The Union shares protocol to measure the impact of COVID-19 on people with TB and HIV/AIDS

The Union’s Centre for Operational Research has made publicly available a protocol for a project in sub-Saharan Africa to determine the impact of COVID-19 on tuberculosis (TB) case detection and HIV testing, diagnosis and care through strengthened real-time surveillance.

The Union worked with the national TB and national HIV/AIDS programmes in Kenya, Malawi and Zimbabwe and with the World Health Organization Special Programme for Research and Training in Tropical Diseases (WHO-TDR) in Geneva and Vital Strategies in USA to develop the protocol. During its inception, other TB and HIV/AIDS programmes around the world expressed interest in conducting similar analyses, and all collaborating partners agreed to make the technical content of this protocol available for others to use.

Sub-Saharan Africa is starting to be hit hard by the COVID-19 pandemic. With attention and resources directed to the COVID-19 crisis and with quarantine and restricted movement being enforced to reduce virus transmission, there is concern that high HIV-TB burden countries will be unable to provide continuous and high-quality health care services to people with TB and HIV/AIDS. The Ebola virus disease outbreak in Sierra Leone and Liberia in 2014 was associated with similar challenges and these adversely affected the ability of programmes to detect and diagnose TB and continue with HIV testing.

The protocol outlines how the Centre for Operational Research and the national programmes will institute monthly recording and reporting of TB case detection and HIV testing in selected health facilities in the capital cities where most COVID-19 cases occur. Currently, recording and reporting in health facilities is done on a quarterly (three-month) basis. More frequent recording and reporting will allow faster interventions to prevent case numbers drastically changing and ensure that patients are not compromised in accessing necessary services.

The protocol, developed in April 2020, provides a background, aim and objectives, a generic methodology and what is required in each country and within the Centre for Operational Research. Also provided are references and two annexes showing the aggregate data to be collected. The protocol was submitted to the Union Ethics Advisory Group and the three National Scientific and Ethics committees of Kenya, Malawi and Zimbabwe: ethics approval or a waiver was obtained. 

The Union is sharing this protocol so that other researchers and national programmes can use and adapt it for their needs in order to enable similar work to be carried out in other countries.

For questions or additional information, please contact Professor Anthony D Harries at

The Union’s Centre for Operational Research enhances the operational research capacity of low- and middle-income countries that are overburdened with serious communicable disease epidemics, and growing epidemics of non-communicable diseases.