scholarly journals Tuberculosis Treatment Outcomes: A Fifteen Year Retrospective Study In Jos North And Mangu, Plateau State, North - Central Nigeria

2020 ◽  
Author(s):  
Comfort Nanbam Sariem ◽  
Patricia Odumosu ◽  
Maxwell Patrick Dapar ◽  
Jonah Musa ◽  
Luka Ibrahim ◽  
...  
Keyword(s):  
Treatment Failure ◽  
Treatment Outcomes ◽  
Descriptive Analysis ◽  
Treatment Success ◽  
Infectious Agent ◽  
Success Rates ◽  
North Central ◽  
Tuberculosis Patients ◽  
Tb Treatment ◽  
Plateau State

Abstract Background: Globally, tuberculosis (TB) is the leading cause of death from a single infectious agent. Adherence to TB therapy is an important factor in treatment outcomes, which is a critical indicator for evaluating TB treatment programs. This study assessed TB treatment outcomes using a fifteen-year record of tuberculosis patients who received treatment in Jos North and Mangu Local Government Areas of Plateau State Nigeria. Methods: The retrospective facility based study was done in five TB treatment centers which account for more than half of data for tuberculosis patients in Plateau State, North-Central Nigeria. Data were collected from 10156 TB patient’s health records between 2001 and 2015. Treatment outcomes were categorized as successful (cured, treatment completed) or unsuccessful (non-adherent, treatment failure or death). A descriptive analysis was done to assess the factors associated with treatment outcomes. Relevant bivariable and multivariable logistic regression were done. All statistical analyses were performed on Stata version 11, College station, Texas, USA.Results: During the study period, 58.1% (5904/10156) of the TB patients who received treatment were males. The Mean age ±SD was 35.5±15.5 years. The overall treatment success rate was 67.4%; non-adherence/defaulting rate was 18.5%, with majority of patients defaulting at the end of intensive phase of treatment. The sputum conversion rate was 72.8% and mortality rate was 7.5%. A decrease in successful treatment outcomes rate from 83.8% in 2001 to 64.4% in 2015 was observed. After adjusting for sex, and TB category, being HIV positive was 2.8 times (95% CI: 1.11-6.83, p=0.028) more likely to be associated with treatment success than having an unknown status. Treatment after loss to follow-up, relapse and treatment failure were less likely associated with treatment success than newly diagnosed TB patients.Conclusion: With the decrease in treatment success rates, underlying reasons for medication non-adherence and treatment failure should be resolved through adherence counseling involving the patient and treatment supporters, with education on voluntary counseling and testing for HIV among TB patients.

scholarly journals Tuberculosis Treatment Outcomes: A Fifteen Year Retrospective Study in Jos North and Mangu, Plateau State, North – Central Nigeria

2020 ◽  
Author(s):  
Comfort Nanbam Sariem ◽  
Patricia Odumosu ◽  
Maxwell Patrick Dapar ◽  
Jonah Musa ◽  
Luka Ibrahim ◽  
...  
Keyword(s):  
Treatment Failure ◽  
Treatment Outcomes ◽  
Descriptive Analysis ◽  
Treatment Success ◽  
Infectious Agent ◽  
Success Rates ◽  
North Central ◽  
Tuberculosis Patients ◽  
Tb Treatment ◽  
Plateau State

Abstract Background: Globally, tuberculosis (TB) is the leading cause of death from a single infectious agent. Adherence to TB therapy is an important factor in treatment outcomes, which is a critical indicator for evaluating TB treatment programs. This study assessed TB treatment outcomes using a fifteen-year record of tuberculosis patients who received treatment in Jos North and Mangu Local Government Areas of Plateau State, North-Central Nigeria. Methods: The retrospective facility based study was done in five TB treatment centers which account for more than half of data for tuberculosis patients in Plateau State. Data were collected from 10156 TB patient’s health records between 2001 and 2015. Treatment outcomes were categorized as successful (cured, treatment completed) or unsuccessful (non-adherent, treatment failure or death). A descriptive analysis was done to assess the factors associated with treatment outcomes. Relevant bivariable and multivariable logistic regression were done. All statistical analyses were performed on Stata version 11, College station, Texas, USA.Results: During the study period, 58.1% (5904/10156) of the TB patients who received treatment were males. The Mean age ±SD was 35.5 ±15.5 years. The overall treatment success rate was 67.4%; non-adherence/defaulting rate was 18.5%, with majority of patients defaulting at the end of intensive phase of treatment. The sputum conversion rate was 72.8% and mortality rate was 7.5%. A decrease in successful treatment outcomes rate from 83.8% in 2001 to 64.4% in 2015 was observed. After adjusting for sex, and TB category, being HIV positive was 2.8 times (95% CI: 1.11-6.83, p=0.028) more likely to be associated with treatment success than having an unknown status. Treatment after loss to follow-up, relapse and treatment failure were less likely associated with treatment success than newly diagnosed TB patients.Conclusion: With the decrease in treatment success rates, underlying reasons for medication non-adherence and treatment failure should be resolved through adherence counseling involving the patient and treatment supporters, with education on voluntary counseling and testing for HIV among TB patients.

