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Kuandyk (Sabitova) A, Ortega MA, Ntegwa MJ, Sarria-Santamera A. Impact of the COVID-19 pandemic on access to and delivery of maternal and child healthcare services in low-and middle-income countries: a systematic review of the literature. Front Public Health 2024; 12:1346268. [PMID: 38655525 PMCID: PMC11036866 DOI: 10.3389/fpubh.2024.1346268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 03/21/2024] [Indexed: 04/26/2024] Open
Abstract
Background The COVID-19 pandemic has had a multifaceted impact on maternal and child services and adversely influenced pregnancy outcomes. This systematic review aims to determine the impact of the COVID-19 pandemic on access to and delivery of maternal and child healthcare services in low- and middle-income countries. Methods The review was reported following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A primary search of electronic databases was performed using a combination of search terms related to the following areas of interest: "impact' AND 'COVID-19' AND 'maternal and child health services' AND 'low- and middle-income countries. A narrative synthesis approach was used to analyse and integrate the results. Results Overall, 45 unique studies conducted across 28 low- and middle-income countries met the inclusion criteria for the review. The findings suggest the number of family planning visits, antenatal and postnatal care visits, consultations for sick children, paediatric emergency visits and child immunisation levels decreased compared to the pre-pandemic levels in the majority of included studies. An analytical framework including four main categories was developed based on the concepts that emerged from included studies: the anxiety of not knowing (1), overwhelmed healthcare systems (2), challenges perceived by healthcare professionals (3) and difficulties perceived by service users (4). Conclusion The COVID-19 pandemic disrupted family planning services, antenatal and postnatal care coverage, and emergency and routine child services. Generalised conclusions are tentative due to the heterogeneity and inconsistent quality of the included studies. Future research is recommended to define the pandemic's impact on women and children worldwide and prepare healthcare systems for future resurgences of COVID-19 and potential challenges beyond. Systematic review registration PROSPERO (CRD42021285178).
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Affiliation(s)
- Alina Kuandyk (Sabitova)
- Department of Biomedical Sciences, School of Medicine, Nazarbayev University, Astana, Kazakhstan
| | - Miguel-Angel Ortega
- Department of Medicine and Medical Specialties, Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, Spain
| | | | - Antonio Sarria-Santamera
- Department of Biomedical Sciences, School of Medicine, Nazarbayev University, Astana, Kazakhstan
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Greg Klazura, Paul Park, Ava Yap, Ruth Laverde, Emma Bryce, Maija Cheung, Ernestina Bioh, Sacha Hamilton, Phyllis Kisa, Nasser Kakembo, Michele Ugazzi, Martin Situma, Eric Borgstein, Miliard Derbew, Samuel Negash, Amezene Tadesse, Bruce Bvulani, Bertille Ki, Tapsoba Toussaint, Zaitun Bokhary, Godfrey Sama Philipo, Emmanuel Ameh, Mulenga Mulewa, Jonathan Mwansa, Ifeanyichukwu Onah, Vanda Amado, Daniel De Ugarte, Fabian Massaga, Samwel Byabato, Wasiu Lanre Adeyemo, Olugbemiga Ogunlewe, Bip Nandi, Doruk Ozgediz. Pediatric Surgical Waitlist in Low Middle Income Countries during the COVID-19 Pandemic. J Surg Res 2023. [PMID: 37018896 PMCID: PMC9970937 DOI: 10.1016/j.jss.2023.02.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 01/18/2023] [Accepted: 02/19/2023] [Indexed: 03/06/2023]
Abstract
Purpose COVID-19 led to significant reduction in surgery worldwide. Studies, however, of the effect on surgical volume for pediatric patients in low- and middle-income countries (LMICs) are limited. Methods A survey was developed to estimate waitlists in LMICs for priority surgical conditions in children. The survey was piloted and revised before it was deployed over email to 19 surgeons. Pediatric surgeons at 15 different sites in 8 countries in Sub-Saharan Africa and Ecuador completed the survey from February 2021 to June 2021. The survey included the total number of children awaiting surgery and estimates for specific conditions. Respondents were also able to add additional procedures. Results Public hospitals had longer wait times than private facilities. The median waitlist was 90 patients and the median wait time was 2 months for elective surgeries. Conclusion Lengthy surgical wait times affect surgical access in LMICs. COVID-19 had been associated with surgical delays around the world, exacerbating existing surgical backlogs. Our results revealed significant delays for elective, urgent and emergent cases across Sub-Saharan Africa. Stakeholders should consider approaches to scale the limited surgical and perioperative resources in LMICs, create mitigation strategies for future pandemics, and establish ways to monitor waitlists on an ongoing basis.
