Francesco Vladimiro Segala, Jerry Ictho, Mariangela L'Episcopia, Emmanuel Onapa, Elda De Vita, Roberta Novara, Nelson Olung, Valentina Totaro, Lameck Olal, Giulia Patti, Christopher Bingom, Umberto Farina, Roberta Papagni, Caroline Agaro, Davide Fiore Bavaro, James Amone, Giovanni Dall'Oglio, Benedict Ngole, Claudia Marotta, Samuel Okori, Maurizio Zarcone, Joseph Ogwang, Carlo Severini, Peter Lochoro, Giovanni Putoto, Annalisa Saracino, Francesco Di Gennaro
{"title":"Impact of the COVID-19 pandemic on malaria in pregnancy indicators in Northern Uganda: a joinpoint regression analysis.","authors":"Francesco Vladimiro Segala, Jerry Ictho, Mariangela L'Episcopia, Emmanuel Onapa, Elda De Vita, Roberta Novara, Nelson Olung, Valentina Totaro, Lameck Olal, Giulia Patti, Christopher Bingom, Umberto Farina, Roberta Papagni, Caroline Agaro, Davide Fiore Bavaro, James Amone, Giovanni Dall'Oglio, Benedict Ngole, Claudia Marotta, Samuel Okori, Maurizio Zarcone, Joseph Ogwang, Carlo Severini, Peter Lochoro, Giovanni Putoto, Annalisa Saracino, Francesco Di Gennaro","doi":"10.1080/20477724.2023.2273023","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Pregnancy is both a risk factor for <i>P. falciparum</i> infection and development of severe malaria. In low- and middle-income countries, the COVID-19 pandemic severely impacted health systems, including utilization of maternal services. This study aimed to assess trends in delivering malaria in pregnancy-related health-care services before and during COVID-19 in Northern Uganda.</p><p><strong>Methods: </strong>An interrupted time-series study comparing pre-COVID-19 (January 2018 to April 2020) and COVID-19 (May to December 2021) periods, based on the date the first COVID case was detected. The study involved 30 health facilities in Northern Uganda with 22,650 estimated pregnancies per year, 14% of which took place in hospital. Monthly data were sourced from District routinely collected indicators. Trends were analyzed by joinpoint regression models.</p><p><strong>Results: </strong>From the onset of the COVID pandemic in Uganda (May 2020), we found a significant reduction in the number of women accessing a fourth antenatal care visit (from APC + 183.5 to + 4.98; <i>p</i> < 0.001) and taking at least three doses of intermittent preventive treatment in pregnancy (IPTp, from APC + 84.28 to -63.12; <i>p</i> < 0.001). However, we found no significant change in the trend of the total number of pregnant women managed as outpatients or hospitalized for malaria, as well as in the number of women attending their first antenatal visit and in the number of institutional deliveries.</p><p><strong>Conclusions: </strong>In our study, the COVID-19 pandemic significantly reduced access to ANC visits and IPTp uptake. However, the healthcare system maintained its capacity for managing malaria cases, first antenatal visits, and institutional deliveries.Trial registration: This study has been registered on the ClinicalTrials.gov public website on 26 April 2022. ClinicalTrials.gov Identifier: NCT05348746.</p>","PeriodicalId":19850,"journal":{"name":"Pathogens and Global Health","volume":null,"pages":null},"PeriodicalIF":4.9000,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11221465/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Pathogens and Global Health","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/20477724.2023.2273023","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/10/23 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"PARASITOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Pregnancy is both a risk factor for P. falciparum infection and development of severe malaria. In low- and middle-income countries, the COVID-19 pandemic severely impacted health systems, including utilization of maternal services. This study aimed to assess trends in delivering malaria in pregnancy-related health-care services before and during COVID-19 in Northern Uganda.
Methods: An interrupted time-series study comparing pre-COVID-19 (January 2018 to April 2020) and COVID-19 (May to December 2021) periods, based on the date the first COVID case was detected. The study involved 30 health facilities in Northern Uganda with 22,650 estimated pregnancies per year, 14% of which took place in hospital. Monthly data were sourced from District routinely collected indicators. Trends were analyzed by joinpoint regression models.
Results: From the onset of the COVID pandemic in Uganda (May 2020), we found a significant reduction in the number of women accessing a fourth antenatal care visit (from APC + 183.5 to + 4.98; p < 0.001) and taking at least three doses of intermittent preventive treatment in pregnancy (IPTp, from APC + 84.28 to -63.12; p < 0.001). However, we found no significant change in the trend of the total number of pregnant women managed as outpatients or hospitalized for malaria, as well as in the number of women attending their first antenatal visit and in the number of institutional deliveries.
Conclusions: In our study, the COVID-19 pandemic significantly reduced access to ANC visits and IPTp uptake. However, the healthcare system maintained its capacity for managing malaria cases, first antenatal visits, and institutional deliveries.Trial registration: This study has been registered on the ClinicalTrials.gov public website on 26 April 2022. ClinicalTrials.gov Identifier: NCT05348746.
期刊介绍:
Pathogens and Global Health is a journal of infectious disease and public health that focuses on the translation of molecular, immunological, genomics and epidemiological knowledge into control measures for global health threat. The journal publishes original innovative research papers, reviews articles and interviews policy makers and opinion leaders on health subjects of international relevance. It provides a forum for scientific, ethical and political discussion of new innovative solutions for controlling and eradicating infectious diseases, with particular emphasis on those diseases affecting the poorest regions of the world.