Imperial College London
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DrFelicityFitzgerald

Faculty of Medicine, Department of Infectious Disease

Senior Clinical Research Fellow
 
 
 
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f.fitzgerald

 
 
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Location

 

Norfolk PlaceSt Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{Chimhuya:2022:10.1136/bmjopen-2021-048955,
author = {Chimhuya, S and Neal, SR and Chimhini, G and Gannon, H and Cortina, Borja M and Crehan, C and Nkhoma, D and Chiyaka, T and Wilson, E and Hull-Bailey, T and Fitzgerald, F and Chiume, M and Heys, M},
doi = {10.1136/bmjopen-2021-048955},
journal = {BMJ Open},
pages = {1--8},
title = {Indirect impacts of the COVID-19 pandemic at two tertiary neonatal units in Zimbabwe and Malawi: an interrupted time series analysis.},
url = {http://dx.doi.org/10.1136/bmjopen-2021-048955},
volume = {12},
year = {2022}
}
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TY  - JOUR
AB  - OBJECTIVES: To examine indirect impacts of the COVID-19 pandemic on neonatal care in low-income and middle-income countries. DESIGN: Interrupted time series analysis. SETTING: Two tertiary neonatal units in Harare, Zimbabwe and Lilongwe, Malawi. PARTICIPANTS: We 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. INTERVENTIONS: The 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. RESULTS: Admission 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). CONCLUSIONS: The 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.
AU  - Chimhuya,S
AU  - Neal,SR
AU  - Chimhini,G
AU  - Gannon,H
AU  - Cortina,Borja M
AU  - Crehan,C
AU  - Nkhoma,D
AU  - Chiyaka,T
AU  - Wilson,E
AU  - Hull-Bailey,T
AU  - Fitzgerald,F
AU  - Chiume,M
AU  - Heys,M
DO  - 10.1136/bmjopen-2021-048955
EP  - 8
PY  - 2022///
SN  - 2044-6055
SP  - 1
TI  - Indirect impacts of the COVID-19 pandemic at two tertiary neonatal units in Zimbabwe and Malawi: an interrupted time series analysis.
T2  - BMJ Open
UR  - http://dx.doi.org/10.1136/bmjopen-2021-048955
UR  - https://www.ncbi.nlm.nih.gov/pubmed/35728901
UR  - https://bmjopen.bmj.com/content/12/6/e048955
UR  - http://hdl.handle.net/10044/1/100149
VL  - 12
ER  -
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