scholarly journals Tuberculosis Treatment Outcomes: A Fifteen Year Retrospective Study In Jos North And Mangu, Plateau State, North - Central Nigeria

2019 ◽  
Author(s):  
Comfort Nanbam Sariem ◽  
Patricia Odumosu ◽  
Maxwell Patrick Dapar ◽  
Jonah Musa ◽  
Luka Ibrahim ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Treatment Failure ◽  
Treatment Outcomes ◽  
Treatment Success ◽  
Infectious Agent ◽  
Tuberculosis Treatment ◽  
Patient Treatment ◽  
North Central ◽  
Unsuccessful Treatment ◽  
Plateau State

Abstract Background Tuberculosis (TB) disease is the leading cause of death from a single infectious agent globally. Medication adherence will be more valuable if it improves clinical/treatment outcomes of the patient because treatment outcomes are major indicators for evaluating TB therapy. Objective To examine a fifteen-year record of tuberculosis treatment outcomes in Jos North and Mangu Local Government Areas of Plateau State. Methods The retrospective registry based study was done in five TB treatment centers which account for more than half of data for tuberculosis patients in Plateau State, North-Central Nigeria. Data were collected from 10,156 TB patient’s health records from 2001 to 2015. Treatment outcomes were classified as successful (cured, treatment completed) or unsuccessful (non-adherent, treatment failure or death). Analysis was done descriptively and factors associated with treatment outcomes were determined using multiple logistic regression with the aid of Stata version 11. Results Males were 58.1% of the population (10,156). Mean age ±SD was 35.5±15.5 years. The overall treatment success rate was 67.4%; non-adherence/defaulting rate was 18.5%, with majority of patients defaulting at the end of intensive phase of treatment; sputum conversion rate was 72.8% and mortality rate was 7.5%. A decrease in successful treatment outcomes from 83.8% to 64.4%, with a corresponding increase in unsuccessful treatment outcomes was observed. After adjusting for sex, and TB category, being HIV positive was 2.8 times (95% CI: 1.11-6.83, p =0.028) more likely to be associated with treatment success than having an unknown status. TALF/RAD, relapse and MDR-TB were less likely associated with treatment success than newly diagnosed TB patients Conclusion Underlying reasons for medication non-adherence and treatment failure identified should be resolved by the patient, treatment supporter and health system through adherence counseling, increased education on voluntary counseling and testing of HIV among TB patients. Keywords: Tuberculosis, Treatment Outcomes, Retrospective Study, Nigeria

scholarly journals TUBERCULOSIS TREATMENT OUTCOMES: A FIFTEEN YEAR COHORT STUDY IN JOS NORTH AND MANGU, PLATEAU STATE, NORTH - CENTRAL NIGERIA

2019 ◽  
Author(s):  
Comfort Nanbam Sariem ◽  
Patricia Odumosu ◽  
Maxwell Patrick Dapar ◽  
Jonah Musa ◽  
Luka Ibrahim ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Treatment Failure ◽  
Treatment Outcomes ◽  
Cause Of Death ◽  
Treatment Success ◽  
Tuberculosis Treatment ◽  
Patient Treatment ◽  
North Central ◽  
Unsuccessful Treatment ◽  
Plateau State

