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Vulnerable populations in 45 high-burden countries worldwide must be prioritised in efforts to reduce the impact of the COVID-19 pandemic on tuberculosis (TB) care, according to new research published in BMC Medicine.

Overall, as many as 195,449 children (below the age of 15 years), 1, west allis wisconsin mortgages 126,133 adults (aged 15 to 64 years old) and 235,402 older individuals (aged 65 years or older) are estimated to have had a missed or delayed diagnosis of tuberculosis in 2020 as a result of COVID-19 disruptions. These figures include 511,546 women and 863,916 men.

The call to action follows the results of a new study investigating potential inequalities by age and sex of the impact of disruptions caused by the COVID-19 pandemic on access to diagnoses of this deadly disease.

The team — including researchers from the London School of Hygiene & Tropical Medicine (LSHTM) — modelled trends in TB case reporting to the World Health Organisation (WHO) for 45 high-burden countries between 2013 and 2019. Predictions for 2020 using these models were then compared to actual observations in the same year.

Although the study found no evidence for systemic disparity in risk by age or sex on a global scale, when broken down by country, setting-specific inequalities were revealed.

For example, in over half of countries (57.1%) analysed, children were at a greater risk of having their TB diagnosis delayed or missed due to COVID-19 than adults, with children in WHO regions in the Eastern Mediterranean (namely Pakistan and Somalia) and Europe (for example Tajikistan and Ukraine) found to be disproportionately affected. Similarly higher risk figures for older individuals compared to adults were also revealed, namely in over two thirds of countries (70.1%), including WHO regions in the Western Pacific (such as China and Mongolia) and Europe (for example, Kazakhstan and Belarus). In almost half of countries (45%), sex was predicted to be an influential risk factor. Men, for example, were found to be particularly susceptible to missed or delayed diagnoses in the WHO region of the Americas (namely Peru and Brazil).

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