Interruption of tuberculosis detection and care during the Ebola virus disease epidemic (2014–2015) in Liberia: time-series analyses for 2013–2017

Objective: Interrupted time-series analyses, using 5 years of routinely collected health information system data, were conducted to estimate the magnitude of impact of the 2014–2015 Ebola virus disease (EVD) epidemic and determine trends in tuberculosis (TB) care services in Liberia. Methods: A segm...

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Autores principales:	Keith L. Gray, Naomi F. Walker, Frederick Martineau, Nahid Bhadelia, Wahdae-mai Harmon-Gray, Laura A. Skrip, Jean DeMarco, Patrick Konwloh, Nelson Dunbar
Formato:	article
Lenguaje:	EN
Publicado:	Elsevier 2021
Materias:	Ebola Interrupted time-series analysis Liberia Mycobacterium tuberculosis Public health Disease outbreaks Infectious and parasitic diseases RC109-216
Acceso en línea:	https://doaj.org/article/6dd47cbccccb452c8a2dc27cde936b66
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spelling	oai:doaj.org-article:6dd47cbccccb452c8a2dc27cde936b662021-11-30T04:13:59ZInterruption of tuberculosis detection and care during the Ebola virus disease epidemic (2014–2015) in Liberia: time-series analyses for 2013–20171201-971210.1016/j.ijid.2021.08.041https://doaj.org/article/6dd47cbccccb452c8a2dc27cde936b662021-11-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S1201971221006755https://doaj.org/toc/1201-9712Objective: Interrupted time-series analyses, using 5 years of routinely collected health information system data, were conducted to estimate the magnitude of impact of the 2014–2015 Ebola virus disease (EVD) epidemic and determine trends in tuberculosis (TB) care services in Liberia. Methods: A segmented linear regression model was used to generate estimates and predictions for trends for three TB service indicators before, during, and after EVD, from January 2013 to December 2017. Results: It was found that the number of presumptive TB cases declined significantly at the start of the EVD outbreak, with an estimated loss of 3222 cases (95% confidence interval (CI) −5691 to −752; P = 0.014). There was also an estimated loss of 709 cases per quarter post-EVD (95% CI −1346 to −71; P = 0.032). However, over the post-EVD period, quarterly increases were observed in the proportion of smear-positive to presumptive cases (1.45%, 95% CI 0.38% to 2.5%; P = 0.011) and the proportion of treatment success to TB cases evaluated (3.3%, 95% CI 0.82% to 5.79%; P = 0.013). Conclusions: These findings suggest that the EVD outbreak (2014–2015) negatively affected TB care services. Rigorous quantitative analyses can be used to assess the magnitude of interruption and advocate for preparedness in settings with limited healthcare capacity.Keith L. GrayNaomi F. WalkerFrederick MartineauNahid BhadeliaWahdae-mai Harmon-GrayLaura A. SkripJean DeMarcoPatrick KonwlohNelson DunbarElsevierarticleEbolaInterrupted time-series analysisLiberiaMycobacterium tuberculosisPublic healthDisease outbreaksInfectious and parasitic diseasesRC109-216ENInternational Journal of Infectious Diseases, Vol 112, Iss , Pp 13-20 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Ebola Interrupted time-series analysis Liberia Mycobacterium tuberculosis Public health Disease outbreaks Infectious and parasitic diseases RC109-216
spellingShingle	Ebola Interrupted time-series analysis Liberia Mycobacterium tuberculosis Public health Disease outbreaks Infectious and parasitic diseases RC109-216 Keith L. Gray Naomi F. Walker Frederick Martineau Nahid Bhadelia Wahdae-mai Harmon-Gray Laura A. Skrip Jean DeMarco Patrick Konwloh Nelson Dunbar Interruption of tuberculosis detection and care during the Ebola virus disease epidemic (2014–2015) in Liberia: time-series analyses for 2013–2017
description	Objective: Interrupted time-series analyses, using 5 years of routinely collected health information system data, were conducted to estimate the magnitude of impact of the 2014–2015 Ebola virus disease (EVD) epidemic and determine trends in tuberculosis (TB) care services in Liberia. Methods: A segmented linear regression model was used to generate estimates and predictions for trends for three TB service indicators before, during, and after EVD, from January 2013 to December 2017. Results: It was found that the number of presumptive TB cases declined significantly at the start of the EVD outbreak, with an estimated loss of 3222 cases (95% confidence interval (CI) −5691 to −752; P = 0.014). There was also an estimated loss of 709 cases per quarter post-EVD (95% CI −1346 to −71; P = 0.032). However, over the post-EVD period, quarterly increases were observed in the proportion of smear-positive to presumptive cases (1.45%, 95% CI 0.38% to 2.5%; P = 0.011) and the proportion of treatment success to TB cases evaluated (3.3%, 95% CI 0.82% to 5.79%; P = 0.013). Conclusions: These findings suggest that the EVD outbreak (2014–2015) negatively affected TB care services. Rigorous quantitative analyses can be used to assess the magnitude of interruption and advocate for preparedness in settings with limited healthcare capacity.
format	article
author	Keith L. Gray Naomi F. Walker Frederick Martineau Nahid Bhadelia Wahdae-mai Harmon-Gray Laura A. Skrip Jean DeMarco Patrick Konwloh Nelson Dunbar
author_facet	Keith L. Gray Naomi F. Walker Frederick Martineau Nahid Bhadelia Wahdae-mai Harmon-Gray Laura A. Skrip Jean DeMarco Patrick Konwloh Nelson Dunbar
author_sort	Keith L. Gray
title	Interruption of tuberculosis detection and care during the Ebola virus disease epidemic (2014–2015) in Liberia: time-series analyses for 2013–2017
title_short	Interruption of tuberculosis detection and care during the Ebola virus disease epidemic (2014–2015) in Liberia: time-series analyses for 2013–2017
title_full	Interruption of tuberculosis detection and care during the Ebola virus disease epidemic (2014–2015) in Liberia: time-series analyses for 2013–2017
title_fullStr	Interruption of tuberculosis detection and care during the Ebola virus disease epidemic (2014–2015) in Liberia: time-series analyses for 2013–2017
title_full_unstemmed	Interruption of tuberculosis detection and care during the Ebola virus disease epidemic (2014–2015) in Liberia: time-series analyses for 2013–2017
title_sort	interruption of tuberculosis detection and care during the ebola virus disease epidemic (2014–2015) in liberia: time-series analyses for 2013–2017
publisher	Elsevier
publishDate	2021
url	https://doaj.org/article/6dd47cbccccb452c8a2dc27cde936b66
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Interruption of tuberculosis detection and care during the Ebola virus disease epidemic (2014–2015) in Liberia: time-series analyses for 2013–2017

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