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Imediegwu KU, Onyebuchukwu CQ, Abor JC, Bobby ED, Okoye NJF, Magbo CV, Onyenagubo EI, Omene WU. The Adequacy of Hospital Response to COVID-19 Pandemic amongst Surgical Institutions in South-Eastern Nigeria. J West Afr Coll Surg 2023; 13:44-49. [PMID: 36923801 PMCID: PMC10010586 DOI: 10.4103/jwas.jwas_239_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 11/09/2022] [Indexed: 03/18/2023]
Abstract
Background The novel corona virus (COVID-19) was first diagnosed in Wuhan, China in December 2019. The healthcare specifically, departments of surgery in Southeastern Nigeria, are making modifications to cope and plan for the pandemic. Objectives To evaluate how well surgical institutions in Southeastern Nigeria are prepared for the anticipated influx of Covid-19 patients, existing patients and to determine the adequacy of hospital provision of essential supplies and awareness creation. Materials and Methods A cross-sectional online study of two hundred and one (201) surgery resident doctors in surgical institutions in South-eastern Nigeria was conducted. Questionnaires were designed and distributed using online platforms. The data obtained was analyzed using the Statistical Package for the Social Sciences (SPSS). Significance was set at P < 0.05. Consent was obtained from all respondents. Results A total of 201 surgery resident doctors filled and submitted their questionnaires, response rate of 71.5%, out of which 50.1% agreed that hospital response to Covid-19 pandemic was inadequate, 78.3% agreed that the Personal Protective Equipment (PPEs) provided by hospitals were inadequate while about 53.8% agreed that the hospital workforce was poor and inadequate and incapable of adapting to the unstable workforce during the pandemic. About 46.2% agreed that the hospitals were conducting an adequate creation of awareness with regards to the pandemic while 25% agreed that the hospital compliance with the CDC (Center for disease control) preventive protocols/guidelines in surgical institutions were adequate.There was a statistically significant association (P = 0.019 (< 0.05); X2= 5.517) between hospital type and provision of adequate Personal protective equipment for surgical procedures. Only 19% of the government hospital employees felt that adequate amount of PPEs were provided compared to 41% of private hospital employees. Conclusion The results from this study show that the hospital response to Covid-19 pandemic and awareness creation amongst surgical institutions in Southeastern Nigeria are inadequate. Recommendations The government should equip the health sector by providing the necessary amenities to adequately combat the challenges of surgical practice in the Covid-19 pandemic.
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Affiliation(s)
| | | | - Jude C. Abor
- College of Medicine, University of Nigeria (UNN), Enugu, Nigeria
| | - Edeani D. Bobby
- College of Medicine, University of Nigeria (UNN), Enugu, Nigeria
| | - Ngozi JF Okoye
- College of Medicine, University of Nigeria (UNN), Enugu, Nigeria
| | - Chidera V. Magbo
- College of Medicine, University of Nigeria (UNN), Enugu, Nigeria
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Filip R, Gheorghita Puscaselu R, Anchidin-Norocel L, Dimian M, Savage WK. Global Challenges to Public Health Care Systems during the COVID-19 Pandemic: A Review of Pandemic Measures and Problems. J Pers Med 2022; 12:1295. [PMID: 36013244 PMCID: PMC9409667 DOI: 10.3390/jpm12081295] [Citation(s) in RCA: 55] [Impact Index Per Article: 27.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 07/21/2022] [Accepted: 08/05/2022] [Indexed: 12/15/2022] Open
Abstract
Beginning in December 2019, the world faced a critical new public health stressor with the emergence of SARS-CoV-2. Its spread was extraordinarily rapid, and in a matter of weeks countries across the world were affected, notably in their ability to manage health care needs. While many sectors of public structures were impacted by the pandemic, it particularly highlighted shortcomings in medical care infrastructures around the world that underscored the need to reorganize medical systems, as they were vastly unprepared and ill-equipped to manage a pandemic and simultaneously provide general and specialized medical care. This paper presents modalities in approaches to the pandemic by various countries, and the triaged reorganization of medical sections not considered first-line in the pandemic that was in many cases transformed into wards for treating COVID-19 cases. As new viruses and structural variants emerge, it is important to find solutions to streamline medical care in hospitals, which includes the expansion of digital network medicine (i.e., telemedicine and mobile health apps) for patients to continue to receive appropriate care without risking exposure to contagions. Mobile health app development continues to evolve with specialized diagnostics capabilities via external attachments that can provide rapid information sharing between patients and care providers while eliminating the need for office visits. Telemedicine, still in the early stages of adoption, especially in the developing world, can ensure access to medical information and contact with care providers, with the potential to release emergency rooms from excessive cases, and offer multidisciplinary access for patients and care providers that can also be a means to avoid contact during a pandemic. As this pandemic illustrated, an overhaul to streamline health care is essential, and a move towards greater use of mobile health and telemedicine will greatly benefit public health to control the spread of new variants and future outbreaks.
