Impact of COVID-19 on tuberculosis notifications

Pontes, Talita Antunes Antoniolli; Fernandez-Llimos, Fernando; Wiens, Astrid

doi:10.1590/S1678-9946202466037

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Original Article • Rev. Inst. Med. trop. S. Paulo 66 • 2024 • https://doi.org/10.1590/S1678-9946202466037 copy

Impact of COVID-19 on tuberculosis notifications

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

The COVID-19 pandemic has significantly impacted the control of diseases by overwhelming healthcare systems, and tuberculosis (TB) notifications may have been affected. This study aimed to analyze the impact of COVID-19 on TB notifications in the Sao Paulo State. This is a retrospective study examining TB notifications extracted from the TBweb database (Jan 2015 to Dec 2022). We conducted an interrupted time series (ITS) analysis of TB notifications using the declaration of the COVID-19 pandemic as the interrupting event (Bayesian causal impact analysis). A total of 177,103 notifications of TB incident cases were analyzed, revealing a significant decrease in 2020 (13%) and in 2021 (9%), which lost significance in 2022. However, changes were not associated with population density or the area of the regions. Future analyses of the effects of TB underdiagnosis might help describe the impact of underreporting on future TB incidence and mortality.

KEYWORDS:
Tuberculosis; COVID-19; Public health; Interrupted time series analysis

Year	SP State^* * incidence of tuberculosis in the immediate regions of the Sao Paulo State;	SP State w/o imprisoned^ incidence of tuberculosis in the immediate regions of the Sao Paulo State, excluding data from Imprisoned people.
Year		Overall	Median	IQR	Min.	Max.
2015	47.91	41.3	23.3	18.89 - 26.03	12.52	101.69
2016	47.56	40.51	23.24	18.58 - 29.01	8.22	106.79
2017	50.94	42.38	24.55	20.76 – 29.45	12.66	105.1
2018	51.1	44.18	24.93	18.85 - 29.9	8.16	114.75
2019	50.18	44.33	25	19.72 - 29.13	10.9	115.46
2020	44.49	39.41	21.32	18.05 - 26.6	8.8	103.63
2021	45.01	40.64	22.46	19.01 - 26.99	11.92	104.99
2022	53.68	48.88	26.63	23.68 - 32.03	14.27	129.51

Year	Population density		GDP per capita
Year	rho^* * Spearman rho; GDP = gross domestic product.	p-value	rho^* * Spearman rho; GDP = gross domestic product.	p-value
2015	0.319	<0.001	0.096	0.016
2016	0.349	<0.001	0.107	0.007
2017	0.217	<0.001	-	0.796
2018	0.289	<0.001	-	0.141
2019	0.273	<0.001	0.102	0.010
2020	0.277	<0.001	0.117	0.003
2021	0.338	<0.001	-	.0152
2022	0.259	<0.001	-	0.354

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[1] Correspondence to: Astrid Wiens Universidade Federal do Paraná, Departamento de Farmácia, Av. Prefeito Lothário Meissner, 632, Jardim Botânico, CEP 80210-170, Curitiba, PR, Brazil Tel: +55 41 3360-4061 E-mail: astrid@ufpr.br