Effects of Coronavirus Disease Pandemic on Tuberculosis Notifications, Malawi

Emerg Infect Dis. 2021 Jul;27(7):1831-1839. doi: 10.3201/eid2707.210557.

Abstract

The coronavirus disease (COVID-19) pandemic might affect tuberculosis (TB) diagnosis and patient care. We analyzed a citywide electronic TB register in Blantyre, Malawi and interviewed TB officers. Malawi did not have an official COVID-19 lockdown but closed schools and borders on March 23, 2020. In an interrupted time series analysis, we noted an immediate 35.9% reduction in TB notifications in April 2020; notifications recovered to near prepandemic numbers by December 2020. However, 333 fewer cumulative TB notifications were received than anticipated. Women and girls were affected more (30.7% fewer cases) than men and boys (20.9% fewer cases). Fear of COVID-19 infection, temporary facility closures, inadequate personal protective equipment, and COVID-19 stigma because of similar symptoms to TB were mentioned as reasons for fewer people being diagnosed with TB. Public health measures could benefit control of both TB and COVID-19, but only if TB diagnostic services remain accessible and are considered safe to attend.

Keywords: COVID-19; SARS; SARS-CoV-2; bacteria; coronavirus; coronavirus disease; disease surveillance; health systems; respiratory infections; severe acute respiratory syndrome coronavirus 2; tuberculosis; viruses; zoonoses.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • COVID-19*
  • Communicable Disease Control
  • Female
  • Humans
  • Malawi / epidemiology
  • Male
  • Pandemics
  • SARS-CoV-2
  • Tuberculosis* / diagnosis
  • Tuberculosis* / epidemiology