The impact of the COVID-19 pandemic on tuberculosis case reporting in Kazakhstan

Abstract Background The COVID-19 pandemic had a significant impact on economic development, lifestyles and health systems in all countries. Due to the lack of medical interventions, many countries adopted restrictive measures to slow the spread of the virus and reduce the burden on the healthcare system. Quarantine measures have had an impact on the transmission of SARS-CoV-2. However, the unintended consequences of such drastic measures were inevitable. In developing countries, there have been adverse effects of disruptions in health services, including the provision of timely medical services in detecting cases of tuberculosis in the population. The aim of this study was to study the influence of COVID-19 pandemic on the tuberculosis incidence in the Republic of Kazakhstan. Methods We analyzed national data on the reported tuberculosis cases and screening results of tuberculosis in Kazakhstan for 2019-2020. The primary data were collected from regular reporting of cases through surveillance. Results The number of registered patients identified during screening activities in 2020 were 2,854 cases compared to 4,288 cases in 2019 before COVID-19 era. The proportion of cases with antibiotic-resistant (poly, multi, super) forms of tuberculosis increased up to 6.7% in 2020 in comparison with 2019. Conclusions There is a need to conduct an analysis of the reasons for the increase in cases of multidrug-resistant and extensively drug-resistant tuberculosis. The working process should be adapted to epidemics and emergencies to ensure the availability of medical services, as well as to improve the system of preventive examinations and screening for the early detection of TB cases. The abstract was submitted under the ‘CATINCA - Capacities and infrastructures for health policy development’ project which is coordinated/led by Robert Koch Institute and supported by the WHO Regional Office for Europe. Key messages The detection of tuberculosis during preventive examinations and screenings significantly decreased in 2020 compared to 2019. In recent years, there has been a significant increase in the number of cases with poly-, multi- and superantibiotic-resistant forms of tuberculosis.


Background:
The COVID-19 pandemic had a significant impact on economic development, lifestyles and health systems in all countries. Due to the lack of medical interventions, many countries adopted restrictive measures to slow the spread of the virus and reduce the burden on the healthcare system. Quarantine measures have had an impact on the transmission of SARS-CoV-2. However, the unintended consequences of such drastic measures were inevitable. In developing countries, there have been adverse effects of disruptions in health services, including the provision of timely medical services in detecting cases of tuberculosis in the population. The aim of this study was to study the influence of COVID-19 pandemic on the tuberculosis incidence in the Republic of Kazakhstan.

Methods:
We analyzed national data on the reported tuberculosis cases and screening results of tuberculosis in Kazakhstan for 2019-2020. The primary data were collected from regular reporting of cases through surveillance.

Results:
The number of registered patients identified during screening activities in 2020 were 2,854 cases compared to 4,288 cases in 2019 before COVID-19 era. The proportion of cases with antibiotic-resistant (poly, multi, super) forms of tuberculosis increased up to 6.7% in 2020 in comparison with 2019.

Conclusions:
There is a need to conduct an analysis of the reasons for the increase in cases of multidrug-resistant and extensively drugresistant tuberculosis. The working process should be adapted to epidemics and emergencies to ensure the availability of medical services, as well as to improve the system of preventive examinations and screening for the early detection of TB cases. The abstract was submitted under the 'CATINCA -Capacities and infrastructures for health policy development' project which is coordinated/led by Robert Koch Institute and supported by the WHO Regional Office for Europe. Key messages: The detection of tuberculosis during preventive examinations and screenings significantly decreased in 2020 compared to 2019. In recent years, there has been a significant increase in the number of cases with poly-, multi-and superantibioticresistant forms of tuberculosis.

Background:
Musculoskeletal and connective tissue diseases represent a growing public health problem, a great burden on health systems and place a heavy burden on society as a whole. Patients with musculoskeletal and connective tissue diseases often retire early, and any early retirement that could be prevented represents a loss of human capital, which means great social and economic damage to society. The present study was conducted in order to calculate for the first time in Slovenia the costs of the six most common diseases of the musculoskeletal and connective tissue diseases for the period from 2016-2018.

Methods:
The calculated burden of musculoskeletal and connective tissue diseases was based on the calculation of various direct and indirect costs cross-sectionally at the level of one year. The methodology of National Transfer Accounts (NTA) was used for the calculation of indirect costs. Six major diagnoses based on the International Classification of Diseases and Related Health Problems for statistical purposes were selected for calculation. Data were obtained from different national routine databases.

Results:
Calculations of the economic burden of musculoskeletal and connective tissue diseases in Slovenia showed that the economic costs of six selected diagnoses in the period 2016-2018 averaged about 5% of total health expenditure or 0.4% of gross domestic product in this period. The highest direct costs were hospitalizations, followed by costs for medicines, first curative visits at the primary level and visits to the outpatient clinic at the secondary level.

Conclusions:
The results of the first calculation of the burden of musculoskeletal and connective tissue diseases in Slovenia showed a high economic burden of these diseases in the period from 2016 to 2018. The economic burden is underestimated and would be significantly higher considering all diagnoses from this group of diseases. Key messages: Reducing the burden of musculoskeletal and connective tissue diseases is absolutely necessary in view of the aging population and in the light of the sustainability of health systems. The preparation of strategic documents for the promotion of musculoskeletal health and the consistent implementation of their contents has become urgent in Slovenia.
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