scholarly journals Impact of the COVID-19 pandemic on neonatal admissions in a tertiary children’s hospital in southwest China: An interrupted time-series study

PLoS ONE ◽  
2022 ◽  
Vol 17 (1) ◽  
pp. e0262202
Author(s):  
Weiqin Liu ◽  
Qifen Yang ◽  
Zhen-e Xu ◽  
Ya Hu ◽  
Yongming Wang ◽  
...  

Background The unprecedented coronavirus disease 2019 (COVID-19) pandemic has caused millions of infections worldwide and represents a significant challenge facing modern health care systems. This study was conducted to investigate the impact of lockdown measures in a tertiary Children’s Hospital in southwest China, which might be used to predict long-term effects related to health-seeking behavior of parents/caregivers. Methods This study included newborns enrolled over a span of 86 weeks between January 4, 2019, and August 27, 2020. We designated two time periods for analysis purposes: a stable pre-COVID period(55 weeks between January 4, 2019, and January 23, 2020) and a COVID-impacted period (31 weeks between January 24, 2020, and August 27, 2020). An interrupted time-series analysis was employed to compare changes and trends in hospital admissions and disease spectra before and after the period of nonpharmaceutical interventions (NPIs). Furthermore, this study was conducted to evaluate whether the health-seeking behavior of parents/caregivers was influenced by pandemic factors. Results Overall, 16,640 infants were admitted to the neonatology department during the pre-COVID period (n = 12,082) and the COVID-impacted period (n = 4,558). The per week neonatal admissions consistently decreased following the first days of NPIs (January 24, 2020). The average weekly admission rates of 220/week pre-COVID period and 147/week COVID-impacted period. There was an evident decrease in the volume of admissions for all disease spectra after the intervention, whereas the decrease of patients complaining about pathological jaundice-related conditions was statistically significant (p<0.05). In the COVID-impacted period, the percentage of patients who suffered from respiratory system diseases, neonatal encephalopathy, and infectious diseases decreased, while the percentage of pathological jaundice-related conditions and gastrointestinal system diseases increased. The neonatal mortality rates (NMRs) increased by 8.7% during the COVID-impacted period compared with the pre-COVID period. Conclusions In summary, there was a significant decline in neonatal admissions in a tertiary care hospital during the COVID-19 Pandemic and the associated NPIs. Additionally, this situation had a remarkable impact on disease spectra and health-seeking behavior of parents/caregivers. We, therefore, advise continuing follow-ups and monitoring the main health indicators in vulnerable populations affected by this Pandemic over time.

2012 ◽  
Vol 98 (1) ◽  
pp. 76-88 ◽  
Author(s):  
Jishnu Das ◽  
Jeffrey Hammer ◽  
Carolina Sánchez-Paramo

2021 ◽  
Vol 5 (2) ◽  

Background: Obstetric fistula is a serious health problem affecting women in low and middle-income countries. It continues to exist in Nigeria because the health care system has failed to provide quality, accessible and affordable maternal health care including family planning, skilled care at birth, basic and comprehensive emergency obstetric care and inadequate access to treatment of obstetric fistula cases. The purpose of this study was to evaluate the impact of educational status and cultural beliefs on the health seeking behavior of women with obstetric fistula in South-South and South Eastern Nigeria. Methods: This was a cross-sectional study. Non-probability sampling involving purposive and simple random sampling technique was adopted in the selection of one hundred and fifty (150) post-operative patients. The data was analyzed using thematic analysis frequency tables and percentage distribution. Results: The findings were that educational status and cultural belief exert significant influence on the health seeking behavior of women with obstetric fistula. Conclusion: The study indicated that obstetric fistula is a major reproductive health challenge affecting women of childbearing age in Nigeria. Based on the findings of the study, educational status and cultural belief of women with obstetric fistula are the major serious challenges to health seeking behaviour of the women with Vesico-vaginal fistula (VVF). It was therefore recommended that more awareness on obstetric fistula should be created using strategies such as sex education programmed in secondary schools and churches so as to educate them on issues concerning obstetric fistula as well as health talk on VVF for youths.


