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Muhaidat J, Albatayneh A. COVID-19 trends across borders: Identifying correlations among countries. J Int Med Res 2024; 52:3000605241266233. [PMID: 39075858 PMCID: PMC11289804 DOI: 10.1177/03000605241266233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Accepted: 06/18/2024] [Indexed: 07/31/2024] Open
Abstract
OBJECTIVES To enhance the accuracy of forecasting future coronavirus disease 2019 (COVID-19) cases and trends by identifying and analyzing correlations between the daily case counts of different countries reported between January 2020 and January 2023, to uncover significant links in COVID-19 patterns between nations, allowing for real-time, precise predictions of disease spread based on observed trends in correlated countries. METHODS Daily COVID-19 cases for each country were tracked between January 2020 and January 2023 to identify correlations between nations. Current case data were obtained from reliable sources, such as Johns Hopkins University and the World Health Organization. Data were analyzed in Microsoft Excel using Pearson's correlation coefficient to assess the strength of connections. RESULTS Strong correlations (r > 0.80) were revealed between the daily reported COVID-19 case counts of numerous countries across various continents. Specifically, 62 nations showed significant correlations with at least one correlated (connected) country per nation. These correlations indicate a similarity in COVID-19 trends over the past 3 or more years. CONCLUSION This study addresses the gap in country-specific correlations within COVID-19 forecasting methodologies. The proposed method offers essential real-time insights to aid effective government and organizational planning in response to the pandemic.
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Affiliation(s)
- Jihan Muhaidat
- Department of Dermatology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Aiman Albatayneh
- Department of Energy Engineering, School of Natural Resources Engineering and Management, German Jordanian University, Amman, Jordan
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Oleribe OO, Taylor-Robinson SD, Taylor-Robinson AW. COVID-19 post-pandemic reflections from sub-Saharan Africa: what we know now that we wish we knew then. PUBLIC HEALTH IN PRACTICE 2024; 7:100486. [PMID: 38495538 PMCID: PMC10943955 DOI: 10.1016/j.puhip.2024.100486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 02/15/2024] [Accepted: 02/19/2024] [Indexed: 03/19/2024] Open
Abstract
The commonly heard aphorism about history repeating itself suggests an endless cycle of recurring events. However, George Santayana offered a similar sentiment when he said, "Those who do not learn from history are doomed to repeat it". This emphasises that the responsibility for the recurrence of events lies not with history itself, but with humanity. It underscores that if we desire change, it is our responsibility to initiate it, rather than attributing it to external forces such as fate, luck, or time. With this thought in mind, here we offer a narrative view from sub-Saharan Africa, focusing primarily on our own experiences in Nigeria and Uganda, on what harsh lessons can be learnt from the COVID-19 pandemic regarding emergency preparedness to respond effectively to the next major infectious disease outbreak. Four strategies are suggested, the implementation of which may contribute substantially to safeguarding against an experience similar to the catastrophic public health, social and economic costs borne by African nations during COVID-19 and in its immediate aftermath.
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Affiliation(s)
- Obinna O. Oleribe
- Nigerian Institute for Medical Research, Lagos, Nigeria
- Best Health Consult Limited Liability Company, Orange, CA, USA
| | - Simon D. Taylor-Robinson
- Department of Medicine, Busitema University, Mbale, Uganda
- Department of Public Health, Busitema University, Mbale, Uganda
- Department of Surgery and Cancer, Imperial College London, St Mary's Hospital Campus, London, UK
| | - Andrew W. Taylor-Robinson
- College of Health Sciences, VinUniversity, Hanoi, Viet Nam
- Center for Global Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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3
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Hahnle L, Mennen M, Gumedze F, Mutithu D, Adriaanse M, Egan D, Mazondwa S, Walters R, Appiah LT, Inofomoh F, Ogah O, Adekanmbi O, Goma F, Ogola E, Mwazo K, Suliman A, Singh K, Raspail L, Prabhakaran D, Perel P, Sliwa K, Ntusi NAB. Greater Disease Severity and Worse Clinical Outcomes in Patients Hospitalised with COVID-19 in Africa. Glob Heart 2024; 19:34. [PMID: 38638124 PMCID: PMC11025574 DOI: 10.5334/gh.1314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 02/27/2024] [Indexed: 04/20/2024] Open
Abstract
Background COVID-19 cardiovascular research from Africa is limited. This study describes cardiovascular risk factors, manifestations, and outcomes of patients hospitalised with COVID-19 in the African region, with an overarching goal to investigate whether important differences exist between African and other populations, which may inform health policies. Methods A multinational prospective cohort study was conducted on adults hospitalised with confirmed COVID-19, consecutively admitted to 40 hospitals across 23 countries, 6 of which were African countries. Of the 5,313 participants enrolled globally, 948 were from African sites (n = 9). Data on demographics, pre-existing conditions, clinical outcomes in hospital (major adverse cardiovascular events (MACE), renal failure, neurological events, pulmonary outcomes, and death), 30-day vitality status and re-hospitalization were assessed, comparing African to non-African participants. Results Access to specialist care at African sites was significantly lower than the global average (71% vs. 95%), as were ICU admissions (19.4% vs. 34.0%) and COVID-19 vaccination rates (0.6% vs. 7.4%). The African cohort was slightly younger than the non-African cohort (55.0 vs. 57.5 years), with higher rates of hypertension (48.8% vs. 46.9%), HIV (5.9% vs. 0.3%), and Tuberculosis (3.6% vs. 0.3%). In African sites, a higher proportion of patients suffered cardiac arrest (7.5% vs. 5.1%) and acute kidney injury (12.7% vs. 7.2%), with acute kidney injury (AKI) appearing to be one of the strongest predictors of MACE and death in African populations compared to other populations. The overall mortality rate was significantly higher among African participants (18.2% vs. 14.2%). Conclusions Overall, hospitalised African patients with COVID-19 had a higher mortality despite a lower mean age, contradicting literature that had previously reported a lower mortality attributed to COVID-19 in Africa. African sites had lower COVID-19 vaccination rates and higher AKI rates, which were positively associated with increased mortality. In conclusion, African patients were hospitalized with more severe COVID-19 cases and had poorer outcomes.
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Affiliation(s)
- Lina Hahnle
- Department of Medicine, University of Cape Town, South Africa
- UCT/SAMRC Extramural Unit on Intersection of Noncommunicable Diseases and Infectious Diseases, South Africa
- ARUA/GUILD Cluster of Research Excellence on Noncommunicable Diseases and associated multimorbidities, South Africa
| | - Mathilda Mennen
- Department of Medicine, University of Cape Town, South Africa
- UCT/SAMRC Extramural Unit on Intersection of Noncommunicable Diseases and Infectious Diseases, South Africa
- ARUA/GUILD Cluster of Research Excellence on Noncommunicable Diseases and associated multimorbidities, South Africa
| | - Freedom Gumedze
- Department of Statistical Sciences, University of Cape Town, South Africa
| | - Daniel Mutithu
- UCT/SAMRC Extramural Unit on Intersection of Noncommunicable Diseases and Infectious Diseases, South Africa
- ARUA/GUILD Cluster of Research Excellence on Noncommunicable Diseases and associated multimorbidities, South Africa
- Cape Heart Institute, University of Cape Town, South Africa
| | - Marguerite Adriaanse
- Department of Medicine, University of Cape Town, South Africa
- UCT/SAMRC Extramural Unit on Intersection of Noncommunicable Diseases and Infectious Diseases, South Africa
- ARUA/GUILD Cluster of Research Excellence on Noncommunicable Diseases and associated multimorbidities, South Africa
| | - Daniel Egan
- Department of Medicine, University of Cape Town, South Africa
| | | | - Rochelle Walters
- Department of Medicine, University of Cape Town, South Africa
- UCT/SAMRC Extramural Unit on Intersection of Noncommunicable Diseases and Infectious Diseases, South Africa
- ARUA/GUILD Cluster of Research Excellence on Noncommunicable Diseases and associated multimorbidities, South Africa
| | - Lambert Tetteh Appiah
- Department of Medicine, Kwame Nkrumah University of Science & Technology (KNUST) and Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Francisca Inofomoh
- Internal Medicine Department, Olabisi Onabanjo University Teaching Hospital, Nigeria
| | - Okechukwu Ogah
- Department of Medicine, College of Medicine, University of Ibadan, and University College Hospital Ibadan, Nigeria
| | | | - Fastone Goma
- Centre for Primary Care Research, Levy Mwanawasa University Teaching Hospital, Lusaka, Zambia
| | | | - Kieran Mwazo
- Department of Medicine, Coast General Teaching and Referral Hospital, Mombasa, Kenya
| | | | - Kavita Singh
- Public Health Foundation of India, Gurugram, Haryana and Centre for Chronic Disease Control, New Delhi, IN
- Heidelberg Institute of Global Health, University of Heidelberg, Germany
| | | | - Dorairaj Prabhakaran
- Public Health Foundation India, Centre for Chronic Disease Control, IN
- World Heart Federation, CH
- London School of Hygiene & Tropical Medicine, GB
| | - Pablo Perel
- World Heart Federation, CH
- Department of Non-communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, GB
| | - Karen Sliwa
- World Heart Federation, CH
- Cape Heart Institute, Department of Medicine & Cardiology, Groote Schuur Hospital, Faculty of Health Sciences, University of Cape Town, South Africa
| | - Ntobeko A. B. Ntusi
- Department of Medicine, University of Cape Town, South Africa
- UCT/SAMRC Extramural Unit on Intersection of Noncommunicable Diseases and Infectious Diseases, South Africa
- World Heart Federation, CH
- J46 (J floor) Old Main Building, Groote Schuur Hospital Observatory, 7925, Cape Town, South Africa
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Feindouno S, Arcand JL, Guillaumont P. COVID-19's death transfer to Sub-Saharan Africa. Soc Sci Med 2024; 340:116486. [PMID: 38141493 DOI: 10.1016/j.socscimed.2023.116486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 11/26/2023] [Accepted: 11/29/2023] [Indexed: 12/25/2023]
Abstract
The COVID-19 spread very quickly around the world following its discovery in China, in December 2019. Lockdowns implemented in China and the Global North to control the propagation of the virus and to save human lives have resulted in a global recession. The transmission of the recessionary effects from the Global North to the Global South is reflected in the decline in sub-Saharan Africa's (SSA) GDP and the associated increase in poverty. The purpose of this paper is to illustrate how the recession induced in China and the Global North by COVID-19 lockdowns may have had indirect effects on SSA mortality that are higher than those directly attributed to the pandemic itself. Our methodology relies on a three-step relationship: (i) the impact of lockdowns on the recession in the North, (ii) the impact of the recession in the North on income in SSA countries, and (iii) the impact of a decline in income on mortality in SSA. We show that COVID-19-induced lockdowns in the Global North, through the severe recessions they induced in the Global South, resulted in the transfer of between 538,000 and 679,000 deaths in one year to SSA, including the deaths of 140,000 to 177,000 children aged 0-5 years. This corresponds to a 6-7% increase in the crude death rate and a 5-6% increase in under-5 mortality. These figures are much higher than the number of deaths directly attributable to COVID-19 in SSA. Thus, policymakers must not lose sight of the indirect excess mortality caused by global economic recession triggered by the pandemic. Our results reveal the need to increase the resilience of SSA countries to exogenous shocks, including COVID-19, which, in addition to increasing poverty, may induce excessive mortality due to the high sensitivity of mortality in SSA countries to economic recession.
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Affiliation(s)
| | - Jean-Louis Arcand
- FERDI, Clermont Ferrand, France; The Graduate Institute, Geneva, Switzerland.
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Vickos U, Camasta M, Grandi N, Scognamiglio S, Schindler T, Belizaire MRD, Lango-Yaya E, Koyaweda GW, Senzongo O, Pounguinza S, Estimé KKJF, N’yetobouko S, Gadia CLB, Feiganazoui DA, Le Faou A, Orsini M, Perno CF, Zinzula L, Rafaï CD. COVID-19 Genomic Surveillance in Bangui (Central African Republic) Reveals a Landscape of Circulating Variants Linked to Validated Antiviral Targets of SARS-CoV-2 Proteome. Viruses 2023; 15:2309. [PMID: 38140550 PMCID: PMC10748234 DOI: 10.3390/v15122309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 11/15/2023] [Accepted: 11/20/2023] [Indexed: 12/24/2023] Open
Abstract
Since its outbreak, Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) spread rapidly, causing the Coronavirus Disease 19 (COVID-19) pandemic. Even with the vaccines' administration, the virus continued to circulate due to inequal access to prevention and therapeutic measures in African countries. Information about COVID-19 in Africa has been limited and contradictory, and thus regional studies are important. On this premise, we conducted a genomic surveillance study about COVID-19 lineages circulating in Bangui, Central African Republic (CAR). We collected 2687 nasopharyngeal samples at four checkpoints in Bangui from 2 to 22 July 2021. Fifty-three samples tested positive for SARS-CoV-2, and viral genomes were sequenced to look for the presence of different viral strains. We performed phylogenetic analysis and described the lineage landscape of SARS-CoV-2 circulating in the CAR along 15 months of pandemics and in Africa during the study period, finding the Delta variant as the predominant Variant of Concern (VoC). The deduced aminoacidic sequences of structural and non-structural genes were determined and compared to reference and reported isolates from Africa. Despite the limited number of positive samples obtained, this study provides valuable information about COVID-19 evolution at the regional level and allows for a better understanding of SARS-CoV-2 circulation in the CAR.
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Affiliation(s)
- Ulrich Vickos
- Department of Diagnostic and Laboratory Medicine, UOC Microbiology and Immunology Diagnostics, Children’s Hospital Bambino Gesù, IRCCS, 00118 Rome, Italy;
- Department of Medicine, Infectious and Tropical Diseases, Sino-Central African Amitié Hospital, Bangui 94045, Central African Republic
| | - Marianna Camasta
- Laboratory of Molecular Virology, Department of Life and Environmental Sciences, University of Cagliari, 09042 Monserrato, Italy; (M.C.); (S.S.)
- Department of Structural Molecular Biology, Max Planck Institute of Biochemistry, 82152 Martinsried, Germany;
| | - Nicole Grandi
- Laboratory of Molecular Virology, Department of Life and Environmental Sciences, University of Cagliari, 09042 Monserrato, Italy; (M.C.); (S.S.)
| | - Sante Scognamiglio
- Laboratory of Molecular Virology, Department of Life and Environmental Sciences, University of Cagliari, 09042 Monserrato, Italy; (M.C.); (S.S.)
| | - Tobias Schindler
- Swiss Tropical and Public Health Institute, 4123 Allschwil, Switzerland;
- Department of Medical Parasitology and Infection Biology, University of Basel, 4051 Basel, Switzerland
| | | | - Ernest Lango-Yaya
- Clinical Biology and Public Health National Laboratory, Bangui 94045, Central African Republic; (E.L.-Y.); (G.W.K.); (O.S.); (S.P.); (K.K.J.F.E.); (S.N.); (C.L.B.G.); (D.-A.F.); (C.D.R.)
| | - Giscard Wilfried Koyaweda
- Clinical Biology and Public Health National Laboratory, Bangui 94045, Central African Republic; (E.L.-Y.); (G.W.K.); (O.S.); (S.P.); (K.K.J.F.E.); (S.N.); (C.L.B.G.); (D.-A.F.); (C.D.R.)
| | - Oscar Senzongo
- Clinical Biology and Public Health National Laboratory, Bangui 94045, Central African Republic; (E.L.-Y.); (G.W.K.); (O.S.); (S.P.); (K.K.J.F.E.); (S.N.); (C.L.B.G.); (D.-A.F.); (C.D.R.)
| | - Simon Pounguinza
- Clinical Biology and Public Health National Laboratory, Bangui 94045, Central African Republic; (E.L.-Y.); (G.W.K.); (O.S.); (S.P.); (K.K.J.F.E.); (S.N.); (C.L.B.G.); (D.-A.F.); (C.D.R.)
| | - Kaleb Kandou Jephté Francis Estimé
- Clinical Biology and Public Health National Laboratory, Bangui 94045, Central African Republic; (E.L.-Y.); (G.W.K.); (O.S.); (S.P.); (K.K.J.F.E.); (S.N.); (C.L.B.G.); (D.-A.F.); (C.D.R.)
| | - Stephanie N’yetobouko
- Clinical Biology and Public Health National Laboratory, Bangui 94045, Central African Republic; (E.L.-Y.); (G.W.K.); (O.S.); (S.P.); (K.K.J.F.E.); (S.N.); (C.L.B.G.); (D.-A.F.); (C.D.R.)
| | - Christelle Luce Bobossi Gadia
- Clinical Biology and Public Health National Laboratory, Bangui 94045, Central African Republic; (E.L.-Y.); (G.W.K.); (O.S.); (S.P.); (K.K.J.F.E.); (S.N.); (C.L.B.G.); (D.-A.F.); (C.D.R.)
| | - Dominos-Alfred Feiganazoui
- Clinical Biology and Public Health National Laboratory, Bangui 94045, Central African Republic; (E.L.-Y.); (G.W.K.); (O.S.); (S.P.); (K.K.J.F.E.); (S.N.); (C.L.B.G.); (D.-A.F.); (C.D.R.)
| | - Alain Le Faou
- EA 3452 CITHEFOR, Campus Brabois Santé, 54500 Vandœuvre-lès-Nancy, France;
- Faculty of Medicine, Maieutic and Health Sciences, University of Lorraine, Pole Brabois Santé, 54500 Nancy, France
| | - Massimiliano Orsini
- General and Experimental Microbiology, Laboratory of Microbial Ecology and Genomics of Microorganisms, Experimental Zooprophylactic Institute of the Venezie (IZSVe), 35020 Legnaro, Italy;
| | - Carlo Federico Perno
- Department of Diagnostic and Laboratory Medicine, UOC Microbiology and Immunology Diagnostics, Children’s Hospital Bambino Gesù, IRCCS, 00118 Rome, Italy;
| | - Luca Zinzula
- Department of Structural Molecular Biology, Max Planck Institute of Biochemistry, 82152 Martinsried, Germany;
| | - Clotaire Donatien Rafaï
- Clinical Biology and Public Health National Laboratory, Bangui 94045, Central African Republic; (E.L.-Y.); (G.W.K.); (O.S.); (S.P.); (K.K.J.F.E.); (S.N.); (C.L.B.G.); (D.-A.F.); (C.D.R.)
