Tuberculosis service utilisation pre-COVID-19 and peri-COVID-19 restrictions in Johannesburg, Gauteng

Abstract

Background: Tuberculosis (TB) has remained a significant public health challenge for many years. Individuals with weakened immune systems because of other illnesses are particularly vulnerable to contracting TB. In March 2020, South Africa implemented a disease control strategy which ceased and disrupted daily routines, including healthcare services delivery. The study aimed to determine and describe the impact of coronavirus disease 2019 (COVID-19) lockdown restrictions on the utilisation of TB services, pre-COVID-19 and peri-COVID-19.
Methods: A cross-sectional retrospective study using National Institute for Communicable Diseases (NICD) and National Department of Health (NDoH) data from Johannesburg, South Africa, was conducted to assess COVID-19 restrictions’ impact on TB service use from January 2018 to December 2021, examining trends across periods and influencing factors. The study included individuals who sought TB services, showed TB symptoms, or tested positive or negative for TB during the study period.
Results: The secondary data collected included children (< 10 years old), young adolescents (10–14 years old), older adolescents (15–19 years old), young adults (20–24 years old), adults (25–49 years old) and older adults (≥ 50 years old). Tuberculosis service use was highest among adult females aged 25–29 years old (51.3%) and lowest among females ≥ 50 years old (32.6%).
Conclusion: A marked decline in TB service use was observed during the peri-COVID-19 period. Results demonstrated that COVID-19 restrictions caused a substantial and sustained decline in TB service utilisation in Johannesburg, even when accounting for broader determinants of care-seeking.
Contributions: This study provides valuable insight into the impact of COVID-19 restrictions on TB service utilisation and highlights the broader societal effects of a pandemic.