Abstract Background Tuberculosis (TB) is an infectious disease with a major global health problem; being the tenth leading cause of death worldwide, and the leading cause of death from a single infectious agent. Nigeria is among the countries with high burden of tuberculosis and the highest global mortality rate. Medication adherence has been shown to have profound effect on other treatment outcomes. Objective To examine a fifteen-year cohort of tuberculosis treatment outcomes in Jos North and Mangu Local Government Areas of Plateau State. Methods The study was done in five treatment centers which account for more than half of data for tuberculosis patients in Plateau State, North-Central Nigeria. The retrospective study was done from 2001 to 2015, where TB patient records who had completed treatment were evaluated. Treatment outcomes were classified as successful (cured, treatment completed) or unsuccessful (non-adherent, treatment failure or death) and analyzed using binomial logistic regression. Results Males composed 58.1% of the population (10,156). Mean age ±SD was 35.5±15.5 years. The overall treatment success rate was 67.4%; non-adherence/defaulting rate was 18.5%, with majority of patients defaulting at the end of intensive phase of treatment; sputum conversion rate was 72.8% and mortality rate was 7.5%. A decrease in successful treatment outcomes from 83.8% to 64.4%, with a corresponding increase in unsuccessful treatment outcomes was observed. The Predictors of medication non-adherence were patients with unknown HIV status (OR 4.29, 95% CI: 3.74-4.91, p < 0.001); being male (OR 1.15, CI: 1.37-1.66, p = 0.008) and having a history of non-adherence (OR 2.27, CI: 1.34-3.87, p = 0.002) and treatment failure (OR 2.83, CI: 0.98 – 8.19, p = 0.05). Conclusion Underlying reasons for medication non-adherence and treatment failure identified should be resolved by the patient, treatment supporter and health worker. Increased awareness and education on voluntary counseling and testing of HIV among TB patients is advocated, particularly among the male population.

Tuberculosis in native Israeli Arabs and Jews: trends and treatment outcomes, 1999–2011

2015 ◽  
Vol 143 (15) ◽  
pp. 3203-3210 ◽  
Author(s):  
H. BISHARA ◽  
D. GOLDBLATT ◽  
E. RORMAN ◽  
Z. MOR
Keyword(s):  
Treatment Outcomes ◽  
Clinical Laboratory ◽  
Treatment Success ◽  
Developed Countries ◽  
National Average ◽  
Success Rates ◽  
Pulmonary Tb ◽  
Tb Treatment ◽  
Lower Treatment ◽  
Israeli Arabs

SUMMARYThe incidence of tuberculosis (TB) in native ethnic minorities remains high in developed countries. Arabs, the major ethnic minority in Israel, comprise 21% of its population. This retrospective study compared TB incidence, demographic, clinical, laboratory, genotyping characteristics and treatment outcomes in all Israeli-born citizens diagnosed with TB between 1999 and 2011 by ethnicity, i.e. Israeli-born Arabs (IA) and Jews (IJ). A total of 831 Israeli-born TB patients were reported. Of those, there were 530 (64%) IJ and 301 (36%) IA, with an average annual TB rate of 1·1 and 1·6 cases/100 000 population, respectively, lower than the national average (7·0 cases/100 000 population). TB rates in IA and IJ declined and converged to 1 case/100 000 residents. IA TB patients were more likely to be older, have more pulmonary TB and have lower treatment success rates than IJ. Older age and HIV co-infection, but not ethnicity, were predictive of non-success in TB treatment. Ten mixed IA–IJ clades were detected by spoligotyping and three mixed IA–IJ clusters were identified by MIRU-VNTR typing. Only one IA–IJ couple recalled mutual contact. In conclusion, TB rate in IA was higher than in IJ, but declined and converged in both to 1 case/100 000. Treatment success was high in both groups, and was unrelated to ethnicity.

scholarly journals Treatment outcomes of patients with MDR-TB in Nepal on a current programmatic standardised regimen: retrospective single-centre study

2020 ◽  
Vol 7 (1) ◽  
pp. e000606 ◽  
Author(s):  
Samiksha Ghimire ◽  
Samriddhi Karki ◽  
Bhagwan Maharjan ◽  
Jos G W Kosterink ◽  
Daan J Touw ◽  
...  
Keyword(s):  
Treatment Outcomes ◽  
Treatment Success ◽  
Retrospective Chart Review ◽  
Therapeutic Drug ◽  
Sputum Smear ◽  
Success Rates ◽  
Tb Treatment ◽  
Treatment Implementation ◽  
Good Treatment Outcome ◽  
Mdr Tb

