Effect of Social Isolation and Quarantine on Tuberculosis Cases in Four Iraqi Governorates

Social isolation and quarantine have been implemented globally during outbreaks of a highly transmissible microbe. For instance, they were employed during the plague outbreak in 1894 and the COVID-19 pandemic in 2019. While these methods have proven effective against highly transmissible infections, they have also had significant negative consequences. In specific regions like Anbar, Diyala, Salahaddin, and Kirkuk, social isolation occurred during the period of ISIS occupation. After their liberation, these regions experienced a COVID-19 outbreak, and quarantine measures were put in place. This study aimed to investigate the effect of social isolation and quarantine on tuberculosis. Patients from Anbar, Diyala, Salahaddin, and Kirkuk districts were diagnosed with pulmonary or extrapulmonary tuberculosis according to the World Health Organization (WHO) guidelines, using methods like chest X-rays, acid-fast positive sputum slide method, culture, and Mycobacterium tuberculosis gene pert testing. All cases were documented at the Iraqi Ministry of Health. All four districts had the same population, socioeconomic status, and medical guidelines. Anbar showed a significant difference compared to the other districts, while the remaining three districts had no significant differences among themselves. The percentage of extrapulmonary tuberculosis was higher than the global average, indicating misdiagnosis. The age group of less than four years old had the lowest percentage of cases compared to other age groups, indicating the effective management of the BCG program. It can be concluded that social isolation and quarantine implemented during the COVID-19 pandemic might have led to an increase in cases of extrapulmonary tuberculosis in the studied regions.