In 2018, 1.5 and 1.1 million people died from TB and from HIV-related illnesses respectively. National programmes for controlling these diseases already face immense challenges, and the pandemic has increased these by diverting healthcare professionals and resources to contain COVID-19.


Modelling studies have predicted that disruptions to TB and HIV care will reverse critical progress in combatting these diseases and have severe impacts on mortality, morbidity, and productivity in already disadvantaged populations. Policies to minimise disruptions to TB and HIV care must be put in place urgently.


The London School of Hygiene & Tropical Medicine (LSHTM) TB Centre conducted a rapid survey of 669 frontline professionals in 64 low-and middle-income countries to identify specific challenges posed by COVID-19 during the May to July 2020 period and practical strategies to address these.

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We analysed quantitative and qualitative data collected through a rapid cross-sectional survey of TB and HIV healthcare delivery, management and research professionals in low- and middle-income countries (LMICs) around the world.

Study Design, Population and Sampling

 The open online survey was conducted between May 12 and August 6 2020 and the target population was individuals who were involved in managing or delivering TB or HIV services.

Three approaches were used to share the invitation to complete the survey:

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Information Sharing

Information was sent through online professional platforms and personal networks with colleagues (using email, WhatsApp or Twitter).

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Focal points

Focal points for Asia, Latin America, and Africa were hired to contact local organisations in their regions.

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Snowball Sampling

Snowball sampling was used, whereby survey participants were asked to share the survey with others who might have information to contribute.

Through these approaches, the survey was shared with over 250 professional networks and organisations.


The survey was designed in English by an international team with diverse expertise in TB and HIV control. It was then translated into 10 additional languages and piloted with eight professionals working in Cambodia, The Gambia, South Africa, The Philippines, Pakistan, Zambia and Zimbabwe.


Following this, an electronic version (in SurveyMonkey) was piloted with five public health professionals to check the accessibility and functionality of the survey as it appeared on the online platform.


The survey included adaptive questioning, multiple choice questions and open response questions.

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Data Management and Analysis

The quantitative data was analysed using descriptive statistics (frequencies and percentages) in Stata/SE V.14 (StatCorp, Texas, USA).


The qualitative analysis was used to identify themes that were supported by the data.


Finally, we triangulated qualitative and quantitative results to validate findings.

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Ethical Approval

Ethical approval was received from LSHTM, the University of Zambia and the South African Medical Association.

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