Table 5 Critical issues for TB program during COVID-19 pandemic and suggested solutions

Low infection prevention control

Increase provisions of personnel protective equipment for health care workers working at DOTS clinic, including N95 respirator, hand washing, use of gloves, decontaminations of surfaces regularly, use of ventilators, keeping the physical distance at the workplace, use safety of sample taking and transporting as per triple packing standards

Increased stigma against TB patients as the symptoms are overlapping with COVID-19

Health education should be strengthened for the public, TB patients, and health care workers; capacity for screening for both diseases during patient’ health facility visits should be strengthened

Incomplete TB service transfer to newly established sites for temporary services

When TB services are transferred to newly established facilities, it should compy the standard TB diagnosis, care, treatment, and prevention measures

Weak TB patients’ transfer to other health facilities

When transferring TB patients from one facility to another, patient preference should be considered and full information of the patient should be shared with the new facility

High interruption of laboratory services

Laboratory supply-chain system should be strengthened to balance the testing needs of TB and COVID-19

Weak contact tracing, surveillance, and monitoring

To minimize interruptions, facility-based contact tracing and surveillance could be switched to a home-based system through mHealth platforms and the role of community health workers should be considered to sustain the TB surveillance and monitoring

Lack of attention for TB care for a marginalized and vulnerable population, and people at COVID-19 quarantine and isolation centers

All COVID-19 confirmed or suspected people should have full access to TB diagnosis and treatment services as per the standard procedure

High fear and less benefit of healthcare workers at DOTS clinics

Healthcare workers at TB clinics need to get adequate training on COVID-19, mental health and psychosocial support, and incentives to maintain quality of and uninterrupted TB services

The potential use of health technologies to monitor TB treatment adherence is rarely explored

Studies that evaluate the effectiveness of TB digital adherence technologies in Ethiopia need to be conducted