PT  - JOURNAL ARTICLE
AU  - Helena J. Chapman
AU  - Bienvenido A. Veras-Estévez
TI  - Lessons Learned During the COVID-19 Pandemic to Strengthen TB Infection Control: A Rapid Review
AID  - 10.9745/GHSP-D-21-00368
DP  - 2021 Dec 31
TA  - Global Health: Science and Practice
PG  - 964--977
VI  - 9
IP  - 4
4099  - http://www.ghspjournal.org/content/9/4/964.short
4100  - http://www.ghspjournal.org/content/9/4/964.full
SO  - GLOB HEALTH SCI PRACT2021 Dec 31; 9
AB  - Key FindingsCurrent challenges in TB control efforts, such as an unprepared public health system leadership and infrastructure and an overwhelmed health care workforce, will require novel approaches, practices, and renewed political commitment to maintain sustainable TB programs.We described proposed recommendations that may strengthen health system preparedness for optimal TB control across low- and middle-income countries: Ensuring leadership and governance for sustainable national health care budgetsBuilding networks of community stakeholdersSupporting high-quality health care workforce training and safe workplace environmentsUsing digital health interventions for TB careKey ImplicationsNational health systems should develop national policies that promote integral, patient-centered TB care, facilitate the implementation of ethical community interventions, support operational research, and allow the integration of appropriate eHealth applications.Program managers who understand challenges in TB prevention and control with coexisting health priorities can serve as instrumental leaders and patient advocates to deliver high-quality and sustainable TB care that leads to achieving targets of the End TB Strategy.Introduction:Over the past 5 years, substantial global investment has resulted in reduced TB incidence rates by 9% and mortality rates by 14%. However, the coronavirus disease (COVID-19) pandemic has hindered access and availability of TB services to maintain robust TB control. The objective of this rapid review was to describe the challenges to be addressed and recommendations to strengthen health system preparedness for optimal TB control across low- and middle-income countries during and after the COVID-19 pandemic.Methods:Five databases were used to systematically search for relevant articles published in 2020. The 5-step framework proposed by Arskey and O'Malley and adapted by Levac et al. guided the review process. Thematic analysis with grounded theory principles was used to summarize themes from selected articles and integrate analyses with barriers reported from authors' previous TB research.Results:Of the 218 peer-reviewed articles, 20 articles met the inclusion criteria. Four emerging themes described challenges: (1) unprepared health system leadership and infrastructure, (2) coexisting health priorities, (3) insufficient health care workforce support for continued training and appropriate workplace environments, and (4) weak connections to primary health centers hindering community engagement. Four recommendations were highlighted: (1) ensuring leadership and governance for sustainable national health budgets, (2) building networks of community stakeholders, (3) supporting health care workforce training and safe workplace environments, and (4) using digital health interventions for TB care.Conclusions:National health systems must promote patient-centered TB care, implement ethical community interventions, support operational research, and integrate appropriate eHealth applications. TB program managers and primary care practitioners can serve as instrumental leaders and patient advocates to deliver high-quality and sustainable TB care that leads to achieving the targets of the End TB Strategy.