Dados do Trabalho

Título

The impact of the COVID-19 pandemic in tuberculosis preventive treatment in Brazil: a retrospective cohort study

Introdução

Disruptions in Tuberculosis (TB) services have been observed around the world since the emergence of the COVID-19 pandemic. However, the pandemic effect on TB preventive treatment (TPT) was poorly explored.

Objetivo(s)

To compare TPT notified prescriptions and outcomes in the national information system before and during the COVID-19 pandemic in
Brazil.

Material e Métodos

We analyzed a retrospective cohort using secondary data from the Brazilian TPT information system (ILTB) for five cities with over 1,000 notifications in the study period. Successive trainings of healthcare workers on TPT followed the implementation of the IL-TB, in 2018. The number of TPT prescriptions was analyzed from 6 months after training to July 2021. The proportion of TPT outcomes was analyzed by date of treatment initiation up to the end of 2020, as most outcomes of the TPT started in 2021 were still open by the time of analyses. TPT data were contrasted with the notifications of new cases of COVID-19 in Brazil, available from health surveillance department. Joint point models were used to evaluate changes

Resultados e Conclusão

Out of 16,909 TPT prescriptions in the database, 14,014 were included, of which 8,032 in São Paulo and 3,187 in Rio de Janeiro. Isoniazid was prescribed for 97%. In 2020, the number prescribed TPT increased due to a 60% increase in Rio de Janeiro. In São Paulo, prescriptions remained stable, while in the other cities, there was a reduction. In 2021, there was a 93% reduction in TPT prescriptions in all cities. The proportion of completed TPT remained constant (median=74%).

Palavras-chave

SARS-CoV-2, coronavirus, tuberculosis, isoniazid, rifampicin, syndemic