Yakupogullari Yusuf, Ermis Hilal, Kazgan Zeynep, Otlu Baris, Bayindir Yasar, Gulbas Gazi, Tanriverdi Elif, Guldogan Emek
Medical Microbiology Department, Medical Faculty, Inonu University, Malatya, Turkey.
Chest Diseases Department, Medical Faculty, Inonu University, Malatya, Turkey.
East Mediterr Health J. 2022 Sep 29;28(9):682-689. doi: 10.26719/emhj.22.060.
The COVID-19 pandemic has put a significant strain on human life and health care systems, however, little is known about its impact on tuberculosis (TB) patients.
To assess the impact of COVID-19 pandemic on pulmonary tuberculosis (PTB) diagnosis, treatment and patient outcomes, using the WHO definitions.
A cross-sectional study was conducted in Malatya region, Turkey (population 800 000). Data on regional PTB test numbers, case notification rates and PTB patients' clinical characteristics and treatment outcomes were collected. Data from the first pandemic year (2020) were compared to data from the previous 3 years (2017-2019). The attitudes and experiences of patients were analysed.
Despite a non-significant 22% decrease in annual PTB case notifications (P = 0.317), the number of TB tests performed (P = 0.001) and PTB patients evaluated (P = 0.001) decreased significantly during the pandemic year compared with the previous 3 years. The proportion of patients with high (3/4+) sputum acid-fast bacilli grades (P = 0.001), TB relapse (P = 0.022) and treatment failure (P = 0.018) increased significantly. The median 64.5-day treatment delay detected in 2017-2019 increased significantly to 113.5 days in 2020 (P = 0.001), due primarily to patients' reluctance to visit a health care facility.
In addition to the problems with case detection, this study shows notable deterioration in several indicators related to the severity, contagiousness and poor outcomes of TB, which had already been suppressed for decades.
2019年冠状病毒病（COVID-19）大流行给人类生命和医疗保健系统带来了巨大压力，然而，人们对其对结核病（TB）患者的影响知之甚少。
使用世界卫生组织的定义，评估COVID-19大流行对肺结核（PTB）诊断、治疗和患者结局的影响。
在土耳其马拉蒂亚地区（人口80万）进行了一项横断面研究。收集了该地区PTB检测数量、病例通报率以及PTB患者的临床特征和治疗结局的数据。将大流行第一年（2020年）的数据与前三年（2017 - 2019年）的数据进行比较。分析了患者的态度和经历。
尽管年度PTB病例通报数量下降了22%，但差异无统计学意义（P = 0.317），与前三年相比，大流行期间进行的TB检测数量（P = 0.001）和接受评估的PTB患者数量（P = 0.001）显著减少。痰涂片抗酸杆菌等级为高（3/4+）的患者比例（P = 0.001）、TB复发（P = 0.022）和治疗失败（P = 0.018）显著增加。2017 - 2019年检测到的中位治疗延迟为64.5天，2020年显著增加至113.5天（P = 0.001），主要原因是患者不愿前往医疗机构就诊。
除了病例发现方面的问题外，本研究还显示，与结核病的严重性、传染性和不良结局相关的几个指标出现了显著恶化，而这些指标在过去几十年中已经得到了控制。