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Ndiaye AJS, Beye M, Sow A, Lo G, Padane A, Sokhna C, Kane CT, Colson P, Fenollar F, Mboup S, Fournier PE. COVID-19 in 16 West African Countries: An Assessment of the Epidemiology and Genetic Diversity of SARS-CoV-2 after Four Epidemic Waves. Am J Trop Med Hyg 2023; 109:861-873. [PMID: 37640294 PMCID: PMC10551082 DOI: 10.4269/ajtmh.22-0469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 07/18/2023] [Indexed: 08/31/2023] Open
Abstract
West Africa faced the COVID-19 pandemic in early March 2020 and, as of March 31, 2022, had more than 900,000 confirmed cases and more than 12,000 deaths. During this period, SARS-CoV-2 genomes evolved genetically, resulting in the emergence of distinct lineages. This review was conducted to provide the epidemiological profile of COVID-19, the mutational profile of SARS-CoV-2, and the dynamics of its lineages in the 16 west African countries by analyzing data from 33 studies and seven situation reports. For a more complete representation of the epidemiology and genetic diversity of SARS-CoV-2, we used reliable public data in addition to eligible studies. As of March 31, 2022, the 16 west African countries experienced four epidemic waves with variable intensities. Higher mortality was noted during the third wave with a case fatality rate (CFR) of 1.9%. After these four epidemic waves, Liberia recorded the highest CFR (4.0%), whereas Benin had the lowest CFR (0.6%). Through mutational analysis, a high genetic heterogeneity of the genomes was observed, with a predominance of mutations in the spike protein. From this high mutational rate, different lineages emerged. Our analysis of the evolutionary diversity allowed us to count 205 lineages circulating in west Africa. This study has provided a good representation of the mutational profile and the prevalence of SARS CoV-2 lineages beyond the knowledge of the global epidemiology of the 16 African countries.
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Affiliation(s)
- Anna Julienne Selbé Ndiaye
- Institut de Recherche en Santé, de Surveillance Epidémiologique et de Formation, Dakar, Senegal
- Institut Hospitalo-Universitaire-Méditerranée Infection, Marseille, France
| | - Mamadou Beye
- Institut Hospitalo-Universitaire-Méditerranée Infection, Marseille, France
| | - Aissatou Sow
- Institut de Recherche en Santé, de Surveillance Epidémiologique et de Formation, Dakar, Senegal
| | - Gora Lo
- Institut de Recherche en Santé, de Surveillance Epidémiologique et de Formation, Dakar, Senegal
| | - Abdou Padane
- Institut de Recherche en Santé, de Surveillance Epidémiologique et de Formation, Dakar, Senegal
- Institut Hospitalo-Universitaire-Méditerranée Infection, Marseille, France
| | - Cheikh Sokhna
- Institut Hospitalo-Universitaire-Méditerranée Infection, Marseille, France
- Vecteurs - Infections Tropicales et Méditerranéennes, Campus International Institut de Recherche pour le Développement-Université Cheikh Anta Diop de l’IRD, Dakar, Senegal
- IRD, Assistance Publique - Hôpitaux de Marseille, Service de Santé des Armées, VITROME, Aix Marseille University, Marseille, France
| | - Coumba Touré Kane
- Institut de Recherche en Santé, de Surveillance Epidémiologique et de Formation, Dakar, Senegal
| | - Philippe Colson
- Institut Hospitalo-Universitaire-Méditerranée Infection, Marseille, France
- IRD, AP-HM, Microbes Evolution Phylogeny and Infections, Aix Marseille University, Marseille, France
| | - Florence Fenollar
- Institut Hospitalo-Universitaire-Méditerranée Infection, Marseille, France
- IRD, Assistance Publique - Hôpitaux de Marseille, Service de Santé des Armées, VITROME, Aix Marseille University, Marseille, France
| | - Souleymane Mboup
- Institut de Recherche en Santé, de Surveillance Epidémiologique et de Formation, Dakar, Senegal
| | - Pierre-Edouard Fournier
- Institut Hospitalo-Universitaire-Méditerranée Infection, Marseille, France
- IRD, Assistance Publique - Hôpitaux de Marseille, Service de Santé des Armées, VITROME, Aix Marseille University, Marseille, France
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7
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Ojeniyi T, Eguavoen A, Chinye-Nwoko F. Moving the needle for COVID-19 vaccinations in Nigeria through leadership, accountability, and transparency. Front Public Health 2023; 11:1199481. [PMID: 37808977 PMCID: PMC10552183 DOI: 10.3389/fpubh.2023.1199481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 09/05/2023] [Indexed: 10/10/2023] Open
Abstract
Background The first set of vaccines arrived in Nigeria in March 2021. The National Primary Health Care Development Agency (NPHCDA) set out to vaccinate at least 70% percent of Nigeria's eligible population, i.e., 111,776,503 people, by December 2022. As of June 2021, only 3% had received at least one dose of the vaccine. This presented a threat to the achievement of NPHCDA's goal. Nigeria Solidarity Support Fund (NSSF) went into a partnership with NPHCDA to accelerate the uptake of COVID-19 vaccinations across Nigeria over 3 months. Methods Across Nigeria's 6 geopolitical zones, 6 states were selected, namely: Adamawa, Edo, Imo, Katsina, Nasarawa, and Ogun states based on performance, political will, and absence of external resources. A two-pronged approach was implemented: unrestricted funding to the sub-national level and providing technical support at the national level. Results 5 out of 6 states received unrestricted funding to ramp up vaccination coverage. They also received adequate vaccine supplies. A total of 12,000 healthcare workers were trained on safe immunization practices and multiple communities were engaged across the 133 local government areas (LGAs) through religious and community leaders. After 6 months, there was an average of 35% increase in the uptake of COVID-19 vaccines in the 5 states. An indicator tracker was developed for weekly reviews at the national level and the total population vaccinated in Nigeria increased from 6,186,647 to 11,985,336 at the end of the partnership. Conclusion Unrestricted funding, though not without its risks, can yield a significant impact on health. The intervention was co-designed with stakeholders and had leadership buy-in, accountability mechanisms, with unrestricted funding. These techniques produced an increase in the vaccination rates in the 5 states and across the country. These elements should be explored for application to other program designs such as routine immunization.
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Affiliation(s)
| | - Amenze Eguavoen
- Programs Department, Nigeria Solidarity Support Fund, Lagos, Nigeria
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8
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Sheppard RJ, Watson OJ, Pieciak R, Lungu J, Kwenda G, Moyo C, Chanda SL, Barnsley G, Brazeau NF, Gerard-Ursin ICG, Olivera Mesa D, Whittaker C, Gregson S, Okell LC, Ghani AC, MacLeod WB, Del Fava E, Melegaro A, Hines JZ, Mulenga LB, Walker PGT, Mwananyanda L, Gill CJ. Using mortuary and burial data to place COVID-19 in Lusaka, Zambia within a global context. Nat Commun 2023; 14:3840. [PMID: 37380650 PMCID: PMC10307769 DOI: 10.1038/s41467-023-39288-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 06/06/2023] [Indexed: 06/30/2023] Open
Abstract
Reported COVID-19 cases and associated mortality remain low in many sub-Saharan countries relative to global averages, but true impact is difficult to estimate given limitations around surveillance and mortality registration. In Lusaka, Zambia, burial registration and SARS-CoV-2 prevalence data during 2020 allow estimation of excess mortality and transmission. Relative to pre-pandemic patterns, we estimate age-dependent mortality increases, totalling 3212 excess deaths (95% CrI: 2104-4591), representing an 18.5% (95% CrI: 13.0-25.2%) increase relative to pre-pandemic levels. Using a dynamical model-based inferential framework, we find that these mortality patterns and SARS-CoV-2 prevalence data are in agreement with established COVID-19 severity estimates. Our results support hypotheses that COVID-19 impact in Lusaka during 2020 was consistent with COVID-19 epidemics elsewhere, without requiring exceptional explanations for low reported figures. For more equitable decision-making during future pandemics, barriers to ascertaining attributable mortality in low-income settings must be addressed and factored into discourse around reported impact differences.
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Affiliation(s)
- Richard J Sheppard
- MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, Imperial College, London, UK
| | - Oliver J Watson
- MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, Imperial College, London, UK
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Rachel Pieciak
- Department of Global Health, Boston University School of Public Health, Boston, MA, USA
| | | | - Geoffrey Kwenda
- Department of Biomedical Sciences, School of Health Sciences, University of Zambia, Lusaka, Zambia
| | | | | | - Gregory Barnsley
- MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, Imperial College, London, UK
| | - Nicholas F Brazeau
- MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, Imperial College, London, UK
| | - Ines C G Gerard-Ursin
- MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, Imperial College, London, UK
| | - Daniela Olivera Mesa
- MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, Imperial College, London, UK
| | - Charles Whittaker
- MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, Imperial College, London, UK
| | - Simon Gregson
- MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, Imperial College, London, UK
- Manicaland Centre for Public Health Research, Biomedical Research and Training Institute, Harare, Zimbabwe
| | - Lucy C Okell
- MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, Imperial College, London, UK
| | - Azra C Ghani
- MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, Imperial College, London, UK
| | - William B MacLeod
- Department of Global Health, Boston University School of Public Health, Boston, MA, USA
| | - Emanuele Del Fava
- Carlo F. Dondena Centre for Research on Social Dynamics and Public Policy, Bocconi University, Milan, Italy
- Max Planck Institute for Demographic Research, Rostock, Germany
| | - Alessia Melegaro
- Carlo F. Dondena Centre for Research on Social Dynamics and Public Policy, Bocconi University, Milan, Italy
- Department of Social and Political Science, Bocconi University, Milano, Italy
| | - Jonas Z Hines
- Centers for Disease Control and Prevention, Lusaka, Zambia
| | | | - Patrick G T Walker
- MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, Imperial College, London, UK.
| | - Lawrence Mwananyanda
- Department of Global Health, Boston University School of Public Health, Boston, MA, USA
- Avencion Limited, Lusaka, Zambia
| | - Christopher J Gill
- Department of Global Health, Boston University School of Public Health, Boston, MA, USA
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Simons E, Nikolay B, Ouedraogo P, Pasquier E, Tiemeni C, Adjaho I, Badjo C, Chamman K, Diomandé M, Dosso M, Doumbia M, Izia YA, Kakompe H, Katsomya AM, Kij V, Akissi VK, Mambula C, Mbala-Kingebeni P, Muzinga J, Ngoy B, Penali L, Pini A, Porten K, Salou H, Sevede D, Luquero F, Gignoux E. Seroprevalence of SARS-CoV-2 antibodies and retrospective mortality in two African settings: Lubumbashi, Democratic Republic of the Congo and Abidjan, Côte d'Ivoire. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001457. [PMID: 37289736 DOI: 10.1371/journal.pgph.0001457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 05/10/2023] [Indexed: 06/10/2023]
Abstract
Although seroprevalence studies have demonstrated the wide circulation of SARS-COV-2 in African countries, the impact on population health in these settings is still poorly understood. Using representative samples of the general population, we evaluated retrospective mortality and seroprevalence of anti-SARS-CoV-2 antibodies in Lubumbashi and Abidjan. The studies included retrospective mortality surveys and nested anti-SARS-CoV-2 antibody prevalence surveys. In Lubumbashi the study took place during April-May 2021 and in Abidjan the survey was implemented in two phases: July-August 2021 and October-November 2021. Crude mortality rates were stratified between pre-pandemic and pandemic periods and further investigated by age group and COVID waves. Anti-SARS-CoV-2 seroprevalence was quantified by rapid diagnostic testing (RDT) and laboratory-based testing (ELISA in Lubumbashi and ECLIA in Abidjan). In Lubumbashi, the crude mortality rate (CMR) increased from 0.08 deaths per 10 000 persons per day (pre-pandemic) to 0.20 deaths per 10 000 persons per day (pandemic period). Increases were particularly pronounced among <5 years old. In Abidjan, no overall increase was observed during the pandemic period (pre-pandemic: 0.05 deaths per 10 000 persons per day; pandemic: 0.07 deaths per 10 000 persons per day). However, an increase was observed during the third wave (0.11 deaths per 10 000 persons per day). The estimated seroprevalence in Lubumbashi was 15.7% (RDT) and 43.2% (laboratory-based). In Abidjan, the estimated seroprevalence was 17.4% (RDT) and 72.9% (laboratory-based) during the first phase of the survey and 38.8% (RDT) and 82.2% (laboratory-based) during the second phase of the survey. Although circulation of SARS-CoV-2 seems to have been extensive in both settings, the public health impact varied. The increases, particularly among the youngest age group, suggest indirect impacts of COVID and the pandemic on population health. The seroprevalence results confirmed substantial underdetection of cases through the national surveillance systems.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | - Hugues Kakompe
- Ministry of Health, Kinshasa, Democratic Republic of the Congo
| | | | - Vicky Kij
- Ministry of Health, Kinshasa, Democratic Republic of the Congo
| | | | | | | | - Jacques Muzinga
- Laboratoire National de Lubumbashi, Lubumbashi, Democratic Republic of the Congo
| | - Basile Ngoy
- Ministry of Health, Kinshasa, Democratic Republic of the Congo
| | - Lou Penali
- Institut Pasteur Cote d'Ivoire, Abidjan, Cote d'Ivoire
| | | | | | | | - Daouda Sevede
- Institut Pasteur Cote d'Ivoire, Abidjan, Cote d'Ivoire
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10
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Altare C, Kostandova N, Gankpe GF, Nalimo P, Almoustapha Abaradine AA, Bruneau S, Antoine C, Spiegel PB. The first year of the COVID-19 pandemic in humanitarian settings: epidemiology, health service utilization, and health care seeking behavior in Bangui and surrounding areas, Central African Republic. Confl Health 2023; 17:24. [PMID: 37210535 DOI: 10.1186/s13031-023-00523-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 05/16/2023] [Indexed: 05/22/2023] Open
Abstract
BACKGROUND Despite increasing evidence on COVID-19, few studies have been conducted in humanitarian settings and none have investigated the direct and indirect effects of the pandemic in the Central African Republic. We studied the COVID-19 epidemiology, health service utilization, and health care seeking behavior in the first year of the pandemic in Bangui and surrounding areas. METHODS This mixed-methods study encompasses four components: descriptive epidemiological analysis of reported COVID-19 cases data; interrupted time series analysis of health service utilization using routine health service data; qualitative analysis of health care workers' perceptions of how health services were affected; and health care seeking behavior of community members with a household survey and focus group discussions. RESULTS The COVID-19 epidemiology in CAR aligns with that of most other countries with males representing most of the tested people and positive cases. Testing capacity was mainly concentrated in Bangui and skewed towards symptomatic cases, travelers, and certain professions. Test positivity was high, and many cases went undiagnosed. Decreases in outpatient department consultations, consultations for respiratory tract infections, and antenatal care were found in most study districts. Cumulative differences in districts ranged from - 46,000 outpatient department consultations in Begoua to + 7000 in Bangui 3; - 9337 respiratory tract infections consultations in Begoua to + 301 in Bangui 1; and from - 2895 antenatal care consultations in Bimbo to + 702 in Bangui 2. Consultations for suspected malaria showed mixed results while delivery of BCG vaccine doses increased. Fewer community members reported seeking care at the beginning of the pandemic compared to summer 2021, especially in urban areas. The fear of testing positive and complying with related restrictions were the main obstacles to seeking care. CONCLUSIONS A large underestimation of infections and decreased health care utilization characterized the first year of the COVID-19 pandemic in Bangui and surrounding area. Improved decentralized testing capacity and enhanced efforts to maintain health service utilization will be crucial for future epidemics. A better understanding of health care access is needed, which will require strengthening the national health information system to ensure reliable and complete data. Further research on how public health measures interact with security constraints is needed.
