Tuberculosis Epidemiology and the Impact of the COVID-19 Pandemic on Tuberculosis Control in Tétouan, Morocco (2015–2022): A Retrospective Descriptive and Analytical Study

Abstract

INTRODUCTION: Tuberculosis (TB) is a major public health problem in Morocco, specifically in the Tangier-Tetouan-Al-Hoceima region, which includes the city of Tetouan. Although the improvement in the epidemiological situation in Tetouan over the past two decades, this remains insufficient to achieve the ultimate goal of eradicating tuberculosis. The present study describes and analyzes tuberculosis's epidemiological status in Tetouan between 2015 and 2022 to understand the evolution of infection, especially before and during the COVID-19 pandemic. METHODS: A retrospective study was conducted on tuberculosis patients registered in Tetouan from January 2015 to December 2022. Data on demographic characteristics and clinical tuberculosis presentations were analyzed using IBM SPSS Statistics software (IBM Corp., Armonk, NY, USA), with significance determined at a p-value < 0.05. RESULTS: A total of 6,397 TB cases were reported between 2015 and 2022, with an average incidence rate of 127.33 per 100,000 inhabitants. Males were more frequently affected, with a sex ratio of 1.64. The majority of cases occurred in young adults (15-34 years), with an average patient age of 39.69 years. New cases accounted for 5,751 (89.90%) of the total. Intra-pulmonary tuberculosis was the most common form, representing 3,612 cases (56.50%), of which 3,038 (88.39%) were bacteriologically confirmed. Among extra-pulmonary tuberculosis cases, pleural tuberculosis was the most prevalent, affecting 1,220 patients (43.79%). The cure rate was 5,236 (89.87%), while mortality remained below 3% (159 cases). The treatment dropout rate was 4.28% (249 cases). The COVID-19 pandemic led to a significant decline in TB notifications and an increase in the number of patients lost to follow-up. CONCLUSION: Despite the favorable epidemiological evolution of the disease in Tetouan, many efforts are essential for more case detection and to overcome the impact of the COVID-19 pandemic.