Unmasking the effects of the COVID-19 pandemic on tuberculosis diagnosis and care in Bungoma County, Kenya

Abstract

INTRODUCTION

After the declaration of COVID-19 as a pandemic by the World Health Organization (WHO) in March 2020, the global focus solely shifted to fighting the pandemic. Tuberculosis (TB) services were affected in that the number of newly diagnosed tuberculosis patients decreased from 7.1 million in 2019 to 5.8 million in 2020. This study investigated the effects of COVID-19 on the diagnosis of tuberculosis patients and their treatment outcomes in Bungoma County, Kenya

MATERIALS AND METHODS

A retrospective cohort study was conducted using TB data from all health facilities in Bungoma County. A total of 5,981 TB patient records were collected, 3337 before COVID-19 and 2644 during COVID-19. An interrupted time series analysis was done to assess the impact of COVID-19 on TB case notification, comparing the period before COVID-19 (April 2018–March 2020) and during the pandemic (April 2020–March 2022). TB cases diagnosed were defined as the number of clinically diagnosed and bacteriologically confirmed TB treatment patients. Treatment outcomes were assigned to patients at the end of treatment according to WHO guideline. Data analysis on proportions was done using Epi Info 7 software.

RESULTS

The number of new patients diagnosed during the pandemic dropped compared to the period before the pandemic. The cure rate among the bacteriologically confirmed patients decreased from 86.9% before COVID-19 to 66.9% during COVID-19. The death rate among the patients increased during the COVID-19 pandemic to 10.8%, compared to 9.3% before the pandemic.

CONCLUSIONS AND RECOMMENDATIONS

COVID-19 not only negatively impacted the number of TB patients diagnosed in Bungoma County but also led to an increase in unfavorable TB patient outcomes. Bungoma County should invest in strategies to safeguard the health system in the future against similar pandemics.