Tuberculosis (TB) is a transmissible infectious disease caused by species of the Mycobacterium tuberculosis complex and, until the emergence of the new Coronavirus Disease (COVID-19), it was the leading cause of death among adults from a single infectious agent. The pandemic emergency substantially affected TB services, as it reorganized actions and health systems with the aim of mitigating transmission and treating those infected with COVID-19, culminating in a break in the TB management chain.

To describe and compare the incidence and outcomes of TB treatment in Bahia before and after the emergence of COVID-19.

This is a retrospective, epidemiological, descriptive and quantitative study using secondary data from new TB cases reported in Bahia between 2017 and 2022, through the National System of Notifiable Diseases (SINAN), available at DATASUS. Data from the pre-pandemic period (2017 to 2019) were compared with the post-pandemic period (2020 to 2022).

Bahia had 16,806 new cases of TB from 2017 to 2019, with an incidence of 114 cases per 100,000 inhabitants. The highest proportion of cases was among males and in the age group of 20 to 39 years, followed by 40 to 59 years. After the onset of COVID-19, from 2020 to 2022, the number of new cases was 14,919 and the incidence of TB was 101 cases per 100,000 inhabitants. The highest proportion of cases remained for males and for the age group 20 to 39 years old, followed by 40 to 59 years old in 2020 and 2021. However, in 2022 there was an inversion between age groups, with a higher proportion of TB between 40 and 59 years old. Regarding treatment outcomes, there were reductions of 33% in TB treatment dropout and 25% in primary dropout. Despite this, there was a 44% reduction in the number of patients cured of TB. Changing treatment regimens increased by 64% and multidrug resistant TB decreased by 18%. Regarding deaths of patients with TB, there was a small increase (2%) in deaths from TB and a 20% reduction in deaths from other causes. Ignored or unfilled outcomes increased 3.97 times post-pandemic.

After the emergence of COVID-19, there was an 11.2% drop in the number of new TB cases in Bahia. Despite the reduction in treatment abandonment, an increase in the number of uncured patients and a slight increase in the number of deaths from TB was observed. The significant increase in ignored or unfilled outcomes can be justified by the reallocation of resources for coping with COVID-19, generating less follow-up of active cases and those undergoing treatment for TB from 2020 to 2022.

Epidemiological monitoring allows tracing and comparing the profile of patients, knowing health-related outcomes, identifying changes and measuring the impact of COVID-19 on TB care and control, in order to help adapt strategies and goals for better management of patients undergoing treatment and contacts.