Indirect impacts of the COVID-19 pandemic at two tertiary neonatal units in Zimbabwe and Malawi: an interrupted time series analysis.
BMJ Open
; 12(6): e048955, 2022 06 21.
Article
em En
| MEDLINE
| ID: mdl-35728901
ABSTRACT
OBJECTIVES:
To examine indirect impacts of the COVID-19 pandemic on neonatal care in low-income and middle-income countries.DESIGN:
Interrupted time series analysis.SETTING:
Two tertiary neonatal units in Harare, Zimbabwe and Lilongwe, Malawi.PARTICIPANTS:
We included a total of 6800 neonates who were admitted to either neonatal unit from 1 June 2019 to 25 September 2020 (Zimbabwe 3450; Malawi 3350). We applied no specific exclusion criteria.INTERVENTIONS:
The first cases of COVID-19 in each country (Zimbabwe 20 March 2020; Malawi 3 April 2020). PRIMARY OUTCOMEMEASURES:
Changes in the number of admissions, gestational age and birth weight, source of admission referrals, prevalence of neonatal encephalopathy, and overall mortality before and after the first cases of COVID-19.RESULTS:
Admission numbers in Zimbabwe did not initially change after the first case of COVID-19 but fell by 48% during a nurses' strike (relative risk (RR) 0.52, 95% CI 0.41 to 0.66, p<0.001). In Malawi, admissions dropped by 42% soon after the first case of COVID-19 (RR 0.58, 95% CI 0.48 to 0.70, p<0.001). In Malawi, gestational age and birth weight decreased slightly by around 1 week (beta -1.4, 95% CI -1.62 to -0.65, p<0.001) and 300 g (beta -299.9, 95% CI -412.3 to -187.5, p<0.001) and outside referrals dropped by 28% (RR 0.72, 95% CI 0.61 to 0.85, p<0.001). No changes in these outcomes were found in Zimbabwe and no significant changes in the prevalence of neonatal encephalopathy or mortality were found at either site (p>0.05).CONCLUSIONS:
The indirect impacts of COVID-19 are context-specific. While our study provides vital evidence to inform health providers and policy-makers, national data are required to ascertain the true impacts of the pandemic on newborn health.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Pandemias
/
Saúde do Lactente
/
COVID-19
Tipo de estudo:
Etiology_studies
/
Risk_factors_studies
Limite:
Humans
/
Newborn
País/Região como assunto:
Africa
Idioma:
En
Ano de publicação:
2022
Tipo de documento:
Article