The impact of the COVID-19 epidemic on tuberculosis control in China.

Fei, Huang; Yinyin, Xia; Hui, Chen; Ni, Wang; Xin, Du; Wei, Chen; Tao, Li; Shitong, Huan et al. · Lancet Reg Health West Pac · 2020

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Abstract

In response to the COVID-19 epidemic, China implemented a series of interventions that impacted tuberculosis (TB) control in the country. Based on routine surveillance data and questionnaires, the study analyzed TB notification, follow-up examinations, and treatment outcomes. The data were split into three phases in relation to outbreak, lockdown and reopen when the nationwide COVID-19 response started in 2020: control (11 weeks prior), intensive (11 weeks during and immediately after), and regular (4 additional weeks). Data from 2017-2019 were used as baseline. The notified number of TB patients decreased sharply in the 1<sup>st</sup> week of the intensive period but took significantly longer to rebound in 2020 compared with baseline. The percentages of TB patients undergoing sputum examination within one week after 2 months treatment and full treatment course in the intensive period were most affected and decreased by 8% in comparison with control period. 75•2% (221/294) of counties reallocated CDC and primary health care workers to fight the COVID-19 epidemic, 26•9% (725/2694) of TB patients had postponed or missed their follow-up examinations due to travel restrictions and fear of contracting COVID-19. In the short term, the COVID-19 epidemic mostly affected TB notification and follow-up examinations in China, which may lead to a surge of demand for TB services in the near future. To cope with this future challenge, an emergency response mechanism for TB should be established. National Health Commission of China-Bill & Melinda Gates Foundation TB Collaboration project (OPP1137180).