Evaluating factors influencing tuberculosis treatment outcomes and the impact of COVID-19 on TB incidence in Bengaluru, India (2017–2023)

BACKGROUND: Tuberculosis (TB) remains a major public health issue in Bengaluru, India. This study analyzes TB trends, treatment outcomes, and the impact of COVID-19 on TB incidence from 2017 to 2023. METHODS: Logistic regression analysis was used to identify factors influencing TB treatment outcomes. An Interrupted Time Series (ITS) analysis using an ARIMA (AutoRegressive Integrated Moving Average) model was used to assess the impact of COVID-19 on TB incidence. RESULTS: Among 71,883 TB cases, age ≥65 years had increased the risk of unsuccessful outcomes for pulmonary TB (PTB) (adjusted odds ratio [aOR] 2.54; 95% confidence interval [CI], 2.24-2.89) and extrapulmonary TB (EPTB) (aOR 3.72; CI, 3.06-4.52). Females had lower odds than males in PTB (aOR 0.72; CI, 0.67-0.78) and EPTB (aOR 0.77; CI, 0.68-0.86). Diabetics had lowered risk for PTB (aOR 0.62; CI, 0.57-0.68) but increased risk for EPTB (aOR 1.44; CI, 1.24-1.67). HIV cases had increased risk in PTB (aOR 1.96; CI, 1.67-2.31) and EPTB (aOR 2.88; CI, 2.32-3.57). Interaction analysis in PTB showed diabetics with ages 35-44 and 45-54 was associated with lower risk (aOR 0.66; CI, 0.44-0.99; aOR 0.67; CI, 0.46-0.99). ITS analysis showed a 24.3% average decline in TB notifications in 2020, reaching a maximum decline of 40.5% in April. CONCLUSION: This study highlights factors affecting TB treatment outcomes and the significant impact of COVID-19 on TB trends in Bengaluru, providing insights to improve TB control and mitigate future pandemic impacts.