코로나19 팬데믹이 결핵신고 지연에 미치는 영향
The Impact of the COVID-19 Pandemic on the Delay in Tuberculosis Notification
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Objectives: To analyze the impact of the COVID-19 pandemic on tuberculosis (TB) diagnosis and notification, providing data for future TB management strategies. Methods: We analyzed 433 TB cases from a rural public health center, divided into pre-pandemic (2017 –2019, 257 cases) and pandemic periods (2020–2022, 176 cases). General and TB-related characteristics were compared, and factors influencing delayed reporting were assessed using multivariate logistic regression analysis. Results: During the pandemic, TB patients exhibited more progressed symptoms and test results, indicating delayed diagnosis. The delayed reporting rate increased significantly from 61.2% before the pandemic to 77% during it. The pandemic was associated with a 2.14-fold higher risk of delayed reporting (adjusted odds ratio [aOR] = 2.14, 95% confidence interval [CI]: 1.15–3.99). Ex-smokers had a 61% lower risk of delay compared to non-smokers (aOR = 0.39, 95% CI: 0.17–0.92). The risk of delay decreased by 60% with two symptoms (aOR = 0.40, 95% CI: 0.16–0.99) and by 90% with three or more symptoms (aOR = 0.10, 95% CI: 0.02–0.53) compared to only one symptom. However, the presence of a cough increased the risk of delay by 3.37 times (aOR = 3.37, 95% CI: 1.40–8.10), and weight loss increased it by 7.06 times (aOR = 7.06, 95% CI: 1.96–25.47). Reporting from clinics or public health centers increased the risk of delay by 5.47 times compared to general hospitals (aOR = 5.47, 95% CI: 1.02–30.23). Conclusion: The COVID-19 pandemic led to delayed TB diagnoses, potentially worsening disease transmission and outcomes. Timely detection and management of TB are essential during respiratory disease pandemics.
Abstract
Objectives: To analyze the impact of the COVID-19 pandemic on tuberculosis (TB) diagnosis and notification, providing data for future TB management strategies. Methods: We analyzed 433 TB cases from a rural public health center, divided into pre-pandemic (2017 –2019, 257 cases) and pandemic periods (2020–2022, 176 cases). General and TB-related characteristics were compared, and factors influencing delayed reporting were assessed using multivariate logistic regression analysis. Results: During the pandemic, TB patients exhibited more progressed symptoms and test results, indicating delayed diagnosis. The delayed reporting rate increased significantly from 61.2% before the pandemic to 77% during it. The pandemic was associated with a 2.14-fold higher risk of delayed reporting (adjusted odds ratio [aOR] = 2.14, 95% confidence interval [CI]: 1.15–3.99). Ex-smokers had a 61% lower risk of delay compared to non-smokers (aOR = 0.39, 95% CI: 0.17–0.92). The risk of delay decreased by 60% with two symptoms (aOR = 0.40, 95% CI: 0.16–0.99) and by 90% with three or more symptoms (aOR = 0.10, 95% CI: 0.02–0.53) compared to only one symptom. However, the presence of a cough increased the risk of delay by 3.37 times (aOR = 3.37, 95% CI: 1.40–8.10), and weight loss increased it by 7.06 times (aOR = 7.06, 95% CI: 1.96–25.47). Reporting from clinics or public health centers increased the risk of delay by 5.47 times compared to general hospitals (aOR = 5.47, 95% CI: 1.02–30.23). Conclusion: The COVID-19 pandemic led to delayed TB diagnoses, potentially worsening disease transmission and outcomes. Timely detection and management of TB are essential during respiratory disease pandemics.
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