■越来越多的证据表明,COVID-19大流行对基本卫生服务的提供产生了不利影响。东南亚地区(SEAR)的COVID-19感染率极高,并继续承担全球相当大比例的传染病负担。
■我们对定量证据进行了系统的文献综述,以评估COVID-19对提供基本预防的影响,检测,治疗,以及为整个SEAR提供的五种高负担传染病的管理服务。
■共回顾了2338项研究,我们的分析中包含了12项研究,覆盖整个SEAR的六个国家(不丹,斯里兰卡,尼泊尔,缅甸,泰国,和印度)三个感兴趣的条件(艾滋病毒,TB,登革热)。我们发现印度的结核病检测(范围=25%至77.9%)和诊断(范围=50%至58%)出现重大中断,尼泊尔,和印度尼西亚;在筛查中观察到类似的中断,新的诊断和开始在印度和泰国的艾滋病毒治疗。在不丹和斯里兰卡,登革热的病例检测也大大减少(范围=75%至90%中断)。在任何国家都没有发现疟疾或肝炎的研究,以及在其余六个SEAR国家/地区的任何服务。
■我们发现了预防受到重大破坏的证据,诊断,治疗,和结核病的管理,艾滋病毒,以及由于COVID-19大流行而在多个SEAR国家/地区引起的登革热。这可能会阻碍整个地区在传染病控制方面取得的艰苦成果。缺乏证据证明大流行对疟疾和肝炎服务的影响,在剩下的六个SEAR国家,是一个重要的证据差距,应该加以解决,以便为未来的服务保护和大流行准备政策提供信息。
这项工作得到了世卫组织斯里兰卡国家办事处的支持。
UNASSIGNED: There is increasing evidence that the COVID-19 pandemic has impacted adversely on the provision of essential health services. The South East Asia region (SEAR) has experienced extremely high rates of COVID-19 infection, and continues to bear a significant proportion of communicable disease burden worldwide.
UNASSIGNED: We conducted a systematic literature
review of quantitative evidence to estimate the impact of COVID-19 on the provision of essential prevention, detection, treatment, and management services for five high-burden infectious diseases across the SEAR.
UNASSIGNED: A total of 2338 studies were reviewed, and 12 studies were included in our analysis, covering six countries across the SEAR (Bhutan, Sri Lanka, Nepal, Myanmar, Thailand, and India) for three conditions of interest (HIV, TB, dengue fever). We identified significant disruption to TB testing (range=25% to 77.9%) and diagnoses (range=50% to 58%) in India, Nepal, and Indonesia; and similar disruptions were observed for screening, new diagnoses and commencing HIV treatment in India and Thailand. There was also drastically reduced case detection for dengue fever (range=75% to 90% disrupted) in Bhutan and Sri Lanka. No studies were identified for malaria nor hepatitis in any country, and nor for any service in the remaining six SEAR countries.
UNASSIGNED: We identified evidence of significant disruption to the prevention, diagnoses, treatment, and management of TB, HIV, and dengue fever due to the COVID-19 pandemic across multiple SEAR country settings. This has the potential to set back hard-fought gains in infectious disease control across the region. The lack of evidence for the impact of the pandemic on malaria and hepatitis services, and in the remaining six SEAR countries, is an important evidence gap that should be addressed in order to inform future policy for service protection and pandemic preparedness.
UNASSIGNED: This work was supported by the WHO Sri Lanka Country office.