Impact of the COVID-19 pandemic on malaria in pregnancy indicators in Northern Uganda: a joinpoint regression analysis

Pregnancy is both a risk factor for infection and development of severe malaria. In low- and middle-income countries, the COVID-19 pandemic severely impacted health systems, including utilization of maternal services. This study aimed to assess trends in delivering malaria in pregnancy-related healt...

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Published in:	Pathogens and global health Vol. 118; no. 3; pp. 253 - 261
Main Authors:	Segala, Francesco Vladimiro, Ictho, Jerry, L'Episcopia, Mariangela, Onapa, Emmanuel, De Vita, Elda, Novara, Roberta, Olung, Nelson, Totaro, Valentina, Olal, Lameck, Patti, Giulia, Bingom, Christopher, Farina, Umberto, Papagni, Roberta, Agaro, Caroline, Bavaro, Davide Fiore, Amone, James, Dall'Oglio, Giovanni, Ngole, Benedict, Marotta, Claudia, Okori, Samuel, Zarcone, Maurizio, Ogwang, Joseph, Severini, Carlo, Lochoro, Peter, Putoto, Giovanni, Saracino, Annalisa, Di Gennaro, Francesco
Format:	Journal Article
Language:	English
Published:	England Taylor & Francis 01-05-2024
Subjects:	Adult Antimalarials - therapeutic use COVID-19 - epidemiology COVID-19 - prevention & control Female Humans Interrupted Time Series Analysis Malaria - epidemiology Malaria - prevention & control Malaria, Falciparum - epidemiology Malaria, Falciparum - prevention & control Pandemics Pregnancy Pregnancy Complications, Parasitic - epidemiology Pregnancy Complications, Parasitic - prevention & control Prenatal Care - statistics & numerical data Regression Analysis SARS-CoV-2 Uganda - epidemiology Uganda COVID-19 maternal and child health Malaria in pregnancy low- and middle-income countries malaria
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Summary:	Pregnancy is both a risk factor for infection and development of severe malaria. In low- and middle-income countries, the COVID-19 pandemic severely impacted health systems, including utilization of maternal services. This study aimed to assess trends in delivering malaria in pregnancy-related health-care services before and during COVID-19 in Northern Uganda. An interrupted time-series study comparing pre-COVID-19 (January 2018 to April 2020) and COVID-19 (May to December 2021) periods, based on the date the first COVID case was detected. The study involved 30 health facilities in Northern Uganda with 22,650 estimated pregnancies per year, 14% of which took place in hospital. Monthly data were sourced from District routinely collected indicators. Trends were analyzed by joinpoint regression models. From the onset of the COVID pandemic in Uganda (May 2020), we found a significant reduction in the number of women accessing a fourth antenatal care visit (from APC + 183.5 to + 4.98; < 0.001) and taking at least three doses of intermittent preventive treatment in pregnancy (IPTp, from APC + 84.28 to -63.12; < 0.001). However, we found no significant change in the trend of the total number of pregnant women managed as outpatients or hospitalized for malaria, as well as in the number of women attending their first antenatal visit and in the number of institutional deliveries. In our study, the COVID-19 pandemic significantly reduced access to ANC visits and IPTp uptake. However, the healthcare system maintained its capacity for managing malaria cases, first antenatal visits, and institutional deliveries.Trial registration: This study has been registered on the ClinicalTrials.gov public website on 26 April 2022. ClinicalTrials.gov Identifier: NCT05348746.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	2047-7724 2047-7732 2047-7732
DOI:	10.1080/20477724.2023.2273023