Shapiro A N, Dolynska M, Chiang S S, Rybak N, Petrenko V, Horsburgh C R, Kobe J, Terleieva I, Sakalska O, Jenkins H E
Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA.
NGO Infection Control Ukraine, Kyiv, Ukraine.
IJTLD Open. 2024 Jun 1;1(6):258-265. doi: 10.5588/ijtldopen.24.0194. eCollection 2024 Jun.
We assessed the impact of the COVID-19 pandemic on TB notifications in Ukraine, stratified by multiple subgroups.
DESIGN/METHODS: We analyzed data from Ukraine's National TB Program from January 2015 to December 2020 using interrupted time series models. We compared observed cases to counterfactual estimated cases had the pandemic not occurred and estimated trends through December 2020 nationally and by various demographics. We compared the proportions of individuals who underwent drug susceptibility testing (DST) in February 2020 and April 2020 to assess the pandemic impact on drug resistance testing.
In April 2020, there were 39% (95% CI 36-42) fewer TB notifications than the estimated counterfactual (3,060 estimated; 95% CI 2,918-3,202; 1,872 observed). We observed a greater decrease in notifications among refugees/migrants compared with non-refugees/migrants (64%, 95% CI 60-67 vs. 39%, 95% CI 36-42), and individuals aged <15 years compared with those aged ≥15 years (60%, 95% CI 57-64 vs. 38%, 95% CI 36-41). We also observed a decrease in the proportion of individuals receiving DST for several drugs.
These findings underscore the challenges to TB prevention and care during disruption and may be generalizable to the current wartime situation, especially considering the substantial increase in refugees within and leaving Ukraine.
我们评估了新冠疫情对乌克兰结核病通报情况的影响，并按多个亚组进行了分层分析。
设计/方法：我们使用中断时间序列模型分析了乌克兰国家结核病规划在2015年1月至2020年12月期间的数据。我们将观察到的病例与假设疫情未发生时的反事实估计病例进行比较，并估计了全国以及按不同人口统计学特征到2020年12月的趋势。我们比较了2020年2月和2020年4月接受药物敏感性检测（DST）的个体比例，以评估疫情对耐药性检测的影响。
2020年4月，结核病通报病例比估计的反事实病例少39%（95%置信区间36 - 42）（估计为3060例；95%置信区间2918 - 3202；观察到1872例）。我们观察到，与非难民/移民相比，难民/移民中的通报病例减少幅度更大（64%，95%置信区间60 - 67 vs. 39%，95%置信区间36 - 42），与15岁及以上人群相比，15岁以下个体中的通报病例减少幅度更大（60%，95%置信区间57 - 64 vs. 38%，95%置信区间36 - 41）。我们还观察到几种药物接受DST的个体比例有所下降。
这些发现凸显了疫情期间结核病预防和护理面临的挑战，并且可能适用于当前的战时情况，特别是考虑到乌克兰境内和离开乌克兰的难民大幅增加。
