Evidence map›Paper›PMID 35728901›Full record

ArticleBMJ open2022

Indirect impacts of the COVID-19 pandemic at two tertiary neonatal units in Zimbabwe and Malawi: an interrupted time series analysis.

Simbarashe Chimhuya, Samuel R Neal, Gwen Chimhini, Hannah Gannon, Mario Cortina Borja, Caroline Crehan, Deliwe Nkhoma, Tarisai Chiyaka, Emma Wilson, Tim Hull-Bailey and 3 more

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In one paragraph

Article in BMJ open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
13citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

13 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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  5. Observational
  6. COVID-19 impacts on healthcare access in sub-Saharan Africa: an overview.The journal of venomous animals and toxins including tropical diseases · 2023
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Simbarashe ChimhuyaChild and Adolescent Health Unit, University of Zimbabwe, Harare, Zimbabwe.
Samuel R NealUCL Great Ormond Street Institute of Child Health, University College London, London, UK.ORCID 0000-0001-6832-9839
Gwen ChimhiniChild and Adolescent Health Unit, University of Zimbabwe, Harare, Zimbabwe.
Hannah GannonUCL Great Ormond Street Institute of Child Health, University College London, London, UK.
Mario Cortina BorjaUCL Great Ormond Street Institute of Child Health, University College London, London, UK.
Caroline CrehanUCL Great Ormond Street Institute of Child Health, University College London, London, UK.
Deliwe NkhomaParent and Child Health Initiative, Lilongwe, Malawi.
Tarisai ChiyakaBiomedical Research and Training Institute, Harare, Zimbabwe.
Emma WilsonUCL Great Ormond Street Institute of Child Health, University College London, London, UK.ORCID 0000-0001-7091-2417
Tim Hull-BaileyUCL Great Ormond Street Institute of Child Health, University College London, London, UK.
Felicity FitzgeraldUCL Great Ormond Street Institute of Child Health, University College London, London, UK.ORCID 0000-0001-9594-3228
Msandeni ChiumeDepartment of Paediatrics, Kamuzu Central Hospital, Lilongwe, Malawi.
Michelle HeysUCL Great Ormond Street Institute of Child Health, University College London, London, UK m.heys@ucl.ac.uk.

Funding

Medical Research Council MR/V029126/1
6 · The paper itself

Abstract

objectivesTo examine indirect impacts of the COVID-19 pandemic on neonatal care in low-income and middle-income countries.

designInterrupted time series analysis.

settingTwo tertiary neonatal units in Harare, Zimbabwe and Lilongwe, Malawi.

participantsWe included a total of 6800 neonates who were admitted to either neonatal unit from 1 June 2019 to 25 September 2020 (Zimbabwe: 3450; Malawi: 3350). We applied no specific exclusion criteria.

interventionsThe first cases of COVID-19 in each country (Zimbabwe: 20 March 2020; Malawi: 3 April 2020). PRIMARY OUTCOME MEASURES: Changes in the number of admissions, gestational age and birth weight, source of admission referrals, prevalence of neonatal encephalopathy, and overall mortality before and after the first cases of COVID-19.

resultsAdmission numbers in Zimbabwe did not initially change after the first case of COVID-19 but fell by 48% during a nurses' strike (relative risk (RR) 0.52, 95% CI 0.41 to 0.66, p<0.001). In Malawi, admissions dropped by 42% soon after the first case of COVID-19 (RR 0.58, 95% CI 0.48 to 0.70, p<0.001). In Malawi, gestational age and birth weight decreased slightly by around 1 week (beta -1.4, 95% CI -1.62 to -0.65, p<0.001) and 300 g (beta -299.9, 95% CI -412.3 to -187.5, p<0.001) and outside referrals dropped by 28% (RR 0.72, 95% CI 0.61 to 0.85, p<0.001). No changes in these outcomes were found in Zimbabwe and no significant changes in the prevalence of neonatal encephalopathy or mortality were found at either site (p>0.05).

conclusionsThe indirect impacts of COVID-19 are context-specific. While our study provides vital evidence to inform health providers and policy-makers, national data are required to ascertain the true impacts of the pandemic on newborn health.

Indexed as

COVID-19Infant HealthPandemicsHospital UnitsHumansInfant, NewbornInterrupted Time Series AnalysisMalawiTertiary Care CentersZimbabweCOVID-19international health servicesneonatal intensive & critical carepaediatricsquality in health care

Identifiers

PMID35728901
PMCPMC9213761

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.