Impact of COVID-19 on routine malaria indicators in rural Uganda: an interrupted time series analysis
Abstract Background In March 2020, the government of Uganda implemented a strict lockdown policy in response to the COVID-19 pandemic. Interrupted time series analysis (ITSA) was performed to assess whether major changes in outpatient attendance, malaria burden, and case management occurred after th...
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ftdoajarticles:oai:doaj.org/article:87ad822db6ed466391c62f3f10fd9bae 2023-05-15T15:16:51+02:00 Impact of COVID-19 on routine malaria indicators in rural Uganda: an interrupted time series analysis Jane F. Namuganga Jessica Briggs Michelle E. Roh Jaffer Okiring Yasin Kisambira Asadu Sserwanga James A. Kapisi Emmanuel Arinaitwe Chris Ebong Isaac Ssewanyana Catherine Maiteki-Ssebuguzi Moses R. Kamya Sarah G. Staedke Grant Dorsey Joaniter I. Nankabirwa 2021-12-01T00:00:00Z https://doi.org/10.1186/s12936-021-04018-0 https://doaj.org/article/87ad822db6ed466391c62f3f10fd9bae EN eng BMC https://doi.org/10.1186/s12936-021-04018-0 https://doaj.org/toc/1475-2875 doi:10.1186/s12936-021-04018-0 1475-2875 https://doaj.org/article/87ad822db6ed466391c62f3f10fd9bae Malaria Journal, Vol 20, Iss 1, Pp 1-11 (2021) Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 article 2021 ftdoajarticles https://doi.org/10.1186/s12936-021-04018-0 2022-12-31T15:47:41Z Abstract Background In March 2020, the government of Uganda implemented a strict lockdown policy in response to the COVID-19 pandemic. Interrupted time series analysis (ITSA) was performed to assess whether major changes in outpatient attendance, malaria burden, and case management occurred after the onset of the COVID-19 epidemic in rural Uganda. Methods Individual level data from all outpatient visits collected from April 2017 to March 2021 at 17 facilities were analysed. Outcomes included total outpatient visits, malaria cases, non-malarial visits, proportion of patients with suspected malaria, proportion of patients tested using rapid diagnostic tests (RDTs), and proportion of malaria cases prescribed artemether-lumefantrine (AL). Poisson regression with generalized estimating equations and fractional regression was used to model count and proportion outcomes, respectively. Pre-COVID trends (April 2017-March 2020) were used to predict the’expected’ trend in the absence of COVID-19 introduction. Effects of COVID-19 were estimated over two six-month COVID-19 time periods (April 2020-September 2020 and October 2020–March 2021) by dividing observed values by expected values, and expressed as ratios. Results A total of 1,442,737 outpatient visits were recorded. Malaria was suspected in 55.3% of visits and 98.8% of these had a malaria diagnostic test performed. ITSA showed no differences between observed and expected total outpatient visits, malaria cases, non-malarial visits, or proportion of visits with suspected malaria after COVID-19 onset. However, in the second six months of the COVID-19 time period, there was a smaller mean proportion of patients tested with RDTs compared to expected (relative prevalence ratio (RPR) = 0.87, CI (0.78–0.97)) and a smaller mean proportion of malaria cases prescribed AL (RPR = 0.94, CI (0.90–0.99)). Conclusions In the first year after the COVID-19 pandemic arrived in Uganda, there were no major effects on malaria disease burden and indicators of case management at these 17 ... Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Malaria Journal 20 1 |
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Directory of Open Access Journals: DOAJ Articles |
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ftdoajarticles |
language |
English |
topic |
Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
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Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 Jane F. Namuganga Jessica Briggs Michelle E. Roh Jaffer Okiring Yasin Kisambira Asadu Sserwanga James A. Kapisi Emmanuel Arinaitwe Chris Ebong Isaac Ssewanyana Catherine Maiteki-Ssebuguzi Moses R. Kamya Sarah G. Staedke Grant Dorsey Joaniter I. Nankabirwa Impact of COVID-19 on routine malaria indicators in rural Uganda: an interrupted time series analysis |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