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Affiliation(s)
- Chiara Altare
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
- Johns Hopkins Center for Humanitarian Health, Baltimore, MD, USA.
| | - Natalya Kostandova
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Johns Hopkins Center for Humanitarian Health, Baltimore, MD, USA
| | | | | | | | | | | | - Paul B Spiegel
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Johns Hopkins Center for Humanitarian Health, Baltimore, MD, USA
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11
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Obasanjo IO, Ahmad Z, Akkaladevi S, Adekoya A, Abass O. Dynamics of factors associated with rates of COVID-19 cases and deaths in African countries. Global Health 2023; 19:20. [PMID: 36959604 PMCID: PMC10034252 DOI: 10.1186/s12992-023-00918-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 03/07/2023] [Indexed: 03/25/2023] Open
Abstract
BACKGROUND African countries have not had the high case and death rates from COVID-19 as was predicted early in the pandemic. It is not well understood what factors modulated the rate of COVID-19 cases and death on the continent. METHODS We collated data from the World Bank data site, Our World in Data and Freedom House for African for 54 African countries who are members of the African Union. We used them as explanatory variables in two general linear model regression analyses. COVID cases and deaths per 100,000 obtained from WHO COVID-19 dashboard on August 12, 2021, as outcome variables in two prediction models. RESULTS GDP, percentage of population under 14 years of age, Maternal Mortality Ratio, number of international tourists visiting per year and public transportation closures were not significant in predicting COVID-19 cases. Higher percentage of unemployed adults in the population, lower percentage of the population over 25 years of age with secondary education, internal travel restrictions increased spread of COVID-19 while international travel restrictions were associated with lower COVID-19 cases per 100,000 population. Higher levels of democratization results in higher cases of COVID-19. Unemployment, education and democratization were still significant for COVID-19 death in the same direction as they were for COVID-19 cases. Number of tourism visitors per year was also associated with higher COVID-19 death rates but not with case rates. CONCLUSION In African countries, internal movement restrictions enacted to inhibit COVID-19, had the opposite effect and enabled COVID-19 spread. Low Education levels and high unemployment were associated with having higher death rates from COVID-19. More studies are needed to understand the impact of tourism on COVID-19 and other infectious diseases arising from other regions on African countries, in order to put in place adequate control protocols.
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Affiliation(s)
- Iyabo O. Obasanjo
- Department of Kinesiology and Health Sciences, College of William and Mary, Williamsburg, VA 23185 USA
| | - Zain Ahmad
- College of William and Mary, Williamsburg, VA 23185 USA
| | - Somasheker Akkaladevi
- Reginald F. Lewis College of Business, Virginia State University, Petersburg, VA 23806 USA
| | - Adeyemi Adekoya
- Reginald F. Lewis College of Business, Virginia State University, Petersburg, VA 23806 USA
| | - Olayide Abass
- Bells University of Technology, Otta, Ogun State Nigeria
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12
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Adekanmbi O, Ilesanmi O, Idowu O, Esan A, Raji YR, Fowotade A, Ogunlade O, Akere A, Ololade O, Ojifinni K, Akinola O, Orunmuyi A, Eze U, Akinmoladun V, Adeoye A, Adebiyi A, Olapade-Olaopa EO, Otegbayo JA, Osungbade K. Characteristics and outcomes of patients hospitalized with COVID-19 at a tertiary hospital in Nigeria. Afr Health Sci 2023; 23:72-82. [PMID: 37545917 PMCID: PMC10398429 DOI: 10.4314/ahs.v23i1.9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/08/2023] Open
Abstract
Background Data regarding the features and outcomes of hospitalized COVID-19 patients in Africa are increasingly available. Objectives To describe socio-demographic, clinical and laboratory characteristics and outcomes of COVID-19 patients. Methods A cross-sectional study of 86 adult patients hospitalized with COVID-19 between March and November 2020. Characteristics were described in survivors and non-survivors. Results Mean age was 60.9±16.1 years, 53(61.6%) were male. Co-morbidities were found in 77(89.5%) patients. On severity, 6(7%) were mild, 23(26.7%) moderate, 51(59.3%) severe and 6(7%) critical. Oxygen saturation and respiratory rate were 71±22% and 38±11/minute in non-survivors and 90±7% and 31±7/minute in survivors respectively (p<0.001, p<0.001)). Overall mortality was 47.7% with no death among patients with mild disease and deaths in all patients with critical disease. Duration of hospitalization was 2.0(1.0-4.5) days in those who died and 12(7.0-15.0) days in those who survived (p<0.001). Of the 42 patients that received dexamethasone, 11(26.2%) died, while 31(73.8%) survived (p=<0.001). Conclusion Most of the patients had co-morbidities and there was high mortality in patients with severe and critical COVID-19. Mean oxygen saturation was low and respiratory rate high overall. Factors associated with mortality included: Significantly greater hypoxia and tachypnea, less dexamethasone use and shorter hospitalization.
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Affiliation(s)
- Olukemi Adekanmbi
- Department of Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
- Department of Medicine, University College Hospital, Ibadan, Nigeria
| | - Olayinka Ilesanmi
- Department of Community Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
- Department of Community Medicine, University College Hospital, Ibadan, Nigeria
| | - Olusola Idowu
- Department of Anaesthesia, College of Medicine, University of Ibadan, Ibadan, Nigeria
- Department of Anaesthesia, University College Hospital, Ibadan, Nigeria
| | - Arinola Esan
- Department of Medicine, University College Hospital, Ibadan, Nigeria
| | - Yemi R Raji
- Department of Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
- Department of Medicine, University College Hospital, Ibadan, Nigeria
| | - Adeola Fowotade
- Department of Medical Microbiology, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Olubunmi Ogunlade
- Department of Medicine, University College Hospital, Ibadan, Nigeria
| | - Adegboyega Akere
- Department of Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
- Department of Medicine, University College Hospital, Ibadan, Nigeria
| | - Oluwaseun Ololade
- Department of Medicine, University College Hospital, Ibadan, Nigeria
| | - Kehinde Ojifinni
- Department of Emergency Medicine, University College Hospital, Ibadan, Nigeria
| | - Olurotimi Akinola
- Department of Emergency Medicine, University College Hospital, Ibadan, Nigeria
| | - Akintunde Orunmuyi
- Department of Nuclear Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Uwom Eze
- Department of Pathology, University College Hospital, Ibadan, Nigeria
| | - Victor Akinmoladun
- Department of Oral and Maxillofacial Surgery, College of Medicine, University of Ibadan
- Department of Oral and Maxillofacial Surgery, University College Hospital, Ibadan
| | - Abiodun Adeoye
- Department of Medicine, University College Hospital, Ibadan, Nigeria
- Institute of Cardiovascular Disease, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Akindele Adebiyi
- Department of Community Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
- Department of Community Medicine, University College Hospital, Ibadan, Nigeria
| | - E Oluwabunmi Olapade-Olaopa
- Department of Surgery, College of Medicine, University of Ibadan, Ibadan, Nigeria
- Department of Surgery, University College Hospital, Ibadan, Nigeria
| | - Jesse A Otegbayo
- Department of Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
- Department of Medicine, University College Hospital, Ibadan, Nigeria
| | - Kayode Osungbade
- Department of Health Policy and Management, College of Medicine, University of Ibadan, Ibadan
- Disease Surveillance Unit, University College Hospital, Ibadan, Nigeria
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Grenfell RFQ, Oyeyemi OT. Access to COVID-19 vaccines and testing in Africa: the importance of COVAX - Nigeria as a case study. Pathog Glob Health 2023; 117:152-166. [PMID: 35770309 PMCID: PMC9970234 DOI: 10.1080/20477724.2022.2091862] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
Abstract
Since pandemic declaration, the vulnerability of countries with serious economic challenges and limited health resources became evident. This vulnerability has been put to the test once again with the appearance of Omicron as another variant of concern. Although great efforts have been made to develop effective and safe vaccines, they need to be made available globally at an affordable price to all governments and distributed equitably to maximize immediate and long-term efforts to contain the virus and advance global public health. Potential sources of unfair allocation of COVID-19 vaccines are not hard to find. The COVID-19 Vaccine Global Access Facility (COVAX) has so far shipped over 406 million COVID-19 vaccines to 144 eligible participants. From that batches, about 115 million doses (28%) were allocated to 49 African countries. If proactive measures are not undertaken, Nigeria, pointed here as a case study, and Sub-Saharan Africa countries may not be self-reliant for COVID-19 vaccines. This report raises a discussion on the difficulties in accessing vaccines and diagnostics in sub-Saharan Africa, compared to high- and middle-income countries. Now more than ever, it is crucial to note that there is no overcoming a pandemic without coordinated action for actions that go beyond borders. The coordinated effort to raise vaccination rates in the African continent is not a humanitarian action aimed exclusively at Africa, but more than that, it is an effort for the benefit of global public health.
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Affiliation(s)
- Rafaella Fortini Queiroz Grenfell
- Diagnosis and Therapy of Infectious Diseases and Cancer, Rene Rachou Institute, Oswaldo Cruz Foundation (Fiocruz), Belo Horizonte, Minas Gerais, Brazil.,Department of Infectious Diseases, College of Veterinary Medicine, University of Georgia, Athens, Georgia, USA
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14
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Value of Verbal Autopsy in a Fragile Setting: Reported versus Estimated Community Deaths Associated with COVID-19, Banadir, Somalia. Pathogens 2023; 12:pathogens12020328. [PMID: 36839600 PMCID: PMC9961735 DOI: 10.3390/pathogens12020328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 01/30/2023] [Accepted: 02/04/2023] [Indexed: 02/18/2023] Open
Abstract
BACKGROUND Accurate mortality data associated with infectious diseases such as coronavirus disease 2019 (COVID-19) are often unavailable in countries with fragile health systems such as Somalia. We compared officially reported COVID-19 deaths in Somalia with COVID-19 deaths estimated using verbal autopsy. METHODS We interviewed relatives of deceased persons to collect information on symptoms, cause, and place of death. We compared these data with officially reported data and estimated the positive and negative predictive values of verbal autopsy. RESULTS We identified 530 deaths during March-October 2020. We classified 176 (33.2%) as probable COVID-19 deaths. Most deaths (78.5%; 416/530) occurred at home and 144 (34.6%) of these were attributed to COVID-19. The positive predictive value of verbal autopsy was lower for home deaths (22.3%; 95% CI: 15.7-30.1%) than for hospital deaths (32.3%; 95% CI: 16.7-51.4%). The negative predictive value was higher: 97.8% (95% CI: 95.0-99.3%) for home deaths and 98.4% (95% CI: 91.5-100%) for hospital deaths. Conclusions Verbal autopsy has acceptable predictive value to estimate COVID-19 deaths where disease prevalence is high and can provide data on the COVID-19 burden in countries with low testing and weak mortality surveillance where home deaths may be missed.
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15
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Olamijuwon E, Konje E, Kansiime C, Kesby M, Keenan K, Neema S, Asiimwe B, Mshana SE, Mushi MF, Loza O, Sunday B, Sandeman A, Sloan DJ, Benitez-Paez F, Mwanga JR, Sabiiti W, Holden MTG. Antibiotic dispensing practices during COVID-19 and implications for antimicrobial resistance (AMR): parallel mystery client studies in Uganda and Tanzania. Antimicrob Resist Infect Control 2023; 12:10. [PMID: 36774512 PMCID: PMC9919751 DOI: 10.1186/s13756-022-01199-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 12/07/2022] [Indexed: 02/13/2023] Open
Abstract
BACKGROUND Over-the-counter antibiotic access is common in low-and-middle-income countries and this may accelerate antimicrobial resistance. Our study explores critical aspects of the drug seller-client interaction and antibiotic dispensing patterns for simulated COVID-19 symptoms during the pandemic in two study sites in Tanzania and Uganda, countries with different government responses to the pandemic. METHODS Research assistants posing as clients approached different types of drug sellers such as pharmacies (Pharms), drug shops (DSs), and accredited drug dispensing outlets (ADDOs) in Mwanza, Tanzania (nPharms = 415, nADDOs = 116) and Mbarara, Uganda (nPharms = 440, nDSs = 67), from June 10 to July 30, 2021. The mystery clients held no prescription and sought advice for simulated COVID-19 symptoms from the drug sellers. They documented the quality of their interaction with sellers and the type of drugs dispensed. RESULTS Adherence to COVID-19 preventive measures and vigilance to COVID-19 symptoms was low in both sites but significantly higher in Uganda than in Tanzania. A higher percentage of drug sellers in Mbarara (Pharms = 36%, DSs = 35%, P-value = 0.947) compared to Mwanza (Pharms = 9%, ADDOs = 4%, P-value = 0.112) identified the client's symptoms as possibly COVID-19. More than three-quarters of drug sellers that sold prescription-only medicines in both Mbarara (Pharms = 86%, DSs = 89%) and Mwanza (Pharms = 93%, ADDOs = 97%) did not ask the MCs for a prescription. A relatively high percentage of drug sellers that sold prescription-only medicines in Mwanza (Pharms = 51%, ADDOs = 67%) compared to Mbarara (Pharms = 31%, DSs = 42%) sold a partial course without any hesitation. Of those who sold antibiotics, a higher proportion of drug sellers in Mbarara (Pharms = 73%, DSs = 78%, P-value = 0.580) compared to Mwanza (Pharms = 40% ADDOs = 46%, P-value = 0.537) sold antibiotics relevant for treating secondary bacterial infections in COVID-19 patients. CONCLUSION Our study highlights low vigilance towards COVID-19 symptoms, widespread propensity to dispense prescription-only antibiotics without a prescription, and to dispense partial doses of antibiotics. This implies that drug dispensing related to COVID-19 may further drive AMR. Our study also highlights the need for more efforts to improve antibiotic stewardship among drug sellers in response to COVID-19 and to prepare them for future health emergencies.
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Affiliation(s)
- Emmanuel Olamijuwon
- School of Geography and Sustainable Development, University of St Andrews, St Andrews, KY16 9AL, UK.
| | - Eveline Konje
- grid.411961.a0000 0004 0451 3858Department of Biostatistics and Epidemiology, School of Public Health, Catholic University of Health and Allied Sciences, P.O. Box 1464, Mwanza, Tanzania
| | - Catherine Kansiime
- grid.11194.3c0000 0004 0620 0548School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Mike Kesby
- grid.11914.3c0000 0001 0721 1626School of Geography and Sustainable Development, University of St Andrews, St Andrews, KY16 9AL UK
| | - Katherine Keenan
- grid.11914.3c0000 0001 0721 1626School of Geography and Sustainable Development, University of St Andrews, St Andrews, KY16 9AL UK
| | - Stella Neema
- grid.11194.3c0000 0004 0620 0548Department of Sociology and Anthropology, Makerere University, Kampala, Uganda
| | - Benon Asiimwe
- grid.11194.3c0000 0004 0620 0548Department of Medical Microbiology, Makerere University College of Health Sciences, Kampala, Uganda
| | - Stephen E. Mshana
- grid.411961.a0000 0004 0451 3858Department of Microbiology, Catholic University of Health and Allied Sciences, P.O. Box 1464, Mwanza, Tanzania
| | - Martha F. Mushi
- grid.411961.a0000 0004 0451 3858Department of Microbiology, Catholic University of Health and Allied Sciences, P.O. Box 1464, Mwanza, Tanzania
| | - Olga Loza
- grid.11914.3c0000 0001 0721 1626School of Geography and Sustainable Development, University of St Andrews, St Andrews, KY16 9AL UK
| | - Benjamin Sunday
- grid.33440.300000 0001 0232 6272Department of Microbiology, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Alison Sandeman
- grid.11914.3c0000 0001 0721 1626School of Medicine, University of St Andrews, St Andrews, KY16 9AL UK
| | - Derek J. Sloan
- grid.11914.3c0000 0001 0721 1626School of Medicine, University of St Andrews, St Andrews, KY16 9AL UK
| | - Fernando Benitez-Paez
- grid.11914.3c0000 0001 0721 1626School of Geography and Sustainable Development, University of St Andrews, St Andrews, KY16 9AL UK
| | - Joseph R. Mwanga
- grid.411961.a0000 0004 0451 3858Department of Biostatistics and Epidemiology, School of Public Health, Catholic University of Health and Allied Sciences, P.O. Box 1464, Mwanza, Tanzania
| | - Wilber Sabiiti
- grid.11914.3c0000 0001 0721 1626School of Medicine, University of St Andrews, St Andrews, KY16 9AL UK
| | - Matthew T. G. Holden
- grid.11914.3c0000 0001 0721 1626School of Medicine, University of St Andrews, St Andrews, KY16 9AL UK
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Chikomba C, Dlamini S, George JA, Pillay T. COVID Diagnostics: From Molecules to Omics. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1412:141-158. [PMID: 37378765 DOI: 10.1007/978-3-031-28012-2_7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/29/2023]
Abstract
The identification and genetic sequencing of a novel coronavirus was key to the diagnosis and management of the global pandemic. An understanding of the SARS-CoV-2 structure and mechanism of injury is vital to explaining the disease course and the pathophysiology of the signs and symptoms observed. This particularly as the presentation, disease course, and severity are noted to be highly variable. The role of the spike protein and angiotensin-converting enzyme 2 (ACE-2) receptor in immune response and viral entry provides great insight into current and future diagnostics and therapeutics. This article reviews the traditional diagnostic methods, which include molecular testing methods, antigen testing, and antibody testing. The gold standard for diagnosis of COVID-19 is reverse transcriptase polymerase chain reaction (RT-PCR). There have been multiple improvements to these principles to help optimize the sensitivity, specificity, and user friendliness of the method. In addition, advancements in gene sequencing and identification have been integral to identifying variants and managing outbreaks. Serological and immunological testing have made significant contributions to the management of the COVID-19 pandemic, each with its unique benefits and limitations. A growing role of the laboratory is in triaging patients to determine which patients will most benefit from hospitalization and specialized care. This is imperative for rationalizing resources during outbreaks. As we learn to live with the pandemic, novel testing methods include the use of multiomic technologies and the greater utility of point of care.
