Makerere University Lung Institute, College of Health Sciences, Makerere University, Kampala, Uganda.
Infectious Disease Institute, College of Health Sciences, Makerere University, Kampala, Uganda.
BMC Health Serv Res. 2024 Jan 10;24(1):52. doi: 10.1186/s12913-023-10513-8.
Lockdown measure has been utilized widely to mitigate COVID-19 pandemic transmission and recently during the 2022 Sudan Ebola Virus Disease outbreak in Uganda. These have setback effects on the continuity of essential health services such as tuberculosis (TB) care, reversing progress made in the fight against tuberculosis (TB) over the past decade. We set out to understand patient-reported barriers to accessing TB care services during the COVID-19 pandemic in Uganda.
Mixed methods study involving review of medical records of TB patients who received TB care from January to September 2020. We used quantitative and qualitative methods including phone questionnaires and in-depth interviews. We carried out descriptive statistics, a chi-square test and conducted a thematic analysis.
We carried out phone interviews with 672 participants. The majority (60%) were male and with an average of 35 years (SD:11). A significantly higher proportion of patients reported a barrier to TB care access during the COVID-19 lockdown than pre-lockdown (79.9% vs. 68.1% p = 0.027). We carried out in-depth interviews with 28 participants (54% (15/28): male). Barriers experienced by these participants included lack of a means of transport to reach the health facility, lack of money to pay the transport fares, long distances to the facility, fear of COVID-19 infection, stigma due to overlap between TB and COVID-19 symptoms, and few health care workers available during the lockdown period.
Lockdown measures instituted to mitigate the transmission of COVID1-19 affected access to TB care services in Uganda. Uganda is at risk of future emerging and re-emerging diseases of epidemic potential. Therefore, there should be measures to ensure the continuity of essential services such as tuberculosis care during the implementation of future epidemic response interventions such as a lockdown.
为了减轻 COVID-19 大流行的传播，封锁措施已被广泛采用，最近在 2022 年乌干达发生的苏丹埃博拉病毒病疫情中也采用了封锁措施。这些措施对结核病（TB）护理等基本卫生服务的连续性产生了倒退影响，逆转了过去十年在结核病（TB）防治方面取得的进展。我们着手了解乌干达在 COVID-19 大流行期间患者获得结核病护理服务的障碍。
这是一项混合方法研究，涉及对 2020 年 1 月至 9 月期间接受结核病护理的结核病患者的病历进行审查。我们使用了定量和定性方法，包括电话问卷调查和深入访谈。我们进行了描述性统计、卡方检验和主题分析。
我们对 672 名参与者进行了电话访谈。大多数（60%）是男性，平均年龄为 35 岁（SD：11）。在 COVID-19 封锁期间，报告结核病护理获取障碍的患者比例显著高于封锁前（79.9% vs. 68.1%，p=0.027）。我们对 28 名参与者（54%（15/28）：男性）进行了深入访谈。这些参与者经历的障碍包括缺乏到达医疗机构的交通工具、缺乏支付交通费的资金、到医疗机构的距离远、对 COVID-19 感染的恐惧、结核病和 COVID-19 症状重叠引起的耻辱感，以及封锁期间可用的医疗保健工作者很少。
为减轻 COVID1-19 传播而实施的封锁措施影响了乌干达获得结核病护理服务的机会。乌干达面临未来具有流行潜力的新发和再发传染病的风险。因此，在实施未来的疫情应对干预措施（如封锁）时，应采取措施确保结核病护理等基本服务的连续性。