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Affiliation(s)
- Roxana Filip
- Faculty of Medicine and Biological Sciences, Stefan cel Mare University of Suceava, 720229 Suceava, Romania
- BK Laboratory, SuceavaCounty Emergency Hospital, 720224 Suceava, Romania
| | - Roxana Gheorghita Puscaselu
- Faculty of Medicine and Biological Sciences, Stefan cel Mare University of Suceava, 720229 Suceava, Romania
- Integrated Center for Research, Development and Innovation in Advanced Materials, Nanotechnologies, and Distributed Systems for Fabrication and Control, Stefan cel Mare University of Suceava, 720229 Suceava, Romania
| | - Liliana Anchidin-Norocel
- Faculty of Medicine and Biological Sciences, Stefan cel Mare University of Suceava, 720229 Suceava, Romania
| | - Mihai Dimian
- Integrated Center for Research, Development and Innovation in Advanced Materials, Nanotechnologies, and Distributed Systems for Fabrication and Control, Stefan cel Mare University of Suceava, 720229 Suceava, Romania
- Department of Computers, Electronics and Automation, Stefan cel Mare University of Suceava, 720229 Suceava, Romania
| | - Wesley K. Savage
- Faculty of Medicine and Biological Sciences, Stefan cel Mare University of Suceava, 720229 Suceava, Romania
- Integrated Center for Research, Development and Innovation in Advanced Materials, Nanotechnologies, and Distributed Systems for Fabrication and Control, Stefan cel Mare University of Suceava, 720229 Suceava, Romania
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Gallaher JR, Yohann A, Kajombo C, Schneider A, Purcell L, Charles A. Reallocation of Hospital Resources During COVID-19 Pandemic and Effect on Trauma Outcomes in a Resource-Limited Setting. World J Surg 2022. [PMID: 35754058 DOI: 10.1007/s00268-022-06636-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/05/2022] [Indexed: 11/07/2022]
Abstract
Background The COVID-19 pandemic has caused unprecedented disruptions to surgical care worldwide, particularly in low-resource countries. We sought to characterize the association between pre-and intra-pandemic trauma clinical outcomes at a busy tertiary hospital in Malawi. Methods We analyzed trauma patients that presented to Kamuzu Central Hospital in Lilongwe, Malawi, from 2011 through July 2021. Burn patients were excluded. We compared patients based on whether they presented before or during the pandemic (defined as starting March 11, 2020, the date of the official WHO designation). We used logistic regression modeling to estimate the adjusted odds ratio of death based on presentation. Results A total of 137,867 patients presented during the study period, with 13,526 patients during the pandemic. During the pandemic, patients were more likely to be older (mean 28 vs. 25 years, p < 0.001), male (79 vs. 74%, p < 0.001), and suffer a traumatic brain injury (TBI) as their primary injury (9.7 vs. 4.9%, p < 0.001). Crude trauma-associated mortality was higher during the pandemic at 3.7% vs. 2.1% (p < 0.001). The odds ratio of mortality during the pandemic compared to pre-pandemic presentation was 1.28 (95% CI 1.06, 1.53) adjusted for age, sex, initial AVPU score, transfer status, injury type, and mechanism. Conclusions During the pandemic, adjusted trauma-associated mortality significantly increased at a tertiary trauma center in a low-resource setting despite decreasing patient volume. Further research is urgently needed to prepare for future pandemics. Potential targets for improvement include improving pre-hospital care and transportation, planning for intensive care utilization, and addressing nursing shortages.
