Impact and projections of the COVID-19 epidemic on attendance and routine vaccinations at a pediatric referral hospital in Cameroon

Abstract

Background: At the beginning of March 2020, Cameroon experienced its first cases of infection with the new coronavirus (SARS-COV-2). Very quickly, there was a drop in the rate of hospital attendance. The purpose of this study was to observe the variations in the uptake of pediatric consultations and vaccinations in a pediatric hospital. Methods: A descriptive and retrospective cross-sectional study was carried out using consultation and vaccination statistics from a pediatric hospital in the city of Yaoundé, political capital of Cameroon, from January 2016 to May 2020. Data were entered in Microsoft Excel and exported to R software (Version 3.3.3) for statistical analysis. First, time series raw data (before and after COVID-19) were plotted and the trend estimated by locally weighted scatterplot smoothing (LOWESS) methods. Then a classic seasonal decomposition was performed to distinguish between seasonal trends and irregular components using moving averages. The Webel–Ollech overall seasonality test (WO test) was also run to formally check for seasonality. The results of the study are presented as narrative tables and graphs. Results: Following the partial confinement recommended by the government of Cameroon, the number of pediatric consultations decreased by 52% in April and by 34% in May 2020 compared with rates during the same periods in 2019 ( p = 0.00001). For antenatal visits, the rates dropped by 45% and 34%, respectively, in April and May 2020 compared with 2019. The demand for immunization services also declined. As a result, the demand for BCG vaccines, third-dose tracer vaccines (diphtheria, tetanus, pertussis), polio, and MMR in children as well as tetanus vaccines in childbearing women dropped significantly. Conclusion: The start of the COVID-19 pandemic was accompanied by a significant drop in consultation and vaccination activities. If no action is taken to correct this phenomenon, the ensuing months could be marked by a considerable increase in patients, sometimes suffering from vaccine-preventable diseases. The death rate could increase considerably in the pediatric population.

Mathematical Modeling to Predict COVID-19 Infection and Vaccination Trends

“…However, confinement is still one of the most suitable prevention measures. The number of pediatric consultations/antenatal visits decreased by 52%/45% in April and 34%/34% in May 2020 compared to the same periods of 2019 ( p = 0.0001), and demand for immunization significantly decreased as well [ 30 ].…”

The Contribution of Periodic Intensification of Routine Immunization to Vaccination Coverage and Disease Surveillance in the South West Region of Cameroon amid Sociopolitical Crisis and Covid-19 Outbreak in 2020

“…The consequences of the ongoing civil strife in the southwest region of Cameroon have been enormous over the previous 03 years with a drop in DPT 3 coverage between 2016 and 2019 by 42 percent points [14]. To this was later added the challenge posed by the Covid-19 outbreak that hit the country from 06 March, 2020 and greatly affecting health service delivery in general and immunization services in particular [11][12][13]16]. Notwithstanding, knowing the bene ts of adapting their strategy to the existing challenges [21], the health actors in this region embarked in the intensi cation of routine immunization activities in a context of insecurity and Covid-19.…”

“…These restrictions limited gatherings, including major health interventions like mass vaccination activities, which indeed led to suspension of the March 2020 national immunization days against poliomyelitis. The Covid-19 outbreak caused a dramatic decline in the utilization of health services, including routine vaccination services in many regions of the country [11][12][13]. In one region-The South West Region-Covid-19 helped to further worsened a prevailing situation: an armed con ict which the region has been witnessing for over half a decade now.…”

Impact of periodic intensification of routine immunization within an armed conflict setting and COVID-19 outbreak in Cameroon in 2020

“…The rules led to suspending the March 2020 national immunization against poliomyelitis. The COVID-19 outbreak caused a dramatic decline in the utilization of health services, including routine vaccination services in many regions of the country [ 12 – 14 ]. In the SW, COVID-19 worsened the negative impact of the prevailing armed conflict.…”

“…With the worsening trend in vaccination coverage and other indicators of the EPI in this region, there was a need to carry out interventions to improve these health indicators. The ministry of health and its partners decided to implement PIRI to limit outbreaks of VPDs in the region [ 14 ]. An assessment of PIRI’s contribution to overall vaccination coverage and surveillance indicators in the SW has not been reported.…”