Impact of Case Detection and COVID-19-Related Disruptions on Tuberculosis in Vietnam: A Modelling Analysis

Le résumé fourni par la source

ABSTRACT Background Vietnam, a high-burden tuberculosis (TB) country, experienced marked declines in TB notifications during the COVID-19 pandemic. We assessed the impact of pandemic-related disruptions on TB case detection and transmission using a dynamic transmission model calibrated to local demographic and epidemiological observations. Methods We developed an age-structured compartmental TB transmission model to estimate COVID-19’s impact on TB in Vietnam. Four model assumptions reflecting reductions in detection and/or transmission were calibrated to notification data, with the best-fitting assumption used for future projections and to evaluate the effects of enhanced case detection scenarios. Results COVID-19 significantly disrupted TB services in Viet Nam, resulting in an estimated 2,000 additional TB episodes (95% credible interval [CrI]: 200-5,100) and 1,100 TB-related deaths (95%CrI: 100-2,700) in 2021.By 2035, the cumulative impact of these disruptions could reach 22,000 additional TB episodes (95%CrI: 2,200-63,000) and 5,900 deaths (95%CrI: 600-16,600) by 2035. We predicted two hypothetical scenarios of enhancing TB case detection. Under the ambitious scenario, enhancing TB case detection could mitigate these potential impacts by preventing 17.8% of new TB episodes (95%CrI: 13.1%-21.9%) and 34.2% (95%CrI: 31.5%-37.0%) of TB-related deaths by 2035, compared to no enhancement. Conclusions COVID-19-related disruptions have hindered TB detection in Vietnam, likely causing long-term increases in new TB episodes and deaths. However, the uncertainty around these effects is considerable. Sustained investment in diagnostics, system resilience, and patient-centric policies have the potential to achieve benefits that are substantially larger than these pandemic-related setbacks. Summary COVID-19 disrupted TB detection in Vietnam, leading to long-term increases in incidence and mortality. Modelling suggests improved case-finding could avert a sizeable portion of new infections and deaths, but sustained investment is essential to improve TB prevention and care.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.