Impact of a multi-disease integrated screening and diagnostic model for COVID-19, TB, and HIV in Lesotho

Author:

Katende BulembaORCID,Bresser Moniek,Kamele Mashaete,Chere Lebohang,Tlahali Mosa,Erhardt Rahel Milena,Muhairwe Josephine,Ayakaka Irene,Glass Tracy R.,Ruhwald Morten,van Ginneken BramORCID,Murphy Keelin,de Vos MargarethaORCID,Amstutz Alain,Mareka Mathabo,Mooko Sekhele Matabo,Reither KlausORCID,González Fernández LuciaORCID

Abstract

The surge of the COVID-19 pandemic challenged health services globally, and in Lesotho, the HIV and tuberculosis (TB) services were similarly affected. Integrated, multi-disease diagnostic services were proposed solutions to mitigate these disruptions. We describe and evaluate the effect of an integrated, hospital-based COVID-19, TB and HIV screening and diagnostic model in two rural districts in Lesotho, during the period between December 2020 and August 2022. Adults, hospital staff, and children above 5 years attending two hospitals were pre-screened for COVID-19 and TB symptoms. After a positive pre-screening, participants were offered to enroll in a service model that included clinical evaluation, chest radiography, SARS-CoV-2, TB, and HIV testing. Participants diagnosed with COVID-19, TB, or HIV were contacted after 28 days to evaluate their health status and linkage to HIV and/or TB care services. Of the 179160 participants pre-screened, 6623(3.7%) pre-screened positive, and 4371(66%) were enrolled in this service model. Of the total 458 diagnoses, only 17 happened in children. One positive rapid antigen test for SARS-CoV-2 was found per 11 participants enrolled, one Xpert-positive TB case was diagnosed per 85 people enrolled, and 1 new HIV diagnosis was done per 182 people enrolled. Of the 321(82.9%) participants contacted after 28 days of diagnosis, 304(94.7%) reported to be healthy. Of the individuals that were newly diagnosed with HIV or TB, 18/24(75.0%) and 46/51(90.1%) started treatment within 28 days of the diagnosis. This screening and diagnostic model successfully maintained same-day, integrated COVID-19, TB, and HIV testing services, despite frequent disruptions caused by the surge of COVID-19 waves, healthcare seeking patterns, and the volatile context (social measures, travel restrictions, population lockdowns). There were positive effects in avoiding diagnostic delays and ensuring linkage to services, however, diagnostic yields for adults and children were low. To inform future preparedness plans, research will need to identify essential health interventions and how to optimize them along each phase of the emergency response.

Funder

Botnar Research Centre for Child Health, University of Basel

Publisher

Public Library of Science (PLoS)

Reference57 articles.

1. The Effects of the Health System Response to the COVID-19 Pandemic on Chronic Disease Management: A Narrative Review;T. Kendzerska;Risk Manag Healthc Policy,2021

2. Impact of COVID-19 pandemic on utilisation of healthcare services: a systematic review;R. Moynihan;BMJ Open,2021

3. COVID-19 and resilience of healthcare systems in ten countries;C. Arsenault;Nat Med,2022

4. “Third round of the global pulse survey on continuity of essential health services during the COVID-19 pandemic: November—December 2021: interim report, 7 February 2022—World | ReliefWeb.” https://reliefweb.int/report/world/third-round-global-pulse-survey-continuity-essential-health-services-during-covid-19 (accessed Dec. 02, 2022).

5. Maintaining essential health services: operational guidance for the COVID-19 context;World Health Organization;World Health Organization,2020

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3