ABSTRACT
BACKGROUND: The current study evaluated the hypothesis that the COVID-19 pandemic is associated with higher stillbirth but lower neonatal mortality rates. METHODS: We compared three epochs: baseline (2016-2019, January-December, weeks 1-52, and 2020, January-February, weeks 1-8), initial pandemic (2020, March-December, weeks 9-52, and 2021, January-June, weeks 1-26), and delta pandemic (2021, July-September, weeks 27-39) periods, using Alabama Department of Public Health database including deliveries with stillbirths ≥20 weeks or live births ≥22 weeks gestation. The primary outcomes were stillbirth and neonatal mortality rates. RESULTS: A total of 325,036 deliveries were included (236,481 from baseline, 74,076 from initial pandemic, and 14,479 from delta pandemic period). The neonatal mortality rate was lower in the pandemic periods (4.4 to 3.5 and 3.6/1000 live births, in the baseline, initial, and delta pandemic periods, respectively, p < 0.01), but the stillbirth rate did not differ (9 to 8.5 and 8.6/1000 births, p = 0.41). On interrupted time-series analyses, there were no significant changes in either stillbirth (p = 0.11 for baseline vs. initial pandemic period, and p = 0.67 for baseline vs. delta pandemic period) or neonatal mortality rates (p = 0.28 and 0.89, respectively). CONCLUSIONS: The COVID-19 pandemic periods were not associated with a significant change in stillbirth and neonatal mortality rates compared to the baseline period. IMPACT: The COVID-19 pandemic could have resulted in changes in fetal and neonatal outcomes. However, only a few population-based studies have compared the risk of fetal and neonatal mortality in the pandemic period to the baseline period. This population-based study identifies the changes in fetal and neonatal outcomes during the initial and delta COVID-19 pandemic period as compared to the baseline period. The current study shows that stillbirth and neonatal mortality rates were not significantly different in the initial and delta COVID-19 pandemic periods as compared to the baseline period.
ABSTRACT
BackgroundDrowning is the leading cause of death among 1–4 years-old children in Bangladesh. The COVID-19 pandemic significantly altered personal and family behaviors that may directly or indirectly impact drowning-prevention activities. The CIPRB is intervening with a package consisting of the Anchals (community-daycare centers), family-education, community-sensitization, and stakeholder-awareness to prevent child-drowning <5children in rural Bangladesh. Due to the closure of over 3,000 Anchals in pandemic, approximately 70,000 rural children were unable to access Anchal supervision services. The study’s aim was to examine the COVID-19 impact of child-drowning in rural Bangladesh before and during the pandemic.MethodsBetween March 2019-February 2021, passive surveillance was conducted in 45-unions in rural Bangladesh, covering nearly one-million people. Information on fatal-drowning events was collected by using a pre-tested structured questionnaire.ResultsCompared to the pre-pandemic year, fatal-drowning rates were 70.8% higher. Before the pandemic, the under-5 fatal-drowning rate was 16.6/100,000/year;95% CI 10.2–26.9, while during the pandemic, the rate was 38.4/100,000/year;95% CI 27.8–52.9. Boys (61.4%) had higher rates, and the majority of drownings happened near dwellers’ homes. Ponds and ditches were the most common drowning locations (69.1%), and nearly all drownings (98%) happened throughout the day between 09:00–17:00.ConclusionThe fatal-drowning rate during the pandemic was consistently higher compared to the rates in the intervening areas before the pandemic. The absence of child supervision services might have caused higher rates of child-drowning.Learning OutcomesUsing this study approach could provide a means to quantify the pre-and-post COVID-19 impact on drowning globally.
ABSTRACT
Festivals traditionally result in mass public mobility from large cities to rural or semi-urban areas in low- and middle-Income Countries (LMIC), which are inadequately prepared for tackling the consequences of the COVID-19 pandemic. This study aimed to explore the trend of COVID-19 infection in a peripheral region of Bangladesh during one of the largest festivals to develop an evidence-based hypothesis for its influence on the transmission rate of COVID-19. This study conducted a quantitative analysis of secondary data on COVID-19 collected from the Directorate General of Health Services Bangladesh (DGHS) and divisional director's office in the Mymensingh division. To explore the influence of one of the biggest festivals (Eid-ul-Adha) on the trend of COVID-19 infection, we analyzed data from a week before the festival to 2 weeks following the festival. The infection rate (positive cases per million of the population) and the test positivity rate (positive cases among the total number of conducted diagnostic tests) of each day during this period were calculated both for the Mymensingh region and national level. Both the test positivity rate (TPR) and infection rates in the Mymensingh region demonstrated an increasing trend. The mean test positivity rate of the Mymensingh region on the week before the festival was 9.5%. It increased to a mean test positivity rate of 13% in the following week and further rose to a rate of 17% in the next week. The infection rate of Mymensingh also increased more than 2 folds from the day of the festival (2.0-5.3 cases per million) within the next 2 weeks. The TPR and infection rate on the national level remained similar throughout the study period. Mass mobility during Eid-ul-Adha influences the increased transmission of COVID-19 among the peripheral regions of Bangladesh from the central capital city Dhaka. The findings will help policymakers plan and implement travel restrictions during festivals during the pandemic in LMICs.