Impact of COVID-19 on Tuberculosis Case Detection and Treatment Outcomes in Sierra Leone
The COVID-19 pandemic has adversely affected tuberculosis (TB) care delivery in high burden countries. We therefore conducted a retrospective study to assess the impact of COVID-19 on TB case detection and treatment outcomes at the Chest Clinic at Connaught Hospital in Freetown, Sierra Leone. Overal...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-08-01
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| Series: | Tropical Medicine and Infectious Disease |
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| Online Access: | https://www.mdpi.com/2414-6366/6/3/154 |
| _version_ | 1827681194359128064 |
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| author | Sulaiman Lakoh Darlinda F. Jiba Mamadu Baldeh Olukemi Adekanmbi Umu Barrie Alhassan L. Seisay Gibrilla F. Deen Robert A. Salata George A. Yendewa |
| author_facet | Sulaiman Lakoh Darlinda F. Jiba Mamadu Baldeh Olukemi Adekanmbi Umu Barrie Alhassan L. Seisay Gibrilla F. Deen Robert A. Salata George A. Yendewa |
| author_sort | Sulaiman Lakoh |
| collection | DOAJ |
| description | The COVID-19 pandemic has adversely affected tuberculosis (TB) care delivery in high burden countries. We therefore conducted a retrospective study to assess the impact of COVID-19 on TB case detection and treatment outcomes at the Chest Clinic at Connaught Hospital in Freetown, Sierra Leone. Overall, 2300 presumptive cases were tested during the first three quarters of 2020 (intra-COVID-19) versus 2636 in 2019 (baseline), representing a 12.7% decline. Testing declined by 25% in women, 20% in children and 81% in community-initiated referrals. Notwithstanding, laboratory-confirmed TB cases increased by 37.0% and treatment success rate was higher in 2020 (55.6% vs. 46.7%, <i>p</i> = 0.002). Multivariate logistic regression analysis found that age < 55 years (aOR 1.74, 95% CI (1.80, 2.56); <i>p</i> = 0.005), new diagnosis (aOR 1.69, 95% CI (1.16, 2.47); <i>p</i> = 0.007), pulmonary TB (aOR 3.17, 95% CI (1.67, 6.04); <i>p</i> < 0.001), HIV negative status (aOR 1.60, 95%CI (1.24, 2.06); <i>p</i> < 0.001) and self-administration of anti-TB drugs through monthly dispensing versus directly observed therapy (DOT) (aOR 1.56, 95% CI (1.21, 2.03); <i>p</i> = 0.001) independently predicted treatment success. These findings may have policy implications for DOTS in this setting and suggest that more resources are needed to reverse the negative impact of the COVID-19 pandemic on TB program activities in Sierra Leone. |
| first_indexed | 2024-03-10T07:09:52Z |
| format | Article |
| id | doaj.art-a6e1753e8a304541be24646d01bc0e96 |
| institution | Directory Open Access Journal |
| issn | 2414-6366 |
| language | English |
| last_indexed | 2024-03-10T07:09:52Z |
| publishDate | 2021-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Tropical Medicine and Infectious Disease |
| spelling | doaj.art-a6e1753e8a304541be24646d01bc0e962023-11-22T15:32:29ZengMDPI AGTropical Medicine and Infectious Disease2414-63662021-08-016315410.3390/tropicalmed6030154Impact of COVID-19 on Tuberculosis Case Detection and Treatment Outcomes in Sierra LeoneSulaiman Lakoh0Darlinda F. Jiba1Mamadu Baldeh2Olukemi Adekanmbi3Umu Barrie4Alhassan L. Seisay5Gibrilla F. Deen6Robert A. Salata7George A. Yendewa8College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra LeoneConnaught Hospital, University of Sierra Leone Teaching Hospitals Complex, Ministry of Health and Sanitation, Freetown, Sierra LeoneConnaught Hospital, University of Sierra Leone Teaching Hospitals Complex, Ministry of Health and Sanitation, Freetown, Sierra LeoneCollege of Medicine, University of Ibadan, Ibadan, NigeriaInfectious Disease Research Network, Freetown, Sierra LeoneNational Tuberculosis and Leprosy Control Program, Ministry of Health and Sanitation, Freetown, Sierra LeoneCollege of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra LeoneDepartment of Medicine, Case Western Reserve University School of Medicine, Cleveland, OH 44106, USADepartment of Medicine, Case Western Reserve University School of Medicine, Cleveland, OH 44106, USAThe COVID-19 pandemic has adversely affected tuberculosis (TB) care delivery in high burden countries. We therefore conducted a retrospective study to assess the impact of COVID-19 on TB case detection and treatment outcomes at the Chest Clinic at Connaught Hospital in Freetown, Sierra Leone. Overall, 2300 presumptive cases were tested during the first three quarters of 2020 (intra-COVID-19) versus 2636 in 2019 (baseline), representing a 12.7% decline. Testing declined by 25% in women, 20% in children and 81% in community-initiated referrals. Notwithstanding, laboratory-confirmed TB cases increased by 37.0% and treatment success rate was higher in 2020 (55.6% vs. 46.7%, <i>p</i> = 0.002). Multivariate logistic regression analysis found that age < 55 years (aOR 1.74, 95% CI (1.80, 2.56); <i>p</i> = 0.005), new diagnosis (aOR 1.69, 95% CI (1.16, 2.47); <i>p</i> = 0.007), pulmonary TB (aOR 3.17, 95% CI (1.67, 6.04); <i>p</i> < 0.001), HIV negative status (aOR 1.60, 95%CI (1.24, 2.06); <i>p</i> < 0.001) and self-administration of anti-TB drugs through monthly dispensing versus directly observed therapy (DOT) (aOR 1.56, 95% CI (1.21, 2.03); <i>p</i> = 0.001) independently predicted treatment success. These findings may have policy implications for DOTS in this setting and suggest that more resources are needed to reverse the negative impact of the COVID-19 pandemic on TB program activities in Sierra Leone.https://www.mdpi.com/2414-6366/6/3/154tuberculosisCOVID-19services utilizationresource-limited settingsSierra Leone |
| spellingShingle | Sulaiman Lakoh Darlinda F. Jiba Mamadu Baldeh Olukemi Adekanmbi Umu Barrie Alhassan L. Seisay Gibrilla F. Deen Robert A. Salata George A. Yendewa Impact of COVID-19 on Tuberculosis Case Detection and Treatment Outcomes in Sierra Leone Tropical Medicine and Infectious Disease tuberculosis COVID-19 services utilization resource-limited settings Sierra Leone |
| title | Impact of COVID-19 on Tuberculosis Case Detection and Treatment Outcomes in Sierra Leone |
| title_full | Impact of COVID-19 on Tuberculosis Case Detection and Treatment Outcomes in Sierra Leone |
| title_fullStr | Impact of COVID-19 on Tuberculosis Case Detection and Treatment Outcomes in Sierra Leone |
| title_full_unstemmed | Impact of COVID-19 on Tuberculosis Case Detection and Treatment Outcomes in Sierra Leone |
| title_short | Impact of COVID-19 on Tuberculosis Case Detection and Treatment Outcomes in Sierra Leone |
| title_sort | impact of covid 19 on tuberculosis case detection and treatment outcomes in sierra leone |
| topic | tuberculosis COVID-19 services utilization resource-limited settings Sierra Leone |
| url | https://www.mdpi.com/2414-6366/6/3/154 |
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