Lower respiratory tract infection admissions and deaths among children under 5 years in public sector facilities in the Western Cape Province, South Africa, before and during the COVID-19 pandemic (2019 - 2021).

Autor:	Kehoe K; Centre for Infectious Disease Epidemiology and Research, School of Public Health, University of Cape Town, South Africa; Population Health Sciences, Bristol Medical School, University of Bristol, UK; Health Intelligence Directorate, Western Cape Government Health and Wellness, South Africa. kathleen.kehoe@westerncape.gov.za., Morden E; Health Intelligence Directorate, Western Cape Government Health and Wellness, South Africa; Division of Public Health Medicine, School of Public Health, University of Cape Town, South Africa. erna.morden@westerncape.gov.za., Zinyakatira N; Health Intelligence Directorate, Western Cape Government Health and Wellness, South Africa; Division of Public Health Medicine, School of Public Health, University of Cape Town, South Africa. nesbert.zinyakatira@westerncape.gov.za., Heekes A; Centre for Infectious Disease Epidemiology and Research, School of Public Health, University of Cape Town, South Africa; Health Intelligence Directorate, Western Cape Government Health and Wellness, South Africa. Alexa.Heekes@westerncape.gov.za., Jones HE; Population Health Sciences, Bristol Medical School, University of Bristol, UK. Hayley.Jones@bristol.ac.uk., Walter SR; Population Health Sciences, Bristol Medical School, University of Bristol, UK; National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK. scott.walter@bristol.ac.uk., Jacobs T; Health Intelligence Directorate, Western Cape Government Health and Wellness, South Africa. theuns.jacobs@westerncape.gov.za., Murray J; Department of Paediatrics & Neonatology, Paarl Hospital, Western Cape Government Health and Wellness, Paarl, South Africa. Jaco.Murray@westerncape.gov.za., Buys H; Department of Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa; Red Cross War Memorial Children's Hospital, Western Cape Government Health and Wellness, Cape Town, South Africa. heloise.buys@uct.ac.za., Redaniel MT; Population Health Sciences, Bristol Medical School, University of Bristol, UK; National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK. Theresa.Redaniel@bristol.ac.uk., Davies MA; Centre for Infectious Disease Epidemiology and Research, School of Public Health, University of Cape Town, South Africa; Health Intelligence Directorate, Western Cape Government Health and Wellness, South Africa. Mary-ann.Davies@uct.ac.za.
Jazyk:	angličtina
Zdroj:	South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde [S Afr Med J] 2024 Mar 18; Vol. 114 (3), pp. e1560. Date of Electronic Publication: 2024 Mar 18.
DOI:	10.7196/SAMJ.2024.v114i3.1560
Abstrakt:	Background: The COVID-19 pandemic resulted in the implementation of strict public health and social measures (PHSMs) (including mobility restrictions, social distancing, mask-wearing and hand hygiene), limitations on non-essential healthcare services, and public fear of COVID-19 infection, all of which potentially affected transmission and healthcare use for other diseases such as lower respiratory tract infections (LRTIs). Objective: To determine changes in LRTI hospital admissions and in-facility mortality in children aged <5 years in the Western Cape Province during the pandemic. Methods: We conducted a retrospective analysis of LRTI admissions and in-facility deaths from January 2019 to November 2021. We estimated changes in rates and trends of LRTI admissions during the pandemic compared with pre-pandemic period using interrupted time series analysis, adjusting for key characteristics. Results: There were 36 277 children admitted for LRTIs during the study period, of whom 58% were male and 51% were aged 28 days - 1 year. COVID-19 restrictions were associated with a 13% step reduction in LRTI admissions compared with the pre-COVID-19 period (incidence rate ratio (IRR) 0.87, 95% confidence interval (CI)) 0.80 - 0.94). The average LRTI admission trend increased on average by 2% per month during the pandemic (IRR 1.02, 95% CI 1.02 - 1.04). Conclusions: The COVID-19 surges and their associated measures were linked to declining LRTI admissions and in-facility deaths, likely driven by a combination of reduced infectious disease transmission and reduced use of healthcare services, with effects diminishing over time. These findings may inform future pandemic response policies.
Databáze:	MEDLINE
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