Centre for Infectious Disease Epidemiology and Research, School of Public Health, University of Cape Town, South Africa; Population Health Sciences, Bristol Medical School, University of Bristol, UK; Health Intelligence Directorate, Western Cape Government Health and Wellness, South Africa.
Health Intelligence Directorate, Western Cape Government Health and Wellness, South Africa; Division of Public Health Medicine, School of Public Health, University of Cape Town, South Africa.
S Afr Med J. 2024 Mar 18;114(3):e1560. doi: 10.7196/SAMJ.2024.v114i3.1560.
The COVID-19 pandemic resulted in the implementation of strict public health and social measures (PHSMs) (including mobility restrictions, social distancing, mask-wearing and hand hygiene), limitations on non-essential healthcare services, and public fear of COVID-19 infection, all of which potentially affected transmission and healthcare use for other diseases such as lower respiratory tract infections (LRTIs).
To determine changes in LRTI hospital admissions and in-facility mortality in children aged <5 years in the Western Cape Province during the pandemic.
We conducted a retrospective analysis of LRTI admissions and in-facility deaths from January 2019 to November 2021. We estimated changes in rates and trends of LRTI admissions during the pandemic compared with pre-pandemic period using interrupted time series analysis, adjusting for key characteristics.
There were 36 277 children admitted for LRTIs during the study period, of whom 58% were male and 51% were aged 28 days - 1 year. COVID-19 restrictions were associated with a 13% step reduction in LRTI admissions compared with the pre-COVID-19 period (incidence rate ratio (IRR) 0.87, 95% confidence interval (CI)) 0.80 - 0.94). The average LRTI admission trend increased on average by 2% per month during the pandemic (IRR 1.02, 95% CI 1.02 - 1.04).
The COVID-19 surges and their associated measures were linked to declining LRTI admissions and in-facility deaths, likely driven by a combination of reduced infectious disease transmission and reduced use of healthcare services, with effects diminishing over time. These findings may inform future pandemic response policies.
COVID-19 大流行导致实施了严格的公共卫生和社会措施（包括流动性限制、社交距离、戴口罩和手部卫生），限制了非必要的医疗保健服务，并使公众对 COVID-19 感染感到恐惧，所有这些都可能影响了呼吸道感染（下呼吸道感染）等其他疾病的传播和医疗保健使用。
确定 COVID-19 大流行期间西开普省 5 岁以下儿童下呼吸道感染住院和院内死亡率的变化。
我们对 2019 年 1 月至 2021 年 11 月期间的下呼吸道感染住院和院内死亡病例进行了回顾性分析。我们使用中断时间序列分析，根据关键特征调整，估计大流行期间与大流行前时期相比下呼吸道感染入院率的变化和趋势。
研究期间共有 36277 名儿童因下呼吸道感染住院，其中 58%为男性，51%为 28 天至 1 岁。与 COVID-19 前时期相比，COVID-19 限制措施使下呼吸道感染入院率下降了 13%（发病率比 (IRR) 0.87，95%置信区间 (CI) 0.80-0.94）。大流行期间，下呼吸道感染的平均入院趋势平均每月增加 2%（IRR 1.02，95%CI 1.02-1.04）。
COVID-19 疫情及其相关措施与下呼吸道感染入院率和院内死亡率下降有关，这可能是由于传染病传播减少和医疗保健服务使用减少的综合作用，随着时间的推移，这些影响逐渐减弱。这些发现可能为未来的大流行应对政策提供信息。
