The Impact of The COVID-19 Pandemic on the Management of Chronic Disease in South Africa: A Systematic Review
Authors: Mboweni Sheillah Hlamalani , Risenga Patrone Rebecca 
Published: October 2022

Introduction:
The abrupt development of the coronavirus (COVID-19) pandemic has posed a threat to persons with chronic diseases' compliance with treatment, which is critical to improving their health, life expectancy, and lowering death and morbidity rates. The public health control measures for the pandemic have been heavily politicized. The focus on the COVID-19 epidemic has resulted in a neglect for chronic disease management. As a result, the goal of this study was to review the literature in order to gain a broader perspective on how the COVID-19 pandemic has impacted chronic disease management, as well as to investigate various strategies to deal with similar occurrences in the future when faced with medical emergencies, in order to reduce the potential harm of these measures to non-communicable disease control.

Methodology:
To analyze and identify full-text studies relevant to the influence of COVID-19 on the management of chronic diseases conducted in an African environment from 2019 to 2021, the suggested reporting items for systematic reviews and meta-analyses were used. Six databases were searched to find relevant studies, which include CINAHL Plus (EBSCO), PubMed, Google Scholar, Medline, ProQuest, and APA PsychINFO. Researchers performed a quality assessment for each included paper prior to data synthesis, as well as a formal risk-of-bias assessment.

Results:
Out of 119 abstracts reviewed, 17 full-text studies were included. Three themes were identified: the impact of COVID-19 on the healthcare system; the psychological impact on people with chronic diseases and healthcare providers; and the digitalization of healthcare services. The majority of studies were conducted in South Africa and other African countries in collaboration with western countries. The majority of studies focused on lessons learned during periods of strict public health measures, however a few empirical investigations of patients or healthcare providers were done. It is recommended that African countries should develop an integrated community-based non-communicable disease (NCD) and infectious disease care model and protocols, initiate innovative ways of central dispensing, pre-packaging and home delivery of medications to stable patients, use of telemedicine, and emphasize mental health services during medical emergencies.

Contribution:
The study’s findings could improve policy implementation regarding the management of chronic diseases during a medical emergency; in this case, COVID-19. It could also improve self-care management. The main goal is to maintain adherence and compliance with treatment to reduce complications and the disease burden. The study mainly focused on the African context.

Conclusion:
The literature revealed that the COVID-19 pandemic has had a severe impact on the management of chronic diseases and disrupted access to related healthcare services in terms of prevention, diagnosis, routine clinical care, and self-care. In addition, the mental health of both patients and healthcare providers has been affected. Chronic diseases should also be considered a public health emergency and should be given the same attention and priority as infectious diseases during a pandemic to reduce the burden of disease, especially in low and middle-income African countries already experiencing a shortage of resources. Rather than depending on the researcher's opinion, viewpoint, and notes taken during the COVID-19 lockdown, primary investigations should be done to address the inadequacies brought to light on the management of chronic diseases due to COVID-19.