Indirect effects of COVID-19 on maternal, neonatal, child, sexual and reproductive health services in Kampala, Uganda.
Indirect effects of COVID-19 on maternal, neonatal, child, sexual and reproductive health services in Kampala, Uganda.
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DOI：
10.1136/bmjgh-2021-006102
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发表时间：
2021-08
影响因子：
8.1
通讯作者：
Le Doare K
中科院分区：
文献类型：
--
作者：
Burt JF;Ouma J;Lubyayi L;Amone A;Aol L;Sekikubo M;Nakimuli A;Nakabembe E;Mboizi R;Musoke P;Kyohere M;Namara Lugolobi E;Khalil A;Le Doare K
新冠肺炎影响了全球孕产妇、新生儿和儿童的健康结果。我们假设，乌干达早期的严格封锁限制了个人的行动，限制了人们获得服务的机会。在坎帕拉的Kawempe区进行了一项观察性研究，使用的是从电子医疗记录中常规收集的数据。中断的时间序列分析评估了2019年7月至2020年12月期间对孕产妇、新生儿、儿童、性健康和生殖健康服务的影响。描述性统计总结了全国封锁前(2019年7月至2020年3月)、期间(2020年4月至2020年6月)和全国封锁后(2020年7月至2020年12月)的主要成果。2019年7月1日至2020年12月31日期间，共有14 401个产前诊所、33 499次分娩、111 658次儿童服务和57 174例性健康护理。所有产前和疫苗接种服务在封锁期间停止了4周。在3个月的封锁期间，产前就诊人数显著减少，并保持在冠状病毒感染前的水平(每月减少370人)。预防艾滋病毒母婴传播的就诊率下降，然后趋于稳定。封锁期间和封锁后立即出现的增长包括因高血压、子痫和先兆子痫接受治疗的妇女人数(每月增加218人)、不良妊娠结局(死产、低出生体重和早产儿)、新生儿住院比率、新生儿死亡和堕胎。孕产妇死亡率保持稳定。免疫门诊就诊率下降，新生儿死亡率上升(从39/1000活产增加到49/1000)。在封锁期间，因肺炎、腹泻和疟疾而接受治疗的儿童数量有所减少。乌干达对新冠肺炎的反应对孕产妇、儿童和新生儿健康产生了负面影响，妊娠并发症和胎儿和婴儿结局增加，这可能是由于就医行为延迟造成的。疫苗接种诊所就诊次数的减少使一批婴儿得不到保护，影响到所有疫苗可预防的疾病。未来的大流行应对措施必须考虑限制行动和获得预防性服务的影响，以保护孕产妇和儿童健康。
COVID-19 impacted global maternal, neonatal and child health outcomes. We hypothesised that the early, strict lockdown that restricted individuals’ movements in Uganda limited access to services. An observational study, using routinely collected data from Electronic Medical Records, was carried out, in Kawempe district, Kampala. An interrupted time series analysis assessed the impact on maternal, neonatal, child, sexual and reproductive health services from July 2019 to December 2020. Descriptive statistics summarised the main outcomes before (July 2019–March 2020), during (April 2020–June 2020) and after the national lockdown (July 2020–December 2020). Between 1 July 2019 and 31 December 2020, there were 14 401 antenatal clinic, 33 499 deliveries, 111 658 childhood service and 57 174 sexual health attendances. All antenatal and vaccination services ceased in lockdown for 4 weeks. During the 3-month lockdown, the number of antenatal attendances significantly decreased and remain below pre-COVID levels (370 fewer/month). Attendances for prevention of mother-to-child transmission of HIV dropped then stabilised. Increases during lockdown and immediately postlockdown included the number of women treated for high blood pressure, eclampsia and pre-eclampsia (218 more/month), adverse pregnancy outcomes (stillbirths, low-birth-weight and premature infant births), the rate of neonatal unit admissions, neonatal deaths and abortions. Maternal mortality remained stable. Immunisation clinic attendance declined while neonatal death rate rose (from 39 to 49/1000 livebirths). The number of children treated for pneumonia, diarrhoea and malaria decreased during lockdown. The Ugandan response to COVID-19 negatively impacted maternal, child and neonatal health, with an increase seen in pregnancy complications and fetal and infant outcomes, likely due to delayed care-seeking behaviour. Decreased vaccination clinic attendance leaves a cohort of infants unprotected, affecting all vaccine-preventable diseases. Future pandemic responses must consider impacts of movement restrictions and access to preventative services to protect maternal and child health.
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DOI：
10.1016/s2214-109x(21)00079-6
发表时间：
2021-06
期刊：
The Lancet. Global health
影响因子：
--
作者：
Chmielewska B;Barratt I;Townsend R;Kalafat E;van der Meulen J;Gurol-Urganci I;O'Brien P;Morris E;Draycott T;Thangaratinam S;Le Doare K;Ladhani S;von Dadelszen P;Magee L;Khalil A
通讯作者：
Khalil A
影响因子：
3.4
作者：
Kotlar B;Gerson EM;Petrillo S;Langer A;Tiemeier H
通讯作者：
Tiemeier H
影响因子：
8.1
作者：
Ahmed, Syed A. K. Shifat;Ajisola, Motunrayo;Yusuf, Rita
通讯作者：
Yusuf, Rita
影响因子：
19
作者：
McDonald, Helen, I;Tessier, Elise;Edelstein, Michael
通讯作者：
Edelstein, Michael
影响因子：
7.1
作者：
Akseer, Nadia;Kandru, Goutham;Bhutta, Zulfiqar A.
通讯作者：
Bhutta, Zulfiqar A.