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Rodo M, Singh L, Russell N, Singh NS. A mixed methods study to assess the impact of COVID-19 on maternal, newborn, child health and nutrition in fragile and conflict-affected settings. Confl Health 2022; 16:30. [PMID: 35659039 PMCID: PMC9162897 DOI: 10.1186/s13031-022-00465-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 05/28/2022] [Indexed: 11/15/2022] Open
Abstract
Background The impacts of COVID-19 are unprecedented globally. The pandemic is reversing decades of progress in maternal, newborn, child health and nutrition (MNCHN), especially fragile and conflict-affected settings (FCAS) whose populations were already facing challenges in accessing basic health and nutrition services. This study aimed to investigate the collateral impact of COVID-19 on funding, services and MNCHN outcomes in FCAS, as well as adaptations used in the field to continue activities. Methods A scoping review of peer-reviewed and grey literature published between 1st March 2020–31st January 2021 was conducted. We analysed 103 publications using a narrative synthesis approach. 39 remote semi-structured key informant interviews with humanitarian actors and donor staff within 12 FCAS were conducted between October 2020 and February 2021. Thematic analysis was undertaken independently by two researchers on interview transcripts and supporting documents provided by key informants, and triangulated with literature review findings. Results Funding for MNCHN has been reduced or suspended with increase in cost of continuing the same activities, and diversion of MNCHN funding to COVID-19 activities. Disruption in supply and demand of interventions was reported across different settings which, despite data evidence still being missing, points towards likely increased maternal and child morbidity and mortality. Some positive adaptations including use of technology and decentralisation of services have been reported, however overall adaptation strategies have been insufficient to equitably meet additional challenges posed by the pandemic, and have not been evaluated for their effectiveness. Conclusions COVID-19 is further exacerbating negative women’s and children’s health outcomes in FCAS. Increased funding is urgently required to re-establish MNCHN activities which have been deprioritised or halted. Improved planning to sustain routine health services and enable surge planning for emergencies with focus on the community/service users throughout adaptations is vital for improved MNCHN outcomes in FCAS. Supplementary Information The online version contains supplementary material available at 10.1186/s13031-022-00465-x.
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Challinor J, Sierra MFO, Burns K, Young A. Oncology nursing in the Global South during COVID-19. Ecancermedicalscience 2022; 15:1329. [PMID: 35211198 PMCID: PMC8816499 DOI: 10.3332/ecancer.2021.1329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Indexed: 11/06/2022] Open
Abstract
In mid-2020, a call was made to oncology nurses in the Global South to share their experiences managing patient care during the coronavirus disease 2019 (COVID-19) pandemic. Eighteen submissions were received from 16 countries across Latin America, Africa, Europe and Asia. Three were research-based and 15 were personal narratives on the psychosocial impact of COVID-19 on the nurses, colleagues, patients and families. Three narratives were from oncology nurses working with cancer-related non-governmental organisations locally or, in one case, internationally. A simultaneous literature search for publications (including grey literature) was performed to identify themes of COVID-19’s impact in these 16 countries and specifically on oncology nurses and patients/families. Four themes were identified: a) interruptions to care; b) support/resource shortages; c) psychosocial impact on nurses and patients and d) staffing and nursing role impacts. The three research-based studies describe oncology nursing in-depth efforts to explore the impact of COVID-19. Findings in the 15 narratives are briefly presented according to the four themes identified in the literature. Due to the severe shortage of physician adult and paediatric oncology specialists, oncology nurses in the Global South often shoulder much of the care for patients with cancer and even more so during COVID-19 with attendant oncology nursing shortages due to reassignment to COVID-19 units. It is important to hear from these critical members of the oncology nursing workforce who often lack the time, resources or training to publish in peer-reviewed journals in English, particularly in the middle of a pandemic. Giving voice to these nurses documents the reality of their work and ability to continue to provide care despite the chaos and rapidly changing guidelines and government action. Lessons learned by these nurses to improve mental health and psychosocial support of the nurses as well as their patients/families will be essential for the next global pandemic.
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Affiliation(s)
- Julia Challinor
- University of California San Francisco, 2 Koret Way, San Francisco, CA 94143, USA.,https://orcid.org/0000-0002-5008-8501
| | | | - Kathryn Burns
- Qualitative Research, Budapest, Hungary.,https://orcid.org/0000-0002-2695-1088
| | - Annie Young
- Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK.,https://orcid.org/0000-0001-6611-6653
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Vaos G, Zavras N. Severe acute respiratory syndrome coronavirus 2 pandemic related morbidity and mortality in patients with pediatric surgical diseases: A concerning challenge. World J Methodol 2022; 12:20-31. [PMID: 35117979 PMCID: PMC8790310 DOI: 10.5662/wjm.v12.i1.20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 07/01/2021] [Accepted: 11/15/2021] [Indexed: 02/06/2023] Open
Abstract
The global spread of the novel severe acute respiratory syndrome coronavirus 2 has had serious consequences in terms of patient morbidity and mortality and overburdened health care systems as well as the socioeconomic implications. In the absence of effective therapies and vaccinations during the viral outbreak, the major and most concise means to control viral spread is spread prevention. Although information concerning the impact of severe acute respiratory syndrome coronavirus 2 on pediatric surgical patients has greatly expanded, relevant comprehensive studies are scarce. However, pandemic related morbidity has increased, while under normal circumstances mortality could have been minimized.
