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

Autor:	Segala FV; Department of Precision and Regenerative Medicine and Ionian Area, Clinic of Infectious Diseases, University of Bari 'Aldo Moro', Bari, Italy., Ictho J; Health Service Management, Doctors with Africa CAUMM, Kampala, Uganda., L'Episcopia M; Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy., Onapa E; Operational Research Unit, St. John's XXIII Hospital Aber, Jaber, Uganda., De Vita E; Department of Precision and Regenerative Medicine and Ionian Area, Clinic of Infectious Diseases, University of Bari 'Aldo Moro', Bari, Italy., Novara R; Department of Precision and Regenerative Medicine and Ionian Area, Clinic of Infectious Diseases, University of Bari 'Aldo Moro', Bari, Italy., Olung N; Operational Research Unit, St. John's XXIII Hospital Aber, Jaber, Uganda., Totaro V; Department of Precision and Regenerative Medicine and Ionian Area, Clinic of Infectious Diseases, University of Bari 'Aldo Moro', Bari, Italy., Olal L; Operational Research Unit, African Network for Change, Kampala, Uganda., Patti G; Department of Precision and Regenerative Medicine and Ionian Area, Clinic of Infectious Diseases, University of Bari 'Aldo Moro', Bari, Italy., Bingom C; Health Service Management, Doctors with Africa CAUMM, Kampala, Uganda., Farina U; Hygiene Unit, Policlinico Riuniti Foggia Hospital, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy., Papagni R; Department of Precision and Regenerative Medicine and Ionian Area, Clinic of Infectious Diseases, University of Bari 'Aldo Moro', Bari, Italy., Agaro C; Health Office, Oyam District Local Government, Loro, Uganda., Bavaro DF; Department of Precision and Regenerative Medicine and Ionian Area, Clinic of Infectious Diseases, University of Bari 'Aldo Moro', Bari, Italy., Amone J; Operational Research Unit, St. John's XXIII Hospital Aber, Jaber, Uganda., Dall'Oglio G; Operational Research Unit, Doctors with Africa CUAMM, Padua, Italy., Ngole B; Operational Research Unit, African Network for Change, Kampala, Uganda., Marotta C; Operational Research Unit, Doctors with Africa CUAMM, Padua, Italy., Okori S; Operational Research Unit, St. John's XXIII Hospital Aber, Jaber, Uganda., Zarcone M; Unità Operativa Complessa di Epidemiologia Clinica con Registro Tumori, Azienda Ospedaliera Universitaria Policlinico 'Paolo Giaccone', Palermo, Italy., Ogwang J; Operational Research Unit, St. John's XXIII Hospital Aber, Jaber, Uganda., Severini C; Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy., Lochoro P; Health Service Management, Doctors with Africa CAUMM, Kampala, Uganda., Putoto G; Health Service Management, Doctors with Africa CAUMM, Kampala, Uganda., Saracino A; Department of Precision and Regenerative Medicine and Ionian Area, Clinic of Infectious Diseases, University of Bari 'Aldo Moro', Bari, Italy., Di Gennaro F; Department of Precision and Regenerative Medicine and Ionian Area, Clinic of Infectious Diseases, University of Bari 'Aldo Moro', Bari, Italy.
Jazyk:	angličtina
Zdroj:	Pathogens and global health [Pathog Glob Health] 2024 May; Vol. 118 (3), pp. 253-261. Date of Electronic Publication: 2023 Oct 23.
DOI:	10.1080/20477724.2023.2273023
Abstrakt:	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.
Databáze:	MEDLINE
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