The impact of COVID-19 pandemic on the dynamics of tuberculosis epidemiological indicators before and during the COVID-19 pandemic in the Republic of Moldova and Ukraine

Abstract

The study aimed to assess the main epidemiological indicators of tuberculosis (TB) before, during, and after the COVID-19 pandemic in the Republic of Moldova and Ukraine, and to identify the key drivers underlying their trends. Material and methods: This study is based on the analysis of global WHO tuberculosis reports and national tuberculosis statistical data. Results: In RM and UA, the COVID-19 pandemic significantly impacted TB detection and case registrations. TB incidence declined before the COVID-19 pandemic, followed by an increase in subsequent years. In R. Moldova, the incidence decreased from 70.88 to 56.73/100000 population between 2015 and 2019, but rose again to 66.34/100000 by 2024. Similarly, in Ukraine, the incidence declined from 62.3/100000 in 2018 to 42.2/100000 before increasing to 45.1/100000 population in 2022. Conclusions: The number of reported tuberculosis (TB) cases decreased during the COVID-19 pandemic in both the Republic of Moldova and Ukraine due to common factors, including mobility restrictions, disruption of TB services, reallocation of healthcare resources, and reduced healthcare-seeking behavior associated with increased stigma and avoidance. A gradual restoration of TB services followed this. In the post-pandemic period (2023–2024), increases in certain indicators, such as global incidence and relapsed cases, may reflect improved case detection.