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da Cunha AR, Antunes JLF. Impact of the COVID-19 pandemic on cancer mortality in Brazil. BMC Cancer 2024; 24:1125. [PMID: 39256699 PMCID: PMC11384704 DOI: 10.1186/s12885-024-12761-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Accepted: 08/05/2024] [Indexed: 09/12/2024] Open
Abstract
BACKGROUND In the first year of the COVID-19 pandemic, data projections indicated an increase in cancer mortality for the following years due to the overload of health services and the replacement of health priorities. The first studies published with data from mortality records have not confirmed these projections. However, cancer mortality is not an outcome that occurs immediately, and analyses with more extended follow-up periods are necessary. This study aims to analyze the impact of the COVID-19 pandemic on the mortality from all types and the five most common types of cancer in Brazil and investigate the relationship between the density of hospital beds and mortality from COVID-19 in cancer patients in Brazil's Intermediate Geographic Regions (RGIs). METHODS The Brazilian Mortality Information System provided data on the deaths from trachea, bronchus, and lung, colorectal, stomach, female breast, and prostate cancer and all types of cancer, and from COVID-19 in individuals who had cancer as a contributing cause of death. Predicted rates for 2020-2022 were compared with the observed ones, through a rate ratio (RR). An association analysis, through multivariate linear regression, was carried out between mortality from COVID-19 in cancer patients, the rate of hospital beds per 100,000 inhabitants, and the Human Development Index of the 133 RGIs of Brazil. RESULTS In 2020, 2021, and 2022, mortality from all cancers in Brazil was lower than expected, with an RR of 0.95, 0.94, and 0.95, respectively, between the observed and predicted rates. Stomach cancer showed the largest difference between observed and expected rates: RR = 0.89 in 2020 and 2021; RR = 0.88 in 2022. Mortality from COVID-19 in cancer patients, which reached its peak in 2021 (6.0/100,000), was negatively associated with the density of hospital beds in the public health system. CONCLUSIONS The lower-than-expected cancer mortality during 2020-2022 seems to be partly explained by mortality from COVID-19 in cancer patients, which was probably underestimated in Brazil. The findings suggested a protective role of the availability of hospital care concerning deaths due to COVID-19 in this population. More extensive follow-up is needed to understand the impact of the COVID-19 pandemic on cancer mortality.
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Affiliation(s)
- Amanda Ramos da Cunha
- School of Public Health, University of SĂŁo Paulo, 715 Doutor Arnaldo Ave, SĂŁo Paulo-SP, 01246904, Brazil.
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Fihel A, Janicka A, Buschner A, UstinaviÄŤienÄ— R, TrakienÄ— A. Unrecognised COVID-19 deaths in central Europe: The importance of cause-of-death certification for the COVID-19 burden assessment. PLoS One 2024; 19:e0307194. [PMID: 39012883 PMCID: PMC11251637 DOI: 10.1371/journal.pone.0307194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Accepted: 07/02/2024] [Indexed: 07/18/2024] Open
Abstract
OBJECTIVE In Central Europe, the increase in mortality during the COVID-19 pandemic exceeded the number of deaths registered due to coronavirus disease. Excess deaths reported to causes other than COVID-19 may have been due to unrecognised coronavirus disease, the interruptions in care in the overwhelmed health care facilities, or socioeconomic effects of the pandemic and lockdowns. Death certificates provide exhaustive medical information, allowing us to assess the extent of unrecognised COVID-19 deaths. MATERIALS AND METHODS Data from 187,300 death certificates with a COVID-19 mention from Austria, Bavaria (Germany), Czechia, Lithuania and Poland, 2020-2021, was used. The two step analysis uses Cause of Death Association Indicators (CDAIs) and Contributing CDAIs to identify and measure the statistical strength of associations between COVID-19 and all other medical mentions. RESULTS 15,700 deaths were reported with COVID-19 only as a contributing condition (comorbidity). In three cases out of four, a typical, statistically significant coronavirus complication or pre-existing condition was registered as the underlying causes of death. In Austria, Bavaria, Czechia and Lithuania the scale of COVID-19 mortality would have been up to 18-27% higher had COVID-19 been coded as the underlying cause of death. Unrecognised coronavirus deaths were equivalent to the entire surplus of excess mortality beyond registered COVID-19 deaths in Austria and the Czech Republic, and its large proportion (25-31%) in Lithuania and Bavaria. CONCLUSIONS Death certificates with typical coronavirus complications or comorbidities as the underlying causes of death and contributing COVID-19 mentions were plausibly unrecognized coronavirus deaths.
