Evidence map›Paper›PMID 38977945›Full record

ArticleBMC pediatrics2024

COVID-19 pandemic effects on neonatal inpatient admissions and mortality: interrupted time series analysis of facilities implementing NEST360 in Kenya, Malawi, Nigeria, and Tanzania.

Lucas Malla, Eric O Ohuma, Josephine Shabani, Samuel Ngwala, Olabisi Dosunmu, John Wainaina, Jalemba Aluvaala, Irabi Kassim, James H Cross, Nahya Salim and 16 more

Abstract read
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. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing 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.

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. Article
  2. Observational
  3. 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

26 authors.

Lucas Malla *Maternal, Adolescent, Reproductive & Child Health (MARCH) Centre, London School of Hygiene & Tropical Medicine, London, UK. lucas.malla@lshtm.ac.uk.
Eric O Ohuma *Maternal, Adolescent, Reproductive & Child Health (MARCH) Centre, London School of Hygiene & Tropical Medicine, London, UK.
Josephine ShabaniHealth Systems Impact Evaluation and Policy Department, Ifakara Health Institute, Dar Es Salaam, Tanzania.
Samuel NgwalaResearch Support Center, School of Public Health and Family Medicine, Kamuzu University of Health Sciences, Blantyre, Malawi.
Olabisi DosunmuAPIN Public Health Initiatives, Abuja, Nigeria.
John WainainaKenya Medical Research Institute-Wellcome Trust, Nairobi, Kenya.
Jalemba AluvaalaKenya Medical Research Institute-Wellcome Trust, Nairobi, Kenya.
Irabi KassimHealth Systems Impact Evaluation and Policy Department, Ifakara Health Institute, Dar Es Salaam, Tanzania.
James H CrossMaternal, Adolescent, Reproductive & Child Health (MARCH) Centre, London School of Hygiene & Tropical Medicine, London, UK.
Nahya SalimDepartment of Paediatrics and Child Health, Muhimbili University of Health and Allied Sciences, Dar Es Salaam, Tanzania.
Evelyn ZimbaRice360 Institute for Global Health Technologies, Rice University, Houston, TX, USA.
Chinyere EzeakaDepartment of Paediatrics, College of Medicine, University of Lagos, Lagos, Nigeria.
Rebecca E PenziasMaternal, Adolescent, Reproductive & Child Health (MARCH) Centre, London School of Hygiene & Tropical Medicine, London, UK.
David GatharaMaternal, Adolescent, Reproductive & Child Health (MARCH) Centre, London School of Hygiene & Tropical Medicine, London, UK.
Robert TillyaHealth Systems Impact Evaluation and Policy Department, Ifakara Health Institute, Dar Es Salaam, Tanzania.
Msandeni ChiumeDepartment of Paediatrics, Kamuzu University of Health Sciences (Formerly College of Medicine, University of Malawi), Blantyre, Malawi.
Opeyemi OdedereRice360 Institute for Global Health Technologies, Rice University, Houston, TX, USA.
Norman LufesiDepartment of Curative and Medical Rehabilitation, Ministry of Health, Lilongwe, Malawi.
Kondwani KawazaDepartment of Paediatrics, Kamuzu University of Health Sciences (Formerly College of Medicine, University of Malawi), Blantyre, Malawi.
Grace IrimuDepartment of Paediatrics and Child Health, University of Nairobi, Nairobi, Kenya.
Olukemi TongoDepartment of Paediatrics, College of Medicine, University of Ibadan, Ibadan, Nigeria.
Sarah Murless-CollinsMaternal, Adolescent, Reproductive & Child Health (MARCH) Centre, London School of Hygiene & Tropical Medicine, London, UK.
Christine BohneRice360 Institute for Global Health Technologies, Rice University, Houston, TX, USA.
Rebecca Richards-KortumRice360 Institute for Global Health Technologies, Rice University, Houston, TX, USA.
Maria OdenRice360 Institute for Global Health Technologies, Rice University, Houston, TX, USA.
Joy E LawnMaternal, Adolescent, Reproductive & Child Health (MARCH) Centre, London School of Hygiene & Tropical Medicine, London, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe emergence of COVID-19 precipitated containment policies (e.g., lockdowns, school closures, etc.). These policies disrupted healthcare, potentially eroding gains for Sustainable Development Goals including for neonatal mortality. Our analysis aimed to evaluate indirect effects of COVID-19 containment policies on neonatal admissions and mortality in 67 neonatal units across Kenya, Malawi, Nigeria, and Tanzania between January 2019 and December 2021.

methodsThe Oxford Stringency Index was applied to quantify COVID-19 policy stringency over time for Kenya, Malawi, Nigeria, and Tanzania. Stringency increased markedly between March and April 2020 for these four countries (although less so in Tanzania), therefore defining the point of interruption. We used March as the primary interruption month, with April for sensitivity analysis. Additional sensitivity analysis excluded data for March and April 2020, modelled the index as a continuous exposure, and examined models for each country. To evaluate changes in neonatal admissions and mortality based on this interruption period, a mixed effects segmented regression was applied. The unit of analysis was the neonatal unit (n = 67), with a total of 266,741 neonatal admissions (January 2019 to December 2021).

resultsAdmission to neonatal units decreased by 15% overall from February to March 2020, with half of the 67 neonatal units showing a decline in admissions. Of the 34 neonatal units with a decline in admissions, 19 (28%) had a significant decrease of ≥ 20%. The month-to-month decrease in admissions was approximately 2% on average from March 2020 to December 2021. Despite the decline in admissions, we found no significant changes in overall inpatient neonatal mortality. The three sensitivity analyses provided consistent findings.

conclusionCOVID-19 containment measures had an impact on neonatal admissions, but no significant change in overall inpatient neonatal mortality was detected. Additional qualitative research in these facilities has explored possible reasons. Strengthening healthcare systems to endure unexpected events, such as pandemics, is critical in continuing progress towards achieving Sustainable Development Goals, including reducing neonatal deaths to less than 12 per 1000 live births by 2030.

Indexed as

COVID-19Infant MortalityInterrupted Time Series AnalysisHospitalizationHumansInfantInfant, NewbornIntensive Care Units, NeonatalKenyaMalawiNigeriaPandemicsPatient AdmissionTanzaniaCOVIDInpatient careInterrupted time seriesLow- and middle-income countriesNeonatal mortalityNewborn

Identifiers

PMID38977945
PMCPMC11232189

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.