Two years since COVID pandemic started, the negative results on TB appear through the increase in the incidence and severity of cases at detection.

Aim

To evaluate a 2022 TB outbreak in a psychiatric unit for delinquent persons from a Romanian County. Before 2020 this community was yearly investigated but sporadic TB cases appeared; the last TB outbreak was in 2004 with 14 TB cases detected.

Method

Retrospective observational analysis of the detection, contact tracing and management of cases in a TB outbreak in a pavilion-type hospital, with 469 patients; TB broke out in a single ward registering 9 cases of TB in patients and 2 cases in medical staff between 01-03.2022.

All patients - males, all - smear negative at T0, 33.3% culture positive, and drug sensitive.

All cases were isolated, successfully treated after a median duration of 190 days.

After 6 months, during an active TB screening in vulnerable groups using GeneXpert Ultra, another 4 cases of TB in patients and 1 case in medical personnel were detected in the same ward.

The duration of the first check in the ward was of 38 days (radiological, bacteriological investigations); the second control lasted only 8 days.

Conclusions

-     The COVID pandemic has had a negative influence on TB control in medical facilities for vulnerable populations through long-term isolation and the absence of specific annual control.

-     Modern molecular diagnostic techniques have significantly shortened the period from detection to the start of treatment.

-     Repeated contact tracing is compulsory.

-     SARS-CoV-2 infection has returned the incidence of tuberculosis to the values of 5-10 years ago.

Training regarding health protection for the medical staff is indispensable.