Tuberculosis in times of COVID-19: Pediatric tuberculosis in Uruguay in 2020

Abstract

Introduction: the WHO warned about the risk of neglecting tuberculosis (TB) control actions during the COVID-19 pandemic.

Objectives: describe the TB situation in children <15 years of age in Uruguay in 2020, and compare it with 2019. Describe strategies of the National Tuberculosis Program (NTP) to mitigate the impact of the COVID 19 pandemic.

Material and methods: descriptive, retrospective study of children <15 years of age with TB in Uruguay 1/1/2020 - 12/31/2020. Patronymic data, clinical and bacteriological diagnosis, treatment and study of contacts; epidemiological indicators of 2019. Incidence rate, frequency and percentages were calculated. NTP strategies aimed at or directly impacting pediatric care were selected.

Results: in 2020, 61 cases of TB in children < 15 years. Incidence rate 8.8/100,000. Pediatric TB 6.3% of total cases (61/968), and in 2019 3.9% (42/1057). Pulmonary forms 84% and extrapulmonary 16%. Bacteriological confirmation: 25%. No deaths in 2020 and 1 in 2019. Contacts: in 2020 the notification decreased by 11%; 86% were studied, 73% chemoprophylaxis. Significant increase in infected contacts < 15(2.4% 2019 and 5% 2020). NTP strategies: 1- Diagnosis: use of GeneXpert Ultra; 2- Treatment: video surveillance (VOT); 3- Contacts: children of <15 years were prioritized, adapting the study protocol.

Conclusions: in 2020, the TB control actions were maintained in the pediatric population. The incidence of TB increased in children <15 years of age. Children and adolescents were prioritized in diagnosis (more sensitive techniques) and contact studies.