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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...

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Autores principales: Jackson, Peter D., Muyanja, Stella Zawedde, Sekitoleko, Isaac, Bbuye, Mudarshiru, Helwig, Madeline, Padalkar, Roma, Hammad, Mariam, Hopkinson, Dennis, Siddharthan, Trishul
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
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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.
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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
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