Masters Degrees (Health Systems and Public Health)

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Browsing Masters Degrees (Health Systems and Public Health) by browse.metadata.advisor "Chivese, Tawanda"

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    The impact of COVID-19 on the cascade of care for tuberculosis : a systematic review
    (Stellenbosch : Stellenbosch University, 2022-09) Fapohunda, Tomiwa Temitayo; Chivese, Tawanda; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Global Health. Health Systems and Public Health.
    ENGLISH SUMMARY: Background: Globally, the effect of the coronavirus pandemic on tuberculosis (TB) cascade of care is not well described. Objectives: To describe the impact of the 2019 coronavirus disease (COVID-19) pandemic on the TB care cascade, particularly on testing, case notifications and treatment of TB. Methods: In this systematic review, the Cochrane library, Scopus, CINAHL, Ebscohost, and PubMed databases were comprehensively searched from December 1st, 2019, the onset of the pandemic, till May 5th, 2022, without language restrictions. Eligible studies were observational studies documenting changes in the TB cascade of care one year before and one year during the COVID- 19 pandemic. The authors could not conduct a meta-analysis due to the expected differences in the contexts of the included studies, thus, a narrative synthesis was conducted. The Hoy et al.'s (2012) risk of bias tool was used for the quality assessment. Results: Twenty-seven studies from Asia, North America, Africa, South America, and Europe were included. TB screening suspected cases decreased between 1.3% and 49.5% (n= 5 studies), and multidrug resistance tuberculosis (MDR-TB) screening decreased by 17% in new patients and by 15% in existing patients (1 study). The diagnostic delay increased by11 and 45 days and 25.1% and 60% (2 studies), contact tracing decreased by 36.1% (1 study), case notification decreased between 2.9% and 63.3% (18 studies) and positivity rate increased between 0.1% and 4.5% (4 studies). General and community detection rates decreased by 11.8% and 44.7%, respectively (1 study), clinically diagnosed TB decreased between 10.4% and 46.0% (5 studies), presumptive TB diagnoses decreased between 12.8% and 45.6% (4 studies) and pulmonary TB diagnoses decreased between 20.0% and 50.7% (2 studies). Treatment enrolment decreased between 15.7% and 35.0% (4 studies), the diagnostic and treatment delay increased by 28 and 36 days, respectively, treatment completion decreased by 8.0% (1 study) and the treatment success rate decreased between 0.1% and 17.0% (7 studies). Conclusion: These results suggest that the pandemic likely had a detrimental impact on the TB care cascade. In future pandemics, stakeholders and governments must protect the care cascade of infectious diseases like TB and other diseases. The results of this study must be applied with caution since only observational studies, mostly without standardized population data, were included.