Analyzing the ultimate impact of COVID-19 in Africa

Patient level barriers to accessing TB care services during the COVID-19 pandemic in Uganda, a mixed methods study

INTRODUCTION

Lockdown measure has been utilized widely to mitigate COVID-19 pandemic transmission and recently during the 2022 Sudan Ebola Virus Disease outbreak in Uganda. These have setback effects on the continuity of essential health services such as tuberculosis (TB) care, reversing progress made in the fight against tuberculosis (TB) over the past decade. We set out to understand patient-reported barriers to accessing TB care services during the COVID-19 pandemic in Uganda.

METHODS

Mixed methods study involving review of medical records of TB patients who received TB care from January to September 2020. We used quantitative and qualitative methods including phone questionnaires and in-depth interviews. We carried out descriptive statistics, a chi-square test and conducted a thematic analysis.

RESULTS

We carried out phone interviews with 672 participants. The majority (60%) were male and with an average of 35 years (SD:11). A significantly higher proportion of patients reported a barrier to TB care access during the COVID-19 lockdown than pre-lockdown (79.9% vs. 68.1% p = 0.027). We carried out in-depth interviews with 28 participants (54% (15/28): male). Barriers experienced by these participants included lack of a means of transport to reach the health facility, lack of money to pay the transport fares, long distances to the facility, fear of COVID-19 infection, stigma due to overlap between TB and COVID-19 symptoms, and few health care workers available during the lockdown period.

CONCLUSION

Lockdown measures instituted to mitigate the transmission of COVID1-19 affected access to TB care services in Uganda. Uganda is at risk of future emerging and re-emerging diseases of epidemic potential. Therefore, there should be measures to ensure the continuity of essential services such as tuberculosis care during the implementation of future epidemic response interventions such as a lockdown.

Experimental and Simulation Study of Solar-Powered Air-Gap Membrane Distillation Technology for Water Desalination

This work aimed to investigate temperature polarization (TP) and concentration polarization (CP), which affect solar-powered air-gap membrane distillation (SP-AGMD) system performance under various operating conditions. A mathematical model for the SP-AGMD system using the experimental results was performed to calculate the temperature polarization coefficient (τ), interface temperature (Tfm), and interface concentration (Cfm) at various salt concentrations (Cf), feed temperatures (Tf), and flow rates (Mf). The system of SP-AGMD was simulated using the TRNSYS program. An evacuated tube collector (ETC) with a 2.5 m2 surface area was utilized for solar water heating. Electrical powering of cooler and circulation water pumps in the SP-AGMD system was provided using a photovoltaic system. Data were subjected to one-way analysis of variance (ANOVA) and Spearman's correlation analysis to test the significant impact of operating conditions and polarization phenomena at p < 0.05. Statistical analysis showed that Mf induced a highly significant difference in the productivity (Pr) and heat-transfer (hf) coefficients (p < 0.001) and a significant difference in τ (p < 0.05). Great F-ratios showed that Mf is the most influential parameter. Pr was enhanced by 99% and 146%, with increasing Tf (60 °C) and Mf (12 L/h), respectively, at a stable salt concentration (Cf) of 0.5% and a cooling temperature (Tc) of 20 °C. Also, the temperature increased to 85 °C when solar radiation reached 1002 W/m2 during summer. The inlet heat temperature of AGMD increased to 73 °C, and the Pr reached 1.62 kg/(m2·h).

Geopolitical risks for Egypt wheat supply and trade

Introduction

Since 2005, Russia has established a stable position in Egypt's wheat imports, and after 2016, it became the largest global wheat exporter. The shift in Russian grain production has visibly affected wheat export destinations in favor of developing countries. This paper identifies the main determinants of wheat trade in Egypt concerning the primary risks associated with the war in Ukraine.

Methods

The paper utilizes time series analysis, index analysis, and an econometric model to define the statistical relationship between the quantity of wheat imported into Egypt and population development, wheat price, and wheat production.

Results

Despite increasing wheat production growth rates (1.9% p.a. over 2000–2020) and a growing population (2.01% p.a.), Egypt is unable to reduce its import dependence below 50% of total consumption. Undernourishment in Egypt remains at 5.2%–5.4% of the population. The econometric model shows that variables describing the evolution of production, population, and prices are statistically significant in relation to wheat imports. Egypt's wheat imports continue to increase even with rising prices, which is typical for developing countries. The war in Ukraine and associated commodity price increases have far-reaching implications for Africa's food security and supply systems.

Discussion

Egypt's vulnerability to external influences, such as climate change, migration, rising commodity prices, and population growth, exacerbates the situation. Most African countries, including Egypt, struggle with the economic and social impacts of the COVID-19 pandemic. They also face rising food and energy prices, conflicts between the world's largest food producers, and increasing poverty rates. The research findings confirm that Egypt is among the highly vulnerable countries due to the war in Ukraine and the disruption of agricultural supply chains.

