Effect of COVID-19 Period on Tuberculosis Treatment Success; a Mixed Methods Study among Tuberculosis patients at Jinja Regional Referral Hospital.

Abstract

Before the COVID-19 pandemic, over 4000 people were dying from TB every day. TB is still a major public health threat globally, but the TB epidemic may be exacerbated by the COVID-19 pandemic. The lockdown in response to the pandemic and the events related to it can have an adverse epidemiologic impact on TB treatment outcome through its effect on poverty, and dietary intakes. Objectives Therefore, this study during COVID-19 would determine the effect of COVID-19 period on Tuberculosis Treatment success among TB patients. Methods Sequential explanatory mixed methods was used. A retrospective cohort study was employed for the quantitative component to determine the association between COVID-19 period and Tuberculosis treatment success among Tuberculosis Patients at Jinja Regional Referral Hospital. A data abstraction sheet was used to extract the required data from the TB treatment registers. Treatment outcomes was dichotomized as successful treatment outcome and poor treatment outcome. Modified possion regression was used to explore associations between treatment outcome and other independent variables. A qualitative study with a phenomenology approach was adopted to get an in-depth understanding to the barriers and facilitators to treatment success during the COVID era among Tuberculosis Patients at Jinja Regional Referral Hospital. The lived experience of the TB patients who had participated in the quantitative component was captured. Data from audio recordings was transcribed and analyzed using a deductive thematic analysis to explore barriers and facilitators. Results There was no significant effect of COVID-19 Period on TB treatment Success (aRR=1.04: 95% CI 0.78- 1.38). In addition, sex, HIV status, age, distance from the health facility, disease classification and treatment mode were not significantly associated with treatment success. The barrier to treatment success were lack of adequate health care information, fearing the COVID thing in the hospital. Some health workers pointed out that donors failed to support most of the TB activities as government redirected most of its funding to COVID-19 activities and neglected TB services. The major facilitators were good relationship with health care workers, TB awareness programs, updating of TB guidelines and availability of free drugs and services. Conclusion This study did not find a significant effect of COVID-19 period on treatment outcomes. Measures towards alleviating fear and stigma and ensuring financial securities of the patients during the time of health crisis are important for preparedness against future epidemics such as COVID-19.