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Competing Health Risks Associated with the COVID-19 Pandemic and Early Response: A Scoping Review

Baral S 1 , Rao A 1 , Twahirwa Rwema JO 1 , Lyons C 1 , Cevik M 2 , Kågesten AE 3 Show all authors , Diouf D 4 , Sohn AH 5 , Phaswana-Mafuya N 6 , Kamarulzaman A 7 , Millett G 8 , Marcus JL 9 , Mishra S 10

Affiliations 

  • 1 Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD
  • 2 Division of Infection and Global Health Research, School of Medicine, University of St. Andrews, Scotland
  • 3 Department of Global Public Health, Karolinska Institutet, Sweden
  • 4 Enda Santé, Dakar, Senegal
  • 5 TREAT Asia, amfAR, the Foundation for AIDS Research, Bangkok, Thailand
  • 6 Department of Environmental Health, Faculty of Health Sciences, University of Johannesburg
  • 7 University of Malaya, Kuala Lumpur, Malaysia
  • 8 Public Policy Office, amfAR, Washington DC
  • 9 Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA
  • 10 Li Ka Shing Knowledge Institute, St. Michael's Hospital, University of Toronto, Toronto, Canada
medRxiv, 2021 Dec 15.
PMID: 33442703 DOI: 10.1101/2021.01.07.21249419

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 January 1st 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 met inclusion criteria, including 8.2% (132/1604) of published studies and 10.2% (21/205) of preprints: 7.3% (68/931) on HIV, 7.1% (24/339) on tuberculosis, 11.6% (26/224) on malaria, 7.8% (13/166) 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.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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