COVID-19 preparedness in Malawi: a national facility-based critical care assessment

Sonenthal, Paul D.; Masiye, Jones; Kasomekera, Noel; Marsh, Regan H.; Wroe, Emily; Scott, Kirstin W.; Li, Ruoran; Murray, Megan; Bukhman, Alice; Connolly, Emilia; Minyaliwa, Tadala; Katete, Martha; Banda, Grace W; Nyirenda, Mulinda; Rouhani, Shada A.

doi:10.1016/s2214-109x(20)30250-3

Cited by 43 publications

(40 citation statements)

References 5 publications

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“…In LMICs, health systems are commonly stretched in terms of resources and staff, and early containment of a pandemic has tremendous advantages, leading to lower numbers of cases and hospital admissions, which, in turn, allows time for expansion of bed numbers, staff training, and resources. 30 However, in response to the COVID-19 pandemic, much attention was dedicated to available resources such as ICU beds and ventilators, and little to training of health professionals in the best evidence to support clinical practice or the early identification of severe cases or clinical management of ventilated patients. The presence of universal health coverage is a fundamental strategy to ensure that everyone has access to testing or treatment without financial hardship.…”

Section: Discussionmentioning

confidence: 99%

Characterisation of the first 250 000 hospital admissions for COVID-19 in Brazil: a retrospective analysis of nationwide data

Ranzani

Bastos

Gelli

et al. 2021

The Lancet Respiratory Medicine

404

337

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Background Most low-income and middle-income countries (LMICs) have little or no data integrated into a national surveillance system to identify characteristics or outcomes of COVID-19 hospital admissions and the impact of the COVID-19 pandemic on their national health systems. We aimed to analyse characteristics of patients admitted to hospital with COVID-19 in Brazil, and to examine the impact of COVID-19 on health-care resources and in-hospital mortality. MethodsWe did a retrospective analysis of all patients aged 20 years or older with quantitative RT-PCR (RT-qPCR)confirmed COVID-19 who were admitted to hospital and registered in SIVEP-Gripe, a nationwide surveillance database in Brazil, between Feb 16 and Aug 15, 2020 (epidemiological weeks 8-33). We also examined the progression of the COVID-19 pandemic across three 4-week periods within this timeframe (epidemiological weeks 8-12, 19-22, and 27-30). The primary outcome was in-hospital mortality. We compared the regional burden of hospital admissions stratified by age, intensive care unit (ICU) admission, and respiratory support. We analysed data from the whole country and its five regions: North, Northeast, Central-West, Southeast, and South. FindingsBetween Feb 16 and Aug 15, 2020, 254 288 patients with RT-qPCR-confirmed COVID-19 were admitted to hospital and registered in SIVEP-Gripe. The mean age of patients was 60 (SD 17) years, 119 657 (47%) of 254 288 were aged younger than 60 years, 143 521 (56%) of 254 243 were male, and 14 979 (16%) of 90 829 had no comorbidities. Case numbers increased across the three 4-week periods studied: by epidemiological weeks 19-22, cases were concentrated in the North, Northeast, and Southeast; by weeks 27-30, cases had spread to the Central-West and South regions. 232 036 (91%) of 254 288 patients had a defined hospital outcome when the data were exported; in-hospital mortality was 38% (87 515 of 232 036 patients) overall, 59% (47 002 of 79 687) among patients admitted to the ICU, and 80% (36 046 of 45 205) among those who were mechanically ventilated. The overall burden of ICU admissions per ICU beds was more pronounced in the North, Southeast, and Northeast, than in the Central-West and South. In the Northeast, 1545 (16%) of 9960 patients received invasive mechanical ventilation outside the ICU compared with 431 (8%) of 5388 in the South. In-hospital mortality among patients younger than 60 years was 31% (4204 of 13 468) in the Northeast versus 15% (1694 of 11 196) in the South.Interpretation We observed a widespread distribution of COVID-19 across all regions in Brazil, resulting in a high overall disease burden. In-hospital mortality was high, even in patients younger than 60 years, and worsened by existing regional disparities within the health system. The COVID-19 pandemic highlights the need to improve access to high-quality care for critically ill patients admitted to hospital with COVID-19, particularly in LMICs.

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Section: Discussionmentioning

confidence: 99%

Characterisation of the first 250 000 hospital admissions for COVID-19 in Brazil: a retrospective analysis of nationwide data

Ranzani

Bastos

Gelli

et al. 2021

The Lancet Respiratory Medicine

404

337

View full text Add to dashboard Cite

show abstract

“…Public health authorities in the continent have responded strongly with the creation of an African taskforce for the novel coronavirus and a multifaceted funding approach to the pandemic [2]. Despite this, healthcare workers (HCWs) across the continent remain susceptible to a variable degree of institutional support that places them at high risk for personal burden and professional burnout [3,4]. We designed and implemented a 43-question survey addressing personal and medical perceptions of HCWs during the pandemic.…”

Section: Risk Of Healthcare Worker Burnout In Africa During the Covidmentioning

confidence: 99%

Risk of Healthcare Worker Burnout in Africa during the COVID-19 Pandemic

Debes

Quadri

Sultan

et al. 2021

Annals of Global Health

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“…It is well known that older people are at a greater risk not only of COVID-19 but also the diverse inevitable sequelae of the pandemic including the separation and isolation from families and caregivers. Like many LMICs, the novel practices of emergency lockdowns in all SSA countries have resulted in changes in national behavioral patterns of usual day-to-day functioning and have escalated poverty and hunger particularly among poor older people (Gyasi, 2020a;Gyasi, 2020b;Sonenthal et al, 2020). The nationwide prohibition on the social gathering by closing down religious activities and stringent directives on the use of public transport as well as the mass quarantine have inevitably become a major barrier to access maintenance treatments for this group.…”

Section: The Covid-19 Crisis Social Isolation and Mental Health In Omentioning

confidence: 99%

COVID-19 and mental health of older Africans: an urgency for public health policy and response strategy

Gyasi

2020

Int. Psychogeriatr.

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COVID-19 preparedness in Malawi: a national facility-based critical care assessment

Cited by 43 publications

References 5 publications

Characterisation of the first 250 000 hospital admissions for COVID-19 in Brazil: a retrospective analysis of nationwide data

Characterisation of the first 250 000 hospital admissions for COVID-19 in Brazil: a retrospective analysis of nationwide data

Risk of Healthcare Worker Burnout in Africa during the COVID-19 Pandemic

COVID-19 and mental health of older Africans: an urgency for public health policy and response strategy

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