2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S662-S662
Author(s):  
Andrea Bedini ◽  
Marianna Meschiari ◽  
Erica Franceschini ◽  
Cristina Mussini

Abstract Background Antimicrobial stewardship programs allow a reduction in antibiotic prescription and, consequently, in the incidence of multidrug-resistance infections. However, the impact on nosocomial candidemia is still unclear. Methods The present study is an interrupted time-series (ITS) before-after study, based on an ecological time-trend analysis. Since 2014, an antimicrobial stewardship program (ASP) has been implemented at an Italian tertiary-care hospital. The first objective of the program was to reduce carbapenem consumption, through an active and computerized surveillance of all carbapenem prescriptions, each of which was checked and validated by ID specialists always after audit of the cases with treating physicians. We retrospectively evaluated the changing in the consumption of antimicrobials, carbapenems, and in the incidence of candidemia, during two study periods: before (2007–2013) and after (2014–2018) the implementation of the ASP. Results The implementation of ASP was followed by a significant decrease in antibiotic consumption, which was consistent through the following 5 years. At the end of the study, total antibiotic consumption has decreased by 38.476 DDDs per 100 patient-days (PDs) per quarter (95% CI: −21.784 to −55.168; P < 0.001) and carbapenems decreased by 4.452 DDD per 100 PDs per quarter (95% CI: −3.658 to −5.246; P = 0.001). After 5 years of ASP, incidence of candidemia decreased by 2.034 episodes per 1,000 PDs per quarter (95% CI: −0.738 to −3.330; P = 0.003), decreasing, at the end of 2018, by 53% compared with the expected value if the program had not been implemented. Conclusion At our Institution, the ASP had a positive impact on the consumption of carbapenems, and antimicrobials. The incidence of candidemia was also favorably affected by the program, reversing the trend after 2014. The ASP, even if not directly targeted to fungal infections, indirectly caused a reduction in the incidence of candidemia, probably reducing the number of patients colonized by Candida spp. Disclosures All authors: No reported disclosures.


Author(s):  
Chandramani Kumar ◽  
Santosh Kumar Soren ◽  
Surendra Singh ◽  
Neelanjali Kumari ◽  
Vidya Sagar ◽  
...  

Background: Rabies is an acute fatal disease of central nervous system, caused by Lyssavirus Type 1. Rabies in dogs is the source of 99% of human infection. Awareness about rabies and health seeking behavior are crucial determinants of rabies control. Present study was done to assess awareness regarding animal bite and health seeking behavior among affected population.Methods: A hospital based cross sectional study was conducted in central emergency department of Rajendra Institute of Medical Sciences, Ranchi, Jharkhand for a period of four months. A semi-structured questionnaire was used for data collection. Sample size was 114 using consecutive sampling method. The participants were interviewed after taking informed consent. Data collected were entered in MS Excel and analyzed using SPSS version 20.Results: A total of 114 subjects participated in the study of which 83 (72.8%) were male and 31 (27.2%) female. Most commonly affected age group found was 21-30 years (35.1%). Majority 101 (88.6%) of them resided in urban areas, and only 79 (69.3%) acquired secondary education and above. Most of the animal bite was caused by dogs 102 (89.5%), unprovoked 79 (69.3%) in nature and most common site involved lower limb 70 (61.4%). Majority 68 (59.6%) of the dog bite wound were of category II. Only 55 (48.2%) of animal bite victims washed their wound with soap and water. Majority 58 (50.9%) of the study participants had no knowledge about consequences of dog bite. Median reporting time to tertiary institute was found to be four hours.Conclusions: There was average level of awareness about rabies among animal bite victims attending RIMS, Ranchi


Author(s):  
Mohamed Abbas ◽  
Nathalie Vernaz ◽  
Elodie von Dach ◽  
Nicolas Vuilleumier ◽  
Stephan J. Harbarth ◽  
...  

Abstract We evaluated the impact of a restriction of procalcitonin measurements on antibiotic use, length of stay, mortality, and cost in a Swiss tertiary-care hospital using interrupted time-series analysis. There was no significant change in level or slope for rates of antibiotic consumption, and costs decreased considerably, by ~54,488 CHF (US$55,714) per month.


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