Lower respiratory tract infection admissions and deaths among children under 5 years in public sector facilities in the Western Cape Province, South Africa, before and during the COVID-19 pandemic (2019 - 2021)

Authors

  • K Kehoe Centre for Infectious Disease Epidemiology and Research, School of Public Health, University of Cape Town, South Africa; Population Health Sciences, Bristol Medical School, University of Bristol, UK; Health Intelligence Directorate, Western Cape Government Health and Wellness, South Africa
  • E Morden Health Intelligence Directorate, Western Cape Government Health and Wellness, South Africa; Division of Public Health Medicine, School of Public Health, University of Cape Town, South Africa
  • N Zinyakatira Health Intelligence Directorate, Western Cape Government Health and Wellness, South Africa; Division of Public Health Medicine, School of Public Health, University of Cape Town, South Africa
  • A Heekes Centre for Infectious Disease Epidemiology and Research, School of Public Health, University of Cape Town, South Africa; Health Intelligence Directorate, Western Cape Government Health and Wellness, South Africa
  • H E Jones Population Health Sciences, Bristol Medical School, University of Bristol, UK
  • S R Walter Population Health Sciences, Bristol Medical School, University of Bristol, UK; National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
  • T Jacobs Health Intelligence Directorate, Western Cape Government Health and Wellness, South Africa
  • J Murray Department of Paediatrics & Neonatology, Paarl Hospital, Western Cape Government Health and Wellness, Paarl, South Africa
  • H Buys Department of Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa; Red Cross War Memorial Children’s Hospital, Western Cape Government Health and Wellness, Cape Town, South Africa
  • M T Redaniel Population Health Sciences, Bristol Medical School, University of Bristol, UK; National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
  • M-A Davies Centre for Infectious Disease Epidemiology and Research, School of Public Health, University of Cape Town, South Africa; Health Intelligence Directorate, Western Cape Government Health and Wellness, South Africa

DOI:

https://doi.org/10.7196/SAMJ.2024.v114i3.1560

Keywords:

Lower respiratory tract infections, children, South Africa, COVID-19 pandemic

Abstract

Background. The COVID‐19 pandemic resulted in the implementation of strict public health and social measures (PHSMs) (including mobility restrictions, social distancing, mask‐wearing and hand hygiene), limitations on non‐essential healthcare services, and public fear of COVID‐19 infection, all of which potentially affected transmission and healthcare use for other diseases such as lower respiratory tract infections (LRTIs).

Objective. To determine changes in LRTI hospital admissions and in‐facility mortality in children aged <5 years in the Western Cape Province during the pandemic.

Methods. We conducted a retrospective analysis of LRTI admissions and in‐facility deaths from January 2019 to November 2021. We estimated changes in rates and trends of LRTI admissions during the pandemic compared with pre‐pandemic period using interrupted time series analysis, adjusting for key characteristics.

Results. There were 36 277 children admitted for LRTIs during the study period, of whom 58% were male and 51% were aged 28 days ‐ 1 year. COVID‐19 restrictions were associated with a 13% step reduction in LRTI admissions compared with the pre‐COVID‐19 period (incidence rate ratio (IRR) 0.87, 95% confidence interval (CI)) 0.80 ‐ 0.94). The average LRTI admission trend increased on average by 2% per month during the pandemic (IRR 1.02, 95% CI 1.02 ‐ 1.04).

Conclusions. The COVID‐19 surges and their associated measures were linked to declining LRTI admissions and in‐facility deaths, likely driven by a combination of reduced infectious disease transmission and reduced use of healthcare services, with effects diminishing over time. These findings may inform future pandemic response policies.

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Published

2024-03-18

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Section

Research

How to Cite

1.
Kehoe K, Morden E, Zinyakatira N, Heekes A, Jones HE, Walter SR, et al. Lower respiratory tract infection admissions and deaths among children under 5 years in public sector facilities in the Western Cape Province, South Africa, before and during the COVID-19 pandemic (2019 - 2021). S Afr Med J [Internet]. 2024 Mar. 18 [cited 2024 Apr. 21];114(3):e1560. Available from: https://samajournals.co.za/index.php/samj/article/view/1560

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