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Affiliation(s)
- George Vaos
- Department of Paediatric Surgery, “ATTIKON” University General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens 12462, Greece
| | - Nikolaos Zavras
- Department of Paediatric Surgery, “ATTIKON” University General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens 12462, Greece
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Ademe Y, Genetu A, Laeke T, Taye M, Bekele A. Impact of COVID-19 on Surgical Volume: Single-Center Experience from Addis Ababa, Ethiopia. Ethiop J Health Sci 2022; 32:37-44. [PMID: 35250215 PMCID: PMC8864390 DOI: 10.4314/ejhs.v32i1.5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 10/12/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic has caused substantial disruptions to surgical-care delivery mainly due to diversion of available resources from surgical to COVID-19 care, reduced flow of patients, supply-chain interruptions and social distancing and restriction measures. The purpose of this study was to understand the impact of the pandemic on surgical volume in our hospital. METHODS A descriptive cross-sectional study was done at Tikur Anbessa Specialized Hospital. A 2- year data was collected from March 2019 up to March 2021 from the operation theatre registration books. The data registry at the admission records office was also reviewed to extract the number pf patients on the elective surgery waiting list. Data were recorded, analyzed and reported using SPSS software package 26. RESULTS The findings showed that there was a significant drop in surgical volume during the COVID-19 era. Surgical volume has dropped by 19% for emergency and by 32% for elective surgeries. COVID-19 test positivity of patients was identified as the single most important reason for elective operation cancellation during the first wave of the pandemic, contributing to as high as 85% of the reasons. CONCLUSION The outcome of our study showed that COVID-19 has adversely affected elective and emergency surgical volume in our institution. This has also led to a dramatic increase in the surgical waiting list load. We recommend immediate surgical systems strengthening measures to re-build the surgical care ecosystem significantly affected by COVID-19. Surgical and anesthesia systems strengthening should be an integral part of pandemic preparedness and management.
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Affiliation(s)
- Yonas Ademe
- Addis Ababa University, College of Health Sciences, School of Medicine, Department of Surgery Addis Ababa, Ethiopia
| | - Abraham Genetu
- Addis Ababa University, College of Health Sciences, School of Medicine, Department of Surgery Addis Ababa, Ethiopia
| | - Tsegazeab Laeke
- Addis Ababa University, College of Health Sciences, School of Medicine, Department of Surgery Addis Ababa, Ethiopia
| | - Mulat Taye
- Addis Ababa University, College of Health Sciences, School of Medicine, Department of Surgery Addis Ababa, Ethiopia
| | - Abebe Bekele
- Professor of Surgery, University of Global Health Equity, School of Medicine Kigali Heights, Plot 772, KG 7 AVE
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Yarhere I, Oragui O. Reduced admissions in the children's emergency room during coronavirus-19 pandemic in the university of port harcourt teaching hospital, Nigeria. Niger J Med 2022. [DOI: 10.4103/njm.njm_34_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Afolalu OO, Atekoja OE, Oyewumi ZO, Adeyeye SO, Jolayemi KI, Akingbade O. Perceived impact of coronavirus pandemic on uptake of healthcare services in South West Nigeria. Pan Afr Med J 2021; 40:26. [PMID: 34733394 PMCID: PMC8531964 DOI: 10.11604/pamj.2021.40.26.28279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 08/25/2021] [Indexed: 11/28/2022] Open
Abstract
Introduction the COVID-19 pandemic since its emergence has posed a great danger to the health of the general populace while impacting the Nigerian healthcare delivery significantly. Since its emergence, the health system has been stretched with overwhelming responsibilities. The study assessed health providers´ perceived impact of coronavirus pandemic on the uptake of health care services in South West Nigeria. Methods a descriptive cross-sectional design using an online structured survey was used to elicit responses from 385 Nigerian health workers selected by convenience sampling technique. Data analysis was done with the Statistical Package for Social Sciences (SPSS) version 26. Comparison of the uptake of healthcare before and during the COVID-19 pandemic was performed using the Chi-square test. Results findings revealed a significant difference between the uptake of health care prior and during the COVID-19 pandemic (χ2= 92.77, p=0.000) as 253 respondents (65.7%) reported that the hospital recorded a low turn-out of patients during the pandemic and 184 (47.8%) indicated that some of the facility units/departments were temporarily closed due to COVID-19 pandemic. Similarly, there was a significant difference between health-related conditions requiring hospital admission before and during COVID-19 pandemic (χ2=3.334 p=0.046). Factors influencing uptake of health services during the COVID-19 pandemic are: fear of nosocomial infection, fear of stigmatization, and misconception/misinformation on COVID-19 diseases and care. Conclusion the Nigerian health system in the past months has been remarkably impacted by the pandemic. This calls for immediate restructuring to maintain an equitable distribution of care, while minimizing risk to patients and health providers.
