School of Pharmacy

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    Pre and Intra COVID-19ERA Comparison of Detection and Clinical Outcomes among Patients with Tuberculosis:A Four-Years Retrospective Follow-UP Study in Selected Public Hospitals in Addis Ababa, Ethiopia, 2023.
    (Addis Ababa University, 2023) Hadgu,Ruth; Chelkeba,Legese (PhD)
    Background: Tuberculosis (TB) is still the biggest cause of death from an infectious disease worldwide, with over 10 million people becoming infected each year. The coronavirus disease 2019 (COVID-19) outbreak has severely disrupted health-care systems and people's overall well- being around the world. People with TB are more likely to develop severe disease or die than people with COVID-19. The coexistence of COVID-19 with pulmonary TB can create a diagnostic dilemma and additional diagnostic challenges for clinicians. Despite these difficulties, there is not enough data to determine how COVID-19 affects TB patient detection and outcomes. Objective: To compare the detection and clinical outcomes of patients with TB pre and intra COVID-19 periods in selected public Hospitals of Addis Ababa, Ethiopia, 2023. Methods: A retrospective observational follow-up study was undertaken among TB patients with pre- and intra-COVID-19 era comparisons. This study was carried out in five public hospitals in Addis Ababa, which were chosen using a stratified sample technique. A 1.2-structured ODK version 2022 questionnaire was employed. Finally, it was exported to SPSS version 26 for analysis. Bivariate analysis at a P-value of 0.25 and multivariable analysis at a P-value of 0.05 were applied to announce for statistical significance Results: Patients who had known treatment outcomes in the selected hospitals were 375 during the COVID-19 period, compared with 469 TB during pre – COVID-19 period, showing a 20% decline in TB testing. Despite the decrement of susceptible (10.6%) and rifampicin resistance (RR) TB (47.7%), there was a 54.3% of multi-drug resistance (MDR) TB increment during the COVID- 19 period. Overall, there was significantly lower treatment success rate of TB during COVID-19 period (75.7% vs. 81.2%, p< 0.001), with higher rate of loss to follow up (8.8% vs. 6.2%, p= <0.001) as well as death (12.8% vs. 8.7%, p= < 0.001) compared with pre-C0VID-19 period. Factors such as treatment method in the pre-COVID-19 and age category, educational level, type of tuberculosis, and HIV status during COVID-19 period were significant indicators of successful TB treatment. Conclusion and recommendation: COVID-19 had a substantial detrimental influence on overall TB detection, RR-TB/MDR-TB, treatment success, lost-to-follow-up and mortality. To reduce the impact on TB case detection, the TB program must rapidly adjust to the new normal, strengthen patient-centered TB care, embrace digital health technology, increase awareness of generation, and guarantee that other opportunities given by the pandemic will be utilized.