Cargando…
Risk factors for disruptions in tuberculosis care in Uganda during the COVID-19 pandemic
Background: During the COVID-19 pandemic, TB mortality increased while diagnoses decreased, likely due to care disruption. In March, 2020, Uganda—a country with high TB burden, implemented a COVID-19 lockdown with associated decrease in TB diagnoses. This study aims to examine patient level risk fac...
Autores principales: | , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2023
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10237487/ https://www.ncbi.nlm.nih.gov/pubmed/37267249 http://dx.doi.org/10.1371/journal.pgph.0001573 |
_version_ | 1785053166789722112 |
---|---|
author | Jackson, Peter D. Muyanja, Stella Zawedde Sekitoleko, Isaac Bbuye, Mudarshiru Helwig, Madeline Padalkar, Roma Hammad, Mariam Hopkinson, Dennis Siddharthan, Trishul |
author_facet | Jackson, Peter D. Muyanja, Stella Zawedde Sekitoleko, Isaac Bbuye, Mudarshiru Helwig, Madeline Padalkar, Roma Hammad, Mariam Hopkinson, Dennis Siddharthan, Trishul |
author_sort | Jackson, Peter D. |
collection | PubMed |
description | Background: During the COVID-19 pandemic, TB mortality increased while diagnoses decreased, likely due to care disruption. In March, 2020, Uganda—a country with high TB burden, implemented a COVID-19 lockdown with associated decrease in TB diagnoses. This study aims to examine patient level risk factors for disruption in TB care during the COVID-19 pandemic in Uganda. This retrospective cross-sectional cohort study included six TB clinics in Uganda. Clustered sampling included phases of TB care and three time-periods: pre-lockdown, lockdown and post-lockdown. Characteristics of patients with TB care disruption (TBCD), defined as those with > 2 months of symptoms prior to diagnosis or who missed a TB clinic, and those without TB care disruption (non-TBCD) were analyzed between time-periods. 1,624 charts were reviewed; 1322 were contacted, 672 consented and completed phone interview; pre-lockdown (n = 213), lockdown (n = 189) and post-lockdown (n = 270). TBCD occurred in 57% (385/672) of patients. There was an increase in the proportion of urban patients in the TBCD and non-TBCD groups during post-lockdown (p <0.001). There was no difference in demographics, HIV co-infection, socioeconomic status, or distance to TB clinic between TBCD and non-TBCD groups or within TBCD by time-period. There were few differences amongst TBCD and all TB patients by time-period. The increase in urban patients’ post-lockdown may represent a portion of urban patients who delayed care until post-lockdown. Insignificant trends suggesting more TBCD amongst those who lived further from clinics and those without HIV-coinfection require more investigation. |
format | Online Article Text |
id | pubmed-10237487 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-102374872023-06-03 Risk factors for disruptions in tuberculosis care in Uganda during the COVID-19 pandemic Jackson, Peter D. Muyanja, Stella Zawedde Sekitoleko, Isaac Bbuye, Mudarshiru Helwig, Madeline Padalkar, Roma Hammad, Mariam Hopkinson, Dennis Siddharthan, Trishul PLOS Glob Public Health Research Article Background: During the COVID-19 pandemic, TB mortality increased while diagnoses decreased, likely due to care disruption. In March, 2020, Uganda—a country with high TB burden, implemented a COVID-19 lockdown with associated decrease in TB diagnoses. This study aims to examine patient level risk factors for disruption in TB care during the COVID-19 pandemic in Uganda. This retrospective cross-sectional cohort study included six TB clinics in Uganda. Clustered sampling included phases of TB care and three time-periods: pre-lockdown, lockdown and post-lockdown. Characteristics of patients with TB care disruption (TBCD), defined as those with > 2 months of symptoms prior to diagnosis or who missed a TB clinic, and those without TB care disruption (non-TBCD) were analyzed between time-periods. 1,624 charts were reviewed; 1322 were contacted, 672 consented and completed phone interview; pre-lockdown (n = 213), lockdown (n = 189) and post-lockdown (n = 270). TBCD occurred in 57% (385/672) of patients. There was an increase in the proportion of urban patients in the TBCD and non-TBCD groups during post-lockdown (p <0.001). There was no difference in demographics, HIV co-infection, socioeconomic status, or distance to TB clinic between TBCD and non-TBCD groups or within TBCD by time-period. There were few differences amongst TBCD and all TB patients by time-period. The increase in urban patients’ post-lockdown may represent a portion of urban patients who delayed care until post-lockdown. Insignificant trends suggesting more TBCD amongst those who lived further from clinics and those without HIV-coinfection require more investigation. Public Library of Science 2023-06-02 /pmc/articles/PMC10237487/ /pubmed/37267249 http://dx.doi.org/10.1371/journal.pgph.0001573 Text en © 2023 Jackson et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Jackson, Peter D. Muyanja, Stella Zawedde Sekitoleko, Isaac Bbuye, Mudarshiru Helwig, Madeline Padalkar, Roma Hammad, Mariam Hopkinson, Dennis Siddharthan, Trishul Risk factors for disruptions in tuberculosis care in Uganda during the COVID-19 pandemic |
title | Risk factors for disruptions in tuberculosis care in Uganda during the COVID-19 pandemic |
title_full | Risk factors for disruptions in tuberculosis care in Uganda during the COVID-19 pandemic |
title_fullStr | Risk factors for disruptions in tuberculosis care in Uganda during the COVID-19 pandemic |
title_full_unstemmed | Risk factors for disruptions in tuberculosis care in Uganda during the COVID-19 pandemic |
title_short | Risk factors for disruptions in tuberculosis care in Uganda during the COVID-19 pandemic |
title_sort | risk factors for disruptions in tuberculosis care in uganda during the covid-19 pandemic |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10237487/ https://www.ncbi.nlm.nih.gov/pubmed/37267249 http://dx.doi.org/10.1371/journal.pgph.0001573 |
work_keys_str_mv | AT jacksonpeterd riskfactorsfordisruptionsintuberculosiscareinugandaduringthecovid19pandemic AT muyanjastellazawedde riskfactorsfordisruptionsintuberculosiscareinugandaduringthecovid19pandemic AT sekitolekoisaac riskfactorsfordisruptionsintuberculosiscareinugandaduringthecovid19pandemic AT bbuyemudarshiru riskfactorsfordisruptionsintuberculosiscareinugandaduringthecovid19pandemic AT helwigmadeline riskfactorsfordisruptionsintuberculosiscareinugandaduringthecovid19pandemic AT padalkarroma riskfactorsfordisruptionsintuberculosiscareinugandaduringthecovid19pandemic AT hammadmariam riskfactorsfordisruptionsintuberculosiscareinugandaduringthecovid19pandemic AT hopkinsondennis riskfactorsfordisruptionsintuberculosiscareinugandaduringthecovid19pandemic AT siddharthantrishul riskfactorsfordisruptionsintuberculosiscareinugandaduringthecovid19pandemic |