O impacto da pandemia de COVID-19 no tratamento preventivo da tuberculose no Brasil: um estudo de coorte retrospectivo utilizando dados secundários

Abstract

The COVID-19 pandemic significantly impacted several sectors of society, especially health services, which were directly affected on a global scale. As a result, other diseases were left in the background, including tuberculosis, which until before the pandemic was the most prevalent infectious disease in the world. Aiming to change the tuberculosis scenario, preventive tuberculosis treatment (TPT) was planned as a tuberculosis strategy elimination, but until the time of the study the impact of COVID on TPT had been little explored. Method: Retrospective cohort study that used secondary data from the Brazilian TPT information system (IL-TB system), covering cities with more than 1,000 notifications. Initially, 5 cities were analyzed, with expansion to 11 cities later. Prescriptions were evaluated from 6 months after training health professionals, between 2018 and July 2021 in the first analysis, and until October 2022 in the second. The proportion of outcomes was examined until the end of 2020 in the first stage and until July 2022 in the second, considering the week of treatment start. To evaluate trends, Joinpoint regression was applied, and time series analysis was performed using the ARIMA model. Results: 14,014 notifications were analyzed in the first stage and 39,701 in the second. In both analyses, the cities of Rio de Janeiro and São Paulo concentrated the majority of records. Isoniazid was the predominant medication, used in 98% of cases until July 2021 and in 87% until October 2022. The 3-month regimen of rifapentine and isoniazid, available since 2022, was the second most used. A 93% reduction in notifications was observed during the first analysis; however, with the extension of the period until October 2022, an increase in TPT notifications was identified in seven of the eleven cities analyzed. The proportion of TPT completed was 73% in the first stage and 65% in the second. Conclusions: Overall, there was a recovery in notifications, suggesting that notifications were not prioritized during the pandemic, although a reduction in the proportion of TPT completed was observed.