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Affiliation(s)
- Agnieszka Fihel
- University of Warsaw, Warsaw, Poland
- Institut Convergences Migrations, Aubervilliers, France
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3
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Petit MP, Ouellette N, Bourbeau R. The case for counting multiple causes of death in the COVID-19 era. Int J Epidemiol 2024; 53:dyad149. [PMID: 37930034 DOI: 10.1093/ije/dyad149] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Indexed: 11/07/2023] Open
Affiliation(s)
- Marie-Pier Petit
- Department of Demography, Université de Montréal, Montreal, QC, Canada
| | - Nadine Ouellette
- Department of Demography, Université de Montréal, Montreal, QC, Canada
| | - Robert Bourbeau
- Department of Demography, Université de Montréal, Montreal, QC, Canada
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Resende BDS, Dias RM, Ferrari G, Rezende LFM. Excess mortality in adults from Sao Paulo during the COVID-19 pandemic in 2020: analyses of all-cause and noncommunicable diseases mortality. Sci Rep 2023; 13:23006. [PMID: 38155297 PMCID: PMC10754941 DOI: 10.1038/s41598-023-50388-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 12/19/2023] [Indexed: 12/30/2023] Open
Abstract
In this study, we estimated the excess mortality from all-causes of death and noncommunicable diseases (NCDs) in adults living in the state of SĂŁo Paulo during the COVID-19 pandemic in 2020. Number of deaths were retrieved from the Mortality Information System before (2017-2019) and during (2020) the COVID-19 pandemic, considering the following underlying causes of death: Neoplasms; Diabetes Mellitus; Circulatory System Diseases, and Respiratory System Diseases. Standardized Mortality Ratio (SMR) were calculated by dividing the mortality rates in 2020 by average mortality rates in 2017-2019, according to sex, age group, geographic location (state, capital, and Regional Health Departments). In 2020, occurred 341,704 deaths in the state of SĂŁo Paulo vs 290,679Â deaths in 2017-2019, representing an 18% increase in all-cause mortality (SMR 1.18) or 51,025 excess deaths during the first year of COVID-19 pandemic. The excess mortality was higher in men (186,741 deaths in 2020 vs 156,371Â deaths in 2017-2019; SMR 1.18; 30,370 excess deaths) compared to women (154,963 deaths in 2020 vs 134,308Â deaths in 2017-2019; SMR 1.15; 20,655 excess deaths). Regarding NCDs mortality, we observed a reduction in cancer mortality (SMR 0.98; -1,354 deaths), diseases of the circulatory system (SMR 0.95; -4,277 deaths), and respiratory system (SMR 0.88; -1,945). We found a 26% increase in Diabetes Mellitus mortality (SMR 1.26; 2885 deaths) during the pandemic year. Our findings corroborate the need to create and strengthen policies aimed at the prevention and control of NCDs, in order to mitigate the impact of future infectious disease pandemics.
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Affiliation(s)
- Bruna de Souza Resende
- Department of Preventive Medicine, Escola Paulista de Medicina, Universidade Federal de SĂŁo Paulo, Sao Paulo, Brazil
| | - Rayara Mozer Dias
- Department of Epidemiology, Instituto de Medicina Social Hesio Cordeiro, Universidade Do Estado Do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Gerson Ferrari
- Universidad de Santiago de Chile (USACH), Escuela de Ciencias de La Actividad FĂsica, El Deporte y La Salud, Santiago, Chile
| | - Leandro F M Rezende
- Department of Preventive Medicine, Escola Paulista de Medicina, Universidade Federal de SĂŁo Paulo, Sao Paulo, Brazil.
- Faculty of Health Sciences, Universidad AutĂłnoma de Chile, Providencia, Chile.