ObjectivesThe objectives of this study were to evaluate treatment in patients on current programmatic multidrug-resistant tuberculosis (MDR-TB) regimen and verify eligibility for the 9-month regimen and therapeutic drug monitoring (TDM).MethodsWe performed a retrospective chart review of patients with MDR-TB receiving standardised regimen at the German Nepal TB Project Clinic, Nepal, between 2014 and 2016. Eligibility for the 9-month regimen and indications for TDM were evaluated.ResultsOut of 107 available patients’ medical records, 98 were included. In this centre, the MDR-TB treatment success rates were 69.0% in 2015, 86.6% in 2016 and 86.5% in 2017. The median time to sputum smear conversion was 60 days (60–90 IQR) and culture conversion was 60 days (60–90 IQR). Observed side effects did not impact treatment outcomes. No difference in treatment success rates was observed between patients with predisposing risk factors and those without. Only 49% (36/74) of patients were eligible for the 9-month regimen and 23 patients for TDM according to American Thoracic Society guideline criteria.ConclusionsNepalese patients with MDR-TB on ambulatory care had good treatment outcome after programmatic treatment. Implementation of the new WHO oral MDR-TB treatment regimen may further improve treatment results. The 9-month regimen and TDM should be considered as part of programmatic care.

Measuring TB drug levels in the hair in adults and children to monitor drug exposure and outcomes

2021 ◽  
Vol 25 (1) ◽  
pp. 52-60
Author(s):  
V. Mave ◽  
D. Kadam ◽  
S. Gaikwad ◽  
A. Kinikar ◽  
D. Aguilar ◽  
...  
Keyword(s):  
Treatment Failure ◽  
Treatment Outcomes ◽  
Drug Exposure ◽  
Treatment Success ◽  
Cox Proportional Hazards ◽  
Tb Treatment ◽  
Drug Concentrations ◽  
Hair Samples ◽  
Adults And Children ◽  
Lower Hazard

INTRODUCTION: Testing for anti-TB drugs in small hair samples may serve as a non-invasive tool to measure cumulative drug exposure and/or adherence, as these determine treatment success. We aimed to assess how well hair assays of TB drugs predict TB treatment outcomes.METHODS: A small thatch of hair, ~30 strands, was cut from the occipital region in adults and children from a prospective TB cohort in India. Isoniazid (INH), acetyl-INH and pyrazinamide (PZA) were extracted from the hair samples and quantified using liquid-chromatography-tandem mass spectrometry. The relationship between drug concentrations in hair and time to unfavourable outcomes was assessed using Cox-proportional hazards regression models.RESULTS: A two-fold increase in hair acetyl-INH concentrations in the 264 participants in our cohort with hair assays for TB drugs indicated a lower hazard of unfavourable TB treatment outcomes (aHR 0.67, 95%CI 0.44–1.02) and TB treatment failure (aHR 0.65, 95%CI 0.42–1.01). Higher summed concentrations (a summed measure of INH and acetyl-INH) indicated a lower hazard of treatment failure (aHR 0.69, 95%CI 0.45–1.05)CONCLUSION: Hair levels of INH and its metabolite may predict TB treatment outcomes, indicating the potential utility of this measure to assess and optimise TB treatment outcomes.

scholarly journals Treatment outcome of tuberculosis patients at Adare general Hospital, Hawassa, Southern Ethiopia. (A five year retrospective study)

2019 ◽  
Author(s):  
Bezunesh Tsegaye ◽  
Zufan Bedewi ◽  
Solomon Lemma Asnake
Keyword(s):  
Treatment Outcome ◽  
Retrospective Study ◽  
Treatment Outcomes ◽  
General Hospital ◽  
Treatment Success ◽  
Southern Ethiopia ◽  
P Value ◽  
Tuberculosis Patients ◽  
Tb Treatment ◽  
Extra Pulmonary

