Evaluation of TB treatment outcomes in outpatient settings during the COVID-19 pandemic
Abstract
<bold>Background.</bold> According to WHO recommendations, patient-oriented outpatient treatment is considered more preferable, as it reduces the likelihood of infection transmission. At the same time, it is especially important for patients receiving anti-tuberculosis treatment to remain under directly observed treatment (DOT), which was particularly challenging during the COVID-19 pandemic. <bold>Methods.</bold> A retrospective study included data from 341 ambulatory cards of adult pulmonary TB patients who started outpatient treatment from the first day during the periods from March to December of 2019-2020-2021 in Tashkent, Uzbekistan. Among the pulmonary TB patients who began outpatient treatment from the first day, drug-sensitive (DS) forms constituted 87.1%, while drug-resistant (DR) TB accounted for 12.9% of cases. <bold>Results.</bold> Analysis of this cohort of pulmonary TB patients demonstrated that the proportion of DS TB cases decreased from 90.5% in 2019 to 87.3% and 81.5% in 2020-2021, respectively. Meanwhile, the proportion of the similar cohort of DR TB cases increased from 9.5% in 2019 to 12.7% and 18.5% in 2020-2021, respectively. Analysis of treatment outcomes for patients with DS TB showed that the proportion of successful outcomes remained stable at 90.6% - 89.6% in 2019-2021. In the cohort of patients with DR TB the proportion of successful outcomes decreased from 69.2% in 2019 to 36.4% in 2020. <bold>Conclusion.</bold> TB treatment outcomes during the COVID-19 pandemic characterized by a decrease in the frequency of successful outcomes among patients with DR TB who began outpatient treatment from the first day, associated with the difficulty of organizing DOT during the COVID-19 pandemic.