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Healthcare utilization during the first two waves of the COVID-19 epidemic in South Africa: A cross-sectional household survey

Healthcare utilization surveys contextualize facility-based surveillance data for burden estimates. We describe healthcare utilization in the catchment areas for sentinel site healthcare facilities during the first year of the COVID-19 pandemic. We conducted a cross-sectional healthcare utilization...

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Autores principales: Wolter, Nicole, Tempia, Stefano, von Gottberg, Anne, Bhiman, Jinal N., Walaza, Sibongile, Kleynhans, Jackie, Moyes, Jocelyn, Aitken, Sue, Magni, Sarah, Yun, Jessica, Fellows, Tamika, Makamadi, Tetelo, Weiner, Renay, Cawood, Cherie, Martinson, Neil, Lebina, Limakatso, Cohen, Cheryl
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10456221/
https://www.ncbi.nlm.nih.gov/pubmed/37624826
http://dx.doi.org/10.1371/journal.pone.0290787
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author Wolter, Nicole
Tempia, Stefano
von Gottberg, Anne
Bhiman, Jinal N.
Walaza, Sibongile
Kleynhans, Jackie
Moyes, Jocelyn
Aitken, Sue
Magni, Sarah
Yun, Jessica
Fellows, Tamika
Makamadi, Tetelo
Weiner, Renay
Cawood, Cherie
Martinson, Neil
Lebina, Limakatso
Cohen, Cheryl
author_facet Wolter, Nicole
Tempia, Stefano
von Gottberg, Anne
Bhiman, Jinal N.
Walaza, Sibongile
Kleynhans, Jackie
Moyes, Jocelyn
Aitken, Sue
Magni, Sarah
Yun, Jessica
Fellows, Tamika
Makamadi, Tetelo
Weiner, Renay
Cawood, Cherie
Martinson, Neil
Lebina, Limakatso
Cohen, Cheryl
author_sort Wolter, Nicole
collection PubMed
description Healthcare utilization surveys contextualize facility-based surveillance data for burden estimates. We describe healthcare utilization in the catchment areas for sentinel site healthcare facilities during the first year of the COVID-19 pandemic. We conducted a cross-sectional healthcare utilization survey in households in three communities from three provinces (KwaZulu-Natal, Western Cape and North West). Field workers administered structured questionnaires electronically with the household members reporting influenza-like illness (ILI) in the past 30 days or severe respiratory illness (SRI) since March 2020. Multivariable logistic regression was used to identify factors associated with healthcare utilization among individuals that reported illness. From November 2020 through April 2021, we enrolled 5804 households and 23,003 individuals. Any respiratory illness was reported by 1.6% of individuals; 0.7% reported ILI only, 0.8% reported SRI only, and 0.1% reported both ILI and SRI. Any form of medical care was sought by 40.8% (95% CI 32.9% - 49.6%) and 71.3% (95% CI 63.2% - 78.6%) of individuals with ILI and SRI, respectively. On multivariable analysis, respiratory illness was more likely to be medically attended for individuals at the Pietermaritzburg site (aOR 3.2, 95% CI 1.1–9.5, compared to Klerksdorp), that were underweight (aOR 11.5, 95% CI 1.5–90.2, compared to normal weight), with underlying illness (aOR 3.2, 95%CI 1.2–8.5), that experienced severe illness (aOR 4.8, 95% CI 1.6–14.3) and those with symptom duration of ≥10 days (aOR 7.9, 95% CI 2.1–30.2, compared to <5 days). Less than half of ILI episodes and only 71% of SRI episodes were medically attended during the first two COVID-19 waves in South Africa. Facility-based data may underestimate disease burden during the COVID-19 pandemic.
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spelling pubmed-104562212023-08-26 Healthcare utilization during the first two waves of the COVID-19 epidemic in South Africa: A cross-sectional household survey Wolter, Nicole Tempia, Stefano von Gottberg, Anne Bhiman, Jinal N. Walaza, Sibongile Kleynhans, Jackie Moyes, Jocelyn Aitken, Sue Magni, Sarah Yun, Jessica Fellows, Tamika Makamadi, Tetelo Weiner, Renay Cawood, Cherie Martinson, Neil Lebina, Limakatso Cohen, Cheryl PLoS One Research Article Healthcare utilization surveys contextualize facility-based surveillance data for burden estimates. We describe healthcare utilization in the catchment areas for sentinel site healthcare facilities during the first year of the COVID-19 pandemic. We conducted a cross-sectional healthcare utilization survey in households in three communities from three provinces (KwaZulu-Natal, Western Cape and North West). Field workers administered structured questionnaires electronically with the household members reporting influenza-like illness (ILI) in the past 30 days or severe respiratory illness (SRI) since March 2020. Multivariable logistic regression was used to identify factors associated with healthcare utilization among individuals that reported illness. From November 2020 through April 2021, we enrolled 5804 households and 23,003 individuals. Any respiratory illness was reported by 1.6% of individuals; 0.7% reported ILI only, 0.8% reported SRI only, and 0.1% reported both ILI and SRI. Any form of medical care was sought by 40.8% (95% CI 32.9% - 49.6%) and 71.3% (95% CI 63.2% - 78.6%) of individuals with ILI and SRI, respectively. On multivariable analysis, respiratory illness was more likely to be medically attended for individuals at the Pietermaritzburg site (aOR 3.2, 95% CI 1.1–9.5, compared to Klerksdorp), that were underweight (aOR 11.5, 95% CI 1.5–90.2, compared to normal weight), with underlying illness (aOR 3.2, 95%CI 1.2–8.5), that experienced severe illness (aOR 4.8, 95% CI 1.6–14.3) and those with symptom duration of ≥10 days (aOR 7.9, 95% CI 2.1–30.2, compared to <5 days). Less than half of ILI episodes and only 71% of SRI episodes were medically attended during the first two COVID-19 waves in South Africa. Facility-based data may underestimate disease burden during the COVID-19 pandemic. Public Library of Science 2023-08-25 /pmc/articles/PMC10456221/ /pubmed/37624826 http://dx.doi.org/10.1371/journal.pone.0290787 Text en © 2023 Wolter et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Wolter, Nicole
Tempia, Stefano
von Gottberg, Anne
Bhiman, Jinal N.
Walaza, Sibongile
Kleynhans, Jackie
Moyes, Jocelyn
Aitken, Sue
Magni, Sarah
Yun, Jessica
Fellows, Tamika
Makamadi, Tetelo
Weiner, Renay
Cawood, Cherie
Martinson, Neil
Lebina, Limakatso
Cohen, Cheryl
Healthcare utilization during the first two waves of the COVID-19 epidemic in South Africa: A cross-sectional household survey
title Healthcare utilization during the first two waves of the COVID-19 epidemic in South Africa: A cross-sectional household survey
title_full Healthcare utilization during the first two waves of the COVID-19 epidemic in South Africa: A cross-sectional household survey
title_fullStr Healthcare utilization during the first two waves of the COVID-19 epidemic in South Africa: A cross-sectional household survey
title_full_unstemmed Healthcare utilization during the first two waves of the COVID-19 epidemic in South Africa: A cross-sectional household survey
title_short Healthcare utilization during the first two waves of the COVID-19 epidemic in South Africa: A cross-sectional household survey
title_sort healthcare utilization during the first two waves of the covid-19 epidemic in south africa: a cross-sectional household survey
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10456221/
https://www.ncbi.nlm.nih.gov/pubmed/37624826
http://dx.doi.org/10.1371/journal.pone.0290787
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