Dlangalala, Thobeka NomzamoMusekiwa, AlfredMashamba‑Thompson, Tivani Phosa2024-02-202024-02-202023-10-03Dlangalala, T., Musekiwa, A. & Mashamba-Thompson, T. Impact of COVID-19 on TB diagnostic services at primary healthcare clinics in eThekwini district, South Africa. Scientific Reports 13, 16645 (2023). https://doi.org/10.1038/s41598-023-43589-7.2045-2322 (online)10.1038/s41598-023-43589-7http://hdl.handle.net/2263/94756DATA AVALILABILITY : The datasets generated during and/or analyzed during the current study are available from the corresponding author upon reasonable request.We assessed the impact of the pandemic on TB diagnostics at primary healthcare clinics (PHCs) during the different stages of COVID-19 in eThekwini district, South Africa. Data from the District Health Information System (DHIS) were used to conduct an interrupted time series analysis that assessed the changes in TB investigations and confirmed TB cases during four pandemic periods: lockdown and the subsequent three peaks of infection compared to the two years prior (2018–2022). The initial lockdown resulted in − 45% (95% CI − 55 to − 31) and − 40% (95% CI − 59 to − 28) immediate declines in TB investigations and confirmed cases, respectively. Both indicators showed substantial recovery in the months after the first wave (p < 0.05). However, while TB investigations sustained smaller declines throughout the pandemic, they rebounded and surpassed pre-COVID-19 levels by the end of the investigation period. On the other hand, confirmed cases experienced reductions that persisted until the end of the investigation period. TB diagnostic services at PHCs were considerably disrupted by COVID-19, with the confirmation of cases being the most adversely affected throughout the pandemic. The reasons for these persistent declines in TB detection must be determined to inform the development of sustainable diagnostic systems that are capable of withstanding future pandemics.en© The Author(s) 2023. Open Access. This article is licensed under a Creative Commons Attribution 4.0 International License.InfectionTuberculosis (TB)COVID-19 pandemicCoronavirus disease 2019 (COVID-19)PandemicPrimary healthcare (PHC)eThekwini district, South AfricaDistrict health information system (DHIS)Health servicesPublic healthArticle