Background: Multidrug resistant tuberculosis (MDR-TB) is a global public health threat. In 2021, an incidence of 3.6% was reported among new TB patients, and 18% was reported among previously treated patients. The emergence of the COVID-19 pandemic impacted the health sector, although little is known about the effect of restrictive COVID-19 measures on MDR-TB case notifications and treatment outcomes in Uganda. This study aimed to assess the effect of COVID-19 restriction measures on MDR-TB case notifications and treatment outcomes at treatment centres in Uganda.
Methods: This was a retrospective cohort study in which a total of 483 participants were enrolled-238 before (March 2018-February 2020) and 245 during (March 2020-February 2022) COVID-19 restrictions. The data were extracted from the Drug-Resistant Tuberculosis (DR-TB) Health Management Information System (HMIS), and patient charts, and census sampling was employed. Interrupted time series (ITSA) was used to compare MDR-TB case notifications and treatment outcomes.
Results: Before the COVID-19 restrictions, the majority 58.0% were aged less than or equal to 38 years whereas during the restrictions, the majority 51.8% were aged greater than 38 years. A total of 238 cases of MDRTB were reported before, and 245 cases were reported during the restrictions. There was no immediate (β2; 0.134) or sustained (β3; 0.494) impact of COVID-19 restriction measures on monthly MDR-TB case notifications. The mean number of monthly MDR-TB notifications was similar for the 3-month period before (11.0 cases per month) and during (10.0 cases per month) the COVID-19 restrictions (p-value 0.661). The proportions of patients who achieved successful MDR-TB treatment before (81.5%) and during (81.7%) COVID-19 restriction was not significantly different (p- value < 0.001). During the COVID-19 restrictions, not being married (aPR 0.85, 95% CI: 0.74-0.97) and treatment delay greater than 7 days (aPR 0.87, 95% CI 0.78-0.96) were negatively associated with successful treatment outcomes.
Conclusion: Restrictive COVID-19 measures did not affect MDR-TB case notifications or treatment outcomes. Not being married and having a treatment delay greater than 7 days reduced the chances of a successful treatment outcome during COVID-19. The WHO and MoH should continue strengthening active case finding, contact screening and community engagement to consolidate MDR-TB control and management in preparation for similar future pandemics.
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http://dx.doi.org/10.1186/s12879-024-10330-2 | DOI Listing |
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11653593 | PMC |
J Infect Public Health
December 2024
Ecosystem Change and Population Health Research Group, School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia. Electronic address:
Background: During the COVID-19 pandemic, seasonal influenza virus circulation was heavily suppressed worldwide. In Australia, since the virus re-emerged in 2022, shifts in seasonal influenza patterns have been observed. Both the 2022 and 2023 seasons started earlier than pre-pandemic norms and were categorised as moderate to severe, highlighting the renewed importance of prevention strategies for seasonal influenza.
View Article and Find Full Text PDFLancet Glob Health
January 2025
Sheffield Centre for Health and Related Research, School of Medicine and Population Health, University of Sheffield, Sheffield, UK.
Background: Tuberculous meningitis is fatal if untreated and can lead to lifelong neurological sequelae. However, to our knowledge, there are no data on the number of children affected by this disease. We aimed to estimate the global disease burden and attributable mortality of childhood tuberculous meningitis by WHO regions, age groups, treatment status, and HIV status in 2019.
View Article and Find Full Text PDFPLoS One
December 2024
Department of Health Policy, Planning and Management, Makerere University School of Public Health, Kampala, Uganda.
Introduction: Private Health Facilities (PHFs), Uganda's main healthcare providers, are indispensable stakeholders in the national tuberculosis (TB) program's efforts to improve TB case notification and combat the epidemic. However, notification rates remain relatively low in PHFs compared to public providers. In this study, we sought to assess facilitators and barriers to TB case notification among private facilities in Kampala Capital City.
View Article and Find Full Text PDFBMC Med Genomics
December 2024
Centre for Molecular Biology, Central University of Jammu, Jammu, UT Jammu and Kashmir, 181143, India.
Background: Hypertension (HTN) is a medical condition characterized by persistent systolic and diastolic blood pressures of ≥ 140 mmHg and ≥ 90 mmHg, respectively. With more than 1200 million adult patients aged 30-79 years worldwide according to the latest WHO data, HTN is a major health risk factor; more importantly, 46% of patients are unaware of this condition. Essential hypertension (EH), also known as primary hypertension, is the predominant subtype and has a complex etiology that involves both genetic and non-genetic factors.
View Article and Find Full Text PDFBMC Public Health
December 2024
WHO Health Emergencies Programme, WHO Country Office in Yemen, Sana'a, Yemen.
Background: The international health emergency caused by the emergence of the SARS-CoV-2 virus demonstrated the expanding usefulness of multi-country disease outbreak information gathered through event-based surveillance (EBS) as an extension beyond the main purposes of early warning, alert, and response (EWAR). In this article, previous events of multi-country outbreaks from 2010-2019 were reviewed for how EBS, within an expanded sphere of Epidemic Intelligence (EI), may help to enhance the understanding of outbreaks for a more timely and nuanced, multiple-point trigger approach to health emergencies.
Methods: The public, open-source database of ProMed reports were reviewed for the date of first notification on major outbreaks of infectious diseases and then compared for subsequent dates of any new, exceptional epidemiological findings (novel host, settings, transmission characteristics) as a determining factor for prolonged, multi-country events later acknowledged on the WHO disease outbreak news (DON) website, or by peer-reviewed journal publication if no related DON information became available.
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