C Mwamba1, A D Kerkhoff2, M Kagujje1, P Lungu3,4, M Muyoyeta1, A Sharma1. 1. Centre for Infectious Disease Research in Zambia, Lusaka, Zambia. 2. Division of HIV, Infectious Diseases and Global Medicine, Zuckerberg San Francisco General Hospital and Trauma Center, University of California, San Francisco, San Francisco, CA, USA. 3. National Tuberculosis and Leprosy Control Programme, Lusaka. 4. Department of Internal Medicine, University Teaching Hospital, Lusaka, Zambia.
Abstract
INTRODUCTION: Delayed TB diagnosis and treatment perpetuate the high burden of TB-related morbidity and mortality in resource-constrained settings. We explored the potential of COVID-19 to further compromise TB care engagement in Zambia. METHODS: From April to May 2020, we purposefully selected 17 adults newly diagnosed with TB from three public health facilities in Lusaka, Zambia, for in-depth phone interviews. We conducted thematic analyses using a hybrid approach. RESULTS: The majority of participants were highly concerned about the impact of lockdowns on their financial security. Most were not worried about being diagnosed with COVID-19 when seeking care for their illness because they felt unwell prior to the outbreak; however, they were very worried about contracting COVID-19 during clinic visits. COVID-19 was perceived as a greater threat than TB as it is highly transmittable and there is no treatment for it, which provoked fear of social isolation and of death among participants in case they contracted it. Nonetheless, participants reported willingness to continue with TB medication and the clinic visits required to improve their health. CONCLUSION: The COVID-19 pandemic did not appear to deter care-seeking for TB by patients. However, messaging on TB in the era of COVID-19 must encourage timely care-seeking by informing people of infection control measures taken at health facilities.
INTRODUCTION: Delayed TB diagnosis and treatment perpetuate the high burden of TB-related morbidity and mortality in resource-constrained settings. We explored the potential of COVID-19 to further compromise TB care engagement in Zambia. METHODS: From April to May 2020, we purposefully selected 17 adults newly diagnosed with TB from three public health facilities in Lusaka, Zambia, for in-depth phone interviews. We conducted thematic analyses using a hybrid approach. RESULTS: The majority of participants were highly concerned about the impact of lockdowns on their financial security. Most were not worried about being diagnosed with COVID-19 when seeking care for their illness because they felt unwell prior to the outbreak; however, they were very worried about contracting COVID-19 during clinic visits. COVID-19 was perceived as a greater threat than TB as it is highly transmittable and there is no treatment for it, which provoked fear of social isolation and of death among participants in case they contracted it. Nonetheless, participants reported willingness to continue with TB medication and the clinic visits required to improve their health. CONCLUSION: The COVID-19 pandemic did not appear to deter care-seeking for TB by patients. However, messaging on TB in the era of COVID-19 must encourage timely care-seeking by informing people of infection control measures taken at health facilities.
Authors: Ana W Torrens; Davide Rasella; Delia Boccia; Ethel L N Maciel; Joilda S Nery; Zachary D Olson; Draurio C N Barreira; Mauro N Sanchez Journal: Trans R Soc Trop Med Hyg Date: 2016-03 Impact factor: 2.184
Authors: Tom Wingfield; Marco A Tovar; Doug Huff; Delia Boccia; Rosario Montoya; Eric Ramos; Sumona Datta; Matthew J Saunders; James J Lewis; Robert H Gilman; Carlton A Evans Journal: Bull World Health Organ Date: 2017-02-09 Impact factor: 9.408
Authors: Alexandra B Hogan; Britta L Jewell; Ellie Sherrard-Smith; Juan F Vesga; Oliver J Watson; Charles Whittaker; Arran Hamlet; Jennifer A Smith; Peter Winskill; Robert Verity; Marc Baguelin; John A Lees; Lilith K Whittles; Kylie E C Ainslie; Samir Bhatt; Adhiratha Boonyasiri; Nicholas F Brazeau; Lorenzo Cattarino; Laura V Cooper; Helen Coupland; Gina Cuomo-Dannenburg; Amy Dighe; Bimandra A Djaafara; Christl A Donnelly; Jeff W Eaton; Sabine L van Elsland; Richard G FitzJohn; Han Fu; Katy A M Gaythorpe; William Green; David J Haw; Sarah Hayes; Wes Hinsley; Natsuko Imai; Daniel J Laydon; Tara D Mangal; Thomas A Mellan; Swapnil Mishra; Gemma Nedjati-Gilani; Kris V Parag; Hayley A Thompson; H Juliette T Unwin; Michaela A C Vollmer; Caroline E Walters; Haowei Wang; Yuanrong Wang; Xiaoyue Xi; Neil M Ferguson; Lucy C Okell; Thomas S Churcher; Nimalan Arinaminpathy; Azra C Ghani; Patrick G T Walker; Timothy B Hallett Journal: Lancet Glob Health Date: 2020-07-13 Impact factor: 26.763
Authors: Patrick S Lungu; Andrew D Kerkhoff; Monde Muyoyeta; Clara C Kasapo; Sarah Nyangu; Mary Kagujje; Rhehab Chimzizi; Sulani Nyimbili; Morton Khunga; Nancy Kasese-Chanda; Victoria Musonda; Bushimbwa Tambatamba; Christopher M Kombe; Charles Sakulanda; Kizito Sampa; Andrew Silumesii; Kennedy Malama Journal: Bull World Health Organ Date: 2022-01-25 Impact factor: 9.408
Authors: Pruthu Thekkur; Kudakwashe C Takarinda; Collins Timire; Charles Sandy; Tsitsi Apollo; Ajay M V Kumar; Srinath Satyanarayana; Hemant D Shewade; Mohammed Khogali; Rony Zachariah; I D Rusen; Selma Dar Berger; Anthony D Harries Journal: Trop Med Infect Dis Date: 2021-05-31
Authors: Pruthu Thekkur; Hannock Tweya; Sam Phiri; James Mpunga; Thokozani Kalua; Ajay M V Kumar; Srinath Satyanarayana; Hemant D Shewade; Mohammed Khogali; Rony Zachariah; I D Rusen; Selma Dar Berger; Anthony D Harries Journal: Trop Med Infect Dis Date: 2021-05-19