Short Report

Outcomes of a model integrating tuberculosis testing into COVID-19 services in South Africa

Chipo Mutyambizi, Lynne Wilkinson, Kate Rees, Shabir Moosa, Tom Boyles
African Journal of Primary Health Care & Family Medicine | Vol 14, No 1 | a3709 | DOI: https://doi.org/10.4102/phcfm.v14i1.3709 | © 2022 Chipo Mutyambizi, Lynne Wilkinson, Kate Rees, Shabir Moosa, Tom Boyles | This work is licensed under CC Attribution 4.0
Submitted: 22 June 2022 | Published: 13 December 2022

About the author(s)

Chipo Mutyambizi, Anova Health Institute, Johannesburg, South Africa
Lynne Wilkinson, International AIDS Society, Johannesburg, South Africa; and, Centre for Infectious Epidemiology and Research, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
Kate Rees, Anova Health Institute, Johannesburg, South Africa; and, Department of Community Health, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
Shabir Moosa, Department of Family Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
Tom Boyles, Right to Care NPC, Johannesburg, South Africa; and, London School of Hygiene and Tropical Medicine, London, United Kingdom

Abstract

The coronavirus disease 2019 (COVID-19) pandemic led to a reordering of healthcare priorities. Health resources were turned to the screening and diagnosis of COVID-19, leading to a reduction in tuberculosis (TB) testing and treatment initiation. An innovative model that integrated TB and COVID-19 services was adopted at primary care facilities in Johannesburg Health District, Gauteng. This short report illustrates results from this model’s implementation in two facilities. Patients were screened for COVID-19 at a single point of entry and separated according to screening result. Self-reported human immunodeficiency virus (HIV) status, symptom, and symptom duration were then used to determine TB risk amongst those screening positive for COVID-19. Data from clinical records were extracted. Approximately 9% of patients with a positive symptom screen (n = 76) were sent for a TB test and 84% were sent for a COVID-19 test. Amongst those sent for a TB test, 8% (n = 6) had TB detected, and amongst those sent for a COVID-19 test, 18% (n = 128) were positive. Amongst those with COVID-19-related symptoms, 15% (n = 130) presented with a cough or fever and were known HIV positive and 121 (93%) of these were sent for a COVID-19 test and 31 (24%) were sent for a TB test. Given the HIV prevalence and symptoms in our study, our results show lower-than-expected TB tests conducted.

Contribution: Our study documents the outcomes of an innovative way to combine operational workflows for TB and COVID-19. This provides a starting point for countries seeking to integrate TB and COVID-19 screening and testing.


Keywords

COVID-19; tuberculosis; South Africa; clinical algorithm; primary health care

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