Time trends in infectious and chronic disease consultations in Dakar, Senegal: Impact of Covid-19 Sanitary Measures

  1. Massamba Diop
  2. Bamba Gaye
  3. Stéphanie Khoury
  4. Anouk Asselin
  5. Samuel Kingue
  6. Roland N’Guetta
  7. Ibrahima Bara Diop
  8. Camille Lassale
  9. Crystal Cene
  10. Xavier Jouven

Reviewed by

Read the full article See related articles

Listed in

Log in to save this article

Abstract

Background

The impact of COVID-19 sanitary measures on the time trends in infectious and chronic disease consultations in Sub-Saharan Africa remains unknown.

Methods

We conducted a cohort study on all emergency medical consultations over a five-year period, January 2016 to July 2020, from SOS Medecins in Dakar, Senegal. The consultation records provided basic demographic information such as age, ethnicity (Senegalese v. Caucasian), and sex as well as the principal diagnosis using an ICD-10 classification (‘infectious, ‘chronic’, and ‘other’). Firstly, we investigated how the pattern in emergency consultation differed from March to July 2020 compared to previous years. Secondly, we examined any potential racial/ethnic disparities in COVID-19 consultation.

Findings

Data on emergency medical consultations were obtained from 53,583 patients of all ethnic origins. The mean age of patients was 37.0 ± 25.2 and 30.3 ± 21.7 in 2016-2019 and 45.5 ± 24.7 and 39·5 ± 23.3 in 2020 for Senegalese and Caucasians. The type of consultations between the months of January and July were similar from 2016 and 2019; however, in 2020, there was a drop among the numbers of infectious disease consultations, particularly from April to May 2020 when sanitary measures for COVID-19 were applied (average of 366.5 and 358.25 in 2016-1019 and 133 and 125 in 2020). The prevalence of chronic conditions remained steady during the same period (average of 381 and 394.75 in 2016-2019 and 373 and 367 in 2020). In a multivariate analysis after adjusting to age and sex, infectious disease consultations were significantly more likely to occur in 2016-2019 compared to 2020 (OR for 2016= 2.39, 2017= 2.74, 2018= 2.39, 2019= 2.01). Furthermore, the trend in the number of infectious and chronic consultations were similar among Senegalese and Caucasian groups, indicating no disparities among those seeking treatment.

Interpretation

During the implementation of COVID-19 sanitary measures, infectious disease rates dropped as chronic disease rates stayed stagnant in Dakar. Furthermore, no racial/ethnic disparities were observed among the infectious and chronic consultations.

Key Points

Question

How has the application of COVID-19 sanitary measures affected emergency medical consultations from March to July 2020 compared to previous years?

Finding

The rates of infectious diseases decreased as rates of chronic diseases stayed stagnant with the application of sanitary measures. Among the infectious and chronic disease consultations, no racial/ethnic disparities were observed.

Meaning

Understanding the effects of the sanitary measures against COVID-19 in Sub-Saharan Africa has helped emphasize the possibility of limiting the spread of other infectious diseases in this part of the world where they are still highly prevalent and the efficiency of controlling the spread of the virus while avoiding racial/ethnic disparities.

Article activity feed

  1. ScreenIT

    SciScore for 10.1101/2020.11.26.20239129: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board Statementnot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variableWe also analyzed separately for women and men as well as across age groups (< 20; from 20 to 45 and > 45 years of age).

    Table 2: Resources

    No key resources detected.

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    An important limitation of this study is the use of a single database, SOS Medecins Dakar, to address our questions. It is unclear whether or not our observations reflect a direct association between COVID-19 prevention measures and its effect on consultations. Furthermore, despite the fact that this study is based on the largest database of emergency medical consultations in Senegal, the extent to which it is fully representative of healthcare utilization in emergency medicine in an urban setting is unclear as other emergency care services were not involved due to lack of documentation in these services. Data were derived from the capital city and it is possible that disease patterns and resource utilization in other regions, especially more rural areas, may be different. However, this study provides unique data on the potential effect of the sanitary measures against COVID-19 in Africa and emphasizes the need to limit the spread of all infectious diseases in this part of the world where they are still highly prevalent.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  2. Version published to 10.1101/2020.11.26.20239129 on medRxiv