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Affiliation(s)
| | | | - Zaccheus Opeyemi Oyewumi
- Department of Nursing, Ladoke Akintola University of Technology, Open and Distance Learning Centre, Ogbomoso, Oyo State, Nigeria
| | - Semiu Opeyemi Adeyeye
- Department of Nursing, Ladoke Akintola University of Technology, Open and Distance Learning Centre, Ogbomoso, Oyo State, Nigeria
| | | | - Oluwadamilare Akingbade
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, China.,Institute of Nursing Research, Nigeria
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Taha-Mehlitz S, Hendie A, Taha A. The Development of Electronic Health and Artificial Intelligence in Surgery after the SARS-CoV-2 Pandemic-A Scoping Review. J Clin Med 2021; 10:jcm10204789. [PMID: 34682912 PMCID: PMC8537136 DOI: 10.3390/jcm10204789] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 10/13/2021] [Accepted: 10/18/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND SARS-CoV-2 has significantly transformed the healthcare environment, and it has triggered the development of electronic health and artificial intelligence mechanisms, for instance. In this overview, we concentrated on enhancing the two concepts in surgery after the pandemic, and we examined the factors on a global scale. OBJECTIVE The primary goal of this scoping review is to elaborate on how surgeons have used eHealth and AI before; during; and after the current global pandemic. More specifically, this review focuses on the empowerment of the concepts of electronic health and artificial intelligence after the pandemic; which mainly depend on the efforts of countries to advance the notions of surgery. DESIGN The use of an online search engine was the most applied method. The publication years of all the studies included in the study ranged from 2013 to 2021. Out of the reviewed studies; forty-four qualified for inclusion in the review. DISCUSSION We evaluated the prevalence of the concepts in different continents such as the United States; Europe; Asia; the Middle East; and Africa. Our research reveals that the success of eHealth and artificial intelligence adoption primarily depends on the efforts of countries to advance the notions in surgery. CONCLUSIONS The study's primary limitation is insufficient information on eHealth and artificial intelligence concepts; particularly in developing nations. Future research should focus on establishing methods of handling eHealth and AI challenges around confidentiality and data security.
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Affiliation(s)
- Stephanie Taha-Mehlitz
- Clarunis, University Center for Gastrointestinal and Liver Diseases, St. Clara Hospital and University Hospital, 4002 Basel, Switzerland;
| | - Ahmad Hendie
- Department of Computer Engineering, McGill University, Montreal, QC H3A 0C6, Canada;
| | - Anas Taha
- Department of Biomedical Engineering, Faculty of Medicine, University of Basel, 4321 Allschwil, Switzerland
- Correspondence: ; Tel.: +41-61-207-54-02
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13
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Saalabian K, Rolle U, Friedmacher F. Impact of the Global COVID-19 Pandemic on the Incidence, Presentation, and Management of Pediatric Appendicitis: Lessons Learned from the First Wave. Eur J Pediatr Surg 2021; 31:311-318. [PMID: 34161983 DOI: 10.1055/s-0041-1731295] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The fast-evolving nature of the coronavirus disease 2019 (COVID-19) pandemic has led to unprecedented clinical, logistical, and socioeconomical challenges for health-care systems worldwide. While several studies have analyzed the impact on the presentation and management of acute appendicitis (AA) in the adult population, there is a relative paucity of similar research in pediatric patients with AA. To date, there is some evidence that the incidence of simple AA in children may have decreased during the first lockdown period in spring 2020, whereas the number of complicated AA cases remained unchanged or increased slightly. Despite a worrying trend toward delayed presentation, most pediatric patients with AA were treated expediently during this time with comparable outcomes to previous years. Hospitals must consider their individual capacity and medical resources when choosing between operative and non-operative management of children with AA. Testing for severe acute respiratory syndrome coronavirus type 2 is imperative in all pediatric patients presenting with fever and acute abdominal pain with diarrhea or vomiting, to differentiate between multisystem inflammatory syndrome and AA, thus avoiding unnecessary surgery. During the further extension of the COVID-19 crisis, parents should be encouraged to seek medical care with their children early in order that the appropriate treatment for AA can be undertaken in a timely fashion.
