Impact of the COVID-19 pandemic on tuberculosis services

BACKGROUND: In Portugal, Outpatient Tuberculosis Centres (OTBC) are responsible for the diagnosis, treatment, screening and prevention of tuberculosis (TB), and only severe or resistant cases are hospitalized. AIM: To understand how infection control norms and standards were applied and how these centres responded during the pandemic. METHOD: We sent an electronic questionnaire to all coordinators of OTBC. The questionnaire included questions on infection control during the COVID-19 pandemic and evaluation of the functioning of the OTBC in two periods: during the 1(st) National State of Emergency and after 1 year. RESULTS: Thirty-two responses were obtained (52.5%). The infection control norms were globally applied; diagnosis, treatment, and prevention were kept, and contact screening was only affected during the 1(st) State of Emergency. However, half of the respondents (53.1%) believed that there were diagnostic delays during the 1(st) State of Emergency, rising to 68.8% after 1 year. Only 31.3% performed Directly Observed Therapy (DOT) in all patients during the 1(st) State of Emergency, and 59.4% after 1 year. Half the inquiries expected an increase in TB incidence in the near future. CONCLUSION: The pandemic affected OTBC functioning, although the services were kept open; diagnostic delay and DOT appliance were the most affected.