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Affiliation(s)
- Chemedzai Chikomba
- Department of Chemical Pathology. National Health Laboratory Services and University of Witwatersrand, Johannesburg, South Africa
| | - Siphelele Dlamini
- Department of Chemical Pathology. National Health Laboratory Services and University of Witwatersrand, Johannesburg, South Africa
| | - Jaya A George
- Wits Diagnostic and Innovation Hub, University of Witwatersrand, Johannesburg, South Africa.
| | - Taryn Pillay
- Department of Chemical Pathology. National Health Laboratory Services and University of Witwatersrand, Johannesburg, South Africa
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Li Z, Pan H, Yang J, Chen D, Wang Y, Zhang H, Cheng Y. Xuanfei Baidu formula alleviates impaired mitochondrial dynamics and activated NLRP3 inflammasome by repressing NF-κB and MAPK pathways in LPS-induced ALI and inflammation models. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2023; 108:154545. [PMID: 36423572 PMCID: PMC9643338 DOI: 10.1016/j.phymed.2022.154545] [Citation(s) in RCA: 27] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 10/23/2022] [Accepted: 11/07/2022] [Indexed: 05/06/2023]
Abstract
BACKGROUND Xuanfei Baidu Formula (XBF) is an effective traditional Chinese medicine (TCM) remedy for treating coronavirus disease 2019 (COVID-19) in China. This herbal medicine has shown effects in reducing clinical symptoms and shortening the average length of hospital stay for COVID-19 patients. Previous studies have demonstrated that XBF alleviates acute lung injury (ALI) by regulating macrophage-mediated immune inflammation, but the mechanisms of action remain elusive. PURPOSE This study aimed to evaluate the lung-protective and anti-inflammatory effects of XBF and its underlying mechanisms. METHODS Here, XBF's effects were investigated in an ALI mouse model induced by inhalation of atomized lipopolysaccharide (LPS). Besides, the LPS-induced inflammation model in RAW264.7 cells was used to clarify the underlying mechanisms of XBF against ALI. RESULTS Our results showed that XBF treatment alleviated LPS-induced lung injury, as evidenced by reduced histopathological changes, pulmonary alveoli permeability, fibrosis, and apoptosis in the lung tissues. In addition, inflammation was alleviated as shown by decreased levels of tumor necrosis factor (TNF)-α, interleukin (IL)-6, IL-1β in serum and bronchoalveolar lavage fluid (BALF), and reduced white blood cell (WBC) count in BALF. Furthermore, consistent with the in vivo assay, XBF inhibited LPS-induced inflammatory cytokines release and pro-inflammatory polarization in RAW264.7 cells. Mechanistically, XBF increased mitochondrial fusion by upregulating Mfn1 and attenuated NLRP3 inflammasome activation by repressing Casp11, respectively, to inhibit NF-κB and MAPK pathways, thus repressing pro-inflammatory macrophage polarization. CONCLUSION In this study, we demonstrate that XBF exerts anti-ALI and -inflammatory effects by recovering mitochondrial dynamics and reducing inflammasome activation, providing a biological illustration of the clinical efficacy of XBF in treating COVID-19 patients.
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Affiliation(s)
- Zhenhao Li
- College of Pharmaceutical Sciences, Zhejiang University, Hangzhou 310058, China; BoYu Intelligent Health Innovation Laboratory, Hangzhou 311121, China.
| | - Haitao Pan
- BoYu Intelligent Health Innovation Laboratory, Hangzhou 311121, China
| | - Jihong Yang
- College of Pharmaceutical Sciences, Zhejiang University, Hangzhou 310058, China; BoYu Intelligent Health Innovation Laboratory, Hangzhou 311121, China
| | - Dongjie Chen
- BoYu Intelligent Health Innovation Laboratory, Hangzhou 311121, China
| | - Yu Wang
- State Key Laboratory of Component-based Chinese Medicine, Tianjin 301617, China
| | - Han Zhang
- College of Pharmaceutical Sciences, Zhejiang University, Hangzhou 310058, China; Institute of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China.
| | - Yiyu Cheng
- College of Pharmaceutical Sciences, Zhejiang University, Hangzhou 310058, China; State Key Laboratory of Component-based Chinese Medicine, Tianjin 301617, China
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18
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Gill CJ, Mwananyanda L, MacLeod WB, Kwenda G, Pieciak RC, Etter L, Bridges D, Chikoti C, Chirwa S, Chimoga C, Forman L, Katowa B, Lapidot R, Lungu J, Matoba J, Mwinga G, Mubemba B, Mupila Z, Muleya W, Mwenda M, Ngoma B, Nakazwe R, Nzara D, Pawlak N, Pemba L, Saasa N, Simulundu E, Yankonde B, Thea DM. What is the prevalence of COVID-19 detection by PCR among deceased individuals in Lusaka, Zambia? A postmortem surveillance study. BMJ Open 2022; 12:e066763. [PMID: 36600354 PMCID: PMC9729848 DOI: 10.1136/bmjopen-2022-066763] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES To determine the prevalence of COVID-19 postmortem setting in Lusaka, Zambia. DESIGN A systematic, postmortem prevalence study. SETTING A busy, inner-city morgue in Lusaka. PARTICIPANTS We sampled a random subset of all decedents who transited the University Teaching Hospital morgue. We sampled the posterior nasopharynx of decedents using quantitative PCR. Prevalence was weighted to account for age-specific enrolment strategies. INTERVENTIONS Not applicable-this was an observational study. PRIMARY OUTCOMES Prevalence of COVID-19 detections by PCR. Results were stratified by setting (facility vs community deaths), age, demographics and geography and time. SECONDARY OUTCOMES Shifts in viral variants; causal inferences based on cycle threshold values and other features; antemortem testing rates. RESULTS From 1118 decedents enrolled between January and June 2021, COVID-19 was detected among 32.0% (358/1116). Roughly four COVID-19+ community deaths occurred for every facility death. Antemortem testing occurred for 52.6% (302/574) of facility deaths but only 1.8% (10/544) of community deaths and overall, only ~10% of COVID-19+ deaths were identified in life. During peak transmission periods, COVID-19 was detected in ~90% of all deaths. We observed three waves of transmission that peaked in July 2020, January 2021 and ~June 2021: the AE.1 lineage and the Beta and Delta variants, respectively. PCR signals were strongest among those whose deaths were deemed 'probably due to COVID-19', and weakest among children, with an age-dependent increase in PCR signal intensity. CONCLUSIONS COVID-19 was common among deceased individuals in Lusaka. Antemortem testing was rarely done, and almost never for community deaths. Suspicion that COVID-19 was the cause of deaths was highest for those with a respiratory syndrome and lowest for individuals <19 years.
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Affiliation(s)
- Christopher J Gill
- Department of Global Health, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Lawrence Mwananyanda
- Department of Global Health, Boston University School of Public Health, Boston, Massachusetts, USA
| | - William B MacLeod
- Department of Global Health, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Geoffrey Kwenda
- Biomedical Sciences, University of Zambia, Ridgeway Campus, Lusaka, Lusaka, Zambia
| | - Rachel C Pieciak
- Department of Global Health, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Lauren Etter
- Department of Global Health, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Daniel Bridges
- Program for Applied Technology in Health (PATH), Lusaka, Zambia
| | | | | | | | - Leah Forman
- Biostatistics and Epidemiology Data Analytics Center, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Ben Katowa
- Macha Research Trust, Choma, Southern Province, Zambia
| | - Rotem Lapidot
- Pediatric Infectious Diseases, Boston Medical Center, Brookline, Massachusetts, USA
| | | | - Japhet Matoba
- Macha Research Trust, Choma, Southern Province, Zambia
| | | | - Benjamin Mubemba
- Wildlife Sciences, The Copperbelt University, Kitwe, Copperbelt, Zambia
| | | | - Walter Muleya
- Biomedical Sciences, University of Zambia School of Veterinary Medicine, Lusaka, Lusaka, Zambia
| | - Mulenga Mwenda
- Program for Applied Technology in Health, Lusaka, Zambia
| | | | - Ruth Nakazwe
- Biomedical Sciences, University of Zambia University Teaching Hospital, Lusaka, Lusaka, Zambia
| | | | - Natalie Pawlak
- Tufts University School of Medicine, Boston, Massachusetts, USA
| | | | - Ngonda Saasa
- University of Zambia School of Veterinary Medicine, Lusaka, Zambia
| | | | | | - Donald M Thea
- Department of Global Health, Boston University School of Public Health, Boston, Massachusetts, USA
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19
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Feleke A, Gebrehiwot M, Kloos H, Embrandiri A, Daba C, Hassen S, Adane M. COVID-19 preventive practices and associated factors among high school and preparatory school students in Dessie City, Ethiopia. Front Public Health 2022; 10:1019584. [PMID: 36478718 PMCID: PMC9720378 DOI: 10.3389/fpubh.2022.1019584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 10/25/2022] [Indexed: 11/22/2022] Open
Abstract
Background As the COVID-19 pandemic continues to ravage the world, the most pretentious sector besides the economy is the education system. Ethiopia is not equipped with the infrastructure and facilities to provide online classes for students at all levels. Hence, all institutions were re-opened with mandatory infection prevention and control (IPC) protocols such as the use of face masks, physical distancing, shifts in classes, and routine hand washing practices with soap and water to restrict the spread of the virus. Nevertheless, there has been no monitoring and follow- up and there is no data on IPC compliance among school children in the country. The purpose of this study was to examine the COVID-19 preventive practices and their associated factors among high and preparatory school students in Dessie City, Ethiopia. Methods A cross-sectional study was carried out by using a pre-tested face-to-face applied structured questionnaire and direct observations from March 8 to March 20, 2021, in five high and preparatory schools in Dessie City. The sample size was proportionally allocated in each school based on the students' total number registered in the first academic semester, then stratified by grade level, and proportionally allocated to each grade and section. Finally, a simple random sampling method was used to select study participants. Variables with p-values < 0.25 in the bivariate logistic regression analysis were entered into the multivariate logistic regression model. Results This study involved 422 students with a response rate of 98.8%. The level of good preventive practices was 43.7%. After adjusting for covariates, female, positive attitudes, received IPC training and clear accessible sharing of information and feedback with parents, students and teachers were identified as predictors of good precaution practices. Conclusion The prevalence of good prevention practices for COVID-19 among students was relatively very low. Therefore, the Department of Health and Education of Dessie City and each school should implement environmental health programs and promote prevention practices in high schools and preparatory schools.
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Affiliation(s)
- Alelgne Feleke
- Department of Environmental Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Mesfin Gebrehiwot
- Department of Environmental Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Helmut Kloos
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, United States
| | - Asha Embrandiri
- Department of Environmental Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Chala Daba
- Department of Environmental Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Seada Hassen
- Department of Environmental Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Metadel Adane
- Department of Environmental Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
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20
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Aubourg MA, Bisimwa L, Bisimwa JC, Sanvura P, Williams C, Boroto R, Lunyelunye C, Timsifu J, Munyerenkana B, Endres K, Winch PJ, Bengehya J, Maheshe G, Cikomola C, Mwishingo A, George CM. A Qualitative Evaluation of COVID-19 Preventative Response Activities in South Kivu, Democratic Republic of the Congo. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13424. [PMID: 36294005 PMCID: PMC9603344 DOI: 10.3390/ijerph192013424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 09/21/2022] [Accepted: 10/11/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVE In this evaluation of COVID-19 preventative response programs in South Kivu, Democratic Republic of the Congo (DRC), we aimed to explore community understandings of COVID-19, assess operational successes and challenges of COVID response activities, and identify barriers to practicing COVID-19 preventative behaviors. METHODS Thirty-one semi-structured interviews were conducted from April to September 2021 in South Kivu, DRC, with community members (n = 16) and programmatic stakeholders (n = 15) (healthcare providers, government officials, and developmental and NGO staff engaged in COVID-19 response). FINDINGS Most community members were aware of COVID-19 and its global burden, but few were aware of local transmission in their area. Some community members attributed COVID-19 to actions of malevolent neighbors, miasma ("bad air"), or spirits. Awareness of COVID-19 preventative measures was widespread, largely because of radio and TV health promotion programs. Community members and programmatic stakeholders both said community-level non-compliance to COVID-19 preventative measures was high despite high awareness of preventative methods. Community members expressed concern that face masks distributed as part of preventative programs contained the COVID-19 virus. Programmatic stakeholders emphasized the need for broader health system strengthening with improved coordination, provision of resources to health facilities at the provincial level, and prioritization of research. Lessons learned from addressing Ebola were leveraged for COVID-19 health promotion, rapid training of healthcare personnel, and surveillance. CONCLUSIONS Community-informed approaches are needed for effective COVID-19 preventative response programs in South Kivu, DRC. Our study identified successes and challenges in COVID-19 response activities. Future research should assess the effectiveness of integrating preventive programs with COVID-19 vaccination efforts.
