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Potential impact of the COVID-19 pandemic on HIV, TB and malaria in low- and middle-income countries: a modelling study

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Title: Potential impact of the COVID-19 pandemic on HIV, TB and malaria in low- and middle-income countries: a modelling study
Authors: Hogan, A
Jewell, B
Sherrard-Smith, E
Watson, O
Whittaker, C
Hamlet, A
Smith, J
Winskill, P
Verity, R
Baguelin, M
Lees, J
Whittles, L
Ainslie, K
Bhatt, S
Boonyasiri, A
Brazeau, N
Cattarino, L
Cooper, L
Coupland, H
Cuomo-Dannenburg, G
Dighe, A
Djaafara, A
Donnelly, C
Eaton, J
Van Elsland, S
Fitzjohn, R
Fu, H
Gaythorpe, K
Green, W
Haw, D
Hayes, S
Hinsley, W
Imai, N
Laydon, D
Mangal, T
Mellan, T
Mishra, S
Parag, K
Thompson, H
Unwin, H
Vollmer, M
Walters, C
Wang, H
Ferguson, N
Okell, L
Churcher, T
Arinaminpathy, N
Ghani, A
Walker, P
Hallett, T
Item Type: Journal Article
Abstract: Background: COVID-19 has the potential to cause substantial disruptions to health services, including by cases overburdening the health system or response measures limiting usual programmatic activities. We aimed to quantify the extent to which disruptions in services for human immunodeficiency virus (HIV), tuberculosis (TB) and malaria in low- and middle-income countries with high burdens of those disease could lead to additional loss of life. Methods: We constructed plausible scenarios for the disruptions that could be incurred during the COVID-19 pandemic and used established transmission models for each disease to estimate the additional impact on health that could be caused in selected settings. Findings: In high burden settings, HIV-, TB- and malaria-related deaths over five years may increase by up to 10%, 20% and 36%, respectively, compared to if there were no COVID-19 pandemic. We estimate the greatest impact on HIV to be from interruption to antiretroviral therapy, which may occur during a period of high health system demand. For TB, we estimate the greatest impact is from reductions in timely diagnosis and treatment of new cases, which may result from any prolonged period of COVID-19 suppression interventions. We estimate that the greatest impact on malaria burden could come from interruption of planned net campaigns. These disruptions could lead to loss of life-years over five years that is of the same order of magnitude as the direct impact from COVID-19 in places with a high burden of malaria and large HIV/TB epidemics. Interpretation: Maintaining the most critical prevention activities and healthcare services for HIV, TB and malaria could significantly reduce the overall impact of the COVID-19 pandemic. Funding: Bill & Melinda Gates Foundation, The Wellcome Trust, DFID, MRC
Issue Date: 1-Sep-2020
Date of Acceptance: 18-Jun-2020
URI: http://hdl.handle.net/10044/1/80149
DOI: 10.1016/S2214-109X(20)30288-6
ISSN: 2214-109X
Publisher: Elsevier
Start Page: e1132
End Page: e1141
Journal / Book Title: The Lancet Global Health
Volume: 8
Issue: 9
Copyright Statement: © 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license (https://creativecommons.org/licenses/by/4.0/)
Sponsor/Funder: Medical Research Council (MRC)
Bill & Melinda Gates Foundation
Wellcome Trust
Medical Research Council (MRC)
Bill & Melinda Gates Foundation
Imperial College Healthcare NHS Trust- BRC Funding
The Academy of Medical Sciences
Bill & Melinda Gates Foundation
National Institute for Health Research
Imperial College LOndon
Medical Research Council
The Royal Society
Wellcome Trust
Funder's Grant Number: MR/R015600/1
OPP1194416
221350/Z/20/Z
MR/K010174/1B
1606H5002/JH6
RDA02
SBF004/1080
CRR00280
NIHR200908
MR/R015600/1
DH140134
200222/B/15/Z
Keywords: Coronavirus Infections
Developing Countries
HIV Infections
Health Services Accessibility
Humans
Malaria
Models, Theoretical
Pandemics
Pneumonia, Viral
Tuberculosis
Humans
Tuberculosis
Pneumonia, Viral
Coronavirus Infections
HIV Infections
Malaria
Models, Theoretical
Developing Countries
Health Services Accessibility
Pandemics
0605 Microbiology
1117 Public Health and Health Services
Publication Status: Published
Online Publication Date: 2020-07-13
Appears in Collections:Department of Infectious Diseases
National Heart and Lung Institute
Faculty of Medicine
Imperial College London COVID-19
School of Public Health



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