Competing health risks associated with the COVID-19 pandemic and early response: A scoping review

Abstract

Background COVID-19 has rapidly emerged as a global public health threat with infections recorded in nearly every country. Responses to COVID-19 have varied in intensity and breadth, but generally have included domestic and international travel limitations, closure of non-essential businesses, and repurposing of health services. While these interventions have focused on testing, treatment, and mitigation of COVID-19, there have been reports of interruptions to diagnostic, prevention, and treatment services for other public health threats. Objectives We conducted a scoping review to characterize the early impact of COVID-19 on HIV, tuberculosis, malaria, sexual and reproductive health, and malnutrition. Methods A scoping literature review was completed using searches of PubMed and preprint servers (medRxiv/bioRxiv) from November 1st, 2019 to October 31st, 2020, using Medical Subject Headings (MeSH) terms related to SARS-CoV-2 or COVID-19 and HIV, tuberculosis, malaria, sexual and reproductive health, and malnutrition. Empiric studies reporting original data collection or mathematical models were included, and available data synthesized by region. Studies were excluded if they were not written in English. Results A total of 1604 published papers and 205 preprints were retrieved in the search. Overall, 8.0% (129/1604) of published studies and 10.2% (21/205) of preprints met the inclusion criteria and were included in this review: 7.3% (68/931) on HIV, 7.1% (24/339) on tuberculosis, 11.6% (26/224) on malaria, 7.8% (19/183) on sexual and reproductive health, and 9.8% (13/132) on malnutrition. Thematic results were similar across competing health risks, with substantial indirect effects of the COVID-19 pandemic and response on diagnostic, prevention, and treatment services for HIV, tuberculosis, malaria, sexual and reproductive health, and malnutrition. Discussion COVID-19 emerged in the context of existing public health threats that result in millions of deaths every year. Thus, effectively responding to COVID-19 while minimizing the negative impacts of COVID-19 necessitates innovation and integration of existing programs that are often siloed across health systems. Inequities have been a consistent driver of existing health threats; COVID-19 has worsened disparities, reinforcing the need for programs that address structural risks. The data reviewed here suggest that effective strengthening of health systems should include investment and planning focused on ensuring the continuity of care for both rapidly emergent and existing public health threats.

The effects of COVID-19 lockdown measures on health and healthcare services in Uganda

“…The findings of our study showed a decline in child health such as an increase in malnutrition among children in both the urban and rural settings. Malnutrition among children in LMICs was projected in studies conducted during the early stages of the pandemic [19][20][21][22][23]. Indeed, our findings are similar to those from earlier studies conducted both in Uganda [6,[23][24][25] and other LMICs [26][27][28] which found increased levels of malnutrition among children.…”

“…Malnutrition among children in LMICs was projected in studies conducted during the early stages of the pandemic [19][20][21][22][23]. Indeed, our findings are similar to those from earlier studies conducted both in Uganda [6,[23][24][25] and other LMICs [26][27][28] which found increased levels of malnutrition among children. Malnutrition in children may have lowered their immunity and made them more susceptible to other diseases.…”

Interlinkages between Climate Change and Food Systems: The Impact on Child Malnutrition—Narrative Review

“…More than four years of progress against poverty have been erased by the COVID-19 pandemic [ 61 ], demonstrating the fragility of current food systems [ 29 ]. Worldwide and particularly in fragile contexts, malnutrition and food insecurity have been worsened by the COVID-19 pandemic due to an increase in unemployment and a decline in household incomes; constraints on the availability and affordability of nutritious foods; interruptions of health, nutrition, and protection services; and limited opportunities for physical activities [ 61 , 62 , 63 , 64 , 65 , 66 ]. School closures, movement restrictions, and nationwide lockdowns impacted food systems by disrupting the production, transportation, and sale of fresh, nutrient-rich, and affordable foods, which, in turn, led to price volatility and forced millions of families to rely on low-cost, nutrient-poor alternatives, thus influencing children’s dietary intake through changes in their home food environment [ 67 ].…”

“…Notably, in LMICs, the price of some essential foods increased significantly, affecting their accessibility [ 68 , 69 ]. Vulnerable populations, such as children and women of low SES, are the most affected [ 62 ]. In drought-affected area, the COVID-19 pandemic, climate change, and the recent wheat crisis created a “perfect storm” of malnutrition in children and breastfeeding mothers [ 70 ].…”

Estimating the global impact of coronavirus disease 2019 on people living with HIV

“…Most PWH reside in resource-limited countries, two-thirds of whom, in sub-Saharan Africa and almost half of those living in Europe and the UK are more than 50 years. Despite advances in HIV, a significant number of new infections and deaths continue to occur globally and the emergence of SARS-CoV-2 has exacerbated the existing challenges, primarily through disruption of services, with significant implications for PWH [2 ▪▪ ].…”