Tovar Mario, Aleta Alberto, Sanz Joaquín, Moreno Yamir
Institute for Biocomputation and Physics of Complex Systems (BIFI), University of Zaragoza, 50009 Zaragoza, Spain.
Department of Theoretical Physics, University of Zaragoza, 50009 Zaragoza, Spain.
Commun Med (Lond). 2022 Jun 29;2:77. doi: 10.1038/s43856-022-00145-0. eCollection 2022.
The ongoing COVID-19 pandemic has greatly disrupted our everyday life, forcing the adoption of non-pharmaceutical interventions in many countries and putting public health services and healthcare systems worldwide under stress. These circumstances are leading to unintended effects such as the increase in the burden of other diseases.
Here, using a data-driven epidemiological model for tuberculosis (TB) spreading, we describe the expected rise in TB incidence and mortality if COVID-associated changes in TB notification are sustained and attributable entirely to disrupted diagnosis and treatment adherence.
Our calculations show that the reduction in diagnosis of new TB cases due to the COVID-19 pandemic could result in 228k (CI 187-276) excess deaths in India, 111k (CI 93-134) in Indonesia, 27k (CI 21-33) in Pakistan, and 12k (CI 9-18) in Kenya.
We show that it is possible to reverse these excess deaths by increasing the pre-covid diagnosis capabilities from 15 to 50% for 2 to 4 years. This would prevent almost all TB-related excess mortality that could be caused by the COVID-19 pandemic if no additional preventative measures are introduced. Our work therefore provides guidelines for mitigating the impact of COVID-19 on tuberculosis epidemic in the years to come.
持续的新冠疫情极大地扰乱了我们的日常生活，迫使许多国家采取非药物干预措施，并使全球公共卫生服务和医疗系统面临压力。这些情况正导致一些意外后果，如其他疾病负担的增加。
在此，我们使用一个数据驱动的结核病传播流行病学模型，描述了如果与新冠相关的结核病报告变化持续存在且完全归因于诊断和治疗依从性的中断，结核病发病率和死亡率预计会上升多少。
我们的计算表明，由于新冠疫情导致的新结核病病例诊断减少，可能会在印度导致22.8万（置信区间18.7 - 27.6万）额外死亡，在印度尼西亚导致11.1万（置信区间9.3 - 13.4万），在巴基斯坦导致2.7万（置信区间2.1 - 3.3万），在肯尼亚导致1.2万（置信区间0.9 - 1.8万）。
我们表明，通过在2至4年内将新冠疫情前的诊断能力提高15%至50%，有可能扭转这些额外死亡。如果不采取额外的预防措施，这将预防几乎所有可能由新冠疫情导致的与结核病相关的额外死亡率。因此，我们的工作为减轻未来几年新冠疫情对结核病流行的影响提供了指导方针。
