Efect of COVID‑19 pandemic on inpatient service utilization and patient outcomes in Uganda
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Date
2023Author
Andia‑Biraro, Irene
Baruch Baluku, Joseph
Olum, Ronald
Bongomin, Felix
Kyazze, Andrew Peter
Ninsiima, Sandra
Ssekamatte, Phillip
Kibirige, Davis
Biraro, Samuel
Seremba, Emmanuel
Kabugo, Charles
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COVID-19 has had devastating efects on health systems but reports from sub-Saharan Africa are
few. We compared inpatient admissions, diagnostic tests performed, clinical characteristics and
inpatient mortality before and during the COVID-19 pandemic at an urban tertiary facility in Uganda.
We conducted a retrospective chart review of patients admitted at Kiruddu National Referral Hospital
in Uganda between January–July 2019 (before the pandemic) and January–July 2020 (during the
pandemic). Of 3749 inpatients, 2014 (53.7%) were female, and 1582 (42.2%) had HIV. There was
a 6.1% decline in admissions from 1932 in 2019 to 1817 in 2020. There were signifcantly fewer
diagnostic tests performed in 2020 for malaria, tuberculosis, and diabetes. Overall, 649 (17.3%)
patients died. Patients admitted during the COVID-19 pandemic (adjusted odds ratio [aOR] 1.2,
95% confdence interval [CI] 1.04–1.5, p= 0.018), patients aged≥ 60 years (aOR 1.6, 95% CI 1.2–2.1,
p= 0.001), HIV co-infected (aOR 1.5, 95% CI 1.2–1.9, p < 0.001), and those admitted as referrals (aOR
1.5, 95% CI 1.2–1.9, p < 0.001) had higher odds of dying. The COVID-19 pandemic disrupted inpatient
service utilization and was associated with inpatient mortality. Policy makers need to build resilience
in health systems in Africa to cope with future pandemics.
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