The George Institute for Global Health, University of New South Wales, Sydney, Australia; and The George Institute for Global Health, New Delhi, India
The George Institute for Global Health, University of New South Wales, Sydney, Australia; and Department of Innovative Technologies, University of Applied Sciences and Arts of Southern Switzerland, Lugano, Switzerland
Rural Remote Health. 2023 Jul;23(3):7881. doi: 10.22605/RRH7881. Epub 2023 Jul 4.
The extensive spread of COVID-19 meant action to address the pandemic took precedence over routine service delivery, thus impacting access to care for many health conditions, including the effects of snakebite.
We prospectively collected facility-level data from several health facilities in India, including number of snakebite admissions and snakebite envenoming admissions on modality of transport to reach the health facility. To analyse the effect of a health facility being in cluster-containment zone, we used negative binomial regression analysis.
Our findings suggest that that health facilities located within a COVID containment zone saw a significant decrease in total snakebite admissions (incidence rate ratio 0.64 (0.43-0.94), standard error 0.13, p≤0.02)) and envenoming snakebite admissions (incidence rate ratio 0.43 (0.23-0.81), standard error 0.14, p≤0.01) compared to when health facilities were not within a COVID containment zone. There was no statistically significant difference in non-envenoming admissions and modalities of transport used to reach health facilities.
This article provides the first quantitative estimate of the impact of COVID-19 containment measures on access to snakebite care. More research is needed to understand how containment measures altered care-seeking pathways and the nature of snake-human-environment conflict. Primary healthcare systems need to be safeguarded for snakebite care to mitigate effects of cluster-containment measures.
COVID-19 的广泛传播意味着应对这一大流行病的行动优先于常规服务提供,从而影响了许多健康状况的护理机会,包括蛇伤的影响。
我们从印度的几个卫生机构前瞻性地收集了机构层面的数据,包括蛇咬伤入院人数和蛇咬伤中毒入院人数,以及到达卫生机构的交通方式。为了分析卫生机构是否处于疫区的影响,我们使用了负二项回归分析。
我们的研究结果表明,位于 COVID 隔离区的卫生机构的总蛇咬伤入院人数(发病率比 0.64(0.43-0.94),标准误差 0.13,p≤0.02)和蛇咬伤中毒入院人数(发病率比 0.43(0.23-0.81),标准误差 0.14,p≤0.01)显著减少,而卫生机构不在 COVID 隔离区时则没有这种减少。非中毒性入院人数和到达卫生机构的交通方式没有统计学上的显著差异。
本文首次定量估计了 COVID-19 隔离措施对获得蛇伤护理的影响。需要进一步研究了解隔离措施如何改变了寻求护理的途径以及蛇-人-环境冲突的性质。初级保健系统需要得到保护,以提供蛇伤护理,减轻疫区隔离措施的影响。