Impact of COVID-19 pandemic and anti-pandemic measures on tuberculosis, viral hepatitis, HIV/AIDS and malaria-A systematic review

Barbora Kessel; Torben Heinsohn; Jördis J Ott; Jutta Wolff; Max J Hassenstein; Berit Lange

doi:10.1371/journal.pgph.0001018

Impact of COVID-19 pandemic and anti-pandemic measures on tuberculosis, viral hepatitis, HIV/AIDS and malaria-A systematic review

PLOS Glob Public Health. 2023 May 1;3(5):e0001018. doi: 10.1371/journal.pgph.0001018. eCollection 2023.

Authors

Barbora Kessel¹, Torben Heinsohn¹, Jördis J Ott^{1

2}, Jutta Wolff², Max J Hassenstein^{1

3}, Berit Lange^{1

4}

Affiliations

¹ Department of Epidemiology, Helmholtz Center for Infection Research, Braunschweig, Germany.
² Hannover Medical School (MHH), Hannover, Germany.
³ PhD Programme "Epidemiology", Braunschweig, Hannover, Germany.
⁴ German Center for Infection research (DZIF), Partner Site Hannover-Braunschweig, Braunschweig, Germany.

Abstract

COVID-19 pandemic puts an enormous strain on health care systems worldwide and may have a detrimental effect on prevention, treatment and outcomes of tuberculosis (TB), viral hepatitis, HIV/AIDS and malaria, whose ending is part of the United Nations 2030 Agenda for Sustainable Development. We conducted a systematic review of scientific and grey literature in order to collect wide-ranging evidence with emphasis on quantification of the projected and actual indirect impacts of COVID-19 on the four infectious diseases with a global focus. We followed PRISMA guidelines and the protocol registered for malaria (CRD42021234974). We searched PubMed, Scopus, preView (last search: January 13, 2021) and websites of main (medical) societies and leading NGOs related to each of the four considered infectious diseases. From modelling studies, we identified the most impactful disruptions; from surveys and other quantitative studies (based e.g. on surveillance or program data), we assessed the actual size of the disruptions. The identified modelling studies warned about under-diagnosis (TB), anti-retroviral therapy interruption/decrease in viral load suppression (HIV), disruptions of insecticide-treated nets (ITN) distribution and access to effective treatment (malaria), and treatment delays and vaccination interruptions (viral hepatitis). The reported disruptions were very heterogeneous both between and within countries. If observed at several points in time, the initial drops (partly dramatic, e.g. TB notifications/cases, or HIV testing volumes decreased up to -80%) were followed by a gradual recovery. However, the often-missing assessment of the changes against the usual pre-pandemic fluctuations hampered the interpretation of less severe ones. Given the recurring waves of the pandemic and the unknown mid- to long-term effects of adaptation and normalisation, the real consequences for the fight against leading infectious diseases will only manifest over the coming years.

Copyright: © 2023 Kessel et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Grants and funding

This work was supported by the project “The Helmholtz Epidemiologic Response against the COVID-19 Pandemic” funded by the Initiative and Networking Fund of the Helmholtz Association. It has received funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement No 101003480. MJH receives a scholarship from the Life Science Foundation to promote science and research. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.