Healthcare utilization during the first two waves of the COVID-19 epidemic in South Africa: A cross-sectional household survey.
Healthcare utilization surveys contextualize facility-based surveillance data for burden estimates. We describe healthcare utilization in the catchment areas for sentinel site healthcare facilities during the first year of the COVID-19 pandemic. We conducted a cross-sectional healthcare utilization...
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Public Library of Science (PLoS)
2023-01-01
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| Series: | PLoS ONE |
| Online Access: | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0290787&type=printable |
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| author | Nicole Wolter Stefano Tempia Anne von Gottberg Jinal N Bhiman Sibongile Walaza Jackie Kleynhans Jocelyn Moyes Sue Aitken Sarah Magni Jessica Yun Tamika Fellows Tetelo Makamadi Renay Weiner Cherie Cawood Neil Martinson Limakatso Lebina Cheryl Cohen |
| author_facet | Nicole Wolter Stefano Tempia Anne von Gottberg Jinal N Bhiman Sibongile Walaza Jackie Kleynhans Jocelyn Moyes Sue Aitken Sarah Magni Jessica Yun Tamika Fellows Tetelo Makamadi Renay Weiner Cherie Cawood Neil Martinson Limakatso Lebina Cheryl Cohen |
| author_sort | Nicole Wolter |
| collection | DOAJ |
| description | Healthcare utilization surveys contextualize facility-based surveillance data for burden estimates. We describe healthcare utilization in the catchment areas for sentinel site healthcare facilities during the first year of the COVID-19 pandemic. We conducted a cross-sectional healthcare utilization survey in households in three communities from three provinces (KwaZulu-Natal, Western Cape and North West). Field workers administered structured questionnaires electronically with the household members reporting influenza-like illness (ILI) in the past 30 days or severe respiratory illness (SRI) since March 2020. Multivariable logistic regression was used to identify factors associated with healthcare utilization among individuals that reported illness. From November 2020 through April 2021, we enrolled 5804 households and 23,003 individuals. Any respiratory illness was reported by 1.6% of individuals; 0.7% reported ILI only, 0.8% reported SRI only, and 0.1% reported both ILI and SRI. Any form of medical care was sought by 40.8% (95% CI 32.9% - 49.6%) and 71.3% (95% CI 63.2% - 78.6%) of individuals with ILI and SRI, respectively. On multivariable analysis, respiratory illness was more likely to be medically attended for individuals at the Pietermaritzburg site (aOR 3.2, 95% CI 1.1-9.5, compared to Klerksdorp), that were underweight (aOR 11.5, 95% CI 1.5-90.2, compared to normal weight), with underlying illness (aOR 3.2, 95%CI 1.2-8.5), that experienced severe illness (aOR 4.8, 95% CI 1.6-14.3) and those with symptom duration of ≥10 days (aOR 7.9, 95% CI 2.1-30.2, compared to <5 days). Less than half of ILI episodes and only 71% of SRI episodes were medically attended during the first two COVID-19 waves in South Africa. Facility-based data may underestimate disease burden during the COVID-19 pandemic. |
| format | Article |
| id | doaj-art-6ea58e766c514ebebc85d50992ab2a5e |
| institution | Kabale University |
| issn | 1932-6203 |
| language | English |
| publishDate | 2023-01-01 |
| publisher | Public Library of Science (PLoS) |
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| series | PLoS ONE |
| spelling | doaj-art-6ea58e766c514ebebc85d50992ab2a5e2025-08-20T03:25:46ZengPublic Library of Science (PLoS)PLoS ONE1932-62032023-01-01188e029078710.1371/journal.pone.0290787Healthcare utilization during the first two waves of the COVID-19 epidemic in South Africa: A cross-sectional household survey.Nicole WolterStefano TempiaAnne von GottbergJinal N BhimanSibongile WalazaJackie KleynhansJocelyn MoyesSue AitkenSarah MagniJessica YunTamika FellowsTetelo MakamadiRenay WeinerCherie CawoodNeil MartinsonLimakatso LebinaCheryl CohenHealthcare utilization surveys contextualize facility-based surveillance data for burden estimates. We describe healthcare utilization in the catchment areas for sentinel site healthcare facilities during the first year of the COVID-19 pandemic. We conducted a cross-sectional healthcare utilization survey in households in three communities from three provinces (KwaZulu-Natal, Western Cape and North West). Field workers administered structured questionnaires electronically with the household members reporting influenza-like illness (ILI) in the past 30 days or severe respiratory illness (SRI) since March 2020. Multivariable logistic regression was used to identify factors associated with healthcare utilization among individuals that reported illness. From November 2020 through April 2021, we enrolled 5804 households and 23,003 individuals. Any respiratory illness was reported by 1.6% of individuals; 0.7% reported ILI only, 0.8% reported SRI only, and 0.1% reported both ILI and SRI. Any form of medical care was sought by 40.8% (95% CI 32.9% - 49.6%) and 71.3% (95% CI 63.2% - 78.6%) of individuals with ILI and SRI, respectively. On multivariable analysis, respiratory illness was more likely to be medically attended for individuals at the Pietermaritzburg site (aOR 3.2, 95% CI 1.1-9.5, compared to Klerksdorp), that were underweight (aOR 11.5, 95% CI 1.5-90.2, compared to normal weight), with underlying illness (aOR 3.2, 95%CI 1.2-8.5), that experienced severe illness (aOR 4.8, 95% CI 1.6-14.3) and those with symptom duration of ≥10 days (aOR 7.9, 95% CI 2.1-30.2, compared to <5 days). Less than half of ILI episodes and only 71% of SRI episodes were medically attended during the first two COVID-19 waves in South Africa. Facility-based data may underestimate disease burden during the COVID-19 pandemic.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0290787&type=printable |
| spellingShingle | Nicole Wolter Stefano Tempia Anne von Gottberg Jinal N Bhiman Sibongile Walaza Jackie Kleynhans Jocelyn Moyes Sue Aitken Sarah Magni Jessica Yun Tamika Fellows Tetelo Makamadi Renay Weiner Cherie Cawood Neil Martinson Limakatso Lebina Cheryl Cohen Healthcare utilization during the first two waves of the COVID-19 epidemic in South Africa: A cross-sectional household survey. PLoS ONE |
| title | Healthcare utilization during the first two waves of the COVID-19 epidemic in South Africa: A cross-sectional household survey. |
| title_full | Healthcare utilization during the first two waves of the COVID-19 epidemic in South Africa: A cross-sectional household survey. |
| title_fullStr | Healthcare utilization during the first two waves of the COVID-19 epidemic in South Africa: A cross-sectional household survey. |
| title_full_unstemmed | Healthcare utilization during the first two waves of the COVID-19 epidemic in South Africa: A cross-sectional household survey. |
| title_short | Healthcare utilization during the first two waves of the COVID-19 epidemic in South Africa: A cross-sectional household survey. |
| title_sort | healthcare utilization during the first two waves of the covid 19 epidemic in south africa a cross sectional household survey |
| url | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0290787&type=printable |
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