ArticleBMC medicine2024
The impact of the COVID-19 pandemic on tuberculosis treatment outcomes in 49 high burden countries.
Article in BMC medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 17 papers.
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Who cites it
17 citing papers in PubMed.
- Article
- Household costs and health-related quality of life of childhood multidrug-resistant TB in Western Cape, South Africa.IJTLD open · 2026Article
- Prevalence and determinants of unsuccessful tuberculosis treatment outcomes among children in Northern Ghana: a retrospective review.BMC infectious diseases · 2026Article
- The Dual Burden: Long-Term Impact of COVID-19 on Tuberculosis Incidence - Presentation and Outcomes.Maedica · 2026Review
- Recrudescence of tuberculosis in the state of São Paulo post-COVID-19: trends and clusters.Revista de saude publica · 2026Article
- Implementation of differentiated service delivery strategies for patients with tuberculosis in Haiti during a severe humanitarian crisis, January-August 2021.PLOS global public health · 2026Article
- Drug resistance patterns among tuberculosis patients at a tuberculosis designated hospital in Yunnan: a retrospective analysis of the 2013-2022 period.BMC infectious diseases · 2025Article
- Molecular Epidemiology ofMicroorganisms · 2025Review
- Article
- Article
- Impact of the COVID-19 pandemic on tuberculosis services in a rural area of Senegal.Le infezioni in medicina · 2025Article
- Assessment of the impact of COVID-19 on tuberculosis care at a tertiary hospital: integrating lessons from COVID-19 learned.Frontiers in public health · 2025Article
- Trends in Drug Resistance and Epidemiological Patterns of Tuberculosis in Elderly Patients in Wenzhou, China (2014-2023).Infection and drug resistance · 2025Article
- Characteristics and outcomes of in-hospital patients with Covid-19 and history of tuberculosis: a matched case-control from the Brazilian Covid-19 Registry.BMC infectious diseases · 2024Article
- Estimating the impact of the first 2 years of the COVID-19 pandemic on tuberculosis diagnosis and treatment outcomes in Southeastern City in Iran: an interrupted time series analysis of the preceding 10 years of ecological data.BMC health services research · 2024Article
- Global, regional, and national burden of tuberculosis and attributable risk factors for 204 countries and territories, 1990-2021: a systematic analysis for the Global Burden of Diseases 2021 study.BMC public health · 2024Article
- Correction: The impact of the COVID-19 pandemic on tuberculosis treatment outcomes in 49 high burden countries.BMC medicine · 2024Article
Corrections and comments
- Erratum issued
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3 authors.
Funding
Abstract
backgroundThe COVID-19 pandemic disrupted tuberculosis (TB) health services, including treatment support and access to drugs, as patients were not able to access health facilities. While the effect of this disruption on treatment outcomes has been studied in isolated treatment centres, cities and provinces, the impact of the pandemic on TB treatment outcomes at a country and regional level has not been evaluated.
methodsWe used treatment outcomes for new and relapse TB cases reported to the World Health Organization (WHO) from 49 high TB, TB/HIV and drug-resistant TB burden countries from 2012 to 2019. We developed multinomial logistic regression models for trends in TB treatment success, failure, death and loss to follow up. We predicted TB treatment outcomes for 2020 and 2021, comparing these to observations, by computing ratios between observed and predicted probabilities. We aggregated these risk ratios (RR) for six WHO-defined regions using random-effects meta-analysis.
resultsAcross 49 countries and four TB treatment outcomes, 17 (out of 196) country-outcome pairs in 2020 and 21 in 2021 had evidence of systematic differences between observed and predicted TB treatment outcome probabilities. Regionally, only four (out of 24) region-outcome pairs had evidence of systematic differences in 2020 and four in 2021, where the European region accounted for four of these in total. Globally, there was evidence of systematic differences in treatment failure in both 2020 (RR: 1.14, 95%CI: 1.01-1.28, p = 0.0381) and 2021 (RR: 1.36, 95%CI: 1.03-1.78, p = 0.0277), deaths in 2020 (RR: 1.08, 95%CI: 1.03-1.13, p = 0.0010) and losses to follow up in 2020 (RR: 0.91, 95%CI: 0.86-0.97, p = 0.0059).
conclusionsWhile for some countries and regions there were significant differences between observed and predicted treatment outcomes probabilities, there was insufficient evidence globally to identify systematic differences between observed and expected TB treatment outcome probabilities because of COVID-19-associated disruptions in general. However, larger numbers of treatment failures and deaths on treatment than expected were observed globally, suggesting a need for further investigation.
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