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Affiliation(s)
- Matthew A. Aubourg
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Lucien Bisimwa
- Center for Tropical Diseases & Global Health, Université Catholique de Bukavu, Bukavu B.P 265, Democratic Republic of the Congo
| | - Jean Claude Bisimwa
- Center for Tropical Diseases & Global Health, Université Catholique de Bukavu, Bukavu B.P 265, Democratic Republic of the Congo
| | - Presence Sanvura
- Center for Tropical Diseases & Global Health, Université Catholique de Bukavu, Bukavu B.P 265, Democratic Republic of the Congo
| | - Camille Williams
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Raissa Boroto
- Center for Tropical Diseases & Global Health, Université Catholique de Bukavu, Bukavu B.P 265, Democratic Republic of the Congo
| | - Claude Lunyelunye
- Center for Tropical Diseases & Global Health, Université Catholique de Bukavu, Bukavu B.P 265, Democratic Republic of the Congo
| | - Jessy Timsifu
- Center for Tropical Diseases & Global Health, Université Catholique de Bukavu, Bukavu B.P 265, Democratic Republic of the Congo
| | - Brigitte Munyerenkana
- Center for Tropical Diseases & Global Health, Université Catholique de Bukavu, Bukavu B.P 265, Democratic Republic of the Congo
| | - Kelly Endres
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Peter J. Winch
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Justin Bengehya
- Bureau de l’Information Sanitaire, Surveillance Epidémiologique et Recherche Scientifique, Division Provinciale de la Santé Sud Kivu, Ministère de la Santé, Bukavu B.P 265, Democratic Republic of the Congo
| | - Ghislain Maheshe
- Faculty of Medicine, Université Catholique de Bukavu, Bukavu B.P 265, Democratic Republic of the Congo
| | - Cirhuza Cikomola
- Center for Tropical Diseases & Global Health, Université Catholique de Bukavu, Bukavu B.P 265, Democratic Republic of the Congo
- Faculty of Medicine, Université Catholique de Bukavu, Bukavu B.P 265, Democratic Republic of the Congo
| | - Alain Mwishingo
- Center for Tropical Diseases & Global Health, Université Catholique de Bukavu, Bukavu B.P 265, Democratic Republic of the Congo
| | - Christine Marie George
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
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21
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Dobreva Z, Gimma A, Rohan H, Djoudalbaye B, Tshangela A, Jarvis CI, van Zandvoort K, Quaife M. Characterising social contacts under COVID-19 control measures in Africa. BMC Med 2022; 20:344. [PMID: 36221094 PMCID: PMC9553295 DOI: 10.1186/s12916-022-02543-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Accepted: 08/26/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Early in the COVID-19 pandemic, countries adopted non-pharmaceutical interventions (NPIs) such as lockdowns to limit SARS-CoV-2 transmission. Social contact studies help measure the effectiveness of NPIs and estimate parameters for modelling SARS-CoV-2 transmission. However, few contact studies have been conducted in Africa. METHODS We analysed nationally representative cross-sectional survey data from 19 African Union Member States, collected by the Partnership for Evidence-based Responses to COVID-19 (PERC) via telephone interviews at two time points (August 2020 and February 2021). Adult respondents reported contacts made in the previous day by age group, demographic characteristics, and their attitudes towards COVID-19. We described mean and median contacts across these characteristics and related contacts to Google Mobility reports and the Oxford Government Response Stringency Index for each country at the two time points. RESULTS Mean reported contacts varied across countries with the lowest reported in Ethiopia (9, SD=16, median = 4, IQR = 8) in August 2020 and the highest in Sudan (50, SD=53, median = 33, IQR = 40) in February 2021. Contacts of people aged 18-55 represented 50% of total contacts, with most contacts in household and work or study settings for both surveys. Mean contacts increased for Ethiopia, Ghana, Liberia, Nigeria, Sudan, and Uganda and decreased for Cameroon, the Democratic Republic of Congo (DRC), and Tunisia between the two time points. Men had more contacts than women and contacts were consistent across urban or rural settings (except in Cameroon and Kenya, where urban respondents had more contacts than rural ones, and in Senegal and Zambia, where the opposite was the case). There were no strong and consistent variations in the number of mean or median contacts by education level, self-reported health, perceived self-reported risk of infection, vaccine acceptance, mask ownership, and perceived risk of COVID-19 to health. Mean contacts were correlated with Google mobility (coefficient 0.57, p=0.051 and coefficient 0.28, p=0.291 in August 2020 and February 2021, respectively) and Stringency Index (coefficient -0.12, p = 0.304 and coefficient -0.33, p=0.005 in August 2020 and February 2021, respectively). CONCLUSIONS These are the first COVID-19 social contact data collected for 16 of the 19 countries surveyed. We find a high reported number of daily contacts in all countries and substantial variations in mean contacts across countries and by gender. Increased stringency and decreased mobility were associated with a reduction in the number of contacts. These data may be useful to understand transmission patterns, model infection transmission, and for pandemic planning.
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Affiliation(s)
- Zlatina Dobreva
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK.
| | - Amy Gimma
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Hana Rohan
- UK Public Health Rapid Support Team, London School of Hygiene and Tropical Medicine, London, UK
| | | | - Akhona Tshangela
- Africa Centres for Disease Control and Prevention, Addis Ababa, Ethiopia
| | - Christopher I Jarvis
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Kevin van Zandvoort
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Matthew Quaife
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
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22
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Lucien MAB, Pierre K, Jean-Denis G, Rigodon J, Worrell CM, Couture A, Flynn A, Calderon MC, Codina LF, Vicari AS, Marseille S, Jean Baptiste KT, Fouche B, Joseph G, Journel I, Rendel K, Grant-Greene Y, Jean-Charles NP, Lafontant D, Amouzou S, Pierre W, Clement MGR, Juin S, Boncy J, Dely P. Epidemiology and risk factors related to severity of clinical manifestations of COVID-19 in outpatients: A retrospective study in Haiti. PLoS One 2022; 17:e0274760. [PMID: 36129879 PMCID: PMC9491605 DOI: 10.1371/journal.pone.0274760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 09/05/2022] [Indexed: 11/19/2022] Open
Abstract
Background Haiti’s first COVID-19 cases were confirmed on March 18, 2020, and subsequently spread throughout the country. The objective of this study was to describe clinical manifestations of COVID-19 in Haitian outpatients and to identify risk factors for severity of clinical manifestations. Methods We conducted a retrospective study of COVID-19 outpatients diagnosed from March 18-August 4, 2020, using demographic, epidemiological, and clinical data reported to the Ministry of Health (MoH). We used univariate and multivariate analysis, including multivariable logistic regression, to explore the risk factors and specific symptoms related to persons with symptomatic COVID-19 and the severity of symptomatic COVID-19 disease. Results Of 5,389 cases reported to MOH during the study period, 1,754 (32.5%) were asymptomatic. Amongst symptomatic persons 2,747 (75.6%) had mild COVID-19 and 888 (24.4%) had moderate-to-severe disease; the most common symptoms were fever (69.6%), cough (51.9%), and myalgia (45.8%). The odds of having moderate-to-severe disease were highest among persons with hypertension (aOR = 1.72, 95% Confidence Interval [CI] (1.34, 2.20), chronic pulmonary disease (aOR = 3.93, 95% CI (1.93, 8.17)) and tuberculosis (aOR = 3.44, 95% CI (1.35, 9.14)) compared to persons without those conditions. The odds of having moderate-to-severe disease increased with age but was also seen among children aged 0–4 years (OR: 1.73, 95% CI (0.93, 3.08)), when using 30–39 years old as the reference group. All of the older age groups, 50–64 years, 65–74 years, 75–84 years, and 85+ years, had significantly higher odds of having moderate-to-severe COVID-19 compared with ages 30–39 years. Diabetes was associated with elevated odds of moderate-to-severe disease in bivariate analysis (OR = 2.17, 95% CI (1.58,2.98) but, this association did not hold in multivariable analyses (aOR = 1.22,95%CI (0.86,1.72)). Conclusion These findings from a resource-constrained country highlight the importance of surveillance systems to track emerging infections and their risk factors. In addition to co-morbidities described elsewhere, tuberculosis was a risk factor for moderate-to-severe COVID-19 disease.
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Affiliation(s)
- Mentor Ali Ber Lucien
- National Public Health Laboratory (LNSP)/ Ministry of Public Health and Population (MSPP), Port au Prince, Haiti
| | - Katilla Pierre
- Directorate of Epidemiology, Laboratories and Research (DELR)/MSPP, Port au Prince, Haiti
| | - Gladzdin Jean-Denis
- Pan American Health Organization, World Health Organization (PAHO/WHO), Port-au-Prince, Haiti
| | - Jonas Rigodon
- U.S. Centers for Disease Control and Prevention, Port-au-Prince, Haiti
- * E-mail:
| | - Caitlin M. Worrell
- Division of Parasitic Diseases and Malaria, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Alexia Couture
- COVID-19 International Task Force Emergency Response Capacity Team, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Aspen Flynn
- COVID-19 International Task Force Emergency Response Capacity Team, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Mauricio Cerpa Calderon
- Pan American Health Organization, World Health Organization (PAHO/WHO), Port-au-Prince, Haiti
| | - Luis Felipe Codina
- Pan American Health Organization, World Health Organization (PAHO/WHO), Port-au-Prince, Haiti
| | - Andrea S. Vicari
- Pan American Health Organization, World Health Organization (PAHO/WHO), Washington, DC, United States of America
| | - Samson Marseille
- Directorate of Epidemiology, Laboratories and Research (DELR)/MSPP, Port au Prince, Haiti
| | | | | | - Gerard Joseph
- National Public Health Laboratory (LNSP)/ Ministry of Public Health and Population (MSPP), Port au Prince, Haiti
| | - Ito Journel
- National Public Health Laboratory (LNSP)/ Ministry of Public Health and Population (MSPP), Port au Prince, Haiti
| | - Kenold Rendel
- Directorate of Epidemiology, Laboratories and Research (DELR)/MSPP, Port au Prince, Haiti
| | | | | | - Donald Lafontant
- Directorate of Epidemiology, Laboratories and Research (DELR)/MSPP, Port au Prince, Haiti
| | - Senou Amouzou
- Directorate of Epidemiology, Laboratories and Research (DELR)/MSPP, Port au Prince, Haiti
| | - Wilnique Pierre
- Directorate of Epidemiology, Laboratories and Research (DELR)/MSPP, Port au Prince, Haiti
| | | | - Stanley Juin
- U.S. Centers for Disease Control and Prevention, Port-au-Prince, Haiti
| | - Jacques Boncy
- National Public Health Laboratory (LNSP)/ Ministry of Public Health and Population (MSPP), Port au Prince, Haiti
| | - Patrick Dely
- Directorate of Epidemiology, Laboratories and Research (DELR)/MSPP, Port au Prince, Haiti
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23
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Njau A, Kimeu J, Gohil J, Nganga D. Informing healthcare operations with integrated pathology, clinical, and epidemiology data: Lessons from a single institution in Kenya during COVID-19 waves. Front Med (Lausanne) 2022; 9:969640. [PMID: 36148453 PMCID: PMC9485835 DOI: 10.3389/fmed.2022.969640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 08/01/2022] [Indexed: 11/20/2022] Open
Abstract
Pathology, clinical care teams, and public health experts often operate in silos. We hypothesized that large data sets from laboratories when integrated with other healthcare data can provide evidence that can be used to optimize planning for healthcare needs, often driven by health-seeking or delivery behavior. From the hospital information system, we extracted raw data from tests performed from 2019 to 2021, prescription drug usage, and admission patterns from pharmacy and nursing departments during the COVID-19 pandemic in Kenya (March 2020 to December 2021). Proportions and rates were calculated. Regression models were created, and a t-test for differences between means was applied for monthly or yearly clustered data compared to pre-COVID-19 data. Tests for malaria parasite, Mycobacterium tuberculosis, rifampicin resistance, blood group, blood count, and histology showed a statistically significant decrease in 2020, followed by a partial recovery in 2021. This pattern was attributed to restrictions implemented to control the spread of COVID-19. On the contrary, D-dimer, fibrinogen, CRP, and HbA1c showed a statistically significant increase (p-value <0.001). This pattern was attributed to increased utilization related to the clinical management of COVID-19. Prescription drug utilization revealed a non-linear relationship to the COVID-19 positivity rate. The results from this study reveal the expected scenario in the event of similar outbreaks. They also reveal the need for increased efforts at diabetes and cancer screening, follow-up of HIV, and tuberculosis patients. To realize a broader healthcare impact, pathology departments in Africa should invest in integrated data analytics, for non-communicable diseases as well.
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Affiliation(s)
- Allan Njau
- Department of Pathology and Laboratory Medicine, Aga Khan University Hospital, Nairobi, Kenya
| | - Jemimah Kimeu
- Department of Nursing, Aga Khan University Hospital, Nairobi, Kenya
| | - Jaimini Gohil
- Department of Pharmacy and Therapeutics, Aga Khan University Hospital, Nairobi, Kenya
| | - David Nganga
- Department of Nursing, Aga Khan University Hospital, Nairobi, Kenya
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24
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Maccaro A, Piaggio D, Vignigbé M, Stingl A, Pecchia L. COVID-19 preparedness and social dynamics in a Sub-Saharan Africa country, Benin. Health Promot Int 2022; 37:6674369. [PMID: 36000532 PMCID: PMC9400093 DOI: 10.1093/heapro/daac105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
This project aims to assess and analyse the perception and impact of the COVID-19 pandemic in Benin. The applied research methodology was interdisciplinary and combined field studies that used ethnographic and social research methods with coding and data analysis, leading to theoretical dilemmas, which were analysed from the viewpoint of bioethical reflection. Furthermore, biomedical engineering approaches were used to assess the preparedness to COVID-19. Despite the preparedness to COVID-19 due to the promoted governmental measures, a peculiar management of the pandemic emerged. The latter, although noteworthy, did not overcome the typical challenges of medical locations in low-resource settings. This, together with the controversial spread of information and local beliefs, caused significant economic and social consequences, exceeding the benefits related to the containment of the virus. This research highlights how the emotion of fear, in this specific situation, was herald of dramatic consequences, rather than having a heuristic and empowering effect.
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Affiliation(s)
- Alessia Maccaro
- School of Engineering, University of Warwick, Library Road, CV47AL Coventry, UK.,Institute of Advanced Studies, University of Warwick, Library Road, CV47AL Coventry, UK
| | - Davide Piaggio
- School of Engineering, University of Warwick, Library Road, CV47AL Coventry, UK
| | - Marius Vignigbé
- Département de Sociologie-Anthropologie, University of Abomey-Calavi, Abomey-Calavi, Benin
| | - Alexander Stingl
- Institute of Advanced Studies, University of Warwick, Library Road, CV47AL Coventry, UK
| | - Leandro Pecchia
- School of Engineering, University of Warwick, Library Road, CV47AL Coventry, UK.,School of Engineering, Università Campus Bio-Medico di Roma, Via Álvaro del Portillo, Roma, Italy
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25
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Igyártó BZ. "Don't Look Up" Your Science-Herd Immunity or Herd Mentality? Microorganisms 2022; 10:1463. [PMID: 35889182 PMCID: PMC9316410 DOI: 10.3390/microorganisms10071463] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 06/02/2022] [Accepted: 06/03/2022] [Indexed: 11/17/2022] Open
Abstract
This analysis piece will attempt to examine some of the critical pandemic-related measures implemented in the United States from an immunological perspective and pinpoint caveats that should have been considered before their implementation. I also discuss alternative measures grounded in scientific data that were not thoroughly explored and likely could have helped fight the pandemic.
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Affiliation(s)
- Botond Z Igyártó
- Department of Microbiology and Immunology, Thomas Jefferson University, Philadelphia, PA 19107, USA
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26
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Commentary on COVID-19 Vaccine Hesitancy in sub-Saharan Africa. Trop Med Infect Dis 2022; 7:tropicalmed7070130. [PMID: 35878142 PMCID: PMC9318427 DOI: 10.3390/tropicalmed7070130] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 07/01/2022] [Accepted: 07/03/2022] [Indexed: 11/23/2022] Open
Abstract
Rates of vaccination against COVID-19 remain lower in sub-Saharan Africa than in other low and middle-income regions. This is, in part, attributed to vaccine hesitancy, mainly due to misinformation about vaccine origin, efficacy and safety. From August to December 2021, we gathered the latest experiences and opinions on four vaccine hesitancy-related areas (policies, perceived risk religious beliefs, and misinformation) from 12 sub-Saharan African researchers, four of whom have published about COVID-19 vaccine hesitancy. The authors included two political and business experts, six public health specialists, five epidemiologists, and four biostatisticians from ten sub-Saharan African countries( Cameroon, Ghana, Kenya, Liberia, Nigeria, Sierra Leone, South Africa, Tanzania, Uganda, and Zimbabwe). The authors’ overarching opinions were that political influences, religious beliefs and low perceived risk exists in sub-Saharan Africa, and they collectively contribute to COVID-19 vaccine hesitancy. Communication strategies should target populations initially thought by policy makers to be at low risk, use multiple communication avenues and address major concerns in the population.
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Nshimyiryo A, Barnhart DA, Kateera F, Mazimpaka C, Niyigena A, Ngoga G, Uwamahoro P, Galaris J, Gato S, Umugisha JP, Nahimana E, Cubaka VK, Umutesi G. Low COVID-19–related knowledge and access to adequate handwashing among patients with chronic diseases in rural Rwanda: a cross-sectional survey. JOURNAL OF GLOBAL HEALTH REPORTS 2022. [DOI: 10.29392/001c.36464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Background The coronavirus disease 2019 (COVID-19) misinformation and inadequate access to hygiene and sanitation amenities could hamper efforts to contain COVID-19 spread in resource-limited settings. In this study, we describe knowledge of COVID-19 symptoms and preventive measures, sources of information, and access to adequate handwashing among patients with chronic diseases in three Rwandan rural districts during the onset of COVID-19 in Rwanda. Methods This was a cross-sectional survey conducted among patients who were enrolled in the HIV/AIDS, non-communicable diseases, mental health, oncology, and pediatric development programs at health facilities in Kayonza, Kirehe and Burera districts. The study sample was randomly selected and stratified by district and clinical program. Telephone-based data collection occurred between 23 April and 11 May 2020. Primary caregivers responded to the survey when the selected patient was a child under age 18 or severely ill. We defined good knowledge of COVID-19 symptoms and preventive measures as knowing that a dry cough and fever were common symptoms and social distancing or staying home and regular handwashing could prevent COVID-19 infection. Access to adequate handwashing was defined as living in a household with a handwashing station and regular access to clean water and soap. We used Fisher’s exact tests and logistic regression to measure associations between the source of information and good knowledge about COVID-19 and between socio-economic characteristics and access to adequate handwashing. Results In total, 150 patients and 70 caregivers responded to the survey. Forty-eight (22.3%) respondents had no formal education. Sources of COVID-19 information included mass media (86.8%), local government leaders (27.3%), healthcare workers (15.9%) and social media (6.8%). Twenty-seven percent (n=59) of respondents had good knowledge of COVID-19 symptoms and preventive measures. In the adjusted analysis, getting information from news media was associated with having good knowledge about COVID-19 (adjusted odds ratio, aOR: 5.46; 95% CI: 1.43-20.75]. Seventy-nine (35.9%) respondents reported access to adequate handwashing at home, with access varying significantly by the district in favour of Kayonza (61.3%). Conclusions COVID-19-related knowledge and access to adequate handwashing were low among patients with chronic diseases at the beginning of the pandemic in Rwanda. Efforts to mitigate COVID-19 spread among chronic care populations may include investment in targeted COVID-19-related education and access to adequate handwashing.
