Evidence map›Paper›PMID 38183019›Full record

ArticleBMC pediatrics2024

Effects of the COVID-19 pandemic on the outcomes of HIV-exposed neonates: a Zimbabwean tertiary hospital experience.

Hannah Gannon, Elizabeth Chappell, Deborah Ford, Diana M Gibb, Anesu Chimwaza, Ngoni Manika, Catherine J Wedderburn, Zivai Mupambireyi Nenguke, Frances M Cowan, Tom Gibb and 6 more

Registry-linked trialAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC pediatrics, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04782739 (Evaluation of the Impact of the COVID-19 Pandemic on Provision and Uptake of Services for the Prevention of Mother-to-child Transmission of HIV and Syphilis in Zimbabwe), which is not on this map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–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.

NCT04782739 completednot on this map

Evaluation of the Impact of the COVID-19 Pandemic on Provision and Uptake of Services for the Prevention of Mother-to-child Transmission of HIV and Syphilis in Zimbabwe

TypeobservationalSponsorUniversity of ZimbabweRan2021 to 2022Enrolled30ConditionsHIV Infections, SyphilisArmsNone - Descriptive study
3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. 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

16 authors.

Hannah Gannon *UCL Great Ormond Street Institute of Child Health, University College London, London, UK. h.gannon@ucl.ac.uk.
Elizabeth Chappell *MRC Clinical Trials Unit at UCL, London, UK.
Deborah FordMRC Clinical Trials Unit at UCL, London, UK.
Diana M GibbMRC Clinical Trials Unit at UCL, London, UK.
Anesu ChimwazaMinistry of Health and Child Care, Harare, Zimbabwe.
Ngoni ManikaMinistry of Health and Child Care, Harare, Zimbabwe.
Catherine J WedderburnMRC Clinical Trials Unit at UCL, London, UK.
Zivai Mupambireyi NengukeCentre for Sexual Health and HIV/AIDS Research (CeSHHAR), Harare, Zimbabwe.
Frances M CowanCentre for Sexual Health and HIV/AIDS Research (CeSHHAR), Harare, Zimbabwe.
Tom GibbPicturing Health, London, UK.
Andrew PhillipsInstitute for Global Health, UCL, London, UK.
Angela MushaviMinistry of Health and Child Care, Harare, Zimbabwe.
Felicity FitzgeraldDepartment of Infectious Disease, Imperial College London, London, UK.
Michelle HeysUCL Great Ormond Street Institute of Child Health, University College London, London, UK.
Simbarashe ChimhuyaChild and Adolescent Health Unit, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe.
Mutsa Bwakura-DangarembiziChild and Adolescent Health Unit, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe.

Funding

Medical Research Council MC_U122886353Medical Research Council MC_UU_00004/03Medical Research Council MC_UU_12023/17Medical Research Council MC_UU_12023/26Medical Research Council MR/V029126/1Wellcome TrustWellcome Trust 215742/Z/19/Z: PI: Heys
6 · The paper itself

Abstract

introductionThe COVID-19 pandemic has globally impacted health service access, delivery and resources. There are limited data regarding the impact on the prevention of mother to child transmission (PMTCT) service delivery in low-resource settings. Neotree ( www.neotree.org ) combines data collection, clinical decision support and education to improve care for neonates. Here we evaluate impacts of COVID-19 on care for HIV-exposed neonates.

methodsData on HIV-exposed neonates admitted to the neonatal unit (NNU) at Sally Mugabe Central Hospital, Zimbabwe, between 01/06/2019 and 31/12/2021 were analysed, with pandemic start defined as 21/03/2020 and periods of industrial action (doctors (September 2019-January 2020) and nurses (June 2020-September 2020)) included, resulting in modelling during six time periods: pre-doctors' strike (baseline); doctors' strike; post-doctors' strike and pre-COVID; COVID and pre-nurses' strike; nurses' strike; post nurses' strike. Interrupted time series models were used to explore changes in indicators over time.

resultsOf 8,333 neonates admitted to the NNU, 904 (11%) were HIV-exposed. Mothers of 706/765 (92%) HIV-exposed neonates reported receipt of antiretroviral therapy (ART) during pregnancy. Compared to the baseline period when average admissions were 78 per week (95% confidence interval (CI) 70-87), significantly fewer neonates were admitted during all subsequent periods until after the nurses' strike, with the lowest average number during the nurses' strike (28, 95% CI 23-34, p < 0.001). Across all time periods excluding the nurses strike, average mortality was 20% (95% CI 18-21), but rose to 34% (95% CI 25, 46) during the nurses' strike. There was no evidence for heterogeneity (p > 0.22) in numbers of admissions or mortality by HIV exposure status. Fewer HIV-exposed neonates received a PCR test during the pandemic (23%) compared to the pre-pandemic periods (40%) (RR 0.59, 95% CI 0.41-0.84, p < 0.001). The proportion of HIV-exposed neonates who received antiretroviral prophylaxis during admission was high throughout, averaging between 84% and 95% in each time-period.

conclusionWhile antiretroviral prophylaxis for HIV-exposed neonates remained high throughout, concerning data on low admissions and increased mortality, similar in HIV-exposed and unexposed neonates, and reduced HIV testing, suggest some aspects of care may have been compromised due to indirect effects of the pandemic.

Indexed as

COVID-19HIV InfectionsChildFemaleHumansInfant, NewbornInfectious Disease Transmission, VerticalPandemicsPregnancyTertiary Care CentersZimbabweCOVID-19HIVMaternal healthNeonatesVertical transmission

Identifiers

PMID38183019
PMCPMC10768266

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Registered trials

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.