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Affiliation(s)
- Kerstin Saalabian
- Department of Pediatric Surgery, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt (Main), Germany
| | - Udo Rolle
- Department of Pediatric Surgery, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt (Main), Germany
| | - Florian Friedmacher
- Department of Pediatric Surgery, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt (Main), Germany
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14
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Ifeanyichi M, Gajewski J, Baltussen R, Borgstein E, Kachimba J, Brugha R, Bijlmakers L. COVID-19 pandemic: Revisiting the case for a dedicated financing mechanism for surgical care in resource-poor countries. J Glob Health 2021; 11:03090. [PMID: 34386211 PMCID: PMC8325879 DOI: 10.7189/jogh.11.03090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Martilord Ifeanyichi
- Department for Health Evidence, Radboud Institute for Health Sciences, Radboud University Medical Centre, Nijmegen, the Netherlands.,EMAI Health Systems and Health Services Consulting, Nijmegen, the Netherlands
| | - Jakub Gajewski
- Institute of Global Surgery, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Rob Baltussen
- Department for Health Evidence, Radboud Institute for Health Sciences, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - Eric Borgstein
- College of Medicine, University of Malawi, Blantyre, Malawi
| | - John Kachimba
- Surgical Society of Zambia, Department of Surgery, University Teaching Hospital, Lusaka, Zambia
| | - Ruairi Brugha
- Department of Public Health and Epidemiology, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Leon Bijlmakers
- Department for Health Evidence, Radboud Institute for Health Sciences, Radboud University Medical Centre, Nijmegen, the Netherlands
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15
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Yasmin F, Bin Zafar MD, Salman A, Farooque U, Asghar MS, Khan AA, Mohiuddin O, Hassan SA. Exploring the impact of the COVID-19 pandemic on pediatric surgical services: a scoping review. Minerva Pediatr (Torino) 2021; 73:460-466. [PMID: 33845565 DOI: 10.23736/s2724-5276.21.06146-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Inevitably, along with other healthcare specializations, pediatric surgery was affected by the Coronavirus disease-19 (COVID-19) pandemic. Children were reported to manifest mild to moderate symptoms and mortality was primarily observed in patients aged <1 year and having underlying comorbidities. The majority of the cases were asymptomatic in children, hence, posing a challenge for pediatric surgery centers to take drastic measures to reduce the virus transmission. Telemedicine was introduced and outpatient consultations were conducted online as out-patient clinics were closed. Elective surgeries were postponed with delayed appointments while the healthcare sector was diverted towards tackling COVID-19. Case urgency was classified and triaged, leading to limited surgeries being performed only in COVID-19 negative patients following an extensive screening process. The screening process consisted of online history taking and RT-PCR tests. Newer practices such as mouth rinse, video laryngoscopy, and anesthesia were introduced to restrict patients from crying, coughing, and sneezing, as an attempt to avoid aerosolization of viral particles and safely conduct pediatric surgeries during the pandemic. Surgical trainees were also affected as the smaller number of surgeries conducted reduced the clinical experience available to medical enthusiasts. There is still room for advanced practices to be introduced in pediatric surgery, and restore all kinds of surgeries to improve the quality of life of the patient.
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Affiliation(s)
- Farah Yasmin
- MBBS, Department of Internal Medicine, Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan -
| | - Muhammad D Bin Zafar
- MBBS, Department of Internal Medicine, Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan
| | - Ariba Salman
- MBBS, Department of Internal Medicine, Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan
| | - Umar Farooque
- Department of Neurology, Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan
| | - Muhammad S Asghar
- Department of Internal Medicine, Dow University Hospital (Ohja Campus), Karachi, Pakistan
| | - Anosh A Khan
- MBBS, Department of Internal Medicine, Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan
| | - Osama Mohiuddin
- MBBS, Department of Internal Medicine, Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan
| | - Syed A Hassan
- Department of Cardiovascular Medicine, University of Louisville, Louisville, KY, USA
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16
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Obanife H, Nkwerem P. Postgraduate neurosurgical education in the current COVID-19 climate: An auspicious time for a paradigm shift in Africa. Niger J Med 2021. [DOI: 10.4103/njm.njm_176_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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17
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Adesunkanmi AO, Ubom AE, Olasehinde O, Fasubaa OB, Ijarotimi OA, Adesunkanmi ARK, Okon NE. Impact of COVID-19 on the cost of surgical and obstetric care: experience from a Nigerian teaching hospital and a review of the Nigerian situation. Pan Afr Med J 2020; 37:15. [PMID: 33343794 PMCID: PMC7733343 DOI: 10.11604/pamj.supp.2020.37.15.25935] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Accepted: 09/19/2020] [Indexed: 12/23/2022] Open
Abstract
The public health impact of the COVID-19 pandemic cannot be overstated. Its impact on the cost of surgical and obstetric care is significant. More so, in a country like Nigeria, where even before the pandemic, out-of-pocket spending (OOPS) has been the major payment method for healthcare. The increased cost of surgical and obstetric care occasioned by the pandemic has principally been due to the additional burden of ensuring the use of adequate/appropriate personal protective equipment (PPE) during patient care as a disease containment measure. These PPE are not readily available in public hospitals across Nigeria. Patients are therefore compelled to bear the financial burden of procuring scarce PPE for use by health care personnel, further increasing the already high cost of healthcare. In this study, we sought to appraise the impact of the COVID-19 pandemic on the cost of surgical and obstetric care in Nigeria, drawing from the experience from one of the major Nigerian teaching hospitals- the Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC), Ile-Ife, Osun State. The cost of surgical and obstetric care was reviewed and compared pre- and during the COVID-19 pandemic, deriving relevant examples from some commonly performed surgical operations in our centre (OAUTHC). We reviewed patients' hospital bills and receipts of consumables procured for surgery. Our findings revealed that the cost of surgical and obstetric care during the COVID-19 pandemic had significantly increased. We identified gaps and made relevant recommendations on measures to reduce the additional costs of surgical and obstetric care during and beyond pandemic.
