The Impact of Covid-19 Pandemic on the Detection of Tuberculosis in Armenia

Abstract
Background: One of the vulnerable components of Tuberculosis Care Programs affected by the Covid-19 pandemic was the detection of tuberculosis (TB). Based on this conviction, a study devoted to the impact of the Covid-19 pandemic on the detection and diagnosis of tuberculosis was conducted in Armenia. Methods: This observational study has a retrospective descriptive research design based on the comparative calculation of the TB incidence rate for the historical pre-pandemic period (01-Mar-2019 to 29-Feb-2020) and during the Covid-19 pandemic period (01-Mar-2020 to 28-Feb-2021). Results: The data evaluation revealed that the number of active TB cases detected during the Covid-19 pandemic was lower by 37.6% compared with the pre-pandemic period (416 vs. 667). The significant reduction of the bacteriologically confirmed cases of pulmonary tuberculosis (28% drop) was most likely related to the decrease in the sputum diagnostic tests, as the number of patients who were tested by sputum microscopy during the pandemic was lower by 43.3% compared with the pre-pandemic period (2329 vs. 4110) and the number of patients tested by sputum GeneXpert test dropped by 23% during the Covid-19 pandemic (2291 vs. 2977). Conclusion: The comparative calculation of TB detection rate changes during the Covid-19 pandemic revealed a significant decrease in TB detection compared with the pre-pandemic period. The probable reasons for this decrease were the restrictions on visits to medical centers, limited access to diagnostic services, and undermined screening and contact tracing activities.

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