{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T01:40:29Z","timestamp":1790127629745,"version":"4.0.1"},"reference-count":26,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2022,10,26]],"date-time":"2022-10-26T00:00:00Z","timestamp":1666742400000},"content-version":"vor","delay-in-days":25,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Int AIDS Soc."],"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>COVID\u201019 stretched healthcare systems to their limits, particularly in settings with a pre\u2010existing high burden of infectious diseases, including HIV and tuberculosis (TB). We studied the impact of COVID\u201019 on TB services at antiretroviral therapy (ART) clinics in low\u2010 and middle\u2010income countries.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We surveyed ART clinics providing TB services in the International Epidemiology Databases to Evaluate AIDS (IeDEA) consortium in Africa and the Asia\u2010Pacific until July 2021 (TB diagnoses until the end of 2021). We collected site\u2010level data using standardized questionnaires.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 46 participating ART clinics, 32 (70%) were in Africa and 14 (30%) in the Asia\u2010Pacific; 52% provided tertiary care. Most clinics (85%) reported disrupted routine HIV care services during the pandemic, both in Africa (84%) and the Asia\u2010Pacific (86%). The most frequently reported impacts were on staff (52%) and resource shortages (37%; protective clothing, face masks and disinfectants). Restrictions in TB health services were observed in 12 clinics (26%), mainly reduced access to TB diagnosis and postponed follow\u2010up visits (6\/12, 50% each), and restrictions in TB laboratory services (22%). Restrictions of TB services were addressed by dispensing TB drugs for longer periods than usual (7\/12, 58%), providing telehealth services (3\/12, 25%) and with changes in directly observed therapy (DOT) (e.g. virtual DOT, 3\/12). The number of TB diagnoses at participating clinics decreased by 21% in 2020 compared to 2019; the decline was more pronounced in tertiary than primary\/secondary clinics (24% vs. 12%) and in sites from the Asia\u2010Pacific compared to Africa (46% vs. 14%). In 2021, TB diagnoses continued to decline in Africa (\u20138%) but not in the Asia\u2010Pacific (+62%) compared to 2020. During the pandemic, new infection control measures were introduced or intensified at the clinics, including wearing face masks, hand sanitation and patient triage.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The COVID\u201019 pandemic led to staff shortages, reduced access to TB care and delays in follow\u2010up visits for people with TB across IeDEA sites in Africa and the Asia\u2010Pacific. Increased efforts are needed to restore and secure ongoing access to essential TB services in these contexts.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jia2.26018","type":"journal-article","created":{"date-parts":[[2022,10,26]],"date-time":"2022-10-26T04:45:27Z","timestamp":1666759527000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Impact of the COVID\u201019 pandemic on TB services at ART programmes in low\u2010 and middle\u2010income countries: a multi\u2010cohort survey"],"prefix":"10.1002","volume":"25","author":[{"given":"Mariana","family":"Marti","sequence":"first","affiliation":[{"name":"Institute of Social and Preventive Medicine University of Bern Bern Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7915-3194","authenticated-orcid":false,"given":"Kathrin","family":"Z\u00fcrcher","sequence":"additional","affiliation":[{"name":"Institute of Social and Preventive Medicine University of Bern Bern Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8390-5881","authenticated-orcid":false,"given":"Leslie A.","family":"Enane","sequence":"additional","affiliation":[{"name":"The Ryan White Center for Pediatric Infectious Disease and Global Health Department of Pediatrics Indiana University School of Medicine Indianapolis Indiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lameck","family":"Diero","sequence":"additional","affiliation":[{"name":"Department of Medicine Moi University School of Medicine Eldoret Kenya"},{"name":"Department of Medicine Moi Teaching and Referral Hospital Eldoret Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3350-112X","authenticated-orcid":false,"given":"Olivier","family":"Marcy","sequence":"additional","affiliation":[{"name":"University of Bordeaux, Inserm U1219 IRD EMR271 Bordeaux France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9393-9732","authenticated-orcid":false,"given":"Thierry","family":"Tiendrebeogo","sequence":"additional","affiliation":[{"name":"University of Bordeaux, Inserm U1219 IRD EMR271 Bordeaux France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcel","family":"Yotebieng","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine Department of Medicine Albert Einstein College of Medicine Bronx New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1102-5564","authenticated-orcid":false,"given":"Christelle","family":"Twizere","sequence":"additional","affiliation":[{"name":"Centre National de R\u00e9f\u00e9rence en mati\u00e8re de VIH\/SIDA Burundi (CNR) Bujumbura Burundi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6975-057X","authenticated-orcid":false,"given":"Suwimon","family":"Khusuwan","sequence":"additional","affiliation":[{"name":"Chiangrai Prachanukroh Hospital Chiang Rai Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6650-0559","authenticated-orcid":false,"given":"Evy","family":"Yunihastuti","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Universitas Indonesia Dr. Cipto Mangunkusumo General Hospital Jakarta Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gary","family":"Reubenson","sequence":"additional","affiliation":[{"name":"Rahima Moosa Mother and Child Hospital Department of Paediatrics and Child Health Faculty of Health Sciences University of the Witwatersrand Johannesburg South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N. Sarita","family":"Shah","sequence":"additional","affiliation":[{"name":"Emory Rollins School of Public Health Emory University Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7462-5132","authenticated-orcid":false,"given":"Matthias","family":"Egger","sequence":"additional","affiliation":[{"name":"Institute of Social and Preventive Medicine University of Bern Bern Switzerland"},{"name":"Centre for Infectious Disease Epidemiology and Research Faculty of Health Sciences University of Cape Town Cape Town South Africa"},{"name":"Population Health Sciences Bristol Medical School University of Bristol Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3133-3011","authenticated-orcid":false,"given":"Marie","family":"Ballif","sequence":"additional","affiliation":[{"name":"Institute of Social and Preventive Medicine University of Bern Bern Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3309-4835","authenticated-orcid":false,"given":"Lukas","family":"Fenner","sequence":"additional","affiliation":[{"name":"Institute of Social and Preventive Medicine University of Bern Bern Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the IeDEA global consortium","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,10,26]]},"reference":[{"key":"e_1_2_12_2_1","unstructured":"World Health Organization.Global Tuberculosis Report 2019. 2020 [cited 2022 Mar 10]. 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