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Affiliation(s)
| | - Akaninyene Eseme Ubom
- Department of Obstetrics, Gynaecology, and Perinatology, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria
| | - Olalekan Olasehinde
- Department of Surgery, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria
- Department of Surgery, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria
| | - Olusola Benjamin Fasubaa
- Department of Obstetrics, Gynaecology, and Perinatology, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria
- Department of Obstetrics, Gynaecology, and Perinatology, Faculty of Clinical Sciences, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria
| | - Omotade Adebimpe Ijarotimi
- Department of Obstetrics, Gynaecology, and Perinatology, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria
- Department of Obstetrics, Gynaecology, and Perinatology, Faculty of Clinical Sciences, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria
| | - Abdul Rashid Kayode Adesunkanmi
- Department of Surgery, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria
- Department of Surgery, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria
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18
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Bethell GS, Rees CM, Sutcliffe JR, Hall NJ. Management and early outcomes of children with appendicitis in the UK and Ireland during the COVID-19 pandemic: a survey of surgeons and observational study. BMJ Paediatr Open 2020; 4:e000831. [PMID: 34192180 PMCID: PMC7582338 DOI: 10.1136/bmjpo-2020-000831] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 09/25/2020] [Accepted: 09/26/2020] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES Acute appendicitis is the most common surgical condition in children. In the UK, appendicectomy is the most common treatment with non-operative management unusual. Due to concerns about the risk of SARS-CoV-2 transmission during surgical procedures, surgeons were advised to consider non-operative treatment and avoid laparoscopy where possible. This study aims to report management and outcomes, to date, of children with appendicitis in the UK and Ireland during the COVID-19 pandemic. DESIGN Survey of consultant surgeons who treat children with appendicitis that informed a prospective multicentre observational cohort study. SETTING Data were collected from centres in the UK and Ireland for cases admitted between 1 April and 31 May 2020 (first 2 months of the COVID-19 pandemic) at both general surgical and specialist paediatric surgical centres. PARTICIPANTS The study cohort includes 838 children with a clinical and/or radiological diagnosis of acute appendicitis of which 527 (63%) were male. MAIN OUTCOMES MEASURED Primary outcome was treatment strategy used for acute appendicitis. Other outcomes reported include change in treatment strategy over time, use of diagnostic imaging and important patient outcomes to 30 days following hospital admission. RESULTS From very early in the pandemic surgeons experienced a change in their management of children with appendicitis and almost all surgeons who responded to the survey anticipated further changes during the pandemic. Overall, 326/838 (39%) were initially treated non-operatively of whom 81/326 (25%) proceeded to appendicectomy within the initial hospital admission. Of cases treated initially surgically 243/512 (48%) were performed laparoscopically. Diagnostic imaging was used in 445/838 (53%) children. Cases treated non-operatively had a shorter hospital stay than those treated surgically but hospital readmissions within 30 days were similar between groups. In cases treated surgically the negative appendicectomy rate was 4.5%. There was a trend towards increased use of surgical treatment and from open to laparoscopic appendicectomy as the pandemic progressed. CONCLUSION Non-operative treatment of appendicitis has been widely used for the first time in children in the UK and Ireland and is safe and effective in selected patients. Overall patient outcomes do not appear to have been adversely impacted by change in management during the pandemic thus far.
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Affiliation(s)
- George S Bethell
- University Surgery Unit, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Clare M Rees
- Department of Paediatric Surgery, Imperial College Healthcare NHS Trust, London, UK
| | | | - Nigel J Hall
- University Surgery Unit, Faculty of Medicine, University of Southampton, Southampton, UK
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