Impact of the COVID-19 pandemic on tuberculosis services in a rural area of Senegal

05/07/2024

Introduction: According to the Global TB Report 2022 [1], the COVID-19 pandemic significantly impacted TB services in both high and low TB burden countries. In 2020, there was in fact a widespread decline in the number of new TB diagnoses and case notifications, which reflects a reduced disease detection and, consequently, access to treatment. This severely affected TB disease burden, with an increased incidence and mortality in both 2020 and 2021. Nevertheless, African countries have apparently been less impacted by the COVID-19 pandemic, showing a less significant drop in TB notifications in 2020. However, it has to be considered that for sub-Saharan Africa only a limited amount of data is available [2, 3].

Senegal is a high TB incidence country, with an estimated incidence rate of 113 cases/100,000 population and a total amount of estimated cases equal to 19,000 in 2021. The estimated HIV-negative TB mortality rate is 16 cases/100,000 population and the total amount of deaths due to TB reached 2,800 in 2021. For People Living With HIV (PLWH), the estimated TB mortality rate is 1.3 cases/100,000 population, with a total amount of deaths related to TB of 230 [1]. Regarding COVID-19 pandemic, Africa resulted to be the less affected region in the world. Senegal, in line with the continent’s data, presented few cases and deaths: from 3rd January 2020 to 12th July 2023, there have been 89,007 confirmed cases of COVID-19 with 1,971 deaths, as reported to WHO [4]. 

The Fimela district, an administrative district of the region of Fatick located in the Southwest part of the Northern outcrop of Senegal, has an estimated population of 80,599 people, mostly farmers, fishermen and merchants living in rural and sub-urban settings, organized in villages. The only tertiary level healthcare centre, the Health Centre of Diofior (HCD), serves the whole Fimela district, an area of 1,115 km2. The HCD hosts an integrated outpatient clinic for TB and HIV infection. Since 2013, the Italian non-governmental organization StopTB Italia has been supporting the Senegalese National Tuberculosis Programme (NTP) to deliver TB awareness, appropriate and updated diagnostic tools, treatment consultation and economic support to TB patients at the HCD.

The aim of our study was to investigate the impact of COVID-19 pandemic on TB outpatient services in this rural area of Senegal.

Menotti 1,2,3 – M. Giglia 1,2,3 – M. Tadolini 1,2,3 – N. Riccardi 1,4 – M. D. Yacine 1,5 – M. Ndiaye 1,6  – G. Besozzi 1 – G. Sotgiu 1,7 – L. Saderi 1,7  – L. R. Codecasa 1,8

1 Stop TB Italia, Milan (Italy). 2 Infectious Diseases Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Italy. 3 Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna (Italy). 4 Clinic of Infectious Diseases and Tropical Medicine, Azienda Ospedaliero Universitaria Pisana, Pisa (Italy). 5 Ministry of Health, Dakar (Senegal). 6 Health Care Centre of Diofior (Senegal). 7 Faculty of Medicine and Surgery- University of Sassari (Italy). 8 Tisiologia Villa Marelli- Ospedale Niguarda, Milan (Italy).

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