The Centre for Operational Research at The Union, working in close collaboration with the National TB Programme and National AIDS Programme in Kenya, Malawi and Zimbabwe as well as the Special Programme for Research and Training in Tropical Diseases at WHO (TDR) and Vital Strategies, has just completed a project to assess the impact of COVID-19 on TB and HIV services in the three African countries.
A total of 36 health facilities in Nairobi, Lilongwe and Harare, the capital cities of Kenya, Malawi and Zimbabwe, respectively, were purposefully selected for the project. The team set up real-time monthly surveillance to capture trends in tuberculosis (TB) case detection, TB treatment outcomes and HIV testing. The data were used to facilitate corrective action. Aggregate data were collected monthly during the COVID-19 period (March 2020 to February 2021) using an Epicollect5 application and compared with monthly data extracted for the pre-COVID-19 period (March 2019 – February 2020). Monthly reports were sent to the national programme directors.
In brief, there were marked declines in numbers of patients presenting with presumptive pulmonary tuberculosis (PTB), with improvements noticed in the second half of the COVID-19 period in Kenya and Malawi but not in Zimbabwe. The numbers of patients registered with TB in each country showed parallel declines. TB treatment outcomes were less severely affected, with TB treatment success in fact improving in the COVID-19 period in Kenya. The key determinant of TB treatment success was the category “not evaluated”, with the follow-up and recording of final treatment outcomes being highly challenging but potentially correctable during the COVID-19 period.
The explanations behind these observations and the interventions adopted by the three countries to try and counteract the negative impact of COVID-19 are provided in the published papers.
The Kenya paper is available at https://www.mdpi.com/2414-6366/6/2/74; the Malawi paper is available at https://www.mdpi.com/2414-6366/6/2/81/htm; and the Zimbabwe paper is available at https://www.mdpi.com/2414-6366/6/2/94. For further information, please contact Professor Anthony Harries (firstname.lastname@example.org).