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Interaction and effect of the COVID-19 pandemic on Tuberculosis control in the State of São Paulo: political-social, clinical-epidemiological aspects and innovative practices

Abstract

TB control may have been worsened by the COVID-19 pandemic, as a result of the focus and reorganization of health systems and services to deal with it. Objective: The study aims to assess the impact of the COVID-19 pandemic on tuberculosis prevention and control. Methods: The study will be carried out in the state of São Paulo and is structured in: Axis 1, political approach - interviews will be carried out with key informants from institutions, management and Social Movements, and official documents will be collected. The material corpus will be treated by Discourse Analysis. Axis 2, epidemiological aspects - there will be a survey of TB and COVID-19 data to form cohorts and assess the real impact of the COVID-19 pandemic on detection, treatment dropout and mortality by TB. Survival analysis, mixed effect models, interrupted time series and spatial analysis will be used. Axis 3, innovative practices - an evaluation of the cost-effectiveness of the Virtual-DOT (VDOT) strategy will be carried out, compared to Self-Administered Treatment and conventional Directly Observed Treatment, through a pragmatic study. For this, people with TB will be interviewed to survey the costs of using the application and to analyze the usability of the VDOT. For this axis, analysis of variance, Kruskal-Wallis test and application of a Mixed Effect Model will be used. Expected results: It is expected to produce and disseminate theoretical and operational knowledge involving the assessment of the impact of the COVID-19 pandemic on the prevention and control of TB, based on the analysis of political-social, clinical-epidemiological aspects and innovative practices for management of nursing care. (AU)

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