Mwamba C, Kerkhoff A D, Kagujje M, Lungu P, Muyoyeta M, Sharma A
Centre for Infectious Disease Research in Zambia, Lusaka, Zambia.
Division of HIV, Infectious Diseases and Global Medicine, Zuckerberg San Francisco General Hospital and Trauma Center, University of California, San Francisco, San Francisco, CA, USA.
Public Health Action. 2020 Dec 21;10(4):141-146. doi: 10.5588/pha.20.0053.
Delayed TB diagnosis and treatment perpetuate the high burden of TB-related morbidity and mortality in resource-constrained settings. We explored the potential of COVID-19 to further compromise TB care engagement in Zambia.
From April to May 2020, we purposefully selected 17 adults newly diagnosed with TB from three public health facilities in Lusaka, Zambia, for in-depth phone interviews. We conducted thematic analyses using a hybrid approach.
The majority of participants were highly concerned about the impact of lockdowns on their financial security. Most were not worried about being diagnosed with COVID-19 when seeking care for their illness because they felt unwell prior to the outbreak; however, they were very worried about contracting COVID-19 during clinic visits. COVID-19 was perceived as a greater threat than TB as it is highly transmittable and there is no treatment for it, which provoked fear of social isolation and of death among participants in case they contracted it. Nonetheless, participants reported willingness to continue with TB medication and the clinic visits required to improve their health.
The COVID-19 pandemic did not appear to deter care-seeking for TB by patients. However, messaging on TB in the era of COVID-19 must encourage timely care-seeking by informing people of infection control measures taken at health facilities.
在资源有限的环境中，结核病诊断和治疗的延迟使结核病相关发病和死亡的高负担长期存在。我们探讨了新冠疫情进一步损害赞比亚结核病治疗参与度的可能性。
2020年4月至5月，我们从赞比亚卢萨卡的三个公共卫生机构中特意挑选了17名新诊断出结核病的成年人进行深入电话访谈。我们采用混合方法进行主题分析。
大多数参与者非常担心封锁对其财务安全的影响。大多数人在就医时并不担心感染新冠病毒，因为他们在疫情爆发前就感觉身体不适；然而，他们非常担心在诊所就诊期间感染新冠病毒。新冠病毒被认为比结核病构成更大的威胁，因为它具有高度传染性且没有治疗方法，这引发了参与者对社会隔离和死亡的恐惧，万一他们感染了这种病毒。尽管如此，参与者表示愿意继续服用结核病药物并按要求进行诊所就诊以改善健康状况。
新冠疫情似乎并未阻碍患者寻求结核病治疗。然而，在新冠时代，关于结核病的宣传信息必须通过告知人们医疗机构采取的感染控制措施来鼓励及时寻求治疗。
