The impact of the COVID-19 pandemic on TB notifications in Ukraine in 2020

A.N. Shapiro, M. Dolynska, S. S. Chiang, N. Rybak, V. Petrenko, C.R. Horsburgh, J. Kobe, I. Terleieva, O. Sakalska, H. E. Jenkins
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Abstract

BACKGROUNDWe assessed the impact of the COVID-19 pandemic on TB notifications in Ukraine, stratified by multiple subgroups.DESIGN/METHODSWe analyzed data from Ukraine’s National TB Program from January 2015 to December 2020 using interrupted time series models. We compared observed cases to counterfactual estimated cases had the pandemic not occurred and estimated trends through December 2020 nationally and by various demographics. We compared the proportions of individuals who underwent drug susceptibility testing (DST) in February 2020 and April 2020 to assess the pandemic impact on drug resistance testing.RESULTSIn April 2020, there were 39% (95% CI 36–42) fewer TB notifications than the estimated counterfactual (3,060 estimated; 95% CI 2,918–3,202; 1,872 observed). We observed a greater decrease in notifications among refugees/migrants compared with non-refugees/migrants (64%, 95% CI 60–67 vs. 39%, 95% CI 36–42), and individuals aged <15 years compared with those aged ≥15 years (60%, 95% CI 57–64 vs. 38%, 95% CI 36–41). We also observed a decrease in the proportion of individuals receiving DST for several drugs.CONCLUSIONSThese findings underscore the challenges to TB prevention and care during disruption and may be generalizable to the current wartime situation, especially considering the substantial increase in refugees within and leaving Ukraine.
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COVID-19 大流行对 2020 年乌克兰结核病通报的影响
背景我们评估了 COVID-19 大流行对乌克兰结核病通报的影响,并按多个亚群进行了分层。设计/方法我们使用间断时间序列模型分析了乌克兰国家结核病计划 2015 年 1 月至 2020 年 12 月的数据。我们将观察到的病例与未发生大流行时的反事实估计病例进行了比较,并按全国和不同人口统计学特征估计了到 2020 年 12 月的趋势。我们比较了 2020 年 2 月和 2020 年 4 月接受药物敏感性检测 (DST) 的人数比例,以评估大流行对耐药性检测的影响。结果 2020 年 4 月,结核病通报数比估计的反事实少 39% (95% CI 36-42)(估计为 3,060 例;95% CI 2,918-3,202 例;观察到 1,872 例)。我们发现,难民/移民与非难民/移民相比(64%,95% CI 60-67 vs. 39%,95% CI 36-42),年龄小于 15 岁的人与年龄大于 15 岁的人相比(60%,95% CI 57-64 vs. 38%,95% CI 36-41),通知率下降幅度更大。我们还观察到,接受多种药物 DST 检测的人数比例有所下降。结论:这些发现强调了混乱时期结核病预防和护理所面临的挑战,并可能适用于当前的战时局势,特别是考虑到乌克兰境内和离开乌克兰的难民人数大幅增加。
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