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5
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Bernal Lara P, Savedoff WD, GarcĂa Agudelo MF, Bernal C, Goyeneche L, Sorio R, PĂ©rez-Cuevas R, da Rocha MG, Shibata LG, San Roman Vucetich C, Bauhoff S. Disruption Of Non-COVID-19 Health Care In Latin America During The Pandemic: Effects On Health, Lessons For Policy. Health Aff (Millwood) 2023; 42:1657-1666. [PMID: 38048496 DOI: 10.1377/hlthaff.2023.00720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/06/2023]
Abstract
COVID-19 had severe direct and indirect effects on health and well-being in Latin America. To understand the extent to which disruptions among non-COVID-19-related health services affected population health, we used administrative data from the period 2015-21 to examine public hospital discharges and mortality for conditions amenable to health care in four Latin American countries: Brazil, Ecuador, Mexico, and Peru. Between March 2020 and December 2021, hospitalization rates for these conditions declined by 28Â percent and mortality rates increased by 15Â percent relative to prepandemic years. Noncommunicable diseases accounted for 89Â percent of this rise in mortality. The poorest states in each country experienced relatively larger increases in mortality. Our results, which focus on the health effects of service disruption, suggest that maintaining health care services in this region during the pandemic could have avoided at least 96,000 deaths. Policies should focus on maintaining essential health care services during emergencies, particularly for patients with noncommunicable diseases, and on minimizing negative consequences by ensuring coordinated and continuous care; leveraging alternative modalities of care, such as telemedicine; broadening the role of nonphysician health care workers; and expanding options for medication delivery.
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Affiliation(s)
- Pedro Bernal Lara
- Pedro Bernal Lara , Inter-American Development Bank, Washington, D.C
| | | | | | - Carolina Bernal
- Carolina Bernal, Inter-American Development Bank, Bogota, Colombia
| | - Laura Goyeneche
- Laura Goyeneche, Inter-American Development Bank, Washington, D.C
| | - Rita Sorio
- Rita Sorio, Inter-American Development Bank, Lima, Peru
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6
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Brant LCC, Pinheiro PC, Passaglia LG, de Souza MFM, Malta DC, Banerjee A, Ribeiro ALP, Nascimento BR. Cardiovascular mortality in Brazil during the COVID-19 pandemic: a comparison between underlying and multiple causes of death. Public Health 2023; 224:131-139. [PMID: 37776607 DOI: 10.1016/j.puhe.2023.08.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 07/26/2023] [Accepted: 08/14/2023] [Indexed: 10/02/2023]
Abstract
OBJECTIVES The COVID-19 pandemic has differentially impacted cardiovascular disease (CVD) mortality worldwide. Causes of death misclassification may be one of the reasons. We evaluated the impact of the pandemic on CVD mortality in Brazil, comparing underlying causes (UCs) and multiple causes (MCs) of death. STUDY DESIGN Ecological time-series study. METHODS An ecological, time-series study was conducted analysing age-standardised death rates for CVD, from epidemiological week (EW) 10/2020 to 39/2021, using data from the Mortality Information System, Brazil. CVD was defined using the International Classification of Diseases (ICD-10) coding, if reported as UC or MC of death. Observed and expected data (mean for the same EW, 2017-2019) were compared. Risk ratios (RiRs) were analysed, and 95% confidence intervals (CIs) were calculated. RESULTS Age-standardised mortality rate for CVD as UC of death was 165.8 (95%CI: 165.4-166.3) per 100,000 inhabitants, similar to what was expected (165.6/100,000, 95%CI: 165.2-166.1, RiR = 1.00). There was increased out-of-hospital mortality (RiR = 1.18; 95%CI: 1.17-1.19) and deaths of ill-defined causes (RiR = 1.43; 95%CI: 1.42-1.44). The increase in out-of-hospital deaths was more pronounced in the North (RiR = 1.33; 95%CI 1.30-1.36) region, with a less resilient health system. Conversely, as MCs of death, there was a 10% increase in CVD mortality (observed: 243.2 [95%CI: 242.7-243.7], expected: 221.6 [95%CI: 221.1-222.1] per 100,000). An increase also occurred in the North and Central West regions (RiR = 1.16; 95%CI: 1.15-1.18), among men (RiR = 1.11; 95%CI: 1.11-1.12) and individuals aged ≥60 years (RiR = 1.11; 95%CI: 1.10-1.11). CONCLUSIONS During the pandemic, mortality rates for CVD as MCs of death increased in Brazil, whereas as UC mortality rates did not change. Higher out-of-hospital mortality, misclassification, and competing causes of death may explain this pattern.
