Cross-sectional study of paediatric case mix presenting to an emergency centre in Cape Town, South Africa, during COVID-19
Date
2021-12
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Stellenbosch : Stellenbosch University
Abstract
ENGLISH SUMMARY : Objective: To describe and compare the effect of level 5 lockdown measures on the workload and case mix of paediatric patients presenting to a district- level emergency centre in Cape Town, South Africa.
Methods: Paediatric patients (<13 years) presenting
to Mitchells Plain Hospital were included. The level 5
lockdown period (27 March 2020–30 April 2020) was
compared with similar 5- week periods immediately
before (21 February 2020–26 March 2020) and after the
lockdown (1 May 2020–4 June 2020), and to similar time
periods during 2018 and 2019. Patient demographics,
characteristics, International Statistical Classi"cation of
Diseases and Related Health Problems, 10th Revision
(ICD-10) diagnosis, disposition and process times
were collected from an electronic patient tracking and
registration database. The X2 test and the independent
samples median test were used for comparisons.
Results: Emergency centre visits during the lockdown
period (n=592) decreased by 58% compared with
2019 (n=1413) and by 56% compared with the 2020
prelockdown period (n=1342). The proportion of under
1 year olds increased by 10.4% (p<0.001), with a 7.4%
increase in self- referrals (p<0.001) and a 6.9% reduction
in referrals from clinics (p<0.001). Proportionally more
children were referred to inpatient disciplines (5.6%,
p=0.001) and to a higher level of care (3.9%, p=0.004).
Signi"cant reductions occurred in respiratory diseases
(66.9%, p<0.001), injuries (36.1%, p<0.001) and
infectious diseases (34.1%, p<0.001). All process times
were signi"cantly different between the various study
periods.
Conclusion: Signi"cantly less children presented to
the emergency centre since the implementation of the
COVID-19 lockdown, with marked reductions in respiratory and infectious- related diseases and in injuries.
AFRIKAANSE OPSOMMING : Geen opsomming beskikbaar.
AFRIKAANSE OPSOMMING : Geen opsomming beskikbaar.
Description
Thesis (MMed)--Stellenbosch University, 2021.
Keywords
Pediatric emergency services -- Cape Town (South Africa), Pediatricians -- Workload -- Effect of lockdown -- Cape Town (South Africa), COVID-19 (Disease) -- Cape Town (South Africa), UCTD