Vander Burg Richard, Agrawal Karoon, Desai Priya, Desalu Ibironke, Donkor Peter
NGO Strategic Consulting, Norfolk, Va.
Department of Burns, Plastic & Maxillofacial Surgery, National Heart Institute, New Delhi, India.
Plast Reconstr Surg Glob Open. 2021 Jun 22;9(6):e3656. doi: 10.1097/GOX.0000000000003656. eCollection 2021 Jun.
The COVID-19 pandemic disrupted health systems worldwide, including in low- and middle-income countries (LMICs). Many countries limited the delivery of elective surgery. To date, COVID-19's impact on elective surgery in LMICs has been unquantified. We use operative data from a large international non-government cleft organization to compare case volume for 2019 and 2020 to quantify the impact of COVID-19.
Smile Train supports a partner network of over 1100 partners globally to deliver treatment to children with cleft lip and cleft palate (CLP). Treatment data is documented into a proprietary digital platform, Smile Train Express. We compared monthly treatment data for 2019 to 2020, by country, and by World Bank Income group to describe the effect that the COVID-19 pandemic has had on CLP surgery in LMICs.
Our analysis shows 25,444 (31.4%) fewer primary operations performed between January and December 2020 than in the same period in 2019 with the most significant decline in procedures observed in April 2020. Many countries resumed elective surgery for CLP procedures from May onward and volume approximated that of pre-pandemic baseline by November of 2020.
The emergence of the COVID-19 pandemic had a large impact on health systems and service delivery across the world. We find that this is evident in the delivery of CLP surgery in LMICs. The impact is characterized by a dramatic decrease in surgery rates in April of 2020 with a recovery of surgical volume from July 2020 onwards. The rate of surgical rate recovery is consistent across World Bank Income groups.
新冠疫情扰乱了全球卫生系统，包括低收入和中等收入国家（LMICs）。许多国家限制了择期手术的开展。迄今为止，新冠疫情对低收入和中等收入国家择期手术的影响尚未量化。我们使用一家大型国际非政府腭裂组织的手术数据，比较2019年和2020年的病例数量，以量化新冠疫情的影响。
微笑列车在全球支持1100多个合作伙伴组成的网络，为唇腭裂（CLP）儿童提供治疗。治疗数据记录在一个专有的数字平台“微笑列车快车”中。我们按国家和世界银行收入组别比较了2019年至2020年的月度治疗数据，以描述新冠疫情对低收入和中等收入国家唇腭裂手术的影响。
我们的分析显示，2020年1月至12月进行的初次手术比2019年同期减少了25444例（31.4%），2020年4月手术量下降最为显著。许多国家从5月起恢复了唇腭裂手术的择期手术，到2020年11月手术量接近疫情前的基线水平。
新冠疫情的出现对全球卫生系统和服务提供产生了重大影响。我们发现，这在低收入和中等收入国家的唇腭裂手术中很明显。其影响表现为2020年4月手术率急剧下降，从2020年7月起手术量恢复。手术率恢复速度在世界银行各收入组别中是一致的。
