Self-Reported Occupational Tuberculosis Exposure Among Healthcare Workers During COVID-19-Related Health System Reprioritisation in South Africa: A Cross-Sectional Study

OBJECTIVE: COVID-19 diverted health system resources from tuberculosis (TB) control, potentially increasing occupational TB exposure among healthcare workers. This study examined associations between COVID-19-related reprioritisation and self-reported occupational TB exposure. METHODS: A retrospective cross-sectional study using self-reported data was conducted in public health facilities in 2022. A questionnaire assessed occupational TB exposure, service disruptions, and resource reallocation before and during COVID-19. Descriptive statistics and exploratory logistic regression were performed. RESULTS: Self-reported TB cases declined during COVID-19, while occupational exposure remained high (79.0% peri-COVID-19 vs 80.0% pre-COVID-19). Many respondents reported TB budget reallocation (81.9%), GeneXpert reassignment (61.3%), inadequate PPE (63.1%), and treatment stock-outs (31.1%). No statistically significant associations were identified. CONCLUSION: COVID-19 reprioritisation may have reduced TB visibility through diagnostic disruption rather than exposure, highlighting the need to protect HCWs during health system shocks.