Changes in tuberculosis control in the state of Bahia following the onset of Covid-19

Background and Objectives: The Covid-19 pandemic reversed years of progress in tuberculosis control worldwide, and for the first time in over a decade, tuberculosis-related deaths increased. This study aimed to compare the epidemiological, clinical, and laboratory variables of pulmonary tuberculosis before and after the onset of Covid-19 in two territories in southern Bahia, Brazil. Methods: This ecological study utilized data from the Notifiable Diseases Information System (Sinan) and the Hospital Information System of the Unified Health System (SIH/SUS). The data included new pulmonary tuberculosis cases reported between 2017 and 2022, which were compared across the pre-pandemic period (2017–2019) and the post-pandemic onset period (2020–2022) in the Costa do Descobrimento and Extremo Sul territories of Bahia. Results: Between January 2017 and December 2022, 1,682 new pulmonary tuberculosis cases were reported, with an annual mean incidence rate of 33.5 cases per 100,000 population, and a mean mortality rate of 1.1 deaths per 100,000 population. Following the onset of Covid-19, a 3.3% increase in incidence and a 20.5% increase in mortality were observed, along with a 5.7% decrease in cure rates and a 38.6% reduction in hospital case fatality rates. Notifications of tuberculosis-HIV/Aids co-infection and cases among individuals with more than eight years of schooling increased during the pandemic. Conclusion: Diagnostic and treatment gaps caused by Covid-19 may have contributed to the increased incidence and mortality of tuberculosis in southern Bahia.