Evidence map›Paper›PMID 37830545›Full record

ArticleJournal of tropical pediatrics2023

COVID-19 lockdown effect on healthcare utilization and in-hospital mortality in children under 5 years in Cape Town, South Africa: a cross-sectional study.

Noradin Elmi, Liezl Smit, Thandi Wessels, Moleen Zunza, Helena Rabie

Open access · hybridAbstract read
In one paragraph

Article in Journal of tropical pediatrics, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
0.9field-weighted citation impact, top 20% of its field
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

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 4 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. The effect of the SARS-CoV2 pandemic and lockdown on non-Covid ICU admissions: Experience from a South African tertiary hospital.The Southern African journal of critical care : the official journal of the Critical Care Society · 2024
    Article
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

5 authors at 1 institution in 1 country.

Noradin ElmiDepartment of Paediatrics and Child Health, Stellenbosch University and Tygerberg Hospital, Cape Town 8000, South Africa.
Liezl SmitDepartment of Paediatrics and Child Health, Stellenbosch University and Tygerberg Hospital, Cape Town 8000, South Africa.ORCID 0000-0003-4843-9875
Thandi WesselsDepartment of Paediatrics and Child Health, Stellenbosch University and Tygerberg Hospital, Cape Town 8000, South Africa.
Moleen ZunzaDepartment of Global Health, Stellenbosch University, Cape Town 8000, South Africa.
Helena RabieDepartment of Paediatrics and Child Health, Stellenbosch University and Tygerberg Hospital, Cape Town 8000, South Africa.
Stellenbosch University · ZA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCOVID-19 pandemic measures resulted in the de-escalation of non-COVID-19 healthcare provision.

methodsA retrospective cross-sectional study of routinely collected data was done to investigate the effect of COVID-19 policies on the healthcare utilization and mortality of children younger than 5 years in Eastern Cape Town, South Africa. We compared visits to primary and urgent care facilities, hospitalization, in-hospital deaths, and vaccine uptake from 1 January to 31 December 2020 to similar periods in 2018 and 2019.

resultsDuring April and May 2020, the most restricted period, visits to primary care facilities declined from 126 049 in 2019 to 77 000 (1.8-fold; p < 0.05). This corresponded with a 1.2-fold reduction in the provision of the first dose of measles vaccine at 6 months compared to 2019. Throughout 2020 there was a 4-fold decline in the number of fully immunized children at 1 year of age (p = 0.84). Emergency room visits fell by 35.7% in 2020 (16 368) compared to 2019 (25 446). Hospital admissions decreased significantly (p < 0.01) in 2020 (9810) compared to 2018 (11 698) and 2019 (10 247). The in-hospital mortality rate increased from 2.3% (96/4163) in 2019 to 3.8% (95/2498) (p < 0.01) in Tygerberg Hospital, where 80% (95/119) of deaths were recorded. Twelve of the 119 (10%) deaths occurred in HIV-positive children (p = <0.01).

conclusionMeasures instituted during the COVID-19 pandemic disrupted access to healthcare services for children. This resulted in an immediate, and potential future, indirect effect on child morbidity and mortality in Cape Town.

Indexed as

COVID-19ChildChild, PreschoolCommunicable Disease ControlCross-Sectional StudiesHospital MortalityHumansPandemicsPatient Acceptance of Health CareRetrospective StudiesSouth AfricachildrenCOVID-19healthcare utilization

Identifiers

PMID37830545
PMCPMC10570990
OpenAlexW4387598569

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

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.