Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, Maryland, United States of America.
Division of Infection and Global Health Research, School of Medicine, University of St. Andrews, St. Andrews, Scotland.
PLoS One. 2022 Aug 29;17(8):e0273389. doi: 10.1371/journal.pone.0273389. eCollection 2022.
COVID-19 has rapidly emerged as a global public health threat with infections recorded in nearly every country. Responses to COVID-19 have varied in intensity and breadth, but generally have included domestic and international travel limitations, closure of non-essential businesses, and repurposing of health services. While these interventions have focused on testing, treatment, and mitigation of COVID-19, there have been reports of interruptions to diagnostic, prevention, and treatment services for other public health threats.
We conducted a scoping review to characterize the early impact of COVID-19 on HIV, tuberculosis, malaria, sexual and reproductive health, and malnutrition.
A scoping literature review was completed using searches of PubMed and preprint servers (medRxiv/bioRxiv) from November 1st, 2019 to October 31st, 2020, using Medical Subject Headings (MeSH) terms related to SARS-CoV-2 or COVID-19 and HIV, tuberculosis, malaria, sexual and reproductive health, and malnutrition. Empiric studies reporting original data collection or mathematical models were included, and available data synthesized by region. Studies were excluded if they were not written in English.
A total of 1604 published papers and 205 preprints were retrieved in the search. Overall, 8.0% (129/1604) of published studies and 10.2% (21/205) of preprints met the inclusion criteria and were included in this review: 7.3% (68/931) on HIV, 7.1% (24/339) on tuberculosis, 11.6% (26/224) on malaria, 7.8% (19/183) on sexual and reproductive health, and 9.8% (13/132) on malnutrition. Thematic results were similar across competing health risks, with substantial indirect effects of the COVID-19 pandemic and response on diagnostic, prevention, and treatment services for HIV, tuberculosis, malaria, sexual and reproductive health, and malnutrition.
COVID-19 emerged in the context of existing public health threats that result in millions of deaths every year. Thus, effectively responding to COVID-19 while minimizing the negative impacts of COVID-19 necessitates innovation and integration of existing programs that are often siloed across health systems. Inequities have been a consistent driver of existing health threats; COVID-19 has worsened disparities, reinforcing the need for programs that address structural risks. The data reviewed here suggest that effective strengthening of health systems should include investment and planning focused on ensuring the continuity of care for both rapidly emergent and existing public health threats.
COVID-19 迅速成为全球公共卫生威胁，几乎每个国家都有感染病例。各国对 COVID-19 的应对措施在强度和广度上有所不同，但通常包括国内和国际旅行限制、非必要企业关闭以及重新调整卫生服务。虽然这些干预措施侧重于 COVID-19 的检测、治疗和缓解，但有报道称，其他公共卫生威胁的诊断、预防和治疗服务也出现了中断。
我们进行了范围界定审查，以描述 COVID-19 对艾滋病毒、结核病、疟疾、性健康和生殖健康以及营养不良的早期影响。
使用与 SARS-CoV-2 或 COVID-19 以及艾滋病毒、结核病、疟疾、性健康和生殖健康以及营养不良相关的医学主题词 (MeSH) 术语，对 2019 年 11 月 1 日至 2020 年 10 月 31 日期间的 PubMed 和预印本服务器（medRxiv/bioRxiv）进行了范围界定文献检索，纳入了报告原始数据收集或数学模型的实证研究，并按区域综合可用数据。如果研究不是用英文撰写，则将其排除在外。
在搜索中总共检索到 1604 篇已发表的论文和 205 篇预印本。总体而言，8.0%（129/1604）的已发表研究和 10.2%（21/205）的预印本符合纳入标准并包含在本综述中：7.3%（68/931）关于艾滋病毒，7.1%（24/339）关于结核病，11.6%（26/224）关于疟疾，7.8%（19/183）关于性健康和生殖健康，9.8%（13/132）关于营养不良。在相互竞争的健康风险中，主题结果相似，COVID-19 大流行及其应对措施对艾滋病毒、结核病、疟疾、性健康和生殖健康以及营养不良的诊断、预防和治疗服务产生了重大的间接影响。
COVID-19 是在每年导致数百万人死亡的现有公共卫生威胁的背景下出现的。因此，在减轻 COVID-19 负面影响的同时，有效应对 COVID-19 需要创新和整合现有的项目，这些项目通常在卫生系统中是孤立的。不平等一直是现有卫生威胁的一个持续驱动因素；COVID-19 加剧了差距，这强化了需要解决结构性风险的项目。这里审查的数据表明，加强卫生系统的有效性应包括投资和规划，重点是确保迅速出现的和现有的公共卫生威胁的护理连续性。
