ArticleBMJ global health2022
COVID-19-related healthcare impacts: an uncontrolled, segmented time-series analysis of tuberculosis diagnosis services in Mozambique, 2017-2020.
Article in BMJ global health, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
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15 citing papers in PubMed, 1 synthesis or guideline pooled it, 21 citations in OpenAlex.
- Inequalities in the impact of COVID-19-associated disruptions on tuberculosis diagnosis by age and sex in 45 high TB burden countries.BMC medicine · 2022Pooled it
- Advanced statistical approaches in tuberculosis diagnosis and treatment outcomes in Africa: a systematic review.Tropical medicine and health · 2026Review
- Mortality before and during the COVID-19 pandemic in Manhiça district, Southern Mozambique.Population health metrics · 2026Article
- Feasibility and acceptability of COVID-19 self-testing offered through community screening posts in Mozambique: a mixed-methods study.BMC public health · 2026Article
- The influenza virus sentinel surveillance: results of system evaluation in Mozambique, 2016-2021.The Pan African medical journal · 2025Article
- The global impact of COVID-19 on tuberculosis: A thematic scoping review, 2020-2023.PLOS global public health · 2024Article
- A critical analysis of the decreasing trends in tuberculosis cure indicators in Brazil, 2001-2022.Jornal brasileiro de pneumologia : publicacao oficial da Sociedade Brasileira de Pneumologia e Tisilogia · 2024Article
- Global-, Regional-, and National-Level Impacts of the COVID-19 Pandemic on Tuberculosis Diagnoses, 2020-2021.Microorganisms · 2023Article
- Article
- What clinic closure reveals about care for drug-resistant TB: a qualitative study.BMC infectious diseases · 2023Article
- Effect of the COVID-19 pandemic on emergency department attendances for pediatric injuries in Mozambique's central hospitals: an interrupted time series and a comparison within the restriction periods between 2019 and 2020.Trauma surgery & acute care open · 2023Article
- COVID-19 impacts on healthcare access in sub-Saharan Africa: an overview.The journal of venomous animals and toxins including tropical diseases · 2023Article
- Early effects of COVID-19 on maternal and child health service disruption in Mozambique.Frontiers in public health · 2023Article
- Impact of COVID-19 on Tuberculosis Indicators in Brazil: A Time Series and Spatial Analysis Study.Tropical medicine and infectious disease · 2022Article
- The Impact of the COVID-19 Pandemic on Tuberculosis Case Notification and Treatment Outcomes in Eswatini.International journal of public health · 2022Article
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Authors and funding
15 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionCurrently, COVID-19 dominates the public health agenda and poses a permanent threat, leading to health systems' exhaustion and unprecedented service disruption. Primary healthcare services, including tuberculosis services, are at increased risk of facing severe disruptions, particularly in low-income and middle-income countries. Indeed, corroborating model-based forecasts, there is increasing evidence of the COVID-19 pandemic's negative impact on tuberculosis case detection.
methodsApplying a segmented time-series analysis, we assessed the effects of COVID-19-related measures on tuberculosis diagnosis service across districts in Mozambique. Ministry health information system data were used from the first quarter of 2017 to the end of 2020. The model, performed under the Bayesian premises, was estimated as a negative binomial with random effects for districts and provinces.
resultsA total of 154 districts were followed for 16 consecutive quarters. Together, these districts reported 96 182 cases of all forms of tuberculosis in 2020. At baseline (first quarter of 2017), Mozambique had an estimated incidence rate of 283 (95% CI 200 to 406) tuberculosis cases per 100 000 people and this increased at a 5% annual rate through the end of 2019. We estimated that 17 147 new tuberculosis cases were potentially missed 9 months after COVID-19 onset, resulting in a 15.1% (95% CI 5.9 to 24.0) relative loss in 2020. The greatest impact was observed in the southern region at 40.0% (95% CI 30.1 to 49.0) and among men at 15% (95% CI 4.0 to 25.0). The incidence of pulmonary tuberculosis increased at an average rate of 6.6% annually; however, an abrupt drop (15%) was also observed immediately after COVID-19 onset in March 2020.
conclusionThe most significant impact of the state of emergency was observed between April and June 2020, the quarter after COVID-19 onset. Encouragingly, by the end of 2020, clear signs of health system recovery were visible despite the initial shock.
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