Abstract Background Globally still Tuberculosis remains a major public health problems and socio-economic issue in the 21st century. Ethiopia is among the countries most heavily affected by Tuberculosis, where it is the leading cause of morbidity, the third cause of hospital admission and the second cause of death. To improve Tuberculosis management and control, early detection of cases, effective treatment and persistent evaluation of treatment outcome are vital issues that should be taken into consideration. Hence, this study was designed to determine treatment outcomes and associated risk factors among TB patients registered and receiving anti-TB treatment at Adare general Hospital, Southern Ethiopia. Methods A five years retrospective study was conducted by reviewing medical records of TB patients at Adare general Hospital. A total of 1151 Tuberculosis patients’ cards registered from (September 2013 to August 2017) for treatment at TB clinic were reviewed. Data was coded, cleaned and entered into Microsoft Excel sheet then ported and analyzed using SPSS version 20 statistical soft ware. Logistic regression with odds ratios (OR) along with the 95% confidence interval was computed and interpreted. A P value <0.05 was declared as statistically significant. Result Among 1122 cases 620 (55.3%) were male, 748(66.7%) were from urban areas, 319 (28.4%) were smear positive, 352 (31.4%) were smear negative and 451 (40.2%) were extra pulmonary patients. Of the 1122 284 (25.3%) were cured, 753(67.1%) completed treatment, 29(2.6%) defaulted, 53(4.7%) died and 3 (0.3%) had treatment failure. The mean treatment success rate was 92.4%. The risk of unsuccessful TB treatment outcome was significantly higher among TB patients from rural areas (AOR = 0.43, 95% CI: 0.27, 0.67); patients with extra pulmonary TB (AOR = 0.87, 95% CI; 0.67, 1.14), and HIV positive TB patients (AOR = 5.47, 95% CI; 3.47, 8.63) were more likely to have poor treatment outcomes as compared to their counter parts. Conclusion The treatment success rates of Tuberculosis, at Adare hospital was comparable to national health facility level coverage, but it should be maintained and strengthen further to attain tuberculosis related national and millennium goal.

scholarly journals Diabetes among tuberculosis patients and its impact on tuberculosis treatment in South Asia: a systematic review and meta-analysis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Sanju Gautam ◽  
Nipun Shrestha ◽  
Sweta Mahato ◽  
Tuan P. A. Nguyen ◽  
Shiva Raj Mishra ◽  
...  
Keyword(s):  
Systematic Review ◽  
Sri Lanka ◽  
Treatment Failure ◽  
South Asia ◽  
Treatment Outcomes ◽  
Meta Analysis ◽  
Tb Treatment ◽  
Effect Model ◽  
Pooled Prevalence ◽  
The Impact

AbstractThe escalating burden of diabetes is increasing the risk of contracting tuberculosis (TB) and has a pervasive impact on TB treatment outcomes. Therefore, we conducted this systematic review and meta-analysis to examine the burden of diabetes among TB patients and assess its impact on TB treatment in South Asia (Afghanistan, Bangladesh, Bhutan, Maldives, Nepal, India, Pakistan, and Sri Lanka). PubMed, Excerpta Medica Database (EMBASE), and CINAHL databases were systematically searched for observational (cross-sectional, case–control and cohort) studies that reported prevalence of diabetes in TB patients and published between 1 January 1980 and 30 July 2020. A random-effect model for computing the pooled prevalence of diabetes and a fixed-effect model for assessing its impact on TB treatment were used. The review was registered with PROSPERO number CRD42020167896. Of the 3463 identified studies, a total of 74 studies (47 studies from India, 10 from Pakistan, four from Nepal and two from both Bangladesh and Sri-Lanka) were included in this systematic review: 65 studies for the prevalence of diabetes among TB patients and nine studies for the impact of diabetes on TB treatment outcomes. The pooled prevalence of diabetes in TB patients was 21% (95% CI 18.0, 23.0; I2 98.3%), varying from 11% in Bangladesh to 24% in Sri-Lanka. The prevalence was higher in studies having a sample size less than 300 (23%, 95% CI 18.0, 27.0), studies conducted in adults (21%, 95% CI 18.0, 23.0) and countries with high TB burden (21%, 95% CI 19.0, 24.0). Publication bias was detected based on the graphic asymmetry of the funnel plot and Egger’s test (p < 0.001). Compared with non-diabetic TB patients, patients with TB and diabetes were associated with higher odds of mortality (Odds Ratio (OR) 1.7; 95% CI 1.2, 2.51; I2 19.4%) and treatment failure (OR 1.7; 95% CI 1.1, 2.4; I2 49.6%), but not associated with Multi-drug resistant TB (OR 1.0; 95% CI 0.6, 1.7; I2 40.7%). This study found a high burden of diabetes among TB patients in South Asia. Patients with TB-diabetes were at higher risk of treatment failure and mortality compared to TB alone. Screening for diabetes among TB patients along with planning and implementation of preventive and curative strategies for both TB and diabetes are urgently needed.

