Impacts of COVID-19 on essential health services in Tigray, Northern Ethiopia: A pre-post study.
Impacts of COVID-19 on essential health services in Tigray, Northern Ethiopia: A pre-post study.
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DOI：
10.1371/journal.pone.0256330
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发表时间：
2021
期刊：
影响因子：
3.7
通讯作者：
Redae G
中科院分区：
文献类型：
--
作者：
Desta AA;Woldearegay TW;Gebremeskel E;Alemayehu M;Getachew T;Gebregzabiher G;Ghebremedhin KD;Zgita DN;Aregawi AB;Redae G
事实证明，COVID-19对世界若干地区的基本卫生服务产生了间接影响，可能导致发病率和死亡率上升，并使过去几十年取得的成果付之东流。没有综合的科学证据可以表明COVID-19流行/大流行对埃塞俄比亚北部提格雷基本卫生服务的影响。因此，本研究旨在评估2019冠状病毒病流行/大流行对埃塞俄比亚北部提格雷市基本卫生服务提供的影响。采用前后研究设计评估了2020年第二季度（COVID-19后）与2019年同期（COVID-19前）相比，COVID-19对埃塞俄比亚北部提格雷市基本卫生服务提供的影响。这项研究主要集中在五个方面；即;孕产妇、新生儿和儿童保健；传染病，重点是艾滋病毒和结核-艾滋病毒合并感染；预防艾滋病毒母婴传播；基本急诊、门诊、住院和血库服务、非传染性疾病和道路交通事故。采用Stata 14.0版本软件包进行分析。根据COVID-19后和COVID-19前时期之间的差异以及使用比例表示的服务中断水平，计算了COVID-19流行病/大流行的影响。进行Wilcoxon符号秩检验，以显著性水平≤0.05为两季度间差异显著。机构分娩、剖腹产分娩、死产、分娩后7天内的产后护理、1岁前接种所有疫苗的儿童人数、接受筛查并患有中度急性营养不良的5岁以下儿童人数、接受筛查并患有严重急性营养不良的5岁以下儿童人数以及接受治疗的急性营养不良儿童人数均有显著增加。然而，随着参加抗逆转录病毒治疗（ART）护理、心血管疾病（CVD）风险≥30%的患者接受治疗、rta、从国家输血服务（NBTS）和区域血库接受的血液总单位数、输血总单位数和紧急转诊，艾滋病毒检测和检出率显著下降。在门诊就诊和入院方面没有明显的变化。尽管在维持若干基本卫生服务方面取得了值得称道的成就，但2019冠状病毒病导致五岁以下儿童营养不足人数增加，艾滋病毒检测和护理、心血管疾病、宫颈癌筛查和血库服务下降。因此，各国政府、地方和国际机构需要采用创新方式，在2019冠状病毒病背景下迅速扩大和提供服务。此外，低收入国家必须定制全面和协调的社区保健办法，包括外联和宣传运动。此外，各国应确保将非传染性疾病纳入其国家COVID-19应对计划，以便在COVID-19大流行期间向非传染性疾病和艾滋病毒或艾滋病毒-结核病合并感染者提供基本卫生保健服务。
COVID-19 has proved to have an indirect impact on essential health services in several parts of the world which could lead to increased morbidity and mortality and loss of the gains made in the past decades. There were no synthesized scientific evidences which could show the impact of COVID-19 epidemics/pandemic on essential health services in Tigray, Northern Ethiopia. Therefore, this study aimed to assess the impacts of COVID-19 epidemics/pandemic on essential health services provision in Tigray, Northern Ethiopia. A pre-post study design was used to assess the impacts of COVID-19 on essential health services delivery in Tigray, Northern Ethiopia in the second quarter of 2020 (Post COVID-19) compared to similar quarter in 2019 (Pre COVID-19). The study focuses on five categories; namely; maternal, neonatal and child health care; communicable diseases with a focus on HIV and TB-HIV co-infection; prevention of mother to child transmission of HIV; basic emergency, outpatient, inpatient and blood bank services, non-communicable diseases and road traffic accidents (RTAs). Analysis was done using Stata version 14.0 software package. The effects of COVID-19 epidemics/pandemic were calculated taking the differences between post COVID -19 and pre COVID-19 periods and the levels of service disruptions presented using proportions. Wilcoxon sign rank test was done and a significance level of ≤0.05 was considered as having significant difference among the two quarters. There were significant increase in institutional delivery, delivery by Caesarian Section (CS), still birth, postnatal care within 7 days of delivery, the number of children who received all vaccine doses before 1st birthday, the number of under 5 children screened and had moderate acute malnutrition, the number of under 5 children screened and had severe acute malnutrition and children with SAM admitted for management. However, there were significant decrease in HIV testing and detection along with enrolment to antiretroviral therapy (ART) care, number of patients with cardiovascular disease (CVD) risk ≥ 30% received treatment, RTAs, total units of blood received from national blood transfusion service (NBTS) and regional blood banks, total number of units of blood transfused and emergency referral. There were no significant changes in outpatient visits and admissions. Despite commendable achievements in maintaining several of the essential health services, COVID-19 has led to an increase in under nutrition in under five children, decline in HIV detection and care, CVD, cervical cancer screening and blood bank services. Therefore, governments, local and international agencies need to introduce innovative ways to rapidly expand and deliver services in the context of COVID-19. Moreover, lower income countries have to customize comprehensive and coordinated community-based health care approaches, including outreach and campaigns. In addition, countries should ensure that NCDs are incorporated in their national COVID-19 response plans to provide essential health care services to people living with NCDs and HIV or HIV-TB co-infection during the COVID-19 pandemic period.
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影响因子：
7.1
作者：
Akseer, Nadia;Kandru, Goutham;Bhutta, Zulfiqar A.
通讯作者：
Bhutta, Zulfiqar A.
影响因子：
11.8
作者：
Mizumoto, Kenji;Chowell, Gerardo
通讯作者：
Chowell, Gerardo
影响因子：
3.2
作者：
Sochas, Laura;Channon, Andrew Amos;Nam, Sara
通讯作者：
Nam, Sara
影响因子：
5.2
作者：
Elston, J. W. T.;Cartwright, C.;Wright, J.
通讯作者：
Wright, J.
DOI：
10.1016/j.trip.2020.100218
发表时间：
2020-11-01
影响因子：
--
作者：
Saladie, Oscar;Bustamante, Edgar;Gutierrez, Aaron
通讯作者：
Gutierrez, Aaron