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2019年冠状病毒病大流行对撒哈拉以南非洲地区非传染性疾病护理及服务提供的影响:一项系统综述

Impact of COVID-19 pandemic on non-communicable diseases care and service deliveries in Sub-Saharan Africa: A systematic review.

作者信息

Kidanemariam Yordanos Tadesse, Abebe Finina, Girma Eshetu, Addisse Adamu, Birhanu Zewdie, Hassen Kalkidan, Taye Abonesh, Amdisa Demuma, Lake Eyasu Alem, Guta Mistire Teshome, Morankar Sudhakar, Kedir Kiya, Mesfin Firaol, Wadilo Fiseha, Hailemeskel Elifaged, Dereje Melat, Hailegebrel Eskedar, Howe Rawleigh, Boltena Minyahil Tadesse, Getachew Hailemicheal, Mengesha Endalkachew Worku, Tesfaye Tadesse Dagget, Fentahun Netsanet, Damtew Bereket, Debebe Adisalem, Tariku Zerihun, Worku Addisu, Abraha Yoseph Gebreyohannes, Ababulgu Sabit Ababor

机构信息

School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia.

Ethiopian Evidence Based Health and Development Centre: A JBI Centre of Excellence, Institute of Health, Jimma University, Jimma, Ethiopia.

出版信息

BMC Health Serv Res. 2025 Aug 13;25(1):1075. doi: 10.1186/s12913-025-13270-y.

Abstract

BACKGROUND

Non-communicable diseases (NCDs) care and services play a crucial role in reducing mortality and morbidity associated with NCDs. However, COVID-19 pandemic has worsened the disparities in NCDs care and services in Sub-Saharan Africa (SSA). To date, there is limited synthesized evidence on the impact of COVID-19 on NCDs care and service delivery in this region. Therefore, this review aims to examine the impact of the COVID-19 pandemic on NCDs care and service in SSA.

METHOD

A systematic search was conducted on various databases and grey literature sources, including PubMed, CINAHL, Web of Science, Embase, Scopus, Google Scholar, and the World Health Organization database. Studies evaluating the impacts of COVID-19 on the management and provision of major NCDs care in SSA were included. Data extraction and review were performed using the JBI SUMARI and PRISMA 2020 checklist, and a narrative synthesis approach was used due to the high heterogeneity of the included studies. The review protocol has been registered with PROSPERO code CRD42022350528.

RESULT

A total of 2,387 records were initially identified, with 2,207articles excluded during abstract and title screening, and 60 articles excluded during full-text screening. Ultimately, 18 studies (13 quantitative and 5 qualitative) were included. The review identified significant disruptions in delivery of care for NCD care across SSA during the pandemic. It include substantial reduction in outpatient attendance, delayed or cancelled diagnostic service and compromised disease management. These disruptions were influenced by healthcare system overloads, patient fears of contracting COVID-19, and public health measures limiting access to routine care. The studies emphasize an urgent need for adaptive strategies to maintain continuity of care for individuals with NCD during health crises.

CONCLUSION

The provision of healthcare services for NCDs experienced substantial disruptions during the COVID-19 pandemic, leading to a shift towards managing emergency care. Individuals with NCDs have encountered increased risks of morbidity and mortality due to the delayed access to essential care amidst the pandemic. Emergent solutions like digital health technologies have shown potential in enhancing NCD care access during such crises. Moving forward, it is critical that countries prioritize NCD care and integrate robust systems to ensure the continuous provision of essential services, regardless of the COVID-19 pandemic and other healthcare emergencies.

摘要

背景

非传染性疾病的护理和服务在降低与非传染性疾病相关的死亡率和发病率方面发挥着关键作用。然而,新冠疫情加剧了撒哈拉以南非洲地区(SSA)在非传染性疾病护理和服务方面的差距。迄今为止,关于新冠疫情对该地区非传染性疾病护理和服务提供的影响,综合证据有限。因此,本综述旨在研究新冠疫情对撒哈拉以南非洲地区非传染性疾病护理和服务的影响。

方法

对多个数据库和灰色文献来源进行系统检索,包括PubMed、CINAHL、科学网、Embase、Scopus、谷歌学术和世界卫生组织数据库。纳入评估新冠疫情对撒哈拉以南非洲地区主要非传染性疾病护理管理和提供影响的研究。使用JBI SUMARI和PRISMA 2020清单进行数据提取和综述,由于纳入研究的高度异质性,采用叙述性综合方法。该综述方案已在PROSPERO注册,注册号为CRD42022350528。

结果

最初共识别出2387条记录,在摘要和标题筛选过程中排除2207篇文章,在全文筛选过程中排除60篇文章。最终纳入18项研究(13项定量研究和5项定性研究)。该综述发现,疫情期间撒哈拉以南非洲地区非传染性疾病护理的提供出现了重大中断。这包括门诊就诊人数大幅减少、诊断服务延迟或取消以及疾病管理受到影响。这些中断受到医疗系统超负荷、患者对感染新冠病毒的恐惧以及限制获得常规护理的公共卫生措施的影响。研究强调迫切需要采取适应性策略,以在健康危机期间维持非传染性疾病患者的护理连续性。

结论

在新冠疫情期间,非传染性疾病的医疗服务提供受到严重干扰,导致转向应急护理管理。由于在疫情期间难以获得基本护理,非传染性疾病患者面临的发病和死亡风险增加。数字健康技术等紧急解决方案在此类危机期间显示出增强非传染性疾病护理可及性的潜力。展望未来,各国必须优先考虑非传染性疾病护理,并整合强大的系统,以确保无论新冠疫情和其他医疗紧急情况如何,都能持续提供基本服务。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cac4/12351779/f37cd5ac4d28/12913_2025_13270_Fig1_HTML.jpg

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