Evidence map›Paper›PMID 39259735›Full record

Observational studyPloS one2024

A decline in tuberculosis diagnosis, treatment initiation and success during the COVID-19 pandemic, using routine health data in Cape Town, South Africa.

Karen Jennings, Martina Lembani, Anneke C Hesseling, Nyameka Mbula, Erika Mohr-Holland, Vanessa Mudaly, Mariette Smith, Muhammad Osman, Sue-Ann Meehan

Erratum issuedAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in PloS one, 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 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

  1. Article
  2. Article
  3. Infection prevention and control measures during the COVID-19 pandemic and airborne tuberculosis transmission during primary care visits in South Africa.International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases · 2025
    Article
  4. Article
  5. Article
  6. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors.

Karen JenningsCity of Cape Town Health Department, Specialised Health, HIV/STI/TB Unit, Cape Town, South Africa.
Martina LembaniSchool of Public Health, University of Western Cape, Cape Town, South Africa.ORCID 0000-0002-6831-4220
Anneke C HesselingDepartment of Paediatrics and Child Health, Desmond Tutu TB Centre, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
Nyameka MbulaDepartment of Health and Wellness, Provincial Government of the Western Cape, Cape Town, South Africa.
Erika Mohr-HollandCity of Cape Town Health Department, Specialised Health, Epidemiology Unit, Cape Town, South Africa.
Vanessa MudalyDepartment of Health and Wellness, Provincial Government of the Western Cape, Cape Town, South Africa.ORCID 0009-0008-4235-230X
Mariette SmithDepartment of Health and Wellness, Provincial Government of the Western Cape, Cape Town, South Africa.
Muhammad OsmanDepartment of Paediatrics and Child Health, Desmond Tutu TB Centre, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
Sue-Ann MeehanDepartment of Paediatrics and Child Health, Desmond Tutu TB Centre, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.ORCID 0000-0002-0826-1833

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCoronavirus disease (COVID-19) negatively impacted tuberculosis (TB) programs which were already struggling to meet End-TB targets globally. We aimed to quantify and compare diagnosis, treatment initiation, treatment success, and losses along this TB care cascade for drug-susceptible TB in Cape Town, South Africa, prior to and during COVID-19.

methodsThis observational study used routine TB data within two predefined cohorts: pre-COVID-19 (1 October 2018-30 September 2019) and during-COVID-19 (1 April 2020-31 March 2021). The numbers of people diagnosed, treated for TB and successfully treated were received from the Western Cape Provincial Health Data Centre. Pre and post treatment loss to follow up and cascade success rates (proportion of individuals diagnosed with an outcome of treatment success) were calculated and compared across cohorts, disaggregated by sex, age, HIV status, TB treatment history and mode of diagnosis.

resultsThere were 27,481 and 19,800 individuals diagnosed with drug-susceptible TB in the pre- and during-COVID-19 cohorts respectively, a relative reduction of 28% (95% CI [27.4% - 28.5%]). Initial loss to follow up increased from 13.4% to 15.2% (p<0.001), while post treatment loss increased from 25.2% to 26.1% (p < 0.033). The overall cascade success rate dropped by 2.1%, from 64.8% to 62.7% (p< 0.001). Pre- and during-COVID-19 cascade success rates were negatively associated with living with HIV and having recurrent TB.

conclusionsAn already poorly performing TB program in Cape Town was negatively impacted by the COVID-19 pandemic. There was a substantial reduction in the number of individuals diagnosed with drug-susceptible. Increases in pre-and post-treatment losses resulted in a decline in TB cascade success rates. Strengthened implementation of TB recovery plans is vital, as health services now face an even greater gap between achievements and targets and will need to become more resilient to possible future public health disruptions.

Indexed as

COVID-19TuberculosisAdolescentAdultAgedAntitubercular AgentsChildChild, PreschoolFemaleHIV InfectionsHumansInfantMaleMiddle AgedPandemicsSARS-CoV-2Antitubercular Agents

Identifiers

PMID39259735
PMCPMC11389921

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.