Effects of the COVID-19 Pandemic on Treatment Outcomes of Drug-Resistant Tuberculosis Patients in Twin Cities of Pakistan
COVID-19 Pandemic on Drug-Resistant Tuberculosis Patients
DOI:
https://doi.org/10.54393/pjhs.v6i3.2477Keywords:
Multidrug-Resistant, Tuberculosis, Treatment Outcome, COVID-19Abstract
Pakistan is the world's fifth-highest Drug-Resistant Tuberculosis burden region. However, it is difficult to evaluate the setback of COVID-19 when concurrent tuberculosis is excluded in patients from Pakistan, where the national burden of tuberculosis and drug-resistant tuberculosis is substantial and rising despite management efforts. The COVID-19 pandemic is prevalent in countries where tuberculosis, notably drug-resistant tuberculosis is high. Objectives: To compare the pre and para-pandemic favourable and unfavorable outcomes of drug-resistant tuberculosis treatment in PMDT Units of Islamabad and Rawalpindi. Methods: A retrospective cross-sectional study was conducted. The study included Pre and Para-COVID-era drug-resistant tuberculosis patients (n=670) in three sites of Rawalpindi and Islamabad from 2016-2021. A non-probability consecutive sampling technique was applied. A validated structured questionnaire was administered to compare the treatment outcomes of drug-resistant tuberculosis patients. Results: Results show that pre-COVID n=240 (35.82%) and Para-Covid era drug-resistant tuberculosis patients n=226 (33.73%) had favourable treatment outcomes. Unfavorable outcomes before and during the pandemic were 128 (18.35%) and 82 (12.2%) respectively. COVID-19 has affected drug-resistant tuberculosis treatment outcomes, both favourable and unfavorable, which are far behind the treatment success targets set by WHO End-tuberculosis. Conclusions: It was concluded that this study compared drug-resistant tuberculosis treatment outcomes pre- and post-COVID-19, showing success rates surpassing WHO-End tuberculosis targets. Key factors included residential status, gender, and occupation.
References
Gunsaru V, Henrion MY, McQuaid CF. The Impact of the COVID-19 Pandemic On Tuberculosis Treatment Outcomes in 49 High Burden Countries. BioMed Central Medicine. 2024 Jul; 22(1): 312. doi: 10.1186/s12916-024-03532-7. DOI: https://doi.org/10.1186/s12916-024-03532-7
Bhatia V, Mandal PP, Satyanarayana S, Aditama TY, Sharma M. Mitigating the Impact of the COVID-19 Pandemic On Progress Towards Ending Tuberculosis in the WHO South-East Asia Region. WHO South-East Asia Journal of Public Health. 2020 Sep; 9(2): 95-9. doi: 10.4103/2224-3151.294300 DOI: https://doi.org/10.4103/2224-3151.294300
Trajman A, Felker I, Alves LC, Coutinho I, Osman M, Meehan SA et al. The COVID-19 and TB Syndemic: The Way Forward. The International Journal of Tuberculosis and Lung Disease. 2022 Aug; 26(8): 710-9. doi: 10.5588/ijtld.22.0006. DOI: https://doi.org/10.5588/ijtld.22.0006
Ichsan I, Redwood-Campbell L, Mahmud NN, Dimiati H, Yani M, Mudatsir M et al. Risk Factors of MDR-TB and Impacts of COVID-19 Pandemic On Escalating of MDR-TB Incidence in Lower-Middle-Income Countries: A Scoping Review. Narra Journal. 2023 Aug; 3(2): e220. doi: 10.52225/narra.v3i2.220. DOI: https://doi.org/10.52225/narra.v3i2.220
Iacobino A, Fattorini L, Giannoni F. Drug-Resistant Tuberculosis 2020: Where We Stand. Applied Sciences. 2020 Mar; 10(6): 2153. doi: 10.3390/app10062153. DOI: https://doi.org/10.3390/app10062153
Silva BP, Almeida AS, Sérgio MG, Gatto TC, Carasek VP, Yamamura M. Drug-Resistant Tuberculosis and COVID-19: A Scoping Review On a New Threat to Antimicrobial Resistance. Brazilian Journal of Nursing. 2023 Dec; 76(Suppl 1): e20220803. doi: 10.1590/0034-7167-2022-0803. DOI: https://doi.org/10.1590/0034-7167-2022-0803
Wang X, He W, Lei J, Liu G, Huang F, Zhao Y. Impact of COVID-19 Pandemic On Pre-Treatment Delays, Detection, and Clinical Characteristics of Tuberculosis Patients in Ningxia Hui Autonomous Region, China. Frontiers in Public Health. 2021 May; 9: 644536. doi: 10.3389/fpubh.2021.644536. DOI: https://doi.org/10.3389/fpubh.2021.644536
