Alao Michael Abel, Ogunbosi Babatunde Oluwatosin, Ibrahim Olayinka Rasheed
Bowen University Teaching Hospital, Oyo State, Nigeria.
College of Medicine University of Ibadan & University College Hospital, Ibadan, Oyo State, Nigeria.
Glob Pediatr Health. 2023 Feb 17;10:2333794X231156048. doi: 10.1177/2333794X231156048. eCollection 2023.
Publications on COVID-19's impact on the global tuberculosis burden are from adult cohorts, pediatric data are lacking for inform decision. We compared the TB trends in southern Nigerian children in the pre-COVID-19 and COVID-19 era. This was a retrospective, cross-sectional study of early morning sputum/gastric washing or stool samples from children with presumptive TB evaluated using GeneXpert in a tertiary hospital from January 2016 to May 2022. Of the 20 589 persons screened for presumed TB in the pre-COVID-19 and the COVID-19 era, only 1104 (88.7%) of 1245 children had complete data for analysis. In the COVID era, a significantly higher number of children were presumed to have TB 755 (68.4%), < .001. The overall incidence of MTB detected by Xpert MTB/RIF during the study period was 6.4% (71/1104). The incidence of MTB in the pre-COVID-19 era was 24/349 (6.9%), which was slightly higher than the COVID-19 era (47/755; 6.2%), > .05). The annual trends of MTB detected peaked in 2019 [18/115; 15.7%] in the pre-COVID-19 era, then plummeted to 12/228 (5.3%) in 2020 in the COVID-19 era, and reached its all-time low of 6/160 (3.8%) in the first half of 2022, ( < .001). The overall incidence of Rifampicin-resistant TB (RR-TB) was 2.8% among the MTB detected cases and all occurred in the COVID-19 era. This study found a significant decline in MTB diagnosis and in the emergence of RR-TB in the COVID-19 era. This necessitates re-prioritizing worldwide efforts to manage childhood tuberculosis, including increased testing, if the aim of eliminating tuberculosis by 2035 is to be met.
关于新冠疫情对全球结核病负担影响的出版物均来自成人队列研究，缺乏儿科数据以供决策参考。我们比较了新冠疫情前和疫情期间尼日利亚南部儿童的结核病发病趋势。这是一项回顾性横断面研究，研究对象为2016年1月至2022年5月在一家三级医院使用GeneXpert检测的疑似结核病儿童的清晨痰液/洗胃样本或粪便样本。在新冠疫情前和疫情期间筛查的20589名疑似结核病患者中，只有1245名儿童中的1104名（88.7%）有完整数据用于分析。在新冠疫情期间，疑似患有结核病的儿童数量显著增加，为755名（68.4%），P<0.001。研究期间，Xpert MTB/RIF检测到的结核分枝杆菌总体发病率为6.4%（71/1104）。新冠疫情前结核分枝杆菌的发病率为24/349（6.9%），略高于新冠疫情期间（47/755；6.2%），P>0.05）。检测到的结核分枝杆菌的年度发病趋势在2019年达到峰值[18/115；15.7%]，处于新冠疫情前时期，然后在2020年新冠疫情期间降至12/228（5.3%），并在2022年上半年降至历史最低点6/160（3.8%），P<0.001）。在检测到的结核分枝杆菌病例中，耐利福平结核病（RR-TB）的总体发病率为2.8%，且均发生在新冠疫情期间。本研究发现，在新冠疫情期间，结核分枝杆菌诊断和RR-TB的出现显著下降。如果要实现到2035年消除结核病的目标，这就需要重新调整全球管理儿童结核病的工作重点，包括增加检测。