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Affiliation(s)
- L C C Brant
- School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil; Telehealth Center, Hospital das ClĂnicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
| | - P C Pinheiro
- School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - L G Passaglia
- School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - M F M de Souza
- School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil; Vital Strategies, SĂŁo Paulo, SP, Brazil
| | - D C Malta
- School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil; Nursing School, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - A Banerjee
- Institute of Health Informatics, University College London, London, UK
| | - A L P Ribeiro
- School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil; Telehealth Center, Hospital das ClĂnicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - B R Nascimento
- School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil; Telehealth Center, Hospital das ClĂnicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil; Serviço de Hemodinâmica do Hospital Madre Teresa, Belo Horizonte, MG, Brazil
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7
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Salha LA, de Menezes JE, Dias DR, Brasil VV, Ferreira PL, de Santana Filho JM, Barbosa MA. Judicialization and cancer: quality of life of patients and caregivers in the COVID-19 pandemic. Health Qual Life Outcomes 2023; 21:87. [PMID: 37568236 PMCID: PMC10422785 DOI: 10.1186/s12955-023-02173-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 07/25/2023] [Indexed: 08/13/2023] Open
Abstract
BACKGROUND In Brazil, cancer patients and caregivers of cancer patients seek judicial intervention for free access to medications from the public health system. Indeed, the COVID-19 pandemic potentially affected the health-related quality of life of cancer patients and caregivers of cancer patients. This study aimed to describe the sociodemographic profile and assess the health-related quality of life of patients and caregivers in the state of Goias, Brazil, in 2020. METHODS A cross-sectional study was conducted using the Medical Outcomes Study 36-Item Short Form Health Survey (SF-36) and a sociodemographic questionnaire. RESULTS A total of 88 (67,7%) patients and 42 (32,3%) caregivers participated in the study, mostly women (55,5%); aged from 18 to 60 (66%) years old; with up to nine years of education (73,1%) and monthly family income lower than the minimum wage (69,2%); married or in a stable union (92,3%); living with multiple people in the same household (73,8%). The quality of life domains with the best scores were mental health for patients and pain for caregivers. The most affected quality of life domain was physical limitation for patients and caregivers. Factors associated with better quality of life were female gender and age between 18 and 60Â years in patients, more than 9Â years of education, living with multiple people in the same house, and having a monthly family income higher than US$200 for caregivers. CONCLUSION The study found evidence of physical and emotional vulnerability during the pandemic, highlighting the need to strengthen public policies of assistance support to this population.
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Affiliation(s)
- Leila Abou Salha
- Faculty of Medicine, Federal University of Goias, Goiânia, Goiás, 74605-050, Brazil.
| | - José Elmo de Menezes
- Federal Institute of Education, Science, and Technology of Goias, Goiânia, 74605-900, Goiás, Brasil
| | - Danilo Rocha Dias
- Faculty of Dentistry, Federal University of Minas Gerais, Belo Horizonte, 31270-901, Brazil
| | | | | | | | - Maria Alves Barbosa
- Faculty of Medicine, Federal University of Goias, Goiânia, Goiás, 74605-050, Brazil
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8
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AraĂşjo MSM, Branco MDRFC, Costa SDSB, de Oliveira DC, Queiroz RCDS, de Oliveira BLCA, Pasklan ANP, dos Santos AM. [COVID-19 mortality in metropolitan areas vs. other regions of Brazil, 2020 to 2021Mortalidad por COVID-19 en las regiones metropolitanas y en el interior de Brasil, 2020-2021]. Rev Panam Salud Publica 2023; 47:e115. [PMID: 37489235 PMCID: PMC10361444 DOI: 10.26633/rpsp.2023.115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 04/21/2023] [Indexed: 07/26/2023] Open
Abstract
Objective To compare hospital mortality rates (HMR) due to severe acute respiratory syndrome (SARS) associated with COVID-19 recorded in metropolitan areas and other regions (interior) of Brazil in 2020 and 2021. Method This ecological study used public data available on OpenDataSUS. The information was accessed in May 2022. The following variables were considered: age, sex, hospitalization, presence of a risk factor, ICU stay, use of ventilatory support, and final classification in the individual registration form of SARS cases due to COVID-19. Cases and deaths were stratified into five age groups (0-19 years, 20-39 years, 40-59 years, 60-79 years, and ≥80 years) and by place of residence (metropolitan area or interior). The HMR had as numerator the absolute number of deaths by SARS associated with covid-19; and, as a denominator, the absolute number of cases of SARS due to covid-19 according to the year of occurrence, area of residence, age bracket, sex, hospitalization, presence of a risk factor, ICU admission, and use of ventilatory support. Results There was a significant increase in HMR due to SARS associated with COVID-19 in 2021 in all age groups, except 0-19 years and ≥80 years, as well as among individuals admitted to an ICU and who used invasive ventilatory support, both in metropolitan areas as well as in the interior. Conclusions There was a worsening of the epidemiological scenario in 2021 with an increase in HMR. However, no differences were identified between the metropolitan regions and the interior of the country.
