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

Type Journal Article Author Alexandra B. Hogan Author Britta L. Jewell Author Ellie Sherrard-Smith Author Juan F. Vesga Author Oliver J. Watson Author Charles Whittaker Author Arran Hamlet Author Jennifer A. Smith Author Peter Winskill Author Robert Verity Author Marc Baguelin Author John A. Lees Author Lilith K. Whittles Author Kylie E. C. Ainslie Author Samir Bhatt Author Adhiratha Boonyasiri Author Nicholas F. Brazeau Author Lorenzo Cattarino Author Laura V. Cooper Author Helen Coupland Author Gina Cuomo-Dannenburg Author Amy Dighe Author Bimandra A. Djaafara Author Christl A. Donnelly Author Jeff W. Eaton Author Sabine L. van Elsland Author Richard G. FitzJohn Author Han Fu Author Katy A. M. Gaythorpe Author William Green Author David J. Haw Author Sarah Hayes Author Wes Hinsley Author Natsuko Imai Author Daniel J. Laydon Author Tara D. Mangal Author Thomas A. Mellan Author Swapnil Mishra Author Gemma Nedjati-Gilani Author Kris V. Parag Author Hayley A. Thompson Author H. Juliette T. Unwin Author Michaela A. C. Vollmer Author Caroline E. Walters Author Haowei Wang Author Yuanrong Wang Author Xiaoyue Xi Author Neil M. Ferguson Author Lucy C. Okell Author Thomas S. Churcher Author Nimalan Arinaminpathy Author Azra C. Ghani Author Patrick G. T. Walker Author Timothy B. Hallett URL https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(20)30288-6/abstract Series Articles Volume 8 Issue 9 Pages e1132-e1141 Publication The Lancet Global Health ISSN 2214-109X Date 13/07/2020 Extra Publisher: Elsevier PMID: 32673577 Journal Abbr The Lancet Global Health DOI 10.1016/S2214-109X(20)30288-6 Library Catalog www.thelancet.com Language English Abstract Background COVID-19 has the potential to cause substantial disruptions to health services, due to cases overburdening the health system or response measures limiting usual programmatic activities. We aimed to quantify the extent to which disruptions to services for HIV, tuberculosis, and malaria in low-income and middle-income countries with high burdens of these diseases could lead to additional loss of life over the next 5 years. Methods Assuming a basic reproduction number of 3·0, we constructed four scenarios for possible responses to the COVID-19 pandemic: no action, mitigation for 6 months, suppression for 2 months, or suppression for 1 year. We used established transmission models of HIV, tuberculosis, and malaria to estimate the additional impact on health that could be caused in selected settings, either due to COVID-19 interventions limiting activities, or due to the high demand on the health system due to the COVID-19 pandemic. Findings In high-burden settings, deaths due to HIV, tuberculosis, and malaria over 5 years could increase by up to 10%, 20%, and 36%, respectively, compared with if there was no COVID-19 pandemic. The greatest impact on HIV was estimated to be from interruption to antiretroviral therapy, which could occur during a period of high health system demand. For tuberculosis, the greatest impact would be from reductions in timely diagnosis and treatment of new cases, which could result from any prolonged period of COVID-19 suppression interventions. The greatest impact on malaria burden could be as a result of interruption of planned net campaigns. These disruptions could lead to a loss of life-years over 5 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 and tuberculosis epidemics. Short Title Potential impact of the COVID-19 pandemic on HIV, tuberculosis, and malaria in low-income and middle-income countries