About: Access to primary healthcare during lockdown measures for COVID-19 in rural South Africa: a longitudinal cohort study

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About: Access to primary healthcare during lockdown measures for COVID-19 in rural South Africa: a longitudinal cohort study Goto Sponge NotDistinct Permalink

An Entity of Type : schema:ScholarlyArticle, within Data Space : wasabi.inria.fr associated with source document(s)

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type	Academic Article research paper schema:ScholarlyArticle
isDefinedBy	Covid-on-the-Web dataset
has title	Access to primary healthcare during lockdown measures for COVID-19 in rural South Africa: a longitudinal cohort study
Creator	Wong, Emily Kraemer, John Siedner, Mark Harling, Guy Dlamini, Siphephelo Gabela, Patrick Gareta, Dickman Hanekom, Willem Herbst, Kobus Iwuji, Collins Majozi, Nomathamsanqa Meyer, Mark Mngomezulu, Thobeka Ngwenya, Nothando Seeley, Janet Shahmanesh, Maryam
Source	MedRxiv; Medline; PMC
abstract	OBJECTIVES: Public health interventions designed to interrupt COVID-19 transmission could have deleterious impacts on primary healthcare access. We sought to identify whether implementation of the nationwide lockdown (shelter-in-place) order in South Africa affected ambulatory clinic visitation in rural Kwa-Zulu Natal (KZN). DESIGN: Prospective, longitudinal cohort study SETTING: Data were analyzed from the Africa Health Research Institute Health and Demographic Surveillance System, which includes prospective data capture of clinic visits at eleven primary healthcare clinics in northern KwaZulu-Natal PARTICIPANTS: A total of 36,291 individuals made 55,545 clinic visits during the observation period. EXPOSURE OF INTEREST: We conducted an interrupted time series analysis with regression discontinuity methods to estimate changes in outpatient clinic visitation from 60 days before through 35 days after the lockdown period. OUTCOME MEASURES: Daily clinic visitation at ambulatory clinics. In stratified analyses we assessed visitation for the following sub-categories: child health, perinatal care and family planning, HIV services, non-communicable diseases, and by age and sex strata. RESULTS: We found no change in total clinic visits/clinic/day from prior to and during the lockdown (−6.9 visits/clinic/day, 95%CI −17.4, 3.7) or trends in clinic visitation over time during the lockdown period (−0.2, 95%CI −3.4, 3.1). We did detect a reduction in child healthcare visits at the lockdown (−7.2 visits/clinic/day, 95%CI −9.2, −5.3), which was seen in both children <1 and children 1–5. In contrast, we found a significant increase in HIV visits immediately after the lockdown (8.4 visits/clinic/day, 95%CI 2.4, 14.4). No other differences in clinic visitation were found for perinatal care and family planning, non-communicable diseases, or among adult men and women. CONCLUSIONS: In rural KZN, the ambulatory healthcare system was largely resilient during the national-wide lockdown order. A major exception was child healthcare visitation, which declined immediately after the lockdown but began to normalize in the weeks thereafter. Future work should explore efforts to decentralize chronic care for high-risk populations and whether catch-up vaccination programs might be required in the wake of these findings.
has issue date	2020-05-20(xsd:dateTime)
bibo:doi	10.1101/2020.05.15.20103226
bibo:pmid	32511504
has license	cc-by-nc-nd
sha1sum (hex)	1267da3c423b9107e408fb342905452482c5fc78
schema:url	https://doi.org/10.1101/2020.05.15.20103226
resource representing a document's title	Access to primary healthcare during lockdown measures for COVID-19 in rural South Africa: a longitudinal cohort study
has PubMed Central identifier	PMC7273272
has PubMed identifier	32511504
schema:publication	medRxiv
resource representing a document's body	covid:1267da3c423b9107e408fb342905452482c5fc78#body_text
is schema:about of	named entity 'interrupt' named entity 'lockdown' named entity 'nationwide' named entity 'Kwa-Zulu Natal' named entity 'COVID' named entity 'KZN' named entity 'shelter-in-place' named entity 'primary healthcare' named entity 'longitudinal cohort study' named entity 'water and sanitation' named entity 'key demographic' named entity 'epidemics' named entity 'Tuberculosis' named entity 'epidemic' named entity 'pharmaceutical' named entity 'Demographic Surveillance' named entity 'low and middle-income countries' named entity 'epidemic' named entity 'insecticide' named entity 'immunizations' named entity 'medRxiv' named entity 'childcare' named entity 'primary healthcare' named entity 'basic public health services' named entity 'South Africa' named entity 'COVID-19' named entity 'AHRI' named entity 'maternal mortality' named entity 'South Africa' named entity 'Scatterplot' named entity 'socioeconomic status' named entity 'medRxiv' named entity 'Primary Care' named entity 'sub-Saharan' named entity 'child health' named entity 'linear regression' named entity 'Europe' named entity 'disease transmission' named entity 'epidemic' named entity 'family planning' named entity 'regression model' named entity 'perinatal' named entity 'KwaZulu-Natal' named entity 'Health Systems' named entity 'HIV' named entity 'global pandemic' named entity 'urgent care' named entity 'epidemics' named entity 'pharmacologic' named entity 'outpatient clinics' named entity 'HIV' named entity 'public health' named entity 'child health' named entity 'time series analysis' named entity 'peer review' named entity 'KwaZulu-Natal' named entity 'South Africa' named entity 'medRxiv' named entity 'shelter-in-place' named entity 'COVID-19' named entity 'KwaZulu-Natal' named entity 'CC-BY-NC-ND 4.0' named entity 'Africa' named entity 'confidence intervals' named entity 'regression model' named entity 'South Africa'

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