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新冠疫情对结核病服务的影响:一家三级医院的经验。

Impact of COVID-19 on tuberculosis services: an experience from a tertiary care hospital.

机构信息

Department of Microbiology, Lokmanya Tilak Municipal Medical College and General Hospital, Sion, Mumbai, Maharashtra, India.

出版信息

J Med Microbiol. 2022 Jun;71(6). doi: 10.1099/jmm.0.001559.

Abstract

India is home to the most significant number of tuberculosis (TB) cases around the globe. The COVID-19 crisis has massively affected TB healthcare services in the country. Are we sufficiently equipped to fight against TB during emergencies? Our study aims to provide a true insight into the disruption of TB care during the pandemic period at a tertiary care hospital in India. A retrospective observational cohort analysis was conducted on 6491 patients who accessed the TB diagnostics at the tertiary care hospital during the study period, i.e. the COVID-19 pandemic period (March 2020 to March 2021) compared with 14 665 in the control period (March 2019 to Feb 2020). Out of the total tested, 3136 patients were notified as new TB cases in the study period than 4370 in the control period (-value=0.0000001), i.e. 28.23 % decline in notifications. A drastic decline of 69 % in notifications was observed during the lock down months in the pandemic period, i.e. March to June 2020 (-value=0.00001). A reduction of 44 % in treatment accession by 3690 TB patients in the control period compared with 2062 in the study period (-value=0.0000001) was noted. Lost to follow-up patients increased by 65 % from 460 in the control period to 760 in the study period (-value=0.0000001). Also, an increased death rate by 43 % from control to study period (-value=0.0000001) was reported. There is an urgent need to maintain the continuity of essential TB services to reduce the rising burden in vulnerable populations. The need of the hour is to undertake novel strategies for tuberculosis control to combat such emergencies in the coming future.

摘要

印度是全球结核病(TB)病例最多的国家。新冠疫情极大地影响了该国的结核病医疗服务。我们是否有足够的能力在紧急情况下对抗结核病?我们的研究旨在深入了解印度一家三级保健医院在大流行期间结核病护理的中断情况。对在研究期间(即 2020 年 3 月至 2021 年 3 月)在三级保健医院接受结核病诊断的 6491 名患者和在对照期间(2019 年 3 月至 2020 年 2 月)的 14665 名患者进行了回顾性观察队列分析。在接受检测的总人数中,研究期间有 3136 名患者被通知为新的结核病病例,而对照期间有 4370 名(检验值=0.0000001),即通知数下降了 28.23%。在大流行期间的封锁月份(即 2020 年 3 月至 6 月),通知数急剧下降了 69%(检验值=0.00001)。与对照期间的 3690 名结核病患者相比,研究期间接受治疗的患者减少了 44%(44%),有 2062 名患者(检验值=0.0000001)。与对照期间的 460 名患者相比,失访患者增加了 65%,达到 760 名(检验值=0.0000001)。与对照期间相比,研究期间的死亡率也增加了 43%(检验值=0.0000001)。迫切需要保持基本结核病服务的连续性,以减轻弱势人群的负担不断增加。当务之急是采取新的结核病控制策略,以应对未来的此类紧急情况。

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