Minimizing the Impact of the Triple Burden of COVID-19, Tuberculosis and HIV on Health Services in Sub-Saharan Africa
Date
2021
Journal Title
Journal ISSN
Volume Title
Publisher
Elsevier Ltd
Abstract
In this perspective, we discuss the impact of COVID-19 on tuberculosis (TB)/HIV health services and
approaches to mitigating the growing burden of these three colliding epidemics in sub-Saharan Africa
(SSA). SSA countries bear significantly high proportions of TB and HIV cases reported worldwide,
compared to countries in the West. Whilst COVID-19 epidemiology appears to vary across Africa, most
countries in this region have reported relatively lower-case counts compared to the West. Nevertheless,
the COVID-19 pandemic has added an additional burden to already overstretched health systems in SSA,
which, among other things, have been focused on the longstanding dual epidemics of TB and HIV. As with
these dual epidemics, inadequate resources and poor case identification and reporting may be
contributing to underestimations of the COVID-19 case burden in SSA. Modelling studies predict that the
pandemic-related disruptions in TB and HIV services will result in significant increases in associated
morbidity and mortality over the next
five years. Furthermore, limited empirical evidence suggests that
SARS-CoV-2 coinfections with TB and HIV are associated with increased mortality risk in SSA. However,
predictive models require a better evidence-base to accurately define the impact of COVID-19, not only on
communicable diseases such as TB and HIV, but on non-communicable disease comorbidities. Further
research is needed to assess morbidity and mortality data among both adults and children across the
African continent, paying attention to geographic disparities, as well as the clinical and socio-economic
determinants of COVID-19 in the setting of TB and/or HIV.
Description
Research Article
Keywords
SARS-CoV-2, Tuberculosis, HIV, Health services