scholarly journals Effect of using electronic medication monitors on tuberculosis treatment outcomes in China: a longitudinal ecological study

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Ni Wang ◽  
Lei Guo ◽  
Hemant Deepak Shewade ◽  
Pruthu Thekkur ◽  
Hui Zhang ◽  
...  
Keyword(s):  
Success Rate ◽  
Treatment Outcomes ◽  
Treatment Success ◽  
Coverage Rate ◽  
Treatment Success Rate ◽  
County Level ◽  
Time Data ◽  
Tb Treatment ◽  
Random Intercept ◽  
Relative Change

Abstract Background In China, an indigenously developed electronic medication monitor (EMM) was designed and used in 138 counties from three provinces. Previous studies showed positive results on accuracy, effectiveness, acceptability, and feasibility, but also found some ineffective implementations. In this paper, we assessed the effect of implementation of EMMs on treatment outcomes. Methods The longitudinal ecological method was used at the county level with aggregate secondary programmatic data. All the notified TB cases in 138 counties were involved in this study from April 2017 to June 2019, and rifampicin-resistant cases were excluded. We fitted a multilevel model to assess the relative change in the quarterly treatment success rate with increasing quarterly EMM coverage rate, in which a mixed effects maximum likelihood regression using random intercept model was applied, by adjusting for seasonal trends, population size, sociodemographic and clinical characteristics, and clustering within counties. Results Among all 69 678 notified TB cases, the treatment success rate was slightly increased from 93.5% [95% confidence interval (CI): 93.0–94.0] in second quarter of 2018 to 94.9% (95% CI: 94.4–95.4) in second quarter of 2019 after implementing EMMs. There was a statistically significant effect between quarterly EMM coverage and treatment success rate after adjusting for potential confounders (P = 0.0036), increasing 10% of EMM coverage rate will lead to 0.2% treatment success rate augment. Besides, an increase of 10% of elderly or bacteriologically confirmed TB will lead to a decrease of 0.4% and 0.9% of the treatment success rate. Conclusions Under programmatic settings, we found a statistically significant effect between increasing coverage of EMM and treatment success rate at the county level. More prospective studies are needed to confirm the effect of using EMM on TB treatment outcomes. We suggest performing operational research on EMMs that provides real-time data under programmatic conditions in the future.

scholarly journals Operational Research to Assess the Real-Time Impact of COVID-19 on TB and HIV Services: The Experience and Response from Health Facilities in Harare, Zimbabwe

2021 ◽  
Vol 6 (2) ◽  
pp. 94
Author(s):  
Pruthu Thekkur ◽  
Kudakwashe C. Takarinda ◽  
Collins Timire ◽  
Charles Sandy ◽  
Tsitsi Apollo ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Treatment Outcomes ◽  
Real Time ◽  
Treatment Success ◽  
Health Facilities ◽  
Case Detection ◽  
Monthly Data ◽  
Hiv Services ◽  
Tb Treatment ◽  
Set Up

When COVID-19 was declared a pandemic, there was concern that TB and HIV services in Zimbabwe would be severely affected. We set up real-time monthly surveillance of TB and HIV activities in 10 health facilities in Harare to capture trends in TB case detection, TB treatment outcomes and HIV testing and use these data to facilitate corrective action. Aggregate data were collected monthly during the COVID-19 period (March 2020–February 2021) using EpiCollect5 and compared with monthly data extracted for the pre-COVID-19 period (March 2019–February 2020). Monthly reports were sent to program directors. During the COVID-19 period, there was a decrease in persons with presumptive pulmonary TB (40.6%), in patients registered for TB treatment (33.7%) and in individuals tested for HIV (62.8%). The HIV testing decline improved in the second 6 months of the COVID-19 period. However, TB case finding deteriorated further, associated with expiry of diagnostic reagents. During the COVID-19 period, TB treatment success decreased from 80.9 to 69.3%, and referral of HIV-positive persons to antiretroviral therapy decreased from 95.7 to 91.7%. Declining trends in TB and HIV case detection and TB treatment outcomes were not fully redressed despite real-time monthly surveillance. More support is needed to transform this useful information into action.

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