Open Access Surgery (Jun 2023)
Impact of War and COVID-19 on Major Surgery in a Tertiary Hospital in Tigray, Ethiopia: An Interrupted Time-Series Study
Abstract
Kibrom Berhanu Gebresilassie, Mengistu Hagazi Tequare, Micheal Berhe Gebremedhin, Wegen Beyene Tesfamariam, Tesfay Hailu Tekle, Teame Tekleab Gebremedhin, Kidanemariam Alem Berhie, Hailemariam Berhe, Hiluf Ebuy Abraha Mekelle University, College of Health Sciences, Mekelle, EthiopiaCorrespondence: Wegen Beyene Tesfamariam, Department of Medical Biochemistry & Molecular Biology, School of Medicine, College of Health Sciences, Mekelle University, P.o.box 1871, Mekelle, Ethiopia, Fax +251 0 344416681, Email [email protected]: To determine the effect of armed conflict and COVID-19 pandemic on the level and trend of surgical volume at Ayder Comprehensive Specialized Hospital, Tigray, Northern Ethiopia.Methods: All major surgeries carried out over four consecutive years were included and subjected to an interrupted time-series analysis called segmented regression analysis to examine the effect of war and COVID-19 on level of and trend changes in major surgeries. The outcome was measured and estimated that there was a significant change in the number of major surgeries as a result of the conflict and COVID-19 pandemic compared to the baseline status.Results: We analyzed 29,877 major surgeries conducted during the study period. The results indicate that, before the beginning of the intervention period, on average 632 surgeries per month were performed [632.1 (95% CI: 575.8, 688.41)]. Right after COVID-19, however, this number dropped by 359 patients per month [− 359.3 (95% CI: − 486.4, − 232.2)]. During the war period, the number of surgeries decreased by 232 patients per month [− 232.7 (95% CI: − 408.5, − 56.9)].Conclusion: This study revealed that both COVID-19 and the war in Tigray have significantly reduced the number of major surgeries that could have been carried out in their absence at a large tertiary hospital in Northern Ethiopia.Keywords: surgery, trend, armed conflict, COVID-19, Tigray, war