Predicting the Incidence Rate of Tuberculosis in Western Iran Using Time Series Models Before and After COVID-19.

Background: Understanding the temporal variation and forecasting the incidence rate of smear-positive tuberculosis may be very helpful in promoting tuberculosis (TB) control initiatives. Therefore, predicting the incidence rate of TB before and after coronavirus disease 2019 (COVID-19) was the aim of this study. Methods: This retrospective study was carried out utilizing data from Iran's National TB Control Program and the monthly TB incidence statistics from April 2005 to March 2021 in Kurdistan Province. There were 192 time points in total cases that were registered each month. Autoregressive Integrated Moving Average (ARIMA) models and interrupted time series were used in the study. Results: The findings demonstrated that TB incidence was declining before the COVID-19 pandemic. However, despite the COVID-19 pandemic, the number of TB diagnoses has unexpectedly declined. During the 26 months of the pandemic, 8 cases of total TB cases, 6 cases of pulmonary TB cases, and 3 cases of extrapulmonary TB cases were detected, while predicted an average number of TB cases during the 26 months of the pandemic is 15 cases per 100,000 for total TB cases, 10 cases per 100,000 for pulmonary TB cases, and 3 cases per 100,000 people for extrapulmonary TB. Conclusion: Our results show that TB patient detection in the Kurdistan region has become significantly more challenging because of the COVID-19 epidemic. In the event that the pandemic persists or recurs in the future, guidelines should be developed to protect these essential services.