Effect of the COVID-19 pandemic on emergency department attendances for pediatric injuries in Mozambique’s central hospitals: an interrupted time series and a comparison within the restriction periods between 2019 and 2020
Objectives Hospital-based studies indicate that restriction measures imposed during the COVID-19 pandemic have affected the number and characteristics of pediatric injuries. However, few studies have been conducted in resource-poor countries. This study aimed to determine whether injury-related emer...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2023-12-01
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| Series: | Trauma Surgery & Acute Care Open |
| Online Access: | https://tsaco.bmj.com/content/8/1/e001062.full |
| _version_ | 1797316405195964416 |
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| author | Lee Wallis Vanda Amado Maria Tereza Couto Lucie Laflamme Jette Möller |
| author_facet | Lee Wallis Vanda Amado Maria Tereza Couto Lucie Laflamme Jette Möller |
| author_sort | Lee Wallis |
| collection | DOAJ |
| description | Objectives Hospital-based studies indicate that restriction measures imposed during the COVID-19 pandemic have affected the number and characteristics of pediatric injuries. However, few studies have been conducted in resource-poor countries. This study aimed to determine whether injury-related emergency department (ED) attendances in Mozambique were affected during the restriction periods in 2020 and how the pattern of injury changed.Methods Mozambique faced two restriction periods in 2020. An interrupted time series was applied to weekly data of pediatric injuries from the ED records of four central hospitals in Mozambique in 2019 and 2020. Weekly numbers of injuries were modeled using a Poisson regression model to estimate the effect of COVID-19 restrictions on trends over calendar time. Then, for each restriction period, differences in injury mechanisms, severity, need for surgery, and intensive care unit (ICU) attendances were compared between 2019 and 2020.Results During the 76 weeks preceding the restrictions, there was a stable trend in ED attendances. The weekly number dropped by 48.7% after implementation of the first restrictions. By the end of 2020, the weekly numbers were back to the levels observed before the restrictions. Road traffic injuries (RTIs) and falls dropped during the first restriction period and RTIs and burns during the second. There was an increase of 80% in ICU attendances in all periods of 2020 at three hospitals during the first and second restriction periods.Conclusion The COVID-19 restrictions yielded a reduction in the weekly number of pediatric injuries seen at Mozambique’s central hospitals, above all RTIs and falls. The drop reflects reductions in visits most importantly for RTIs, falls, and burns, but was accompanied by an increase in the proportion of ICU cases. This effect was not maintained when the restrictions were relaxed. Whether this reflects reduced exposure to injury or hesitancy to seek care remains to be determined.Level of evidence Level III, retrospective study with up to two negative criteria. |
| first_indexed | 2024-03-08T03:17:55Z |
| format | Article |
| id | doaj.art-af23a2f2c9eb47f899db45021fd43e84 |
| institution | Directory Open Access Journal |
| issn | 2397-5776 |
| language | English |
| last_indexed | 2024-03-08T03:17:55Z |
| publishDate | 2023-12-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | Trauma Surgery & Acute Care Open |
| spelling | doaj.art-af23a2f2c9eb47f899db45021fd43e842024-02-12T15:05:09ZengBMJ Publishing GroupTrauma Surgery & Acute Care Open2397-57762023-12-018110.1136/tsaco-2022-001062Effect of the COVID-19 pandemic on emergency department attendances for pediatric injuries in Mozambique’s central hospitals: an interrupted time series and a comparison within the restriction periods between 2019 and 2020Lee Wallis0Vanda Amado1Maria Tereza Couto2Lucie Laflamme3Jette Möller4Division of Emergency Medicine, University of Cape Town Faculty of Health Sciences, Cape Town, South AfricaDepartment of Global Public Health, Karolinska Institute, Stockholm, SwedenDepartment of Community Health, University of Eduardo Mondlane Faculty of Medicine, Maputo, MozambiqueDepartment of Global Public Health, Karolinska Institute, Stockholm, SwedenDepartment of Global Public Health, Karolinska Institute, Stockholm, SwedenObjectives Hospital-based studies indicate that restriction measures imposed during the COVID-19 pandemic have affected the number and characteristics of pediatric injuries. However, few studies have been conducted in resource-poor countries. This study aimed to determine whether injury-related emergency department (ED) attendances in Mozambique were affected during the restriction periods in 2020 and how the pattern of injury changed.Methods Mozambique faced two restriction periods in 2020. An interrupted time series was applied to weekly data of pediatric injuries from the ED records of four central hospitals in Mozambique in 2019 and 2020. Weekly numbers of injuries were modeled using a Poisson regression model to estimate the effect of COVID-19 restrictions on trends over calendar time. Then, for each restriction period, differences in injury mechanisms, severity, need for surgery, and intensive care unit (ICU) attendances were compared between 2019 and 2020.Results During the 76 weeks preceding the restrictions, there was a stable trend in ED attendances. The weekly number dropped by 48.7% after implementation of the first restrictions. By the end of 2020, the weekly numbers were back to the levels observed before the restrictions. Road traffic injuries (RTIs) and falls dropped during the first restriction period and RTIs and burns during the second. There was an increase of 80% in ICU attendances in all periods of 2020 at three hospitals during the first and second restriction periods.Conclusion The COVID-19 restrictions yielded a reduction in the weekly number of pediatric injuries seen at Mozambique’s central hospitals, above all RTIs and falls. The drop reflects reductions in visits most importantly for RTIs, falls, and burns, but was accompanied by an increase in the proportion of ICU cases. This effect was not maintained when the restrictions were relaxed. Whether this reflects reduced exposure to injury or hesitancy to seek care remains to be determined.Level of evidence Level III, retrospective study with up to two negative criteria.https://tsaco.bmj.com/content/8/1/e001062.full |
| spellingShingle | Lee Wallis Vanda Amado Maria Tereza Couto Lucie Laflamme Jette Möller Effect of the COVID-19 pandemic on emergency department attendances for pediatric injuries in Mozambique’s central hospitals: an interrupted time series and a comparison within the restriction periods between 2019 and 2020 Trauma Surgery & Acute Care Open |
| title | Effect of the COVID-19 pandemic on emergency department attendances for pediatric injuries in Mozambique’s central hospitals: an interrupted time series and a comparison within the restriction periods between 2019 and 2020 |
| title_full | Effect of the COVID-19 pandemic on emergency department attendances for pediatric injuries in Mozambique’s central hospitals: an interrupted time series and a comparison within the restriction periods between 2019 and 2020 |
| title_fullStr | Effect of the COVID-19 pandemic on emergency department attendances for pediatric injuries in Mozambique’s central hospitals: an interrupted time series and a comparison within the restriction periods between 2019 and 2020 |
| title_full_unstemmed | Effect of the COVID-19 pandemic on emergency department attendances for pediatric injuries in Mozambique’s central hospitals: an interrupted time series and a comparison within the restriction periods between 2019 and 2020 |
| title_short | Effect of the COVID-19 pandemic on emergency department attendances for pediatric injuries in Mozambique’s central hospitals: an interrupted time series and a comparison within the restriction periods between 2019 and 2020 |
| title_sort | effect of the covid 19 pandemic on emergency department attendances for pediatric injuries in mozambique s central hospitals an interrupted time series and a comparison within the restriction periods between 2019 and 2020 |
| url | https://tsaco.bmj.com/content/8/1/e001062.full |
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