Abstract:
Background: In the context of global TB epidemic, besides the TB challenges already present, the current COVID-19 pandemic threatens to undo recent promising progress towards global TB targets as it has effect on TB control initiatives worldwide. During the pandemic, like most countries, the Ethiopia government announced movement restrictions targeting to control the spread of COVID-19 pandemic. Alongside the government's restrictions, the population started to fear contracting COVID-19 virus and decreased the habit of going to health facilities.
Objective: Therefore, the aim of this paper is to analyse the effect of COVID-19 on the trend of TB case detection and treatment outcomes in Addis Ababa city, Ethiopia.
Methods: a quantitative retrospective comparative study was used based on an aggregate secondary data collected from the Addis Ababa Health Bureau DHIS-2 database for study period of four years (April/2018-March/2021). The Study area includes all sub-cities of Addis Ababa city. The data was collected using structured format and analysis was done by excel software.
Result. Overall,13190 TB cases were detected during COVID-19 era and 15038 in pre-COVID-19 era, representing a 12.3 % decline with P= 0.0092. Corresponded to a total of 5883 TB cases were notified in the quarters of first year intra-COVID-19 versus 7731 in pre-COVID-19 era, representing a 23% decline. The highest declination was in Q-1 and Q-2 (30% and 29.8%), respectively. And a total of 7307 TB cases were notified in the quarters of second year intra-COVID-19 versus 8123 in pre-COVID-19 era, reported a 10 % decrease. The highest increase was in Q-4 by 21.2%.
Out of the TB-treatment out-comes variables; completed, lost to follow-up and death rates had a better treatment outcomes rate during the COVID-19 period compared with the pre-COVID-19 period. Whereas treatment failure, not evaluated and moved to MDR-TB categories indicated no change. During the first year period of after the COVID-19 pandemic the treatment completed rate was higher (63.8% Vs. 60%, P=0.0001), with lower rate of lost to follow (1.8% Vs 1.9%, P=0.659) and death rate (3.8% Vs 4.8% P=0.0034) compared with the first year pre-COVID-19 period. During the second year period of after the COVID-19 pandemic TB the treatment completed rate was higher (64.5 % Vs. 62.4%, P= 0.0003), with lower rate of lost to follow (1.7% Vs 1.9%, P=0.2036) and death rate (4.3% Vs 4.6%, P=0.2232) compared with the pre-COVID-19 period.
Conclusion & recommendation
Finally, the unpredicted study finding of treatment out-comes had a potential to change the existing DOT treatment policy in Ethiopia. In a view of this, further study in a broader context at Health Minister level is recommended. Moreover, to mitigate catastrophic impact of COVID-19 pandemic on TB case-detection improving access towards quality TB care service is mandatory to increase TB detection. Ultimately, able to reverse the catastrophic impact of COVID-19 pandemic on TB care program activities in Addis Ababa, Ethiopia.................. Thesis available at Addis Continental Institute of Public Health Library