Management of pulmonary TB in Thailand was severely hit by COVID-19 pandemic, but it also resulted in novel innovations for the future of pulmonary TB care.
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
© Journal of Asian Medical Students’ Association (JAMSA). Released under a Creative Commons license.
References
Glaziou P, Sismanidis C, Floyd K, Raviglione M. Global epidemiology of tuberculosis. Cold Spring Harb Perspect Med. 2015;5(2):a017798.
Global tuberculosis report 2021. Geneva: World Health Organization.
Alene KA, Wangdi K, Clements AC. Impact of the COVID-19 pandemic on tuberculosis control: an overview. Trop Med Infect Dis. 2020;5(3):123.
Pai M, Kasaeva T, Swaminathan S. Covid-19’s devastating effect on tuberculosis care—a path to recovery. N Engl J Med. 2022;386(16):1490-3.
Malik AA, Safdar N, Chandir S, Khan U, Khowaja S, Riaz N, et al. Tuberculosis control and care in the era of COVID-19. Health Policy Plan. 2020;35(8):1130-2.
Desta KT, Kessely DB, Daboi JG. Evaluation of the performance of the National Tuberculosis Program of Liberia during the 2014–2015 Ebola outbreak. BMC Public Health. 2019;19(1):1-10.
Triukose S, Nitinawarat S, Satian P, Somboonsavatdee A, Chotikarn P, Thammasanya T, et al. Effects of public health interventions on the epidemiological spread during the first wave of the COVID-19 outbreak in Thailand. PLoS One. 2021;16(2):e0246274.
Apisarnthanarak A, Siripraparat C, Apisarnthanarak P, Ullman M, Saengaram P, Leeprechanon N, et al. Patients’ anxiety, fear, and panic related to coronavirus disease 2019 (COVID-19) and confidence in hospital infection control policy in outpatient departments: a survey from four Thai hospitals. Infect Control Hosp Epidemiol. 2021;42(10):1288-90.
Jamwal A, Mohanty A, Swami A, Turbadkar D. Impact of COVID-19 on tuberculosis services: an experience from a tertiary care hospital. J Med Microbiol. 2022;71(6):001559.
Rodrigues I, Aguiar A, Migliori GB, Duarte R. Impact of the COVID-19 pandemic on tuberculosis services. Pulmonology. 2022;28(3):210-9.
Fei H, Yinyin X, Hui C, Ni W, Xin D, Wei C, et al. The impact of the COVID-19 epidemic on tuberculosis control in China. Lancet Reg Health West Pac. 2020;3:100032.
Aznar ML, Espinosa-Pereiro J, Saborit N, Jové N, Martinez FS, Pérez-Recio S, et al. Impact of the COVID-19 pandemic on tuberculosis management in Spain. Int J Infect Dis. 2021;108:300-5.
Treatment of Tuberculosis: Guidelines. Geneva: World Health Organization.
World Health Organization. Definitions and reporting framework for tuberculosis–2013 revision: updated December 2014 and January 2020. World Health Organization; 2013. Report No.: 9241505346.
National tuberculosis control programme guideline, Thailand, 2021. Bangkok: Bureau of Tuberculosis, Ministry of Public Health; 2021.
Charoensakulchai S, Lertpheantum C, Aksornpusitpong C, Trakulsuk P, Sakboonyarat B, Rangsin R, et al. Six-year trend and risk factors of unsuccessful pulmonary tuberculosis treatment outcomes in Thai Community Hospital. BMC Res Notes. 2021;14(1):1-8.
Komiya K, Yamasue M, Takahashi O, Hiramatsu K, Kadota J-i, Kato S. The COVID-19 pandemic and the true incidence of Tuberculosis in Japan. J Infect. 2020;81(3):e24-e5.
Kwak N, Hwang S-S, Yim J-J. Effect of COVID-19 on tuberculosis notification, South Korea. Emerg Infect Dis. 2020;26(10):2506.
Rotejanaprasert C, Lawpoolsri S, Pan-Ngum W, Maude RJ. Preliminary estimation of temporal and spatiotemporal dynamic measures of COVID-19 transmission in Thailand. PLoS One. 2020;15(9):e0239645.
Tangcharoensathien V, Bassett MT, Meng Q, Mills A. Are overwhelmed health systems an inevitable consequence of covid-19? Experiences from China, Thailand, and New York State. BMJ. 2021;372.
Lai C-C, Yu W-L. The COVID-19 pandemic and tuberculosis in Taiwan. J Infect. 2020;81(2):e159-e61.
Zimmer AJ, Heitkamp P, Malar J, Dantas C, O'Brien K, Pandita A, et al. Facility-based directly observed therapy (dot) for tuberculosis during COVID-19: a community perspective. J Clin Tuberc Other Mycobact Dis. 2021;24:100248.
Karumbi J, Garner P. Directly observed therapy for treating tuberculosis. Cochrane Database Syst Rev. 2015(5).
Pasipanodya JG, Gumbo T. A meta-analysis of self-administered vs directly observed therapy effect on microbiologic failure, relapse, and acquired drug resistance in tuberculosis patients. Clin Infect Dis. 2013;57(1):21-31.
Charoensakulchai S, Limsakul M, Saengungsumalee I, Usawachoke S, Udomdech A, Pongsaboripat A, et al. Characteristics of Poor Tuberculosis Treatment Outcomes among Patients with Pulmonary Tuberculosis in Community Hospitals of Thailand. Am J Trop Med Hyg. 2020;102(3):553-61.