Impact of the COVID-19 pandemic on malaria in pregnancy indicators in Northern Uganda: a joinpoint regression analysis.

IF 4.9 4区 医学 Q1 PARASITOLOGY Pathogens and Global Health Pub Date : 2024-05-01 Epub Date: 2023-10-23 DOI:10.1080/20477724.2023.2273023
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
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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.

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新冠肺炎大流行对乌干达北部妊娠期疟疾指标的影响:联合点回归分析。
背景:妊娠是恶性疟原虫感染和发展为严重疟疾的危险因素。在中低收入国家,新冠肺炎疫情严重影响了卫生系统,包括孕产妇服务的利用。这项研究旨在评估乌干达北部新冠肺炎之前和期间在妊娠相关医疗服务中提供疟疾的趋势。方法:一项中断的时间序列研究,根据发现第一例新冠肺炎病例的日期,比较新冠肺炎之前(2018年1月至2020年4月)和新冠肺炎期间(2021年5月至12月)。这项研究涉及乌干达北部的30家卫生机构,估计每年有22650例妊娠,其中14%在医院进行。月度数据来源于捷运局定期收集的指标。趋势通过连接点回归模型进行分析。结果:自2020年5月乌干达新冠肺炎疫情爆发以来,我们发现接受第四次产前护理的女性人数显著减少(来自APC + 183.5至 + 4.98;p p 结论:在我们的研究中,新冠肺炎大流行显著减少了ANC就诊和IPTp摄入。然而,医疗保健系统保持了管理疟疾病例、首次产前检查和机构分娩的能力。试验注册:本研究已于2022年4月26日在ClinicalTrials.gov公共网站上注册。ClinicalTrials.gov标识符:NCT05348746。
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来源期刊
Pathogens and Global Health
Pathogens and Global Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-PARASITOLOGY
CiteScore
6.00
自引率
0.00%
发文量
60
审稿时长
6-12 weeks
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.
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