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Affiliation(s)
- Mayra Sharlenne Moraes AraĂşjo
- Universidade Federal do MaranhĂŁo (UFMA)Programa de PĂłs-Graduação em SaĂşde ColetivaSĂŁo LuĂs (MA)BrasilUniversidade Federal do MaranhĂŁo (UFMA), Programa de PĂłs-Graduação em SaĂşde Coletiva, SĂŁo LuĂs (MA), Brasil.
| | - Maria dos Remédios Freitas Carvalho Branco
- Universidade Federal do MaranhĂŁo (UFMA)Programa de PĂłs-Graduação em SaĂşde ColetivaSĂŁo LuĂs (MA)BrasilUniversidade Federal do MaranhĂŁo (UFMA), Programa de PĂłs-Graduação em SaĂşde Coletiva, SĂŁo LuĂs (MA), Brasil.
| | - Silmery da Silva Brito Costa
- Universidade Federal do MaranhĂŁoDepartamento de SaĂşde ColetivaSĂŁo LuĂs (MA)BrasilUniversidade Federal do MaranhĂŁo, Departamento de SaĂşde Coletiva, SĂŁo LuĂs (MA), Brasil.
| | - Daniel Cavalcante de Oliveira
- Universidade Federal do ABC (UFABC)Departamento de Engenharia BiomédicaSanto André (SP)BrasilUniversidade Federal do ABC (UFABC), Departamento de Engenharia Biomédica, Santo André (SP), Brasil.
| | - Rejane Christine de Sousa Queiroz
- Universidade Federal do MaranhĂŁo (UFMA)Programa de PĂłs-Graduação em SaĂşde ColetivaSĂŁo LuĂs (MA)BrasilUniversidade Federal do MaranhĂŁo (UFMA), Programa de PĂłs-Graduação em SaĂşde Coletiva, SĂŁo LuĂs (MA), Brasil.
| | - Bruno Luciano Carneiro Alves de Oliveira
- Universidade Federal do MaranhĂŁo (UFMA)Programa de PĂłs-Graduação em SaĂşde ColetivaSĂŁo LuĂs (MA)BrasilUniversidade Federal do MaranhĂŁo (UFMA), Programa de PĂłs-Graduação em SaĂşde Coletiva, SĂŁo LuĂs (MA), Brasil.
| | - Amanda NamĂbia Pereira Pasklan
- Universidade Federal do MaranhĂŁoDepartamento de MedicinaSĂŁo LuĂs (MA)BrasilUniversidade Federal do MaranhĂŁo, Departamento de Medicina, SĂŁo LuĂs (MA), Brasil.
| | - Alcione Miranda dos Santos
- Universidade Federal do MaranhĂŁo (UFMA)Programa de PĂłs-Graduação em SaĂşde ColetivaSĂŁo LuĂs (MA)BrasilUniversidade Federal do MaranhĂŁo (UFMA), Programa de PĂłs-Graduação em SaĂşde Coletiva, SĂŁo LuĂs (MA), Brasil.