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Affiliation(s)
| | - Dale A. Barnhart
- Research and Training, Partners In Health/Inshuti Mu Buzima (PIH/IMB); Department of Global Health and Social Medicine, Harvard Medical School
| | | | | | | | | | | | | | | | | | | | | | - Grace Umutesi
- Partners In Health/Inshuti Mu Buzima (PIH/IMB); Department of Global Health, University of Washington
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28
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Moser W, Fahal MAH, Abualas E, Bedri S, Elsir MT, Mohamed MFERO, Mahmoud AB, Ahmad AII, Adam MA, Altalib S, DafaAllah OA, Hmed SA, Azman AS, Ciglenecki I, Gignoux E, González A, Mwongera C, Miranda MA. SARS-CoV-2 Antibody Prevalence and Population-Based Death Rates, Greater Omdurman, Sudan. Emerg Infect Dis 2022; 28:1026-1030. [PMID: 35450565 PMCID: PMC9045432 DOI: 10.3201/eid2805.211951] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
In a cross-sectional survey in Omdurman, Sudan, during March–April 2021, we estimated that 54.6% of the population had detectable severe acute respiratory syndrome coronavirus 2 antibodies. Overall population death rates among those >50 years of age increased 74% over the first coronavirus disease pandemic year.
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29
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Ogunjo ST, Fuwape IA, Rabiu AB. Predicting COVID-19 Cases From Atmospheric Parameters Using Machine Learning Approach. GEOHEALTH 2022; 6:e2021GH000509. [PMID: 35415381 PMCID: PMC8983058 DOI: 10.1029/2021gh000509] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 02/06/2022] [Accepted: 02/28/2022] [Indexed: 06/14/2023]
Abstract
The dynamical nature of COVID-19 cases in different parts of the world requires robust mathematical approaches for prediction and forecasting. In this study, we aim to (a) forecast future COVID-19 cases based on past infections, (b) predict current COVID-19 cases using PM2.5, temperature, and humidity data, using four different machine learning classifiers (Decision Tree, K-nearest neighbor, Support Vector Machine, and Random Forest). Based on RMSE values, k-nearest neighbor and support vector machine algorithms were found to be the best for predicting future incidences of COVID-19 based on past histories. From the RMSE values obtained, temperature was found to be the best predictor for number of COVID-19 cases, followed by relative humidity. Decision tree models was found to perform poorly in the prediction of COVID-19 cases considering particulate matter and atmospheric parameters as predictors. Our results suggests the possibility of predicting virus infection using machine learning. This will guide policy makers in proactive monitoring and control.
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Affiliation(s)
- S. T. Ogunjo
- Department of PhysicsFederal University of Technology AkureAkureNigeria
| | - I. A. Fuwape
- Department of PhysicsFederal University of Technology AkureAkureNigeria
- Office of the Vice ChancellorMichael and Cecilia Ibru UniversityUghelliNigeria
| | - A. B. Rabiu
- Centre for Atmospheric ResearchNational Space and Research Development AgencyAnyigbaNigeria
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30
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Kohler IV, Kämpfen F, Ciancio A, Mwera J, Mwapasa V, Kohler HP. Curtailing Covid-19 on a dollar-a-day in Malawi: Role of community leadership for shaping public health and economic responses to the pandemic. WORLD DEVELOPMENT 2022; 151:105753. [PMID: 34848913 PMCID: PMC8612821 DOI: 10.1016/j.worlddev.2021.105753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 11/12/2021] [Indexed: 06/13/2023]
Abstract
Utilizing population-based data from the Covid-19 phone survey ( N = 2 , 262 ) of the Malawi Longitudinal Study of Families and Health (MLSFH) collected during June 2nd-August 17th, 2020, we focus on the crucial role that community leadership and trust in institutions played in shaping behavioral, economic and social responses to Covid-19 in this low-income sub-Saharan African context. We argue that the effective response of Malawi to limit the spread of the virus was facilitated by the engagement of local leadership to mobilize communities to adapt and adhere to Covid-19 prevention strategies. Using linear and ordered probit models and controlling for time fixed effects, we show that village heads (VHs) played pivotal role in shaping individuals' knowledge about the pandemic and the adoption of preventive health behaviors and were crucial for mitigating the negative economic and health consequences of the pandemic. We further show that trust in institutions is of particular importance in shaping individuals' behavior during the pandemic, and these findings highlight the pivotal role of community leadership in fostering better compliance and adoption of public health measures essential to contain the virus. Overall, our findings point to distinctive patterns of pandemic response in a low-income sub-Saharan African rural population that emphasized local leadership as mediators of public health messages and policies. These lessons from the first pandemic wave remain relevant as in many low-income countries behavioral responses to Covid-19 will remain the primary prevention strategy for a foreseeable future.
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Affiliation(s)
- Iliana V Kohler
- Population Studies Center, University of Pennsylvania, Philadelphia, PA, USA
- Population Aging Research Center, University of Pennsylvania, Philadelphia, PA, USA
| | - Fabrice Kämpfen
- Population Studies Center, University of Pennsylvania, Philadelphia, PA, USA
- School of Economics, University College Dublin, Ireland
| | - Alberto Ciancio
- Population Studies Center, University of Pennsylvania, Philadelphia, PA, USA
- Adam Smith Business School, University of Glasgow, UK
| | - James Mwera
- Invest in Knowledge Initiative (IKI), Zomba, Malawi
| | | | - Hans-Peter Kohler
- Population Aging Research Center, University of Pennsylvania, Philadelphia, PA, USA
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31
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van Rooyen C, Brauer M, Swanepoel P, van den Berg S, van der Merwe C, van der Merwe M, Green R, Becker P. Comparison of T-cell immune responses to SARS-CoV-2 spike (S) and nucleocapsid (N) protein using an in-house flow-cytometric assay in laboratory employees with and without previously confirmed COVID-19 in South Africa: nationwide cross-sectional study. J Clin Pathol 2022; 76:384-390. [PMID: 35039453 PMCID: PMC8783969 DOI: 10.1136/jclinpath-2021-207556] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 12/06/2021] [Indexed: 12/13/2022]
Abstract
AIMS To compare specific T-cell responses between laboratory employees in South Africa with and without previously diagnosed SARS-CoV-2 infection. METHODS Employees at a private pathology laboratory in South Africa were invited to participate in a nationwide cross-sectional study. T-cell proliferation to SARS-CoV-2 nucleocapsid (N)-proteins and spike (S)-proteins was measured by flow cytometry and compared between participants. RESULTS Based on classification according to SARS-CoV-2 reverse transcription (RT)-PCR results, a total of 81% (42/52) of positive participants demonstrated T-cell proliferation to SARS-CoV-2 N-proteins or S-proteins (95% CI 67.5% to 90.4%), while 62% (68/110) of negative participants also had detectable T-cell responses to SARS-CoV-2 proteins (95% CI 52.1% to 70.9%). When classified according to SARS-CoV-2 serology results, 92.6% (50/54) of positive participants demonstrated T-cell proliferation to SARS-CoV-2 proteins (95% CI 82.1 to 97,9 %), while 56% (60/108) of negative participants demonstrated T-cell proliferation (95% CI 45.7% to 65.1%). The magnitude of the T-cell responses as determined by a stimulation index, was significantly higher in the group previously infected by SARS-CoV-2 than in the negative group. A statistically significant difference in T-cell proliferation was noted between high risk and low risk groups for exposure to SARS-CoV-2 within the negative group, but no significant difference in magnitude of the response. CONCLUSIONS A significant proportion of South African laboratory employees who were not previously diagnosed with COVID-19 demonstrated T-cell reactivity to SARS-CoV-2 N-proteins and S-proteins. The pre-existing T-cell proliferation responses may be attributable to cross-reactive immune responses to other human coronaviruses, or possibly asymptomatic infection.
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Affiliation(s)
- Cathrine van Rooyen
- Immunology, Ampath Laboratories, Centurion, Gauteng, South Africa .,Paediatrics and Child Health, University of Pretoria Faculty of Health Sciences, Pretoria, Gauteng, South Africa
| | - Marieke Brauer
- Immunology, Ampath Laboratories, Centurion, Gauteng, South Africa
| | - Petri Swanepoel
- Immunology, Ampath Laboratories, Centurion, Gauteng, South Africa
| | | | | | | | - Robin Green
- Paediatrics and Child Health, University of Pretoria Faculty of Health Sciences, Pretoria, Gauteng, South Africa
| | - Piet Becker
- Research Office, University of Pretoria Faculty of Health Sciences, Pretoria, Gauteng, South Africa.,Biostatistics Unit, South African Medical Research Council, Pretoria, Gauteng, South Africa
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Muhaidat J, Albatayneh A, Abdallah R, Papamichael I, Chatziparaskeva G. Predicting COVID-19 future trends for different European countries using Pearson correlation. EURO-MEDITERRANEAN JOURNAL FOR ENVIRONMENTAL INTEGRATION 2022; 7:157-170. [PMID: 35578685 PMCID: PMC9096068 DOI: 10.1007/s41207-022-00307-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 04/21/2022] [Indexed: 05/10/2023]
Abstract
The ability to accurately forecast the number of COVID-19 cases and future case trends would certainly assist governments and various organisations in strategising and preparing for the newly infected cases well in advance. Many predictions have failed to foresee future COVID-19 cases due to the lack of reliable data; however, such data are now widely available for predicting future trends in COVID-19 after more than one and a half years of the pandemic. Also, various countries are closely monitoring other countries that are experiencing a surge in COVID-19 cases in the expectation of similar scenarios, but this does not always produce correct results, as no research has identified specific correlations between different countries in terms of COVID-19 cases. During the past 18 months, many nations have watched countries whose COVID-19 cases have risen sharply, in anticipation of handling the situation themselves. However, this did not provide accurate results, as no research was conducted that compared countries to determine if their COVID-19 case trends were correlated. As official data on COVID-19 cases has become increasingly available, using the Pearson correlation technique to pinpoint the countries that should be closely monitored will help governments plan and prepare for the number of infections that are expected in the future at an early stage. In this study, a simple and real-time prediction of COVID-19 cases incorporating existing variables of coronavirus variants was used to explore the correlation among different European countries in terms of the number of COVID-19 cases officially recorded on a daily basis. Data from selected countries over the past 76 weeks were analysed using a Pearson correlation technique to determine if there were correlations between case trends and geographical position. The correlation coefficient (r) was employed for identifying whether the different countries in Europe were interrelated, with r > 0.85 indicating they were very strongly correlated, 0.85 > r > 0.8 indicating that they were strongly correlated, 0.8 > r > 0.7 indicating that they were moderately correlated, and r < 0.7 indicating that the examined countries were either weakly correlated or that a correlation did not exist. The results showed that although some neighbouring countries are strongly correlated, other countries that are not geographically close are also correlated. In addition, some countries on opposite sides of Europe (Belgium and Armenia) are also correlated. Other countries (France, Iceland, Israel, Kosovo, San Marino, Spain, Sweden and Turkey) were either weakly correlated or had no relationship at all.
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Affiliation(s)
- Jihan Muhaidat
- Department of Dermatology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, 22110 Jordan
| | - Aiman Albatayneh
- Energy Engineering Department, School of Natural Resources Engineering and Management, German Jordanian University, P.O. Box 35247, Amman, 11180 Jordan
| | - Ramez Abdallah
- Mechanical and Mechatronics Engineering Department, Faculty of Engineering and Information Technology, An-Najah National University, P.O. Box 7, Nablus, Palestine
| | - Iliana Papamichael
- Lab of Chemical Engineering and Engineering Sustainability, Faculty of Pure and Applied Sciences, Open University of Cyprus, Giannou Kranidioti 33, 2220 Nicosia, Cyprus
| | - Georgia Chatziparaskeva
- Lab of Chemical Engineering and Engineering Sustainability, Faculty of Pure and Applied Sciences, Open University of Cyprus, Giannou Kranidioti 33, 2220 Nicosia, Cyprus
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Gignoux E, Athanassiadis F, Garat Yarrow A, Jimale A, Mubuto N, Déglise C, Onsongo Mosoti D, Azman AS, Mwau M, Luquero F, Ciglenecki I. Seroprevalence of SARS-CoV-2 antibodies and retrospective mortality in a refugee camp, Dagahaley, Kenya. PLoS One 2021; 16:e0260989. [PMID: 34919545 PMCID: PMC8683031 DOI: 10.1371/journal.pone.0260989] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 11/19/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Camps of forcibly displaced populations are considered to be at risk of large COVID-19 outbreaks. Low screening rates and limited surveillance led us to conduct a study in Dagahaley camp, located in the Dadaab refugee complex in Kenya to estimate SARS-COV-2 seroprevalence and, mortality and to identify changes in access to care during the pandemic. METHODS To estimate seroprevalence, a cross-sectional survey was conducted among a sample of individuals (n = 587) seeking care at the two main health centres and among all household members (n = 619) of community health workers and traditional birth attendants working in the camp. A rapid immunologic assay was used (BIOSYNEX® COVID-19 BSS [IgG/IgM]) and adjusted for test performance and mismatch between the sampled population and that of the general camp population. To estimate mortality, all households (n = 12860) were exhaustively interviewed in the camp about deaths occurring from January 2019 through March 2021. RESULTS In total 1206 participants were included in the seroprevalence study, 8% (95% CI: 6.6%-9.7%) had a positive serologic test. After adjusting for test performance and standardizing on age, a seroprevalence of 5.8% was estimated (95% CI: 1.6%-8.4%). The mortality rate for 10,000 persons per day was 0.05 (95% CI 0.05-0.06) prior to the pandemic and 0.07 (95% CI 0.06-0.08) during the pandemic, representing a significant 42% increase (p<0.001). Médecins Sans Frontières health centre consultations and hospital admissions decreased by 38% and 37% respectively. CONCLUSION The number of infected people was estimated 67 times higher than the number of reported cases. Participants aged 50 years or more were among the most affected. The mortality survey shows an increase in the mortality rate during the pandemic compared to before the pandemic. A decline in attendance at health facilities was observed and sustained despite the easing of restrictions.
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Affiliation(s)
| | | | | | | | | | | | | | - Andrew S. Azman
- Médecins Sans Frontières, Geneva, Switzerland
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
- Institute for Global Health, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Matilu Mwau
- Kenya Medical Research Institute, Nairobi, Kenya
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González-Rodríguez R. Spread of COVID-19 cases in Africa. Letter to the Director to collation of the article: Why is the COVID-19 epidemic in Africa less “intense”? REVISTA ESPAÑOLA DE ANESTESIOLOGÍA Y REANIMACIÓN (ENGLISH EDITION) 2021; 68:607-608. [PMID: 34840100 PMCID: PMC8614226 DOI: 10.1016/j.redare.2021.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 01/26/2021] [Indexed: 12/05/2022]
Affiliation(s)
- R González-Rodríguez
- Consultante en anestesia y salud pública para la Organización Mundial de la Salud en Mauritania, Barcelona, Spain.
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Rothschild N. Does Fecal-Oral Transmission of SARS-CoV-2 Due to Low Sanitation Conditions Contribute to Low Mortality Rates From COVID-19. Cureus 2021; 13:e18557. [PMID: 34754698 PMCID: PMC8571565 DOI: 10.7759/cureus.18557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/04/2021] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND The novel coronavirus disease 2019 (COVID-19) is a global pandemic generated by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The primary infection site is mucosal surfaces, mainly the lungs and the intestine, where epithelial cells can be infected. COVID-19 has spread throughout the world, causing millions of deaths and hundreds of millions of confirmed infections. Despite the global spread of SARS-CoV-2, there are extreme differences between countries in mortality rates and confirmed infections. METHODS Pearson correlations and a t-test were performed on data from 137 countries in order to test the correlation between number of deaths from diarrheal diseases (pre-COVID-19 pandemic data) as a marker for countries' sanitation level, and the number of confirmed COVID-19 cases and deaths per million. RESULTS It was found that countries' prevalence of confirmed COVID-19 cases and deaths per million are statistically correlated with their sanitation level. CONCLUSIONS The hypothesis proposed in this article is that the low mortality rates from COVID-19 in countries where the level of sanitation is low are due to fecal-oral infection of the population by SARS-CoV-2, rather than infection of the respiratory system. This hypothesis is supported by the protective effect of the low sanitation level presented in this work and the fact that lung infection by SARS-CoV-2 can cause severe pathology, while infection in the intestine generally causes minor or no symptoms.