description |
Abstract Background In March 2020, the government of Uganda implemented a strict lockdown policy in response to the COVID-19 pandemic. Interrupted time series analysis (ITSA) was performed to assess whether major changes in outpatient attendance, malaria burden, and case management occurred after the onset of the COVID-19 epidemic in rural Uganda. Methods Individual level data from all outpatient visits collected from April 2017 to March 2021 at 17 facilities were analysed. Outcomes included total outpatient visits, malaria cases, non-malarial visits, proportion of patients with suspected malaria, proportion of patients tested using rapid diagnostic tests (RDTs), and proportion of malaria cases prescribed artemether-lumefantrine (AL). Poisson regression with generalized estimating equations and fractional regression was used to model count and proportion outcomes, respectively. Pre-COVID trends (April 2017-March 2020) were used to predict the’expected’ trend in the absence of COVID-19 introduction. Effects of COVID-19 were estimated over two six-month COVID-19 time periods (April 2020-September 2020 and October 2020–March 2021) by dividing observed values by expected values, and expressed as ratios. Results A total of 1,442,737 outpatient visits were recorded. Malaria was suspected in 55.3% of visits and 98.8% of these had a malaria diagnostic test performed. ITSA showed no differences between observed and expected total outpatient visits, malaria cases, non-malarial visits, or proportion of visits with suspected malaria after COVID-19 onset. However, in the second six months of the COVID-19 time period, there was a smaller mean proportion of patients tested with RDTs compared to expected (relative prevalence ratio (RPR) = 0.87, CI (0.78–0.97)) and a smaller mean proportion of malaria cases prescribed AL (RPR = 0.94, CI (0.90–0.99)). Conclusions In the first year after the COVID-19 pandemic arrived in Uganda, there were no major effects on malaria disease burden and indicators of case management at these 17 ... |
format |
Article in Journal/Newspaper |
author |
Jane F. Namuganga Jessica Briggs Michelle E. Roh Jaffer Okiring Yasin Kisambira Asadu Sserwanga James A. Kapisi Emmanuel Arinaitwe Chris Ebong Isaac Ssewanyana Catherine Maiteki-Ssebuguzi Moses R. Kamya Sarah G. Staedke Grant Dorsey Joaniter I. Nankabirwa |
author_facet |
Jane F. Namuganga Jessica Briggs Michelle E. Roh Jaffer Okiring Yasin Kisambira Asadu Sserwanga James A. Kapisi Emmanuel Arinaitwe Chris Ebong Isaac Ssewanyana Catherine Maiteki-Ssebuguzi Moses R. Kamya Sarah G. Staedke Grant Dorsey Joaniter I. Nankabirwa |
author_sort |
Jane F. Namuganga |
title |
Impact of COVID-19 on routine malaria indicators in rural Uganda: an interrupted time series analysis |
title_short |
Impact of COVID-19 on routine malaria indicators in rural Uganda: an interrupted time series analysis |
title_full |
Impact of COVID-19 on routine malaria indicators in rural Uganda: an interrupted time series analysis |
title_fullStr |
Impact of COVID-19 on routine malaria indicators in rural Uganda: an interrupted time series analysis |
title_full_unstemmed |
Impact of COVID-19 on routine malaria indicators in rural Uganda: an interrupted time series analysis |
title_sort |
impact of covid-19 on routine malaria indicators in rural uganda: an interrupted time series analysis |
publisher |
BMC |
publishDate |
2021 |
url |
https://doi.org/10.1186/s12936-021-04018-0 https://doaj.org/article/87ad822db6ed466391c62f3f10fd9bae |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
Malaria Journal, Vol 20, Iss 1, Pp 1-11 (2021) |
op_relation |
https://doi.org/10.1186/s12936-021-04018-0 https://doaj.org/toc/1475-2875 doi:10.1186/s12936-021-04018-0 1475-2875 https://doaj.org/article/87ad822db6ed466391c62f3f10fd9bae |
op_doi |
https://doi.org/10.1186/s12936-021-04018-0 |
container_title |
Malaria Journal |
container_volume |
20 |
container_issue |
1 |
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1766347147282743296 |