Effect of COVID-19 lockdown on glycated haemoglobin testing and utilisation in KwaZulu-Natal, South Africa

IF 1 Q4 MEDICINE, RESEARCH & EXPERIMENTAL

African Journal of Laboratory Medicine Pub Date : 2024-05-13 DOI:10.4102/ajlm.v13i1.2302

Rucita Severaj, Verena Gounden

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引用次数: 0

Abstract

Background: Diabetic monitoring and treatment guidelines are easily accessible, but compliance is poor in KwaZulu-Natal. The coronavirus disease 2019 (COVID-19) pandemic had a devastating impact on diabetic healthcare, both directly and through public health interventions.Objective: This study aimed to close the gaps in knowledge concerning glycated haemoglobin (HbA1c) test utilisation and how this was affected by the COVID-19 lockdown in KwaZulu-Natal.Methods: We reviewed HbA1c test volumes and results from public health facilities in the 11 health districts in KwaZulu-Natal, South Africa. We compared testing trends and glycaemic control between two 10-month study periods before (March 2019 – December 2019) and during (March 2020 – December 2020) the COVID-19 pandemic.Results: The number of HbA1c tests performed decreased 6.1% during the pandemic period, with 173 760 HbA1c tests performed in 2019 and 163 236 HbA1c tests performed in 2020. There was a statistically significant increase in the average HbA1c level during the pandemic (mean HbA1c level in the pre-pandemic period: 70.5 mmol/mol [8.6%] versus mean HbA1c level in the pandemic period: 72.7 mmol/mol [8.8%]; p-value 0.001). Of patients with suboptimal HbA1c results (83 421 in 2019, 83 259 in 2020), 11 656 (14.0%) in 2019 and 10 086 (12.1%) in 2020 had more than one HbA1c test performed during the study period.Conclusion: The COVID-19 pandemic impacted glycaemic monitoring in KwaZulu-Natal with lower HbA1c test volumes and worse glycaemic control seen during the pandemic. HbA1c testing practices are not in keeping with recommended guidelines.What this study adds: The study demonstrates that the COVID-19 pandemic impacted HbA1c utilisation in KwaZulu-Natal. Importantly, HbA1c testing practices in KwaZulu-Natal are not in keeping with Society for Endocrinology, Metabolism and Diabetes of South Africa guidelines regarding the monitoring of diabetic patients, and this requires more attention for future diabetic healthcare interventions.

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COVID-19 封锁对南非夸祖鲁-纳塔尔省糖化血红蛋白检测和使用的影响

背景：在夸祖鲁-纳塔尔省，糖尿病监测和治疗指南很容易获得，但遵守情况很差。2019年冠状病毒病（COVID-19）大流行直接或通过公共卫生干预措施对糖尿病患者的医疗保健产生了破坏性影响：本研究旨在填补有关糖化血红蛋白（HbA1c）检测利用率以及 COVID-19 在夸祖鲁-纳塔尔省的封锁对其影响的知识空白：我们回顾了南非夸祖鲁-纳塔尔省 11 个卫生区公共卫生机构的 HbA1c 检测量和结果。我们比较了 COVID-19 大流行之前（2019 年 3 月至 2019 年 12 月）和期间（2020 年 3 月至 2020 年 12 月）两个 10 个月研究期间的检测趋势和血糖控制情况：大流行期间进行的 HbA1c 检测次数减少了 6.1%，2019 年进行了 173 760 次 HbA1c 检测，2020 年进行了 163 236 次 HbA1c 检测。在大流行期间，平均 HbA1c 水平出现了统计学意义上的显著增长（大流行前的平均 HbA1c 水平为 70.5 mmol/mol[1.5mmol/mol]）：70.5 mmol/mol [8.6%] 与大流行期间的平均 HbA1c 水平相比：72.7 mmol/mol [8.8%]；P 值为 0.001）。在 HbA1c 结果不达标的患者中（2019 年为 83 421 人，2020 年为 83 259 人），2019 年有 11 656 人（14.0%），2020 年有 10 086 人（12.1%）在研究期间进行了一次以上的 HbA1c 检测：COVID-19大流行影响了夸祖鲁-纳塔尔省的血糖监测，大流行期间HbA1c检测量减少，血糖控制情况恶化。HbA1c 检测方法与推荐指南不符：该研究表明，COVID-19 大流行影响了夸祖鲁-纳塔尔省的 HbA1c 使用率。重要的是，夸祖鲁-纳塔尔省的 HbA1c 检测方法不符合南非内分泌、代谢和糖尿病学会关于监测糖尿病患者的指南，这需要在未来的糖尿病医疗干预措施中予以更多关注。

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来源期刊

African Journal of Laboratory Medicine MEDICINE, RESEARCH & EXPERIMENTAL-

CiteScore

1.70

自引率

9.10%

发文量

审稿时长

12 weeks

期刊介绍： The African Journal of Laboratory Medicine, the official journal of ASLM, focuses on the role of the laboratory and its professionals in the clinical and public healthcare sectors,and is specifically based on an African frame of reference. Emphasis is on all aspects that promote and contribute to the laboratory medicine practices of Africa. This includes, amongst others: laboratories, biomedical scientists and clinicians, medical community, public health officials and policy makers, laboratory systems and policies (translation of laboratory knowledge, practices and technologies in clinical care), interfaces of laboratory with medical science, laboratory-based epidemiology, laboratory investigations, evidence-based effectiveness in real world (actual) settings.