Mitigating the impact of COVID-19 on tuberculosis and HIV services: A cross-sectional survey of 669 health professionals in 64 low and middle-income countries

• Published in: PloS one Vol. 16; no. 2; p. e0244936
• Main Authors: Khan, Mishal S., Rego, Sonia, Rajal, Joaquín Benítez, Bond, Virginia, Fatima, Razia Kaneez, Isani, Afshan Khurshid, Sutherland, Jayne, Kranzer, Katharina
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 02.02.2021; Public Library of Science (PLoS)
• Subjects: Acquired immune deficiency syndrome; AIDS; Biology and Life Sciences; Care and treatment; Communicable Disease Control; Coronaviruses; COVID-19; COVID-19 - epidemiology; COVID-19 - prevention & control; Cross-Sectional Studies; Developing countries; Earth Sciences; Economic Factors; Editing; Epidemics; Health aspects; Health care facilities; Health facilities; Health Personnel; Health Services Accessibility; HIV; HIV infection; HIV Infections - therapy; Human immunodeficiency virus; Humans; Hygiene; Malaria; Medical diagnosis; Medical personnel; Medical research; Medicine; Medicine and Health Sciences; Methodology; Pandemics; Polls & surveys; Poverty; Professionals; Public health; Research and Analysis Methods; Reviews; Severe acute respiratory syndrome coronavirus 2; Social Sciences; Surveys; Surveys and Questionnaires; Tuberculosis; Tuberculosis - therapy; Vector-borne diseases; Pakistan; United Kingdom > UK; Islamabad Pakistan; Asia; Gambia; Africa; Zambia
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0244936

The experiences of frontline healthcare professionals are essential in identifying strategies to mitigate the disruption to healthcare services caused by the COVID-19 pandemic. We conducted a cross-sectional study of TB and HIV professionals in low and middle-income countries (LMIC). Between May 12 and August 6, 2020, we collected qualitative and quantitative data using an online survey in 11 languages. We used descriptive statistics and thematic analysis to analyse responses. 669 respondents from 64 countries completed the survey. Over 40% stated that it was either impossible or much harder for TB and HIV patients to reach healthcare facilities since COVID-19. The most common barriers reported to affect patients were: fear of getting infected with SARS-CoV-2, transport disruptions and movement restrictions. 37% and 28% of responses about TB and HIV stated that healthcare provider access to facilities was also severely impacted. Strategies to address reduced transport needs and costs-including proactive coordination between the health and transport sector and cards that facilitate lower cost or easier travel-were presented in qualitative responses. Access to non-medical support for patients, such as food supplementation or counselling, was severely disrupted according to 36% and 31% of HIV and TB respondents respectively; qualitative data suggested that the need for such services was exacerbated. Patients and healthcare providers across numerous LMIC faced substantial challenges in accessing healthcare facilities, and non-medical support for patients was particularly impacted. Synthesising recommendations of frontline professionals should be prioritised for informing policymakers and healthcare service delivery organisations.