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The effect of COVID-19 on essential surgical admissions in South Africa: A retrospective observational analysis of admissions before and during lockdown at a tertiary healthcare complex.
S Afr Med J. 2020 08 31; 110(9):910-915.SA

Abstract

BACKGROUND

With COVID-19 having spread across the globe, it has become standard to implement infection control strategies (colloquially known as lockdown) with the intention of reducing the magnitude and delaying the peak of the epidemiological curve. Personal infection mitigation strategies coupled with lockdown have caused a change in healthcare-seeking behaviour, with individuals not attending to their ill health as they previously did.

OBJECTIVES

To determine whether admissions for urgent and emergency surgical pathologies have declined during the COVID-19 lockdown period, and the magnitude of the decline.

METHODS

A retrospective analysis was conducted, comparing pre-lockdown (3 February - 26 March 2020) and lockdown (27 March - 30 April 2020) admission incidences for surgical pathologies at a tertiary healthcare complex in North West Province, South Africa. Poisson regression models were created to determine admission incidence rate ratios (IRRs).

RESULTS

Of 769 surgical admissions included in the analysis, 49.7% were male and 67.2% were unemployed. There was a 44% reduction in the incidence of non-trauma admissions during lockdown (IRR 0.56; 95% confidence interval (CI) 0.47 - 0.68; p<0.001) and a 53% reduction in the incidence of trauma-related admissions (IRR 0.47; 95% CI 0.34 - 0.66; p<0.001).

CONCLUSIONS

Even when the prevalence of SARS-CoV-2 infection was minimal, COVID-19 lockdown in North West was associated with a significant reduction in surgical admissions. In order to ensure an overall benefit to public health, a balance between maintaining the integrity of COVID-19 control mechanisms and access to healthcare services is essential.

Authors+Show Affiliations

Johannesburg District Health, Gauteng Department of Health, Johannesburg, South Africa. moustakisy@gmail.com.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Observational Study

Language

eng

PubMed ID

32880277

Citation

Moustakis, J, et al. "The Effect of COVID-19 On Essential Surgical Admissions in South Africa: a Retrospective Observational Analysis of Admissions Before and During Lockdown at a Tertiary Healthcare Complex." South African Medical Journal = Suid-Afrikaanse Tydskrif Vir Geneeskunde, vol. 110, no. 9, 2020, pp. 910-915.
Moustakis J, Piperidis AA, Ogunrombi AB. The effect of COVID-19 on essential surgical admissions in South Africa: A retrospective observational analysis of admissions before and during lockdown at a tertiary healthcare complex. S Afr Med J. 2020;110(9):910-915.
Moustakis, J., Piperidis, A. A., & Ogunrombi, A. B. (2020). The effect of COVID-19 on essential surgical admissions in South Africa: A retrospective observational analysis of admissions before and during lockdown at a tertiary healthcare complex. South African Medical Journal = Suid-Afrikaanse Tydskrif Vir Geneeskunde, 110(9), 910-915. https://doi.org/10.7196/SAMJ.2020.v110i9.15025
Moustakis J, Piperidis AA, Ogunrombi AB. The Effect of COVID-19 On Essential Surgical Admissions in South Africa: a Retrospective Observational Analysis of Admissions Before and During Lockdown at a Tertiary Healthcare Complex. S Afr Med J. 2020 08 31;110(9):910-915. PubMed PMID: 32880277.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The effect of COVID-19 on essential surgical admissions in South Africa: A retrospective observational analysis of admissions before and during lockdown at a tertiary healthcare complex. AU - Moustakis,J, AU - Piperidis,A A, AU - Ogunrombi,A B, Y1 - 2020/08/31/ PY - 2020/08/31/received PY - 2020/9/4/entrez PY - 2020/9/4/pubmed PY - 2020/9/18/medline SP - 910 EP - 915 JF - South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde JO - S Afr Med J VL - 110 IS - 9 N2 - BACKGROUND: With COVID-19 having spread across the globe, it has become standard to implement infection control strategies (colloquially known as lockdown) with the intention of reducing the magnitude and delaying the peak of the epidemiological curve. Personal infection mitigation strategies coupled with lockdown have caused a change in healthcare-seeking behaviour, with individuals not attending to their ill health as they previously did. OBJECTIVES: To determine whether admissions for urgent and emergency surgical pathologies have declined during the COVID-19 lockdown period, and the magnitude of the decline. METHODS: A retrospective analysis was conducted, comparing pre-lockdown (3 February - 26 March 2020) and lockdown (27 March - 30 April 2020) admission incidences for surgical pathologies at a tertiary healthcare complex in North West Province, South Africa. Poisson regression models were created to determine admission incidence rate ratios (IRRs). RESULTS: Of 769 surgical admissions included in the analysis, 49.7% were male and 67.2% were unemployed. There was a 44% reduction in the incidence of non-trauma admissions during lockdown (IRR 0.56; 95% confidence interval (CI) 0.47 - 0.68; p<0.001) and a 53% reduction in the incidence of trauma-related admissions (IRR 0.47; 95% CI 0.34 - 0.66; p<0.001). CONCLUSIONS: Even when the prevalence of SARS-CoV-2 infection was minimal, COVID-19 lockdown in North West was associated with a significant reduction in surgical admissions. In order to ensure an overall benefit to public health, a balance between maintaining the integrity of COVID-19 control mechanisms and access to healthcare services is essential. SN - 2078-5135 UR - https://www.unboundmedicine.com/medline/citation/32880277/The_effect_of_COVID_19_on_essential_surgical_admissions_in_South_Africa:_A_retrospective_observational_analysis_of_admissions_before_and_during_lockdown_at_a_tertiary_healthcare_complex_ L2 - http://www.samj.org.za/index.php/samj/article/view/13073 DB - PRIME DP - Unbound Medicine ER -