COVID-19 response in Africa: impacts and lessons for environmental management and climate change adaptation

The COVID-19 pandemic adds pressure on Africa; the most vulnerable continent to climate change impacts, threatening the realization of most Sustainable Development Goals (SDGs). The continent is witnessing an increase in intensity and frequency of extreme weather events, and environmental change. The COVID-19 was managed relatively well across in the continent, providing lessons and impetus for environmental management and addressing climate change. This work examines the possible impact of the COVID-19 pandemic on the environment and climate change, analyses its management and draws lessons from it for climate change response in Africa. The data, findings and lessons are drawn from peer reviewed articles and credible grey literature on COVID-19 in Africa. The COVID-19 pandemic spread quickly, causing loss of lives and stagnation of the global economy, overshadowing the current climate crisis. The pandemic was managed through swift response by the top political leadership, research and innovations across Africa providing possible solutions to COVID-19 challenges, and redirection of funds to manage the pandemic. The well-coordinated COVID-19 containment strategy under the African Centers for Disease Control and Prevention increased sharing of resources including data was a success in limiting the spread of the virus. These strategies, among others, proved effective in limiting the spread and impact of COVID-19. The findings provide lessons that stakeholders and policy-makers can leverage in the management of the environment and address climate change. These approaches require solid commitment and practical-oriented leadership.

Supplementary Information

The online version contains supplementary material available at 10.1007/s10668-023-02956-0.

Comprehensive Literature Review on the Impacts of COVID-19 Pandemic on Public Road Transportation System: Challenges and Solutions

The COVID-19 pandemic is a significant public health problem and the leading cause of reduction in the demand and supply of public transit in the last three years. It has caused an unprecedented reduction in the demand for public road transportation, and it has changed passengers’ perceptions from positive to negative when it comes to using public transportation amenities. There is an increasing concern that the public road transportation systems are witnessing a new horizon, especially now that developed and developing countries are trying to resume their daily activities post COVID-19 pandemic. In this research, we focused on the overview of literature reviews of research within the past three years that focused on the challenges and solutions of the impact of the COVID-19 pandemic on public road transportation systems, especially when it comes to the enforcement of physical distancing in public transportation, usage of face masks and government interventions. The inclusion and exclusion criteria were used in reviewing the articles used for this literature review, and an original 140 articles were reduced to 100 articles that were used in this literature review. This research aims to create an overview literature review that highlights the impact of the pandemic on public transportation and identifies strategic ways in which urban planners and public road transportation researchers can develop constructive and efficient public road transportation planning to ensure the sustainability of public transportation systems in the post-COVID-19 era. This literature review extends our knowledge of the COVID-19 pandemic in public road transportation. It also provides additional evidence concerning the effectiveness of physical distancing and the use of face masks to prevent the COVID-19 virus in public road transportation networks.

Impact of COVID-19 lockdown on small-scale farming in Northeastern Nile Delta of Egypt and learned lessons for water conservation potentials

The coronavirus disease-2019 (COVID-19) pandemic had a great impact on the agricultural sector, especially in developing countries. In particular, it caused exceptional challenges to small and local-scale farmers. Field questionnaires and interviews were used to investigate the effects of COVID-19 on small-scale farmers in the Northern Nile Delta of Egypt. Agricultural farms in Southern Port Said City represent emerging agricultural communities on newly reclaimed land, while those in Damietta are stable agricultural communities (old land of the Nile Delta). The questionnaire was divided into four questions groups to identify and analyze the different reasons that contributed to the disruption of farming systems and the agricultural sector. These groups were farmers' data, the effect of COVID-19 on agriculture inputs, infection rates and precautionary measures against COVID-19, and potential measures and governmental policies for controlling the negative impacts of COVID-19 and achieving agricultural sustainability. Results showed that the effect of lockdown was slightly lower in Damietta as compared to Port Said. Although fertilizers and labors costs, as well as water availability near Port Said, was not considerably affected during the lockdown, the total income of the small-scale farmers' notability decreased. The reluctance of major traders to buy crop production and keep the required balance of cash during the pandemic dramatically affected the crop production selling prices. Results showed that in the absence of agricultural extensions possibilities, there is a lack of awareness toward improving agricultural practices and switching to smart irrigation systems as a way of saving water and increasing crop productivity. The resistance against applying new agricultural practices and switching to smart irrigation systems depends mainly on farmers' financial capability and the nature of agricultural land either old or new. Activating the agricultural extensions roles is considered a keystone for enhancing agricultural sustainability in small-scale farming not only in developing regions of Egypt but also in other similar agricultural communities worldwide.

Dealing with impact of COVID-19 on transportation in a developing country: Insights and policy recommendations

While developed nations have established policy frameworks for dealing with various macroeconomic shocks, developing countries respond to the influx of COVID-19 on heterogeneous scales, borne out of varying institutional bottlenecks. These inadequate transport facilities are not diversified enough to deal with an impending public health crisis. With the growing divergence in public transport management procedures and societal responses and willingness to adjust to a "new normal" transport procedures in time of COVID-19 and post-pandemic, it becomes expedient to learn evidence-based policy responses to transport service delivery. Qualitative data from semi-structured interviews with commuters and operators were thematically analysed to understand the impact of COVID-19 on transportation in Lagos Nigeria. The analysis revealed that increased cost of transportation, financial sustainability, changes in travel needs and loss of revenue were the significant impacts of the pandemic. This study contributes such that transport stakeholders can better understand how to navigate their transportation needs at this time of global uncertainty. The understanding of these impacts advances policy recommendations that are most inclined to the development objectives of developing nations in the time of COVID-19 and beyond. The limitations and suggestions for further research were discussed.

The COVID-19 pandemic and healthcare systems in Africa: a scoping review of preparedness, impact and response

BACKGROUND

The COVID-19 pandemic has overwhelmed health systems in both developed and developing nations alike. Africa has one of the weakest health systems globally, but there is limited evidence on how the region is prepared for, impacted by and responded to the pandemic.

METHODS

We conducted a scoping review of PubMed, Scopus, CINAHL to search peer-reviewed articles and Google, Google Scholar and preprint sites for grey literature. The scoping review captured studies on either preparedness or impacts or responses associated with COVID-19 or covering one or more of the three topics and guided by Arksey and O'Malley's methodological framework. The extracted information was documented following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension checklist for scoping reviews. Finally, the resulting data were thematically analysed.

RESULTS

Twenty-two eligible studies, of which 6 reported on health system preparedness, 19 described the impacts of COVID-19 on access to general and essential health services and 7 focused on responses taken by the healthcare systems were included. The main setbacks in health system preparation included lack of available health services needed for the pandemic, inadequate resources and equipment, and limited testing ability and surge capacity for COVID-19. Reduced flow of patients and missing scheduled appointments were among the most common impacts of the COVID-19 pandemic. Health system responses identified in this review included the availability of telephone consultations, re-purposing of available services and establishment of isolation centres, and provisions of COVID-19 guidelines in some settings.

CONCLUSIONS

The health systems in Africa were inadequately prepared for the pandemic, and its impact was substantial. Responses were slow and did not match the magnitude of the problem. Interventions that will improve and strengthen health system resilience and financing through local, national and global engagement should be prioritised.

Real-Time Impact of COVID-19 on Clinical Care and Treatment of Patients with Tuberculosis: A Multicenter Cross-Sectional Study in Addis Ababa, Ethiopia

Background:

There were global concerns and predictions that Coronavirus disease 2019 (COVID-19) would severely affect tuberculosis (TB) care and treatment services in resource-constrained countries. This study aimed to assess the real-time impact of COVID-19 on clinical care and treatment of patients with TB in Addis Ababa, Ethiopia.

Methods:

This was a facility-based, multicenter, cross-sectional study conducted in 10 health centers with high TB clients in Addis Ababa, Ethiopia. Participants were patients with TB who have been attending TB clinical care and treatment in the COVID-19 pandemic period. Data were collected using adapted, interviewer-administered questionnaires to investigate the impact of COVID-19 in their routine care and treatment.

Result:

The study included a total of 212 consented participants. Study participants who missed appointments for medication refill were 40 (18.9%). The most important predictors of missed appointments were fear of COVID-19 [AOR = 4.25, 95% CI (1.710–25.446)], transport disruption [AOR = 8.88, 95% CI (1.618–48.761)], lockdown [AOR = 6.56, 95% CI (1.300–33.131)], traveling costs [AOR = 10.26, 95% CI (1.552–67.882)], and personal protective equipment costs [AOR = 11.15, 95% CI (2.164–57.437)]. The most costly COVID-19 preventive measures that caused financial burden to the patients were face mask [107 (50.5%)], disinfectant [106 (50%)], and sop [50 (23.6%)]. The participants were well aware of the recommended COVID-19 preventive measures. Their perceived most effective preventive measures were the use of face mask (90.1%), frequent hand washing with soap and use of disinfectant (83.0%), avoid touching eyes, nose and mouth with unwashed hands (77.8%), and stay at home (75.5%).

Conclusions:

COVID-19 significantly hampered the clinical care and treatment of patients with TB. The impact was primarily on their appointments for scheduled medication refills, clinical follow-ups, and laboratory follow-ups. Fear of getting infected with COVID-19, limited access to transportation, reduced income for traveling to health facilities, costs for personal protective equipment and traveling to healthcare facilities, and the lockdown were the major determinants. The impact could be mitigated by reducing the number of visits, rationing personal protective equipment as feasible, compensating travel expenses, providing health educations and community-based TB services, and maintaining TB services.