COVID-19 Pandemic Disruption on the Management of Tuberculosis Treatment in Indonesia

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Abstract
The current coronavirus disease 2019 (COVID-19) situation might deteriorate the efforts to eliminate tuberculosis (TB) in Indonesia. This study aimed to review the COVID-19 pandemic disruption on the management of TB treatment in Indonesia. We identified several disruptions due to the pandemic on TB control management. Firstly, there is a potential decrease in the funding for TB treatment. Financial disruptions caused by the COVID-19 pandemic have led to further setbacks. In many countries, including Indonesia, financial and other resources have been reallocated from TB to the COVID-19 response. Secondly, it has been highlighted that all TB services, including case detection and rapid diagnostic, have been disrupted by the pandemic. Thirdly, the pandemic would be associated with the lower quality of care and treatment for TB in Indonesia. It might decrease the enthusiasm of patients with TB, multi-drug resistant (MDR)-TB, and TB-human immunodeficiency virus (HIV) to visit TB hospitals because of social distancing measures by the government. Finally, the COVID-19 pandemic also has impacted critical activities of monitoring, evaluation, and surveillance. There are several lessons from other countries about managing TB treatment during the pandemic, such as combining screening for COVID-19 and TB by applying x-ray technology and artificial intelligence-based software. In addition, the use of telemedicine or telehealth in TB treatment is also beneficial to deliver medication, assess patients’ progress, and inform prevention strategies. To reach the target with the end TB strategy, the government of Indonesia can adopt the World Health Organization’s (WHO’s) comprehensive strategies, such as integrated, patient-centered TB care and prevention strategies; bold policies and supportive systems; and intensified research and innovations.

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