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Karp C, Moreau C, Sheehy G, Anjur-Dietrich S, Mbushi F, Muluve E, Mwanga D, Nzioki M, Pinchoff J, Austrian K. Youth Relationships in the Era of COVID-19: A Mixed-Methods Study Among Adolescent Girls and Young Women in Kenya. J Adolesc Health 2021; 69:754-761. [PMID: 34465510 PMCID: PMC8460286 DOI: 10.1016/j.jadohealth.2021.07.017] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 06/21/2021] [Accepted: 07/14/2021] [Indexed: 11/03/2022]
Abstract
BACKGROUND Measures to mitigate COVID-19's impact may inhibit development of healthy youth relationships, affecting partnership quality and sexual and reproductive health (SRH) outcomes. METHODS We conducted a mixed-methods study to understand how COVID-19 affected girls' and young women's relationships in Kenya. Bivariate and multivariate logistic regression examined factors associated with relationship quality dynamics and SRH outcomes among 756 partnered adolescents aged 15-24 years. Qualitative data from in-depth interviews were analyzed using inductive thematic analysis to explore youth perceptions of how intimate relationships changed during COVID-19. RESULTS Nearly three-quarters of youth described changes in relationship quality since COVID-19 began, with 24% reporting worsening. Reduced time with partners was the strongest predictor of changed relationship quality. Youth experiencing complete or partial COVID-19-related household income loss had heightened risk of deteriorating partnerships (relative risk ratio = 2.43 and 2.02; p < .05); those whose relationships worsened were more likely to experience recent intimate partner violence, relative to no relationship change (20.8% vs. 3.5%; p < .001). Qualitative analysis revealed how COVID-19 mitigation measures hindered intimate relationships, school closures accelerated marriage timelines, and economic hardships strained relationships, while increasing early pregnancy risk and girls' financial dependency on their partners. CONCLUSIONS COVID-19 disrupted adolescent girls' and young women's romantic relationships, depriving some of partner emotional support and exposing others to sexual violence, early pregnancy, and economically motivated transactional relationships. Increased social support systems, including access to psychosocial services, are needed in low-income communities in Kilifi, Kisumu, and Nairobi, in particular the informal settlement areas, to mitigate COVID-19's consequences on girls' SRH.
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Affiliation(s)
- Celia Karp
- Department of Population Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore Maryland.
| | - Caroline Moreau
- Department of Population Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore Maryland; Soins et Santé Primaire, CESP Centre for Research in Epidemiology and Population Health, Inserm, Villejuif, France
| | - Grace Sheehy
- Department of Population Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore Maryland
| | - Selena Anjur-Dietrich
- Department of Population Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore Maryland
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Bouba Y, Tsinda EK, Fonkou MDM, Mmbando GS, Bragazzi NL, Kong JD. The Determinants of the Low COVID-19 Transmission and Mortality Rates in Africa: A Cross-Country Analysis. Front Public Health 2021; 9:751197. [PMID: 34746085 PMCID: PMC8568130 DOI: 10.3389/fpubh.2021.751197] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Accepted: 09/14/2021] [Indexed: 01/08/2023] Open
Abstract
Background: More than 1 year after the beginning of the international spread of coronavirus 2019 (COVID-19), the reasons explaining its apparently lower reported burden in Africa are still to be fully elucidated. Few studies previously investigated the potential reasons explaining this epidemiological observation using data at the level of a few African countries. However, an updated analysis considering the various epidemiological waves and variables across an array of categories, with a focus on African countries might help to better understand the COVID-19 pandemic on the continent. Thus, we investigated the potential reasons for the persistently lower transmission and mortality rates of COVID-19 in Africa. Methods: Data were collected from publicly available and well-known online sources. The cumulative numbers of COVID-19 cases and deaths per 1 million population reported by the African countries up to February 2021 were used to estimate the transmission and mortality rates of COVID-19, respectively. The covariates were collected across several data sources: clinical/diseases data, health system performance, demographic parameters, economic indicators, climatic, pollution, and radiation variables, and use of social media. The collinearities were corrected using variance inflation factor (VIF) and selected variables were fitted to a multiple regression model using the R statistical package. Results: Our model (adjusted R-squared: 0.7) found that the number of COVID-19 tests per 1 million population, GINI index, global health security (GHS) index, and mean body mass index (BMI) were significantly associated (P < 0.05) with COVID-19 cases per 1 million population. No association was found between the median life expectancy, the proportion of the rural population, and Bacillus Calmette-Guérin (BCG) coverage rate. On the other hand, diabetes prevalence, number of nurses, and GHS index were found to be significantly associated with COVID-19 deaths per 1 million population (adjusted R-squared of 0.5). Moreover, the median life expectancy and lower respiratory infections rate showed a trend towards significance. No association was found with the BCG coverage or communicable disease burden. Conclusions: Low health system capacity, together with some clinical and socio-economic factors were the predictors of the reported burden of COVID-19 in Africa. Our results emphasize the need for Africa to strengthen its overall health system capacity to efficiently detect and respond to public health crises.
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Affiliation(s)
- Yagai Bouba
- Chantal BIYA International Reference Center for Research on HIV/AIDS Prevention and Management (CIRCB), Yaoundé, Cameroon
- Department of Experimental Medicine, University of Rome “Tor Vergata”, Rome, Italy
| | | | | | | | - Nicola Luigi Bragazzi
- Laboratory for Industrial and Applied Mathematics (LIAM), Department of Mathematics and Statistics, York University, Toronto, ON, Canada
- Africa-Canada Artificial Intelligence and Data Innovation Consortium (ACADIC), Department of Mathematics and Statistics, York University, Toronto, ON, Canada
| | - Jude Dzevela Kong
- Africa-Canada Artificial Intelligence and Data Innovation Consortium (ACADIC), Department of Mathematics and Statistics, York University, Toronto, ON, Canada
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El Khamlichi S, Maurady A, Sedqui A. Comparative study of COVID-19 situation between lower-middle-income countries in the eastern Mediterranean region. J Oral Biol Craniofac Res 2021; 12:165-176. [PMID: 34660189 PMCID: PMC8500844 DOI: 10.1016/j.jobcr.2021.10.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Revised: 06/02/2021] [Accepted: 10/04/2021] [Indexed: 12/22/2022] Open
Abstract
Background and aims The COVID-19 health crisis has created a disastrous situation worldwide. All nations are facing this pandemic, including eastern Mediterranean countries. The aim of this study is to assess and compare the impact of this devastating pandemic on lower-middle-income countries in the eastern Mediterranean region, identify the leading causes of its spread, examine the various risk factors associated with its virulence in each country, and provide effective intervention strategies to contain it. Methods Using the analysis of variance method, this research compares infection, case fatality, recovery, and positivity rates in seven countries, namely, Morocco, Tunisia, Egypt, Djibouti, Pakistan, Sudan, and Palestine. It focuses on their daily reported confirmed incidents, recoveries, deaths, and tests. Results The results highlight the significant differences in the effect of COVID-19 in these countries. Regarding the infection rate, Djibouti and Palestine have the highest rate, which could be related to the high poverty and the young population in these countries. However, it has been demonstrated that Tunisia, Djibouti, Egypt, and Sudan have the greatest case fatality rate in this comparison, which might be attributed to the relatively old population in Tunisia, the co-morbidity in Egypt, and the deficiency of the healthcare system in Djibouti and Sudan. Furthermore, the comparison of the recovery rate in these countries indicates that Djibouti has the highest recovery rate, which might be due to the young population. Conclusion This work allows us to come up with recommendations that could support policymakers to act efficiently in containing the pandemic flare-up.
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Affiliation(s)
- Sokaina El Khamlichi
- Laboratory of Innovative Technologies, National School of Applied Sciences of Tangier, Abdelmalek Essaâdi University, Tangier, Morocco
| | - Amal Maurady
- Laboratory of Innovative Technologies, National School of Applied Sciences of Tangier, Abdelmalek Essaâdi University, Tangier, Morocco.,Faculty of Sciences and Techniques, Abdelmalek Essaâdi University, Tangier, Morocco
| | - Abdelfettah Sedqui
- Laboratory of Innovative Technologies, National School of Applied Sciences of Tangier, Abdelmalek Essaâdi University, Tangier, Morocco
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Losso JN, Losso MN, Toc M, Inungu JN, Finley JW. The Young Age and Plant-Based Diet Hypothesis for Low SARS-CoV-2 Infection and COVID-19 Pandemic in Sub-Saharan Africa. PLANT FOODS FOR HUMAN NUTRITION (DORDRECHT, NETHERLANDS) 2021; 76:270-280. [PMID: 34169470 PMCID: PMC8225309 DOI: 10.1007/s11130-021-00907-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/15/2021] [Indexed: 05/06/2023]
Abstract
Since the outbreak of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that caused the coronavirus disease-19 (COVID-19), in December 2019, the infection has spread around the globe. Some of the risk factors include social distancing, mask wearing, hand washing with soap, obesity, diabetes, hypertension, asthma, cardiovascular disease, and dysbiosis. Evidence has shown the incidence of total infection and death rates to be lower in sub-Saharan Africa when compared with North Africa, Europe and North America and many other parts of the world. The higher the metabolic syndrome rate, the higher the risk of SARS-CoV-2 infection. Africa has a lower rate of metabolic syndrome risk than many other continents. This paradox has puzzled several in the biomedical and scientific communities. Published results of research have demonstrated the exciting correlation that the combination of young age of the population coupled with their native plant-based diet has lowered their risk factors. The plant-based diet include whole grains (millet, sorghum), legumes (black-eye peas, dry beans, soybean), vegetables, potato, sweet potato, yams, squash, banana, pumpkin seeds, and moringa leaves, and lower consumption of meat. The plant-based diet results in a different gut microbiota than of most of the rest of the world. This has a significant impact on the survival rate of other populations. The "plant-based diet" results in lower rates of obesity, diabetes and dysbiosis, which could contribute to lower and less severe infections. However, these hypotheses need to be supported by more clinical and biostatistics data.
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Affiliation(s)
- Jack N Losso
- School of Nutrition and Food Sciences, Louisiana State University, Baton Rouge, LA, USA.
| | - MerryJean N Losso
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Marco Toc
- Department of Food Science and Nutrition, University of Illinois, Urbana Champaign, Champaign, IL, USA
| | - Joseph N Inungu
- School of Health Sciences, Central Michigan University, Mt Pleasant, MI, USA
| | - John W Finley
- School of Nutrition and Food Sciences, Louisiana State University, Baton Rouge, LA, USA
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Wamai RG, Hirsch JL, Van Damme W, Alnwick D, Bailey RC, Hodgins S, Alam U, Anyona M. What Could Explain the Lower COVID-19 Burden in Africa despite Considerable Circulation of the SARS-CoV-2 Virus? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:8638. [PMID: 34444386 PMCID: PMC8391172 DOI: 10.3390/ijerph18168638] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 08/13/2021] [Accepted: 08/13/2021] [Indexed: 01/12/2023]
Abstract
The differential spread and impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), causing Coronavirus Disease 2019 (COVID-19), across regions is a major focus for researchers and policy makers. Africa has attracted tremendous attention, due to predictions of catastrophic impacts that have not yet materialized. Early in the pandemic, the seemingly low African case count was largely attributed to low testing and case reporting. However, there is reason to consider that many African countries attenuated the spread and impacts early on. Factors explaining low spread include early government community-wide actions, population distribution, social contacts, and ecology of human habitation. While recent data from seroprevalence studies posit more extensive circulation of the virus, continuing low COVID-19 burden may be explained by the demographic pyramid, prevalence of pre-existing conditions, trained immunity, genetics, and broader sociocultural dynamics. Though all these prongs contribute to the observed profile of COVID-19 in Africa, some provide stronger evidence than others. This review is important to expand what is known about the differential impacts of pandemics, enhancing scientific understanding and gearing appropriate public health responses. Furthermore, it highlights potential lessons to draw from Africa for global health on assumptions regarding deadly viral pandemics, given its long experience with infectious diseases.
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Affiliation(s)
- Richard G. Wamai
- Department of Cultures, Societies, and Global Studies, Northeastern University, 201 Renaissance Park, 360 Huntington Ave., Boston, MA 02115, USA;
| | - Jason L. Hirsch
- Department of Cultures, Societies, and Global Studies, Northeastern University, 201 Renaissance Park, 360 Huntington Ave., Boston, MA 02115, USA;
| | - Wim Van Damme
- Department of Public Health, Institute of Tropical Medicine, B-2000 Antwerp, Belgium;
| | - David Alnwick
- DUNDEX (Deployable U.N.-Experienced Development Experts), FX68 Belturbet, Ireland;
| | - Robert C. Bailey
- School of Public Health, University of Illinois at Chicago, Chicago, IL 60607, USA;
| | - Stephen Hodgins
- School of Public Health, University of Alberta, Edmonton, AB T6G 1C9, Canada;
| | - Uzma Alam
- Researcher Africa Institute for Health Policy Foundation, Nairobi 020, Kenya;
| | - Mamka Anyona
- T.H. Chan School of Public Health, Harvard University, Boston, MA 02115, USA;
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Abstract
The coronavirus epidemic has had a significant impact on various aspects of socioeconomic relations in the Russian Federation. In the field of demography, the negative impact of the epidemic was twofold: the decline in fertility was accompanied by an increase in mortality. However, the real picture of mortality from COVID-19 is very difficult to draw. Different sources of 1information contain different numbers. The purpose of the study, based on a comparative analysis, is to determine the total mortality rate from coronavirus infection in Russia in 2020.To do this, it is necessary to compare the available data for individual constituent entities of the Russian Federation, as well as compare them with data from other countries similar to Russia in terms of the dynamics of the COVID-19 epidemic. As a result of a comparative analysis of regional data, as well as a comparison of Russian mortality rates with those of the United States and England, the article concludes that: data on mortality associated with COVID-19 differ significantly in different constituent entities of the Russian Federation, which at least indicates about significant and difficult to explain differences in the methodology used; the largest share of deaths associated with COVID-19 in excess mortality in December 2020 falls on Moscow, where it reaches 98.4%; mortality data in Moscow are close to similar data in the United States for December 2020; extrapolation of Moscow data for the whole of Russia and for the entire period of the epidemic makes it possible to estimate the total mortality associated with coronavirus infection in the Russian Federation, at the end of2020, at 337 thousand people, which is more than 6 times morethan according to the data of the Operational Headquarters.
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Affiliation(s)
- Alexey Smirnov
- Sankt-Petersburg State Marine Technical University, Sankt-Petersburg, Russia
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Colebunders R, Kenyon C. Extensive SARS-CoV-2 transmission associated with low mortality in Kinshasa, Democratic Republic of Congo. For how long? Clin Infect Dis 2021; 74:891-892. [PMID: 34181705 DOI: 10.1093/cid/ciab593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Indexed: 11/12/2022] Open
Affiliation(s)
| | - Chris Kenyon
- Institute of Tropical Medicine, Department of Clinical Science, Antwerp , Belgium
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Dufailu OA, Afriyie-Asante A, Gyan B, Kwabena DA, Yeboah H, Ntiakoh F, Asare-Werehene M. COVID-19 in Africa: an ovarian victory? J Ovarian Res 2021; 14:70. [PMID: 34020688 PMCID: PMC8138090 DOI: 10.1186/s13048-021-00820-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 05/04/2021] [Indexed: 01/08/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) mainly attacks the respiratory system and is characterized by pneumonia, cytokine storm, coagulation disorders and severe immune downregulation. Although public health experts predicted worst outcomes in Africa, the incidence, hospitalization and mortality rates have been lower in Africa compared to other continents. Interestingly, lower incidence and mortality rates have been observed in women from Africa compared to their cohorts from other continents. Also, in the US non-Hispanic Black females have lower COVID-19 and death rates compared to their white counterparts. It's unclear why this significant difference exists; however, the ovarian function, genetics and immunological statuses could play a major role. Women of African descent have elevated levels of estrogen compared with Caucasians hence we anticipate that estrogen might offer some protection against the SARS-CoV-2 infections. The racial differences in lifestyle, age and inaccessibility to contraceptive usage might also play a role. Here, we provide insight on how the high levels of estrogen in African women might contribute to the lower cases and fatalities in Africa. Specifically, estrogen might offer protection against COVID-19 by suppressing hyper-production of cytokines, promoting anti-inflammatory cytokines, stimulating antibody production and suppressing endoplasmic reticulum (ER) stress. This will as well provide useful information on how future pandemics could be managed using Africa as a case study.
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Affiliation(s)
- Osman A Dufailu
- Department of Microbiology, Faculty of Biosciences, University for Development Studies, Box 1882, Nyankpala Campus, Tamale, Ghana
| | - Afrakoma Afriyie-Asante
- Department of Biochemistry, Microbiology and Immunology, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, K1H 8M5, Canada
| | - Bernard Gyan
- Department of Medical Diagnostics, College of Health and Well-Being, Kintampo, Ghana
| | - David Adu Kwabena
- Department of Medical Diagnostics, College of Health and Well-Being, Kintampo, Ghana
- School of Allied Health Sciences, University for Development Studies, Tamale, Ghana
| | - Helena Yeboah
- School of International Development and Global Studies, University of Ottawa, Ottawa, Ontario, Canada
| | - Frank Ntiakoh
- Department of Medical Laboratory, Effia-Nkwanta Regional Hospital, Sekondi, Western Region, Ghana
| | - Meshach Asare-Werehene
- Departments of Cellular and Molecular Medicine and Obstetrics and Gynecology, University of Ottawa, Ottawa, Ontario, K1H 8M5, Canada.
- Chronic Disease Program, Ottawa Hospital Research Institute, The Ottawa Hospital, Ottawa, Ontario, K1H 8L6, Canada.
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Lamptey J, Oyelami FO, Owusu M, Nkrumah B, Idowu PO, Adu-Gyamfi EA, Czika A, El-Duah P, Yeboah R, Sylverken A, Olasunkanmi OI, Owusu-Dabo E, Drosten C, Adu-Sarkodie Y. Genomic and epidemiological characteristics of SARS-CoV-2 in Africa. PLoS Negl Trop Dis 2021; 15:e0009335. [PMID: 33901167 PMCID: PMC8101992 DOI: 10.1371/journal.pntd.0009335] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 05/06/2021] [Accepted: 03/26/2021] [Indexed: 12/27/2022] Open
Abstract
Since late 2019, the coronavirus disease 2019 (COVID-19) outbreak, caused by SARS-CoV-2, has rapidly evolved to become a global pandemic. Each country was affected but with a varying number of infected cases and mortality rates. Africa was hit late by the pandemic but the number of cases rose sharply. In this study, we investigated 224 SARS-CoV-2 genome sequences from the Global Initiative on Sharing Avian Influenza Data (GISAID) in the early part of the outbreak, of which 69 were from Africa. We analyzed a total of 550 mutations by comparing them with the reference SARS-CoV-2 sequence from Wuhan. We classified the mutations observed based on country and region, and afterwards analyzed common and unique mutations on the African continent as a whole. Correlation analyses showed that the duo variants ORF1ab/RdRp 4715L and S protein 614G variants, which are strongly linked to fatality rate, were not significantly and positively correlated with fatality rates (r = -0.03757, P = 0.5331 and r = -0.2876, P = 0.6389, respectively), although increased number of cases correlated with number of deaths (r = 0.997, P = 0.0002). Furthermore, most cases in Africa were mainly imported from American and European countries, except one isolate with no mutation and was similar to the original isolate from Wuhan. Moreover, unique mutations specific to countries were identified in the early phase of the outbreak but these mutations were not regional-specific. There were common mutations in all isolates across the continent as well as similar isolate-specific mutations in different regions. Our findings suggest that mutation is rapid in SARS-CoV-2 in Africa and although these mutations spread across the continent, the duo variants could not possibly be the sole cause of COVID-19 deaths in Africa in the early phase of the outbreak.
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Affiliation(s)
- Jones Lamptey
- Centre for Health System Strengthening (CfHSS), Kumasi, Ghana
- Department of Microbiology, School of Medical Sciences, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana
- Kumasi Centre for Collaborative Research in Tropical Medicine (KCCR), Kumasi, Ghana
| | | | - Michael Owusu
- Centre for Health System Strengthening (CfHSS), Kumasi, Ghana
- Department of Microbiology, School of Medical Sciences, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana
- Kumasi Centre for Collaborative Research in Tropical Medicine (KCCR), Kumasi, Ghana
| | | | | | - Enoch Appiah Adu-Gyamfi
- Department of Physiology, School of Medical Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Armin Czika
- Faculty of Medicine, Transilvania University of Brasov, Brasov, Romania
| | - Philip El-Duah
- Institute of Virology, Charite University, Berlin, Germany
| | - Richmond Yeboah
- Kumasi Centre for Collaborative Research in Tropical Medicine (KCCR), Kumasi, Ghana
| | - Augustina Sylverken
- Kumasi Centre for Collaborative Research in Tropical Medicine (KCCR), Kumasi, Ghana
- Department of Theoretical and Applied Biology, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana
| | | | - Ellis Owusu-Dabo
- School of Public Health, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana
| | | | - Yaw Adu-Sarkodie
- Department of Microbiology, School of Medical Sciences, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana
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Nachega JB, Kapata N, Sam-Agudu NA, Decloedt EH, Katoto PDMC, Nagu T, Mwaba P, Yeboah-Manu D, Chanda-Kapata P, Ntoumi F, Geng EH, Zumla A. Minimizing the impact of the triple burden of COVID-19, tuberculosis and HIV on health services in sub-Saharan Africa. Int J Infect Dis 2021; 113 Suppl 1:S16-S21. [PMID: 33757874 PMCID: PMC7980520 DOI: 10.1016/j.ijid.2021.03.038] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 02/28/2021] [Accepted: 03/10/2021] [Indexed: 02/08/2023] Open
Abstract
In this perspective, we discuss the impact of COVID-19 on tuberculosis (TB)/HIV health services and approaches to mitigating the growing burden of these three colliding epidemics in sub-Saharan Africa (SSA). SSA countries bear significantly high proportions of TB and HIV cases reported worldwide, compared to countries in the West. Whilst COVID-19 epidemiology appears to vary across Africa, most countries in this region have reported relatively lower-case counts compared to the West. Nevertheless, the COVID-19 pandemic has added an additional burden to already overstretched health systems in SSA, which, among other things, have been focused on the longstanding dual epidemics of TB and HIV. As with these dual epidemics, inadequate resources and poor case identification and reporting may be contributing to underestimations of the COVID-19 case burden in SSA. Modelling studies predict that the pandemic-related disruptions in TB and HIV services will result in significant increases in associated morbidity and mortality over the next five years. Furthermore, limited empirical evidence suggests that SARS-CoV-2 coinfections with TB and HIV are associated with increased mortality risk in SSA. However, predictive models require a better evidence-base to accurately define the impact of COVID-19, not only on communicable diseases such as TB and HIV, but on non-communicable disease comorbidities. Further research is needed to assess morbidity and mortality data among both adults and children across the African continent, paying attention to geographic disparities, as well as the clinical and socio-economic determinants of COVID-19 in the setting of TB and/or HIV.
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Affiliation(s)
- Jean B Nachega
- Department of Medicine and Center for Infectious Diseases, Stellenbosch University Faculty of Medicine and Health Sciences, Cape Town, South Africa; Department of Epidemiology, Infectious Diseases and Microbiology, and Center for Global Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Department of International Health, Johns Hopkins University, Bloomberg School of Public Health, Baltimore, MD, USA.
| | - Nathan Kapata
- Zambia National Public Health Institute, University of Zambia-University College London Medical School Research and Training Project, University Teaching Hospital, Ministry of Health, Lusaka, Zambia.
| | - Nadia A Sam-Agudu
- International Research Center of Excellence, Institute of Human Virology Nigeria, Abuja, Nigeria; Institute of Human Virology and Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland, USA; Department of Pediatrics and Child Health, School of Medical Sciences, University of Cape Coast, Cape Coast, Ghana.
| | - Eric H Decloedt
- Division of Clinical Pharmacology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa.
| | - Patrick D M C Katoto
- Department of Medicine and Center for Infectious Diseases, Stellenbosch University Faculty of Medicine and Health Sciences, Cape Town, South Africa.
| | - Tumaini Nagu
- School of Medicine, Muhimbili University of Health and Allied Sciences, Dar Es Salaam, Tanzania.
| | - Peter Mwaba
- Lusaka Apex Medical University, Lusaka, Zambia.
| | - Dorothy Yeboah-Manu
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana.
| | | | - Francine Ntoumi
- Fondation Congolaise pour la Recherche Médicale (FCRM), Brazzaville, Congo; Institute for Tropical Medicine, University of Tübingen, Tübingen, Germany.
| | - Elvin H Geng
- Division of Infectious Diseases, Department of Medicine, and Center for Dissemination and Implementation, Institute for Public Health, Washington University, St Louis, Missouri, USA.
| | - Alimuddin Zumla
- Division of Infection and Immunity, University College London, London, UK; NIHR Biomedical Research Centre, University College London Hospitals, London, UK.
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González-Rodríguez R. Spread of COVID-19 cases in Africa. Letter to the Director to collation of the article: Why is the COVID-19 epidemic in Africa less "intense"? REVISTA ESPANOLA DE ANESTESIOLOGIA Y REANIMACION 2021; 68:S0034-9356(21)00099-2. [PMID: 33867156 PMCID: PMC7938786 DOI: 10.1016/j.redar.2021.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 01/26/2021] [Indexed: 11/23/2022]
Affiliation(s)
- R González-Rodríguez
- Consultante en anestesia y salud pública para la Organización Mundial de la Salud en Mauritania, Barcelona, España.
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Bright B, Babalola CP, Sam-Agudu NA, Onyeaghala AA, Olatunji A, Aduh U, Sobande PO, Crowell TA, Tebeje YK, Phillip S, Ndembi N, Folayan MO. COVID-19 preparedness: capacity to manufacture vaccines, therapeutics and diagnostics in sub-Saharan Africa. Global Health 2021; 17:24. [PMID: 33658050 PMCID: PMC7927760 DOI: 10.1186/s12992-021-00668-6] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 02/04/2021] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE The COVID-19 pandemic is a biosecurity threat, and many resource-rich countries are stockpiling and/or making plans to secure supplies of vaccine, therapeutics, and diagnostics for their citizens. We review the products that are being investigated for the prevention, diagnosis, and treatment of COVID-19; discuss the challenges that countries in sub-Saharan Africa may face with access to COVID-19 vaccine, therapeutics, and diagnostics due to the limited capacity to manufacture them in Africa; and make recommendations on actions to mitigate these challenges and ensure health security in sub-Saharan Africa during this unprecedented pandemic and future public-health crises. MAIN BODY Sub-Saharan Africa will not be self-reliant for COVID-19 vaccines when they are developed. It can, however, take advantage of existing initiatives aimed at supporting COVID-19 vaccine access to resource-limited settings such as partnership with AstraZeneca, the Coalition for Epidemic Preparedness and Innovation, the Global Alliance for Vaccine and Immunisation, the Serum Institute of India, and the World Health Organization's COVID-19 Technology Access Pool. Accessing effective COVID-19 therapeutics will also be a major challenge for countries in sub-Saharan Africa, as production of therapeutics is frequently geared towards profitable Western markets and is ill-adapted to sub-Saharan Africa realities. The region can benefit from pooled procurement of COVID-19 therapy by the Africa Centres for Disease Control and Prevention in partnership with the African Union. If the use of convalescent plasma for the treatment of patients who are severely ill is found to be effective, access to the product will be minimally challenging since the region has a pool of recovered patients and human resources that can man supportive laboratories. The region also needs to drive the local development of rapid-test kits and other diagnostics for COVID-19. CONCLUSION Access to vaccines, therapeutics, and diagnostics for COVID-19 will be a challenge for sub-Saharan Africans. This challenge should be confronted by collaborating with vaccine developers; pooled procurement of COVID-19 therapeutics; and local development of testing and diagnostic materials. The COVID-19 pandemic should be a wake-up call for sub-Saharan Africa to build vaccines, therapeutics, and diagnostics manufacturing capacity as one of the resources needed to address public-health crises.
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Affiliation(s)
- Bisi Bright
- , COVID-19 Think Tank, Nigeria
- Live Well Initiative Academy Nigeria, Lagos, Nigeria
| | - Chinedum Peace Babalola
- , COVID-19 Think Tank, Nigeria
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, University of Ibadan, Ibadan, Nigeria
- Centre for Drug Discovery, Development & Production, University of Ibadan, Ibadan, Nigeria
- Genetics & Bioethics Unit, Institute of Advanced Medical Research & Training, College of Medicine, Ibadan, Nigeria
- College of Basic Medical Sciences, Chrisland University, Abeokuta, Ogun State, Nigeria
| | - Nadia Adjoa Sam-Agudu
- , COVID-19 Think Tank, Nigeria
- Institute of Human Virology Nigeria, Abuja, Nigeria
- Institute of Human Virology, University of Maryland School of Medicine, Baltimore, USA
- Department of Paediatrics, University of Cape Coast School of Medical Sciences, Cape Coast, Ghana
| | - Augustine Anayochukwu Onyeaghala
- , COVID-19 Think Tank, Nigeria
- Unit of Clinical Chemistry, Department of Medical Laboratory Science, University College Hospital, Ibadan, Nigeria
- Unit of Clinical Chemistry, Department of Medical Laboratory Science, Lead City University, Ibadan, Nigeria
| | - Adebola Olatunji
- , COVID-19 Think Tank, Nigeria
- Fort Worth Internal Medicine, Fort Worth, TX, USA
| | - Ufuoma Aduh
- , COVID-19 Think Tank, Nigeria
- World Health Organisation, Asaba, Delta State, Nigeria
| | - Patrick O Sobande
- , COVID-19 Think Tank, Nigeria
- Stephen's Pedi & Pulmonary Medicine, Fort Worth, TX, USA
| | - Trevor A Crowell
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
| | - Yenew Kebede Tebeje
- Africa Center for Disease Control and Prevention, African Union Commission, Addis Ababa, Ethiopia
| | - Sunny Phillip
- , COVID-19 Think Tank, Nigeria
- Institute of Human Virology Nigeria, Abuja, Nigeria
| | - Nicaise Ndembi
- , COVID-19 Think Tank, Nigeria
- Institute of Human Virology Nigeria, Abuja, Nigeria
- Institute of Human Virology, University of Maryland School of Medicine, Baltimore, USA
- Africa Center for Disease Control and Prevention, African Union Commission, Addis Ababa, Ethiopia
- Kanazawa University, Graduate School of Medical Sciences, Kanazawa, Japan
| | - Morenike Oluwatoyin Folayan
- , COVID-19 Think Tank, Nigeria.
- Department of Child Dental Health, Obafemi Awolowo University, Ile-Ife, Nigeria.
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Affiliation(s)
- John Tembo
- HerpeZ, University Teaching Hospital, Lusaka, Zambia
| | - Kwitaka Maluzi
- HerpeZ, University Teaching Hospital, Lusaka, Zambia
- Liverpool School of Tropical Medicine, Liverpool, UK
| | - Franklyn Egbe
- School of Life Sciences, University of Lincoln, Lincoln, UK
| | - Matthew Bates
- HerpeZ, University Teaching Hospital, Lusaka, Zambia
- School of Life Sciences, University of Lincoln, Lincoln, UK
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49
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Fronteira I, Sidat M, Magalhães JP, de Barros FPC, Delgado AP, Correia T, Daniel-Ribeiro CT, Ferrinho P. The SARS-CoV-2 pandemic: A syndemic perspective. One Health 2021; 12:100228. [PMID: 33614885 PMCID: PMC7887445 DOI: 10.1016/j.onehlt.2021.100228] [Citation(s) in RCA: 55] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 02/10/2021] [Accepted: 02/11/2021] [Indexed: 01/07/2023] Open
Abstract
The SARS-CoV-2 pandemic has affected communities, populations, and countries throughout the world. As the SARS-CoV-2 pandemic developed, the extent to which the disease interacted with already existing endemic, non-communicable and infectious diseases became evident, hence deeply influencing health outcomes. Additionally, a synergistic effect has been demonstrated also with socio-economic, cultural, and contextual determinants of health which seem to contribute to poorer health and accumulating social disadvantages. In this essay, using as a starting point the syndemic theory that translates the cumulative and intertwined factors between different epidemics, we argue that the SARS-CoV-2 is a one health issue of a syndemic nature and that the failure to acknowledge this contributes to weakened policy-making processes and public health responses and ineffective health policies and programs.
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Affiliation(s)
- Inês Fronteira
- Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Portugal,Corresponding author.
| | - Mohsin Sidat
- Community Health Department, Faculty of Medicine, University Eduardo Mondlane, Mozambique
| | - João Paulo Magalhães
- Public Health Unit, Group of Primary Care Centers of Porto Oriental, North Health Regional Administration, Ministry of Health, Portugal
| | | | - António Pedro Delgado
- University of Cabo Verde, Cabo Verde, Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Portugal
| | - Tiago Correia
- Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Portugal
| | - Cláