COVID-19-related healthcare impacts: an uncontrolled, segmented time-series analysis of tuberculosis diagnosis services in Mozambique, 2017-2020.
COVID-19-related healthcare impacts: an uncontrolled, segmented time-series analysis of tuberculosis diagnosis services in Mozambique, 2017-2020.
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DOI：
10.1136/bmjgh-2021-007878
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发表时间：
2022-04
影响因子：
8.1
通讯作者：
Fernandes, Quinhas
中科院分区：
文献类型：
--
作者：
Manhica, Ivan;Augusto, Orvalho;Sherr, Kenneth;Cowan, James;Cuco, Rosa Marlene;Agostinho, Saozinha;Macuacua, Bachir C.;Ramiro, Isaias;Carimo, Naziat;Matsinhe, Maria Benigna;Gloyd, Stephen;Chicumbe, Sergio;Machava, Raimundo;Tembe, Stelio;Fernandes, Quinhas
目前，COVID-19在公共卫生议程中占据主导地位，并构成永久性威胁，导致卫生系统枯竭和前所未有的服务中断。初级保健服务，包括结核病服务，面临严重中断的风险增加，特别是在低收入和中等收入国家。事实上，越来越多的证据证实了基于模型的预测，即COVID-19大流行对结核病病例发现产生了负面影响。应用分段时间序列分析，我们评估了COVID-19相关措施对莫桑比克各地区结核病诊断服务的影响。卫生部卫生信息系统数据使用时间为2017年第一季度至2020年底。在贝叶斯前提下进行的模型估计为负二项分布，对地区和省份具有随机效应。连续16个季度对154个地区进行了跟踪调查。这些地区在2020年共报告了96182例各种形式的结核病病例。在基线（2017年第一季度），莫桑比克的结核病发病率估计为每10万人283例（95% CI 200至406），到2019年底，这一数字以5%的年增长率增长。我们估计，17 147例新发结核病病例可能在COVID-19发病后9个月被遗漏，导致2020年的相对损失为15. 1%（95% CI 5. 9至24. 0）。南部地区的影响最大，为40.0%（95% CI 30.1至49.0），男性为15%（95% CI 4.0至25.0）。肺结核的发病率以平均每年6. 6%的速度上升;然而，在2020年3月COVID-19爆发后，也立即出现了急剧下降（15%）。2020年4月至6月期间，即COVID-19爆发后的第一季度，观察到紧急状态的最大影响。令人鼓舞的是，尽管最初受到冲击，但到2020年底，卫生系统恢复的明显迹象明显可见。
Currently, COVID-19 dominates the public health agenda and poses a permanent threat, leading to health systems’ exhaustion and unprecedented service disruption. Primary healthcare services, including tuberculosis services, are at increased risk of facing severe disruptions, particularly in low-income and middle-income countries. Indeed, corroborating model-based forecasts, there is increasing evidence of the COVID-19 pandemic’s negative impact on tuberculosis case detection. Applying a segmented time-series analysis, we assessed the effects of COVID-19-related measures on tuberculosis diagnosis service across districts in Mozambique. Ministry health information system data were used from the first quarter of 2017 to the end of 2020. The model, performed under the Bayesian premises, was estimated as a negative binomial with random effects for districts and provinces. A total of 154 districts were followed for 16 consecutive quarters. Together, these districts reported 96 182 cases of all forms of tuberculosis in 2020. At baseline (first quarter of 2017), Mozambique had an estimated incidence rate of 283 (95% CI 200 to 406) tuberculosis cases per 100 000 people and this increased at a 5% annual rate through the end of 2019. We estimated that 17 147 new tuberculosis cases were potentially missed 9 months after COVID-19 onset, resulting in a 15.1% (95% CI 5.9 to 24.0) relative loss in 2020. The greatest impact was observed in the southern region at 40.0% (95% CI 30.1 to 49.0) and among men at 15% (95% CI 4.0 to 25.0). The incidence of pulmonary tuberculosis increased at an average rate of 6.6% annually; however, an abrupt drop (15%) was also observed immediately after COVID-19 onset in March 2020. The most significant impact of the state of emergency was observed between April and June 2020, the quarter after COVID-19 onset. Encouragingly, by the end of 2020, clear signs of health system recovery were visible despite the initial shock.
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影响因子：
15.1
作者：
Cilloni L;Fu H;Vesga JF;Dowdy D;Pretorius C;Ahmedov S;Nair SA;Mosneaga A;Masini E;Sahu S;Arinaminpathy N
通讯作者：
Arinaminpathy N
DOI：
10.1016/s2352-3018(20)30359-3
发表时间：
2021-03
期刊：
The lancet. HIV
影响因子：
--
作者：
Dorward J;Khubone T;Gate K;Ngobese H;Sookrajh Y;Mkhize S;Jeewa A;Bottomley C;Lewis L;Baisley K;Butler CC;Gxagxisa N;Garrett N
通讯作者：
Garrett N
DOI：
10.1016/j.ijtb.2020.07.004
发表时间：
2020-12-01
期刊：
The Indian journal of tuberculosis
影响因子：
--
作者：
Bhargava, Anurag;Shewade, Hemant Deepak
通讯作者：
Shewade, Hemant Deepak
DOI：
10.1164/rccm.201107-1190oc
发表时间：
2012-05-15
影响因子：
24.7
作者：
Dharmadhikari, Ashwin S.;Mphahlele, Matsie;Nardell, Edward A.
通讯作者：
Nardell, Edward A.
影响因子：
8.8
作者：
Eikenberry, Steffen E.;Mancuso, Marina;Gumel, Abba B.
通讯作者：
Gumel, Abba B.