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Luciani S, Caixeta R, Chavez C, Ondarsuhu D, Hennis A. What is the NCD service capacity and disruptions due to COVID-19? Results from the WHO non-communicable disease country capacity survey in the Americas region. BMJ Open 2023; 13:e070085. [PMID: 36863746 PMCID: PMC9990165 DOI: 10.1136/bmjopen-2022-070085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/04/2023] Open
Abstract
OBJECTIVE This article presents the Americas regional results of the WHO non-communicable diseases (NCDs) Country Capacity Survey from 2019 to 2021, on NCD service capacity and disruptions from the COVID-19 pandemic. SETTING Information on public sector primary care services for NCDs, and related technical inputs from 35 countries in the Americas region are provided. PARTICIPANTS All Ministry of Health officials managing a national NCD programme, from a WHO Member State in the Americas region, were included throughout this study. Government health officials from countries that are not WHO Member States were excluded. OUTCOME MEASURES The availability of evidence-based NCD guidelines, essential NCD medicines and basic technologies in primary care, cardiovascular disease risk stratification, cancer screening and palliative care services were measured in 2019, 2020 and 2021. NCD service interruptions, reassignments of NCD staff during the COVID-19 pandemic and mitigation strategies to reduce disruptions for NCD services were measured in 2020 and 2021. RESULTS More than 50% of countries reported a lack of comprehensive package of NCD guidelines, essential medicines and related service inputs. Extensive disruptions in NCD services resulted from the pandemic, with only 12/35 countries (34%), reporting that outpatient NCD services were functioning normally. Ministry of Health staff were largely redirected to work on the COVID-19 response, either full time or partially, reducing the human resources available for NCD services. Six of 24 countries (25%) reported stock out of essential NCD medicines and/or diagnostics at health facilities which affected service continuity. Mitigation strategies to ensure continuity of care for people with NCDs were deployed in many countries and included triaging patients, telemedicine and teleconsultations, and electronic prescriptions and other novel prescribing practices. CONCLUSIONS The findings from this regional survey suggest significant and sustained disruptions, affecting all countries regardless of the country's level of investments in healthcare or NCD burden.
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Affiliation(s)
- Silvana Luciani
- Department of Noncommunicable Diseases and Mental Health, Pan American Health Organization, Washington, District of Columbia, USA
| | - Roberta Caixeta
- Department of Noncommunicable Diseases and Mental Health, Pan American Health Organization, Washington, District of Columbia, USA
| | - Carolina Chavez
- Department of Noncommunicable Diseases and Mental Health, Pan American Health Organization, Washington, District of Columbia, USA
| | - Dolores Ondarsuhu
- Department of Noncommunicable Diseases and Mental Health, Pan American Health Organization, Washington, District of Columbia, USA
| | - Anselm Hennis
- Department of Noncommunicable Diseases and Mental Health, Pan American Health Organization, Washington, District of Columbia, USA
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Sanmarchi F, Esposito F, Adorno E, De Dominicis F, Fantini MP, Golinelli D. The impact of the SARS-CoV-2 pandemic on cause-specific mortality patterns: a systematic literature review. ZEITSCHRIFT FUR GESUNDHEITSWISSENSCHAFTEN = JOURNAL OF PUBLIC HEALTH 2022; 31:1-19. [PMID: 36188447 PMCID: PMC9510758 DOI: 10.1007/s10389-022-01755-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 09/04/2022] [Indexed: 11/25/2022]
Abstract
Background Understanding the effects of the COVID-19 pandemic on cause-specific mortality should be a priority, as this metric allows for a detailed analysis of the true burden of the pandemic. The aim of this systematic literature review is to estimate the impact of the pandemic on different causes of death, providing a quantitative and qualitative analysis of the phenomenon. Methods We searched MEDLINE, Scopus, and ProQuest for studies that reported cause-specific mortality during the COVID-19 pandemic, extracting relevant data. Results A total of 2413 articles were retrieved, and after screening 22 were selected for data extraction. Cause-specific mortality results were reported using different units of measurement. The most frequently analyzed cause of death was cardiovascular diseases (n = 16), followed by cancer (n = 14) and diabetes (n = 11). We reported heterogeneous patterns of cause-specific mortality, except for suicide and road accident. Conclusions Evidence on non-COVID-19 cause-specific deaths is not exhaustive. Reliable scientific evidence is needed by policymakers to make the best decisions in an unprecedented and extremely uncertain historical period. We advocate for the urgent need to find an international consensus to define reliable methodological approaches to establish the true burden of the COVID-19 pandemic on non-COVID-19 mortality. Supplementary Information The online version contains supplementary material available at 10.1007/s10389-022-01755-7.
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Affiliation(s)
- Francesco Sanmarchi
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum—Università di Bologna, Via San Giacomo 12, 40126 Bologna, Italy
| | - Francesco Esposito
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum—Università di Bologna, Via San Giacomo 12, 40126 Bologna, Italy
| | - Emanuele Adorno
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum—Università di Bologna, Via San Giacomo 12, 40126 Bologna, Italy
| | - Francesco De Dominicis
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum—Università di Bologna, Via San Giacomo 12, 40126 Bologna, Italy
| | - Maria Pia Fantini
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum—Università di Bologna, Via San Giacomo 12, 40126 Bologna, Italy
| | - Davide Golinelli
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum—Università di Bologna, Via San Giacomo 12, 40126 Bologna, Italy
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