Fatima R, Akhtar N, Yaqoob A, Harries AD, Khan MS. Building Better Tuberculosis Control Systems in A Post-COVID World: Learning from Pakistan During the COVID-19 Pandemic. International Journal of Infectious Diseases. 2021 Dec; 113: S88-90. doi: 10.1016/j.ijid.2021.03.026. DOI: https://doi.org/10.1016/j.ijid.2021.03.026
Pang Y, Liu Y, Du J, Gao J, Li L. Impact of COVID-19 on Tuberculosis Control in China. International Journal of Tuberculosis and Lung Disease. 2020 May; 24(5): 545-7. doi: 10.5588/ijtld.20.0127. DOI: https://doi.org/10.5588/ijtld.20.0127
Atif M, Mukhtar S, Sarwar S, Naseem M, Malik I, Mushtaq A. Drug Resistance Patterns, Treatment Outcomes and Factors Affecting Unfavourable Treatment Outcomes Among Extensively Drug-Resistant Tuberculosis Patients in Pakistan; A Multicentre Record Review. Saudi Pharmaceutical Journal. 2022 Apr; 30(4): 462-9. doi: 10.1016/j.jsps.2022.01.015. DOI: https://doi.org/10.1016/j.jsps.2022.01.015
Espinal MA and Raviglione MC. Tuberculosis—A World Health Organization Perspective. Tuberculosis and Nontuberculous Mycobacterial Infections. 2021 Jan: 182-204. doi: 10.1128/9781555817138.ch11. DOI: https://doi.org/10.1128/9781555817138.ch11
Mondjila A. Factors associated with the unsuccessful Tuberculosis Treatment Outcomes of the DOTS Programme in Kunene and Oshana Regions, Namibia (Doctoral Dissertation, University of Namibia). 2022.
Mbithi I, Thekkur P, Chakaya JM, Onyango E, Owiti P, Njeri NC et al. Assessing the Real-Time Impact of COVID-19 On TB and HIV Services: The Experience and Response from Selected Health Facilities in Nairobi, Kenya. Tropical Medicine and Infectious Disease. 2021 May; 6(2): 74. doi: 10.3390/tropicalmed6020074. DOI: https://doi.org/10.3390/tropicalmed6020074
Monedero-Recuero I, Gegia M, Wares DF, Chadha SS, Mirzayev F. Situational Analysis of 10 Countries with A High Burden of Drug-Resistant Tuberculosis 2 Years Post-UNHLM Declaration: Progress and Setbacks in A Changing Landscape. International Journal of Infectious Diseases. 2021 Jul; 108: 557-67. doi: 10.1016/j.ijid.2021.06.022. DOI: https://doi.org/10.1016/j.ijid.2021.06.022
Chen H and Zhang K. Insight into the Impact of the COVID-19 Epidemic On Tuberculosis Burden in China. European Respiratory Journal. 2020 Jul. doi: 10.1183/13993003.02710-2020. DOI: https://doi.org/10.1183/13993003.02710-2020
Singh R, Dwivedi SP, Gaharwar US, Meena R, Rajamani P, Prasad T. Recent Updates On Drug Resistance in Mycobacterium Tuberculosis. Journal of Applied Microbiology. 2020 Jun; 128(6): 1547-67. doi: 10.1111/jam.14478. DOI: https://doi.org/10.1111/jam.14478
Li Q, Shi CX, Lu M, Wu L, Wu Y, Wang M et al. Treatment Outcomes of Multidrug-Resistant Tuberculosis in Hangzhou, China, 2011 to 2015. Medicine. 2020 Jul; 99(30): e21296. doi: 10.1097/MD.0000000000021296. DOI: https://doi.org/10.1097/MD.0000000000021296
Manyazewal T, Woldeamanuel Y, Blumberg HM, Fekadu A, Marconi VC. The Fight to End Tuberculosis Must Not Be Forgotten in the COVID-19 Outbreak. Nature Medicine. 2020 Jun; 26(6): 811-2. doi: 10.1038/s41591-020-0917-1. DOI: https://doi.org/10.1038/s41591-020-0917-1
Bade AB and Mega TA. Survival Status and Its Predictors Among Multi-Drug Resistance Tuberculosis Treated Patients in Ethiopia: A Multicenter Observational Study. PLoS One. 2020 Nov; 15(11): e0241684. doi: 10.1371/journal.pone.0241684. DOI: https://doi.org/10.1371/journal.pone.0241684
Magro P, Formenti B, Marchese V, Gulletta M, Tomasoni LR, Caligaris S et al. Impact of the SARS-CoV-2 Epidemic On Tuberculosis Treatment Outcome in Northern Italy. European Respiratory Journal. 2020 Oct; 56(4). doi: 10.1183/13993003.02665-2020. DOI: https://doi.org/10.1183/13993003.02665-2020
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Pakistan Journal of Health Sciences
This work is licensed under a Creative Commons Attribution 4.0 International License.
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments
