The impact of COVID-19 on the cascade of care for tuberculosis : a systematic review

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dc.contributor.advisorChivese, Tawandaen_ZA
dc.contributor.authorFapohunda, Tomiwa Temitayoen_ZA
dc.contributor.otherStellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Global Health. Health Systems and Public Health.en_ZA
dc.date.accessioned2022-11-17T13:29:48Z
dc.date.accessioned2023-01-16T12:54:28Z
dc.date.available2022-11-17T13:29:48Z
dc.date.available2023-01-16T12:54:28Z
dc.date.issued2022-09
dc.descriptionThesis (MPhil)--Stellenbosch University, 2022.en_ZA
dc.description.abstractENGLISH SUMMARY: Background: Globally, the effect of the coronavirus pandemic on tuberculosis (TB) cascade of care is not well described. Objectives: To describe the impact of the 2019 coronavirus disease (COVID-19) pandemic on the TB care cascade, particularly on testing, case notifications and treatment of TB. Methods: In this systematic review, the Cochrane library, Scopus, CINAHL, Ebscohost, and PubMed databases were comprehensively searched from December 1st, 2019, the onset of the pandemic, till May 5th, 2022, without language restrictions. Eligible studies were observational studies documenting changes in the TB cascade of care one year before and one year during the COVID- 19 pandemic. The authors could not conduct a meta-analysis due to the expected differences in the contexts of the included studies, thus, a narrative synthesis was conducted. The Hoy et al.'s (2012) risk of bias tool was used for the quality assessment. Results: Twenty-seven studies from Asia, North America, Africa, South America, and Europe were included. TB screening suspected cases decreased between 1.3% and 49.5% (n= 5 studies), and multidrug resistance tuberculosis (MDR-TB) screening decreased by 17% in new patients and by 15% in existing patients (1 study). The diagnostic delay increased by11 and 45 days and 25.1% and 60% (2 studies), contact tracing decreased by 36.1% (1 study), case notification decreased between 2.9% and 63.3% (18 studies) and positivity rate increased between 0.1% and 4.5% (4 studies). General and community detection rates decreased by 11.8% and 44.7%, respectively (1 study), clinically diagnosed TB decreased between 10.4% and 46.0% (5 studies), presumptive TB diagnoses decreased between 12.8% and 45.6% (4 studies) and pulmonary TB diagnoses decreased between 20.0% and 50.7% (2 studies). Treatment enrolment decreased between 15.7% and 35.0% (4 studies), the diagnostic and treatment delay increased by 28 and 36 days, respectively, treatment completion decreased by 8.0% (1 study) and the treatment success rate decreased between 0.1% and 17.0% (7 studies). Conclusion: These results suggest that the pandemic likely had a detrimental impact on the TB care cascade. In future pandemics, stakeholders and governments must protect the care cascade of infectious diseases like TB and other diseases. The results of this study must be applied with caution since only observational studies, mostly without standardized population data, were included.en_ZA
dc.description.abstractAFRIKAANSE OPSOMMING: Agtergrond: Wereldwyd word die uitwerking van die koronaviruspandemie op die tuberkulose (TB)-kaskade van sorg nie goed beskryf nie. Doelwitte: Om die impak van die 2019-koronavirussiekte (COVID-19)-pandemie op die TB-sorgkaskade te beskryf, veral op toetsing, gevallekennisgewings en behandeling van TB. Metodes: In hierdie sistematiese oorsig is die Cochrane-biblioteek, Scopus, CINAHL, Ebscohost en PubMed-databasisse omvattend deursoek vanaf 1 Desember 2019, die aanvang van die pandemie, tot 5 Mei 2022, sonder taalbeperkings. Kwalifiserende studies was waarnemingstudies wat veranderinge in die TB-kaskade van sorg een jaar voor en een jaar tydens die COVID-19- pandemie gedokumenteer het. Die skrywers kon weens die verwagte verskille in die kontekste van die ingeslote studies nie 'n meta-analise doen nie, en daarom is 'n narratiewe sintese uitgevoer. Die Hoy et al. (2012) se risiko van vooroordeel-instrument is gebruik vir die kwaliteitsbeoordeling. Resultate: Sewe-en-twintig studies uit Asie, Noord-Amerika, Afrika, Suid-Amerika en Europa is ingesluit. Vermoedelike gevalle van TB-sifting het tussen 1,3% en 49,5% afgeneem (n = 5 studies), en multi-middelweerstandigheid tuberkulose (MDR-TB) sifting het met 17% afgeneem by nuwe pasiente en met 15% in bestaande pasiente (1 studie). Die diagnostiese vertraging het met 11 en 45 dae toegeneem en 25,1% en 60% (2 studies), kontakopsporing het met 36,1% afgeneem (1 studie), gevallekennisgewing het tussen 2,9% en 63,3% afgeneem (18 studies) en positiwiteitskoers het tussen 0,1% en 4,5% toegeneem (4 studies). Algemene en gemeenskapsopsporingsyfers het onderskeidelik met 11,8% en 44,7% afgeneem (1 studie), klinies gediagnoseerde TB het tussen 10,4% en 46,0% afgeneem (5 studies), vermoedelike TBdiagnoses het tussen 12,8% en 45,6% afgeneem (4 studies) en pulmonale TB-diagnoses het tussen 20,0% en 50,7% afgeneem (2 studies). Behandelingsinskrywing het tussen 15,7% en 35,0% afgeneem (4 studies), die diagnostiese en behandelingsvertraging het onderskeidelik met 28 en 36 dae toegeneem, die voltooiing van die behandeling het met 8,0% afgeneem (1 studie) en die sukseskoers van die behandeling het tussen 0,1% en 17,0% gedaal (7 studies). Gevolgtrekking: Hierdie resultate dui daarop dat die pandemie waarskynlik 'n nadelige impak op die TBsorgkaskade gehad het. In toekomstige pandemies moet belanghebbendes en regerings die versorgingskaskade van aansteeklike siektes soos TB en ander siektes beskerm. Die resultate van hierdie studie moet met omsigtigheid toegepas word, aangesien slegs waarnemingstudies, meestal sonder gestandaardiseerde bevolkingsdata, ingesluit is.af_ZA
dc.description.versionMasters
dc.format.extent62 pages : illustrations, includes annexures
dc.identifier.urihttp://hdl.handle.net/10019.1/126185
dc.language.isoen_ZAen_ZA
dc.publisherStellenbosch : Stellenbosch University
dc.rights.holderStellenbosch University
dc.subjectCOVID-19 (Disease) -- Diagnosisen_ZA
dc.subjectCoronavirus infectionsen_ZA
dc.subjectTuberculosis -- Treatmenten_ZA
dc.subjectUCTD
dc.titleThe impact of COVID-19 on the cascade of care for tuberculosis : a systematic reviewen_ZA
dc.typeThesisen_ZA
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