Pediatric Asthma Exacerbation Admissions and Stringency of Non-Pharmaceutical Interventions; Results from a Developing Country.

Alsulaiman, Jomana W; Kheirallah, Khalid A; Ajlony, Mohammed-Jafar; Al-Tamimi, Taha; Khasawneh, Rawand A; Al-Natour, Lara

BACKGROUND Non-Pharmaceutical Interventions (NPI) mitigation measures implemented to mitigate COVID-19 has brought unprecedented global impact. Changes in daily living routines, reduction in physical activities, and changes in environmental indicators were suggested to positively impact pediatric asthma indicators in western cultures. Little is known about such impact in developing countries. This study investigating the potential impact of COVID-19 NPI measures on pediatric asthma exacerbation admissions in Northern Jordan. METHODS Aggregate data from a pediatric hospital, Princess Rahma Pediatric Teaching Hospital, and King Abdulla University Teaching Hospital were utilized between 2018 and 2020. Number of pediatric asthma exacerbation admissions were calculated by week and compared by year, lockdown status, and weeks for lockdown (weeks 13 to 19). Stringency index was correlated with number of weekly pediatric asthma exacerbation admissions for 2020. RESULTS A total of 1,207 pediatric asthma exacerbation admissions were reported; 40.3%, 35.2%, and 24.5% in 2018, 2019 and 2020, respectively. The number of weekly admissions ranged between 1 and 13 pediatric asthma cases (mean (SD) = 7.6 (2.7)). In 2018 and 2019, respectively, the mean weekly admissions was 9.2 (1.9) and 8.0 (2.0) pediatric asthma cases, while in 2020 the mean was 5.6 (2.7) cases. Significant differences in mean weekly pediatric asthma exacerbation admissions were detected by year, with mean weekly admissions for 2020 being significantly lower than that for 2018 and 2019. During the lockdown (March 22nd to May 1st 2020), mean weekly admissions (2.6 (1.4)) was significantly lower than that before the lockdown (8.6 (2.0)) and after the lockdown (5.2 (2.0)). For the lockdown weeks only, the mean admissions for year 2020 was significantly lower than that for years 2019 and 2018. Stringency index negatively correlated with number of weekly admissions. CONCLUSION NPI measures in Jordan seems to have positively impacted pediatric asthma exacerbation admissions. Further studies are needed to draw public health policies and fine-tune environmental and community policies.