PDF(Pubmed)
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 was done to assess the impact of COVID-19 on TB case notification comparing period before (December 2018-February 2020, n = 1,560) and during the pandemic (March 2020-May 2021, n = 840). Case notification was defined as number of TB cases registered in the TB treatment register. Treatment outcomes was result assigned to patients at the end of treatment according to WHO rules. Results: There was a significant decrease in TB case notification (IRR 0.71, 95% CI: 0.60-0.83) and a significant increase in death rate among registrants during the pandemic (21.3%) compared to pre-pandemic (10.8%, 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 (aOR 2.91, 95% CI: 2.17-3.89). Conclusion: COVID-19 negatively impacted TB services in Eswatini. Eswatini should invest in strategies to safe-guard the health system against similar pandemics.
摘要：
目标：我们调查了COVID-19对Eswatini结核病（TB）病例通知和治疗结果的影响。方法：使用来自8个机构的TB数据进行比较回顾性队列研究。中断的时间序列分析，使用分段泊松回归评估COVID-19对结核病病例通报的影响,比较了大流行前(2018年12月至2020年2月,n=1,560)和大流行期间(2020年3月至2021年5月,n=840).病例通知定义为在结核病治疗登记册中登记的结核病病例数。根据WHO规则在治疗结束时将治疗结果分配给患者。结果：与大流行前相比，大流行期间结核病病例通报显着减少（IRR0.71，95％CI：0.60-0.83），注册人的死亡率显着增加（21.3％）（10.8％，p<0.01)。Logistic回归显示不良结局的几率较高(死亡，失访，且未评估）在大流行期间比大流行前（aOR2.91，95%CI：2.17-3.89）。结论：COVID-19对埃斯瓦蒂尼的结核病服务产生负面影响。埃斯瓦蒂尼应该投资于战略，以保护卫生系统免受类似流行病的侵害。
