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The impact of COVID-19 on essential health service provision for noncommunicable diseases in the South-East Asia region: A systematic review.
Gadsden, Thomas; Downey, Laura E; Vilas, Victor Del Rio; Peiris, David; Jan, Stephen.
  • Gadsden T; The George Institute for Global Health, University of New South Wales, Sydney, Australia.
  • Downey LE; The George Institute for Global Health, University of New South Wales, Sydney, Australia.
  • Vilas VDR; School of Public Health, Imperial College London, London, United Kingdom.
  • Peiris D; World Health Organization (WHO) South East Asia Regional Office (SEARO), New Delhi, India.
  • Jan S; The George Institute for Global Health, University of New South Wales, Sydney, Australia.
Lancet Reg Health Southeast Asia ; 1: 100010, 2022 Jun.
Article in English | MEDLINE | ID: covidwho-1819559
ABSTRACT

Background:

COVID-19 has had a profound impact on the health systems of the 11 countries of the WHO South East Asia Region. We conducted a systematic review of studies that used quantitative and comparative approaches to assess the impact of the pandemic on the service provision of four noncommunicable diseases (NCDs) (cancer, cardiovascular disease, chronic respiratory diseases, and diabetes) in the region.

Methods:

A systematic search was conducted in PubMed, Embase, MedRxiv, and WHO COVID-19 databases in December 2021. The quality of studies was evaluated using the Joanna Briggs Institute Critical Appraisal Checklist and the ROBINS-I risk of bias tool. A narrative synthesis was conducted following the 'synthesis without meta-analysis' reporting guidelines.

Findings:

Two review authors independently screened 5,397 records with 31 studies included, 26 which were cross-sectional studies. Most studies (n=24, 77%) were conducted in India and 19 (61%) were single-site studies. Compared to a pre-pandemic period, 10/17 cancer studies found a >40% reduction in outpatient services, 9/14 cardiovascular disease found a reduction of 30% or greater in inpatient admissions and 2 studies found diagnoses and interventions for respiratory diseases reduced up to 78.9% and 83.0%, respectively. No eligible studies on the impact of COVID-19 on diabetes services were found.

Interpretation:

COVID-19 has substantially disrupted the provision of essential health services for NCDs in the WHO South East Asia Region, particularly cancer and cardiovascular disease. This is likely to have serious and potentially long-term downstream impacts on health and mortality of those living with or at risk of NCDs in the region.

Funding:

This work was supported by the WHO Sri Lanka Country Office.
Keywords

Full text: Available Collection: International databases Database: MEDLINE Type of study: Experimental Studies / Observational study / Prognostic study / Randomized controlled trials / Reviews / Systematic review/Meta Analysis Language: English Journal: Lancet Reg Health Southeast Asia Year: 2022 Document Type: Article Affiliation country: J.lansea.2022.04.006

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Experimental Studies / Observational study / Prognostic study / Randomized controlled trials / Reviews / Systematic review/Meta Analysis Language: English Journal: Lancet Reg Health Southeast Asia Year: 2022 Document Type: Article Affiliation country: J.lansea.2022.04.006