BackgroundThe ongoing coronavirus disease 2019 (COVID-19) pandemic has disrupted essential health services globally. COVID-19 related disruptions threaten malaria control and elimination as untreated and inappropriately treated malaria cases can lead to excess mortality and impede the COVID-19 response. This study characterized malaria service provision during the pandemic in Manicaland Province, Zimbabwe. MethodsA cross-sectional survey was conducted in randomly selected health facilities in Buhera, Makoni, and Mutare districts in August 2020. Data on the provision of malaria services, the availability of infection prevention control measures and the display of COVID-19 related information, education, and communication (IEC) materials were collected using a standardized questionnaire. Descriptive analyses by facility type, managing authority, and district were used. ResultsA total of 100 health facilities were surveyed and most were publicly managed health centers and clinics. 5% of health facilities reported testing for COVID-19, 3% reported COVID-19 related health worker absences and 1% reported disruptions to any essential health services. About two-thirds (67%) of facilities displayed COVID-19 related IEC materials and 75% had infection prevention control measures available. Despite inequities in malaria readiness by managing authority, district, and type of facility, 70% of facilities were considered "ready" to provide malaria services. ConclusionsMalaria services were fairly available with very few COVID-19 related disruptions to essential health services. Maintaining essential malaria services remains crucial in preventing excess malaria morbidity and mortality.

Background Neonatal hypothermia is a prominent issue in low-resource settings. Preterm and low birth weight (LBW) infants are at increased risk for developing hypothermia. If left untreated, hypothermia can lead to hypoxia, sepsis, hypoglycemia, apnea, and poor weight gain in neonates, contributing to neonatal morbidity and mortality. Identifying risk factors for neonatal hypothermia is important, especially in low-resource settings, where the burden of neonatal mortality is highest. The study sought to describe the distribution of neonatal hypothermia and examine risk factors associated with neonatal hypothermia among LBW infants admitted to Korle-Bu Teaching Hospital in Accra, Ghana. Methods Infants in the neonatal intensive care unit (NICU) at Korle-Bu Teaching Hospital, who were less than 28 days old, weighing less than <2,500 grams, and clinically stable, were enrolled. Infants of mothers under 18 years old and those expected to be discharged within 24 hours were excluded from the study. A standardized questionnaire was administered to collect information on the mother, infant, pregnancy, and birth characteristics. Axillary temperature readings were taken every 4 hours over a 24-hour monitoring period and during hypothermic events detected by the continuous temperature monitoring bracelet. Univariate and multivariate linear regression analyses with generalized estimating equations were used to examine risk factors associated with temperature. Results Of the 254 infants included in the analysis, 42.1% were male, 49.6% were very LBW (<1,500 grams), and 94.1% were preterm (<37 weeks). Of the 1,948 temperature readings, 44.5% were hypothermic (<36.5oC). Hypothermia occurred in 85.8% of infants during the 24-hour monitoring period. Multivariate linear regression demonstrated that being very LBW, having no skin-to-skin contact immediately after birth, not being wrapped or treated in an incubator at the time of temperature, and mixed feeding (compared to exclusive breastfeeding) were associated with lower neonatal temperatures. Conclusions Neonatal hypothermia was common among infants admitted to the NICU. The findings highlight the importance of thermal practices such as wrapping, exclusive breastfeeding and skin-to-skin contact. Increased education to promote thermal care is needed.