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Dinh LV, Vo LNQ, Wiemers AMC, Nguyen HB, Vu HQ, Mo HTL, Nguyen LP, Nguyen NTT, Dong TTT, Tran KT, Dang TMH, Nguyen LH, Pham AT, Codlin AJ, Forse RJ. Ensuring Continuity of Tuberculosis Care during Social Distancing through Integrated Active Case Finding at COVID-19 Vaccination Events in Vietnam: A Cohort Study. Trop Med Infect Dis 2024; 9:26. [PMID: 38276637 PMCID: PMC10819868 DOI: 10.3390/tropicalmed9010026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 01/15/2024] [Accepted: 01/18/2024] [Indexed: 01/27/2024] Open
Abstract
COVID-19 significantly disrupted tuberculosis (TB) services in Vietnam. In response, the National TB Program (NTP) integrated TB screening using mobile chest X-rays into COVID-19 vaccination events. This prospective cohort study evaluated the integrated model's yield, treatment outcomes, and costs. We further fitted regressions to identify risk factors and conduct interrupted time-series analyses in the study area, Vietnam's eight economic regions, and at the national level. At 115 events, we conducted 48,758 X-ray screens and detected 174 individuals with TB. We linked 89.7% to care, while 92.9% successfully completed treatment. The mean costs per person diagnosed with TB was $547. TB risk factors included male sex (aOR = 6.44, p < 0.001), age of 45-59 years (aOR = 1.81, p = 0.006) and ≥60 years (aOR = 1.99, p = 0.002), a history of TB (aOR = 7.96, p < 0.001), prior exposure to TB (aOR = 3.90, p = 0.001), and symptomatic presentation (aOR = 2.75, p < 0.001). There was a significant decline in TB notifications during the Delta wave and significant increases immediately after lockdowns were lifted (IRR(γ1) = 5.00; 95%CI: (2.86, 8.73); p < 0.001) with a continuous upward trend thereafter (IRR(γ2) = 1.39; 95%CI: (1.22, 1.38); p < 0.001). Similar patterns were observed at the national level and in all regions but the northeast region. The NTP's swift actions and policy decisions ensured continuity of care and led to the rapid recovery of TB notifications, which may serve as blueprint for future pandemics.
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Affiliation(s)
- Luong Van Dinh
- National Lung Hospital, Ha Noi 100000, Vietnam; (L.V.D.); (H.B.N.); (H.Q.V.)
| | - Luan Nguyen Quang Vo
- Friends for International Tuberculosis Relief (FIT), Ha Noi 100000, Vietnam; (A.M.C.W.); (H.T.L.M.); (N.T.T.N.); (T.T.T.D.); (K.T.T.); (A.J.C.); (R.J.F.)
- Department of Global Health, WHO Collaboration Centre on Tuberculosis and Social Medicine, Karolinska Institutet, 171 77 Stockholm, Sweden
| | - Anja Maria Christine Wiemers
- Friends for International Tuberculosis Relief (FIT), Ha Noi 100000, Vietnam; (A.M.C.W.); (H.T.L.M.); (N.T.T.N.); (T.T.T.D.); (K.T.T.); (A.J.C.); (R.J.F.)
| | - Hoa Binh Nguyen
- National Lung Hospital, Ha Noi 100000, Vietnam; (L.V.D.); (H.B.N.); (H.Q.V.)
| | - Hoa Quynh Vu
- National Lung Hospital, Ha Noi 100000, Vietnam; (L.V.D.); (H.B.N.); (H.Q.V.)
| | - Huong Thi Lan Mo
- Friends for International Tuberculosis Relief (FIT), Ha Noi 100000, Vietnam; (A.M.C.W.); (H.T.L.M.); (N.T.T.N.); (T.T.T.D.); (K.T.T.); (A.J.C.); (R.J.F.)
| | - Lan Phuong Nguyen
- IRD VN Social Enterprise Company Limited, Ho Chi Minh City 700000, Vietnam;
| | - Nga Thi Thuy Nguyen
- Friends for International Tuberculosis Relief (FIT), Ha Noi 100000, Vietnam; (A.M.C.W.); (H.T.L.M.); (N.T.T.N.); (T.T.T.D.); (K.T.T.); (A.J.C.); (R.J.F.)
| | - Thuy Thi Thu Dong
- Friends for International Tuberculosis Relief (FIT), Ha Noi 100000, Vietnam; (A.M.C.W.); (H.T.L.M.); (N.T.T.N.); (T.T.T.D.); (K.T.T.); (A.J.C.); (R.J.F.)
| | - Khoa Tu Tran
- Friends for International Tuberculosis Relief (FIT), Ha Noi 100000, Vietnam; (A.M.C.W.); (H.T.L.M.); (N.T.T.N.); (T.T.T.D.); (K.T.T.); (A.J.C.); (R.J.F.)
| | - Thi Minh Ha Dang
- Pham Ngoc Thach Hospital, Ho Chi Minh City 700000, Vietnam; (T.M.H.D.); (L.H.N.)
| | - Lan Huu Nguyen
- Pham Ngoc Thach Hospital, Ho Chi Minh City 700000, Vietnam; (T.M.H.D.); (L.H.N.)
| | | | - Andrew James Codlin
- Friends for International Tuberculosis Relief (FIT), Ha Noi 100000, Vietnam; (A.M.C.W.); (H.T.L.M.); (N.T.T.N.); (T.T.T.D.); (K.T.T.); (A.J.C.); (R.J.F.)
- Department of Global Health, WHO Collaboration Centre on Tuberculosis and Social Medicine, Karolinska Institutet, 171 77 Stockholm, Sweden
| | - Rachel Jeanette Forse
- Friends for International Tuberculosis Relief (FIT), Ha Noi 100000, Vietnam; (A.M.C.W.); (H.T.L.M.); (N.T.T.N.); (T.T.T.D.); (K.T.T.); (A.J.C.); (R.J.F.)
- Department of Global Health, WHO Collaboration Centre on Tuberculosis and Social Medicine, Karolinska Institutet, 171 77 Stockholm, Sweden
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