The impact of the COVID-19 pandemic in tuberculosis preventive treatment in Brazil: a retrospective cohort study using secondary data
The impact of the COVID-19 pandemic in tuberculosis preventive treatment in Brazil: a retrospective cohort study using secondary data
Data
2023
Autores
Coutinho, Iane
Alves, Layana Costa
Werneck, Guilherme Loureiro
Trajman, Anete
Journal Title
Journal ISSN
Volume Title
Publisher
Lancet Regional Health Americas
Resumo
Background Disruptions in tuberculosis services have been reported around the world since the emergence of the
COVID-19 pandemic. However, the pandemic’s effect on tuberculosis preventive treatment (TPT) has been poorly
explored. We compared TPT-notified prescriptions and outcomes before and during the pandemic in Brazil.
Methods Retrospective cohort using secondary data from the Brazilian TPT information system in five cities with over
1000 notifications. The number of TPT prescriptions was analysed from 6 months after healthcare workers’ training,
in 2018, to July 2021. The proportion of TPT outcomes by the date of treatment initiation was analysed up to the end
of 2020, as most outcomes of TPT started in 2021 were still unknown in July 2021. Joinpoint regression was used to
evaluate trends.
Findings 14,014 TPT prescriptions were included, most from São Paulo (8032) and Rio de Janeiro (3187). Compared
to the same epidemiological weeks in 2019, the number of TPT prescribed in 2020 increased in Rio de Janeiro (82%)
and São Paulo (14%) and decreased in Recife (65%), Fortaleza (31%) and Manaus (44%). In 2021, however, there was
a 93% reduction in TPT prescriptions in all cities. The proportion of completed TPT remained constant
(median = 74%).
Interpretation The COVID-19 pandemic in Brazil was associated with a dramatic decrease in TPT prescriptions in
2021. Treatment adherence remained constant, suggesting that health services were able to keep people on
treatment but did not perform well in providing opportunities for people to enter care. Efforts are needed to
expand access to TPT.
Funding Brazilian Ministry of Science, Technology and Innovation, CNPq.
Description
Palavras-chave
SARS-CoV-2, Coronavirus, Tuberculosis, Isoniazid, Rifampicin, Syndemic.
Citação
Coutinho I, Alves LC, Werneck GL, Trajman A. The impact of the COVID-19 pandemic in tuberculosis preventive treatment in Brazil: a retrospective cohort study using secondary data. Lancet Reg Health Am. 2023 Mar;19:100444. doi: 10.1016/j.lana.2023.100444. Epub 2023 Feb 10.