Impact of the COVID-19 pandemic on the temporal trend of indicators for access to tuberculosis diagnosis: A systematic review

Introduction: The COVID-19 pandemic influenced the behaviour of numerous diseases, overloading health systems and weakening public health infrastructure and access. Methodology: This study aimed to analyse the repercussions of the COVID-19 pandemic on tuberculosis diagnosis indicators. A systematic review was conducted, examining studies published between 2020 and 2024 in Portuguese, English, or Spanish across five databases and Google Scholar. The search, performed in March 2024, led to the identification of 6,378 studies, of which 23 were included after an independent review of titles, abstracts, and full texts. Data were extracted and narratively synthesized following a methodological quality assessment. Results: The review revealed significant declines in TB incidence, detection, notification, and diagnosis during the pandemic, alongside reduced etiological confirmation of cases. Conclusions: The findings highlight a need to reorganize and enhance health service responses to address the disruptions caused by the pandemic. Strengthening these services is crucial to recover missed TB cases and improve indicators, supporting the goal of eliminating TB by 2030.