SynthesisBMC medicine2022
Inequalities in the impact of COVID-19-associated disruptions on tuberculosis diagnosis by age and sex in 45 high TB burden countries.
Synthesis in BMC medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it, 20 citations in OpenAlex.
- Differences in tuberculosis prevalence by sex in low- and middle-income countries over 1993-2025: A systematic review and meta-analysis.PLoS medicine · 2026Pooled it
- Impact of the COVID-19 pandemic on tuberculosis program performance in Alberta, Canada: a population-based evaluation.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2025Article
- Predicting the Incidence Rate of Tuberculosis in Western Iran Using Time Series Models Before and After COVID-19.Medical journal of the Islamic Republic of Iran · 2025Article
- The impact of the COVID-19 pandemic on tuberculosis treatment outcomes in 49 high burden countries.BMC medicine · 2024Article
- COVID-19 and Tuberculosis: Mathematical Modeling of Infection Spread Taking into Account Reduced Screening.Diagnostics (Basel, Switzerland) · 2024Article
- Community-based active-case finding for tuberculosis: navigating a complex minefield.BMC global and public health · 2024Review
- The global impact of COVID-19 on tuberculosis: A thematic scoping review, 2020-2023.PLOS global public health · 2024Article
- A Key Role of CD8+ T Cells in Controlling of Tuberculosis Infection.Diagnostics (Basel, Switzerland) · 2023Article
- Global-, Regional-, and National-Level Impacts of the COVID-19 Pandemic on Tuberculosis Diagnoses, 2020-2021.Microorganisms · 2023Article
- What clinic closure reveals about care for drug-resistant TB: a qualitative study.BMC infectious diseases · 2023Article
- Impact of the COVID-19 Pandemic on Tuberculosis Testing and Treatment at a Tertiary Hospital in Zambia.The American journal of tropical medicine and hygiene · 2023Article
- Pediatric Post-TB Lung Disease: Ready for Prime Time?American journal of respiratory and critical care medicine · 2023Article
- Impact of COVID-19 pandemic on Tuberculosis and HIV services in Ghana: An interrupted time series analysis.PloS one · 2023Article
- COVID-19 andWestern Pacific surveillance and response journal : WPSARArticle
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 2 countries.
Funding
Abstract
backgroundTuberculosis remains a major public health priority and is the second leading cause of mortality from infectious disease worldwide. TB case detection rates are unacceptably low for men, the elderly and children. Disruptions in TB services due to the COVID-19 pandemic may have exacerbated these and other inequalities.
methodsWe modelled trends in age- and sex- disaggregated case notifications for all forms of new and relapse TB reported to the World Health Organization for 45 high TB, TB/HIV and MDR-TB burden countries from 2013 to 2019. We compared trend predicted notifications to observed notifications in 2020 to estimate the number of people with TB likely to have missed or delayed diagnosis. We estimated the risk ratio (RR) of missed or delayed TB diagnosis for children (aged < 15 years) or the elderly (aged ≥ 65 years) compared to adults (aged 15-64 years) and women compared to men (both aged ≥ 15 years) using a random-effects meta-analysis.
resultsAn estimated 195,449 children (95% confidence interval, CI: 189,673-201,562, 37.8% of an expected 517,168), 1,126,133 adults (CI: 1,107,146-1,145,704, 21.8% of an expected 5,170,592) and 235,402 elderly (CI: 228,108-243,202, 28.5% of an expected 826,563) had a missed or delayed TB diagnosis in 2020. This included 511,546 women (CI: 499,623-523,869, 22.7%, of an expected 2,250,097) and 863,916 men (CI: 847,591-880,515, 23.0% of an expected 3,763,363). There was no evidence globally that the risk of having TB diagnosis missed or delayed was different for children and adults (RR: 1.09, CI: 0.41-2.91), the elderly and adults (RR: 1.40, CI: 0.62-3.16) or men and women (RR: 0.59, CI: 0.25-1.42). However, there was evidence of disparities in risk by age and/or sex in some WHO regions and in most countries.
conclusionsThere is no evidence at an aggregate global level of any difference by age or sex in the risk of disruption to TB diagnosis as a result of the COVID-19 pandemic. However, in many countries, disruptions in TB services have been greater for some groups than others. It is important to recognise these context-specific inequalities when prioritising key populations for catch-up campaigns.
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