Publication date: Oct 14, 2024
The COVID-19 pandemic negatively impacted tuberculosis (TB) treatment services, including directly observed therapy (DOT) programs used to promote medication adherence. We compared DOT adherence embedded in a research study before and after COVID-19 lockdowns in South Africa. We analyzed data from 263 observational study participants undergoing drug susceptible (DS)-TB DOT between May 2017 to March 2022. Participants enrolled before October 2019 were considered ‘pre-COVID-19’ and those enrolled after September 2020 were considered ‘post-COVID-19 lockdown groups. Negative binomial regression models were used to compare DOT non-adherence rates between the two lockdown groups. We then conducted a sensitivity analysis which only included participants enrolled in the immediate period following the first COVID-19 lockdown. DOT non-adherence rate was higher in the post-COVID-19 lockdown group (aIRR = 1. 42, 95% CI = 1. 04-1. 96; p = 0. 028) compared to pre-COVID-19 lockdown period, adjusting for age, sex, employment status, household hunger, depression risk, and smoked substance use. DOT non-adherence was highest immediately following the initial lockdown (aIRR = 1. 74, 95% CI = 1. 17-2. 67; p = 0. 006). The COVID-19 lockdowns adversely effected adherence to TB DOT in the period after lockdowns were lifted. The change in DOT adherence persisted even after adjusting for socioeconomic and behavioral variables. We need a better understanding of what treatment adherence barriers were exacerbated by COVID-19 lockdowns to improve outcomes in post-pandemic times. ClinicalTrials. gov Registration Number: NCT02840877. Registered on 19 July 2016.
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Semantics
| Type | Source | Name |
|---|---|---|
| disease | MESH | tuberculosis |
| pathway | KEGG | Tuberculosis |
| disease | MESH | COVID-19 |
| disease | MESH | depression |
| disease | MESH | substance use |
| drug | DRUGBANK | Tropicamide |
| disease | MESH | Infectious Diseases |
| pathway | REACTOME | Reproduction |
| disease | IDO | country |
| drug | DRUGBANK | Ethanol |
| drug | DRUGBANK | Coenzyme M |
| drug | DRUGBANK | Rifampicin |
| disease | MESH | epilepsy |
| drug | DRUGBANK | Etoperidone |
| disease | IDO | blood |
| disease | IDO | history |
| drug | DRUGBANK | Indoleacetic acid |
| drug | DRUGBANK | Phosphatidyl ethanol |
| drug | DRUGBANK | Metamfetamine |
| drug | DRUGBANK | Methaqualone |
| disease | MESH | underweight |
| disease | MESH | overweight |
| drug | DRUGBANK | Trestolone |
| drug | DRUGBANK | Medical Cannabis |
| disease | MESH | unemployment |
| disease | IDO | symptom |
| disease | MESH | Allergy |
| disease | MESH | AIDS |
| disease | MESH | anxiety |
| disease | MESH | pulmonary tuberculosis |
| disease | IDO | colony |
| disease | MESH | treatment delays |