Accepted for/Published in: JMIR Public Health and Surveillance
Date Submitted: Jun 28, 2022
Date Accepted: Jan 12, 2023
Date Submitted to PubMed: Jan 12, 2023
The impact of COVID-19 lockdown on cases and deaths of AIDS, gonorrhea, syphilis, hepatitis B, and hepatitis C in China: an interrupted time series analysis
ABSTRACT
Background:
China has implemented nationwide non-pharmaceutical interventions (NPIs) to contain COVID-19 from an early stage. Previous studies of the impact of COVID-19 on sexually transmitted diseases (STDs) and diseases caused by blood-borne viruses (BBVs) in China have yielded widely disparate results, and data on deaths attributable to STDs and BBVs are scarce.
Objective:
We aimed to elucidate the impact of COVID-19 NPIs on the cases, deaths, and case-fatality ratios of STDs and BBVs.
Methods:
We extracted the monthly cases and deaths data for AIDS, gonorrhea, syphilis, hepatitis B, and hepatitis C between January 2015 and December 2021 from the notifiable disease reporting database on the official website of the National Health Commission of China. We used descriptive statistics to summarize the number of cases and deaths, and calculated incidence and case-fatality ratios before and after implementing massive NPIs (January 2020). We used Poisson segmented regression models to estimate the immediate and long-term impacts of NPIs on cases, deaths, and case-fatality ratios in January 2020 and December 2021, respectively.
Results:
A total of 14,800,330 cases and 127,030 deaths of AIDS, gonorrhea, syphilis, hepatitis B, and hepatitis C were reported from January 2015 to December 2021, with an incidence of 149.11/100,000 before NPIs and 151.41/100,000 after NPIs, and a case-fatality ratio of 8.21/1000 before NPIs and 9.50/1000 after NPIs. In the Poisson model, accounting for seasonal fluctuations and long-term trends, there was a 17.8% (IRR 0.822, 95% CI 0.729-0.926) decline in overall cases and a 23.3% (0.767, 0.658-0.894) decline in overall deaths in January 2020. AIDS cases (-21.6%; 0.784, 0.646-0.951) and deaths (-24.5%; 0.755, 0.639-0.893), gonorrhea cases (-30.5%; 0.695, 0.558-0.866), syphilis cases (-15.0%; 0.850, 0.770-0.938), hepatitis B cases (-17.2%; 0.828, 0.733-0.935) and hepatitis C cases (-19.2%; 0.808, 0.700-0.934) showed significant decreases in January 2020. Gonorrhea, syphilis and hepatitis C showed small increases in the number of deaths or case-fatality ratios in January 2020. By December 2021, the cases, deaths, and case-fatality ratios for each disease either reached or remained below expected levels.
Conclusions:
NPIs may have contributed to fewer reported cases of gonorrhea, syphilis, hepatitis B, and hepatitis C, and more reported deaths or case-fatality ratios of gonorrhea, syphilis and hepatitis C in China.
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