Abstract
Tuberculosis (TB) has remained a significant public health challenge for many years, classified
as a contagious infectious disease primarily affecting the lungs. Individuals with weakened
immune systems due to other illnesses are particularly vulnerable to contracting TB, making
it crucial to effectively manage the disease, especially during pandemics and for those with
co-infections. Thus, after the SARS-CoV-2 coronavirus (COVID-19) pandemic occurred,
South Africa implemented a disease control strategy which seized and disrupted daily routines
including healthcare services delivery. It is important to study the impact that such strategies
have on TB service utilization.
The aim of this study was to determine and describe the impact of COVID-19 lockdown
restrictions on the utilization of TB services, pre and peri-COVID-19 in Johannesburg,
Gauteng. Using data from National Institute of Communicable Diseases (NICD) and the
National Department of Health (NdoH), the researcher assessed the impact that COVID-19
restrictions had on TB service utilization from January 2018 to December 2021 in the City of
Johannesburg Metropolitan Municipalities in the Gauteng Province. Among the data received,
TB service utilization within different time zones and factors leading to TB service utilization
was assessed.
Children (<10 years), young adolescent (10-14), older adolescent (15-19), young adults (20-
24), adult (25-49), older adults (≥50), and those with null age who utilised TB services within
the study time frame were identified as participants. Tuberculosis service utilization was higher
(51.3%) for female adult between the age of 25-29 years and lower (32.6%) for females older
than 50 years. TB service utilization decreased by a difference of 2671 cases between January
2018 to December 2020. Due to lack of TB routine patient data, TB treatment adherence
trends and patterns could not be assessed.
A significant decrease in TB service utilization was evident within the peri-COVID-19 era, and
it is recommended that further research is done to understand the impact of the COVID-19
restrictions on TB treatment adherence. This will assist to establish out of facility mobilisation
strategies that will enhance treatment uptake and adherence outside of the primary health
care facilities.