AUTHOR=Masina Hloniphile Victory , Lin I-Feng , Chien Li-Yin 

TITLE=The Impact of the COVID-19 Pandemic on Tuberculosis Case Notification and Treatment Outcomes in Eswatini

JOURNAL=International Journal of Public Health

VOLUME=Volume 67 - 2022

YEAR=2022

URL=https://www.ssph-journal.org/journals/international-journal-of-public-health/articles/10.3389/ijph.2022.1605225

DOI=10.3389/ijph.2022.1605225

ISSN=1661-8564

ABSTRACT=Objectives: We investigated the impact of COVID-19 on tuberculosis (TB) case notification and treatment outcomes in Eswatini.
Methods: A comparative retrospective cohort study was conducted using TB data from eight facilities. An interrupted time series analysis, using segmented Poisson regression and logistic regression was done to assess the impact of COVID-19 on TB case notification and TB treatment outcomes, respectively; comparing period before (December 2018-February 2020, n=1050) and during the pandemic (March 2020-May 2021, n=690). Case notification was defined as number of TB cases diagnosed. Treatment outcomes was result assigned to patients at the end of treatment according to WHO rules. 
Results: There was a significant drop in TB case notification (IRR 0.58, 95% CI: 0.46-0.73) and a significant increase in death rate among registrants during the pandemic (21.59%) compared to pre-pandemic (8.68%, p<0.01). Logistic regression indicated higher odds of unfavorable outcomes (death, lost-to-follow-up, and not evaluated) during the pandemic than pre pandemic (adjusted OR 2.68, 95% CI: 1.99-3.61).  
Conclusions: COVID-19 negatively impacted TB services in Eswatini. Eswatini should invest in strategies to safe-guard the health system against similar pandemics.