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Open Access Adapting active case-finding for TB during the COVID-19 pandemic in Yogyakarta, Indonesia

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The COVID-19 pandemic and response measures, including lockdowns and the reorientation of health services, have disrupted essential health services for other diseases, including TB, HIV and malaria. For TB, reductions in case detection due to the COVID-19 pandemic are projected to result in increased TB transmission, morbidity and mortality. Active case-finding (ACF) for TB using community-based approaches is a potential strategy to offset reductions in TB detection by obviating the need for patients to seek care at a health facility. A number of approaches can be used to conduct TB ACF safely and screen designated target populations while managing the risks of SARS-CoV-2 transmission for staff, individuals and the community. We present a framework of options for and experience of adapting TB ACF services in response to the challenges of COVID-19 in our programme in Yogyakarta, Indonesia. Key changes have included revised prioritisation of target populations focusing on household contacts, reducing case-finding throughput, implementation of additional infection control measures and precautions, and integration of COVID-19 screening among those being screened for TB. Our approach could inform other programmes seeking to adapt TB ACF services to mitigate the negative impact of COVID-19 on TB case detection.
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Keywords: contact investigation; diagnosis; screening

Document Type: Research Article

Affiliations: 1: Burnet Institute, Melbourne, VIC, Australia 2: Department of Paediatrics, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito Hospital, Yogyakarta, Indonesia, Centre of Tropical Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia 3: Centre of Tropical Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia 4: Burnet Institute, Melbourne, VIC, Australia, Department of Paediatrics, University of Melbourne and Murdoch Children’s Research Institute, Melbourne, VIC, Australia, International Union Against Tuberculosis and Lung Disease, Paris, France 5: Burnet Institute, Melbourne, VIC, Australia, Department of Paediatrics, University of Melbourne and Murdoch Children’s Research Institute, Melbourne, VIC, Australia 6: KIT Royal Tropical Institute, Amsterdam, The Netherlands 7: STOP TB Partnership, Geneva, Switzerland

Publication date: June 21, 2021

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  • Public Health Action (PHA), The Union's quarterly Open Access journal, welcomes the submission of articles on operational research. It publishes high-quality scientific research on health services, providing new knowledge on how to improve access, equity, quality and efficiency of health systems and services.

    The Editors will consider any manuscript reporting original research on quality improvements, cost-benefit analysis, legislation, training and capacity building, with a focus on all relevant areas of public health (e.g. infection control, nutrition, TB, HIV, vaccines, smoking, COVID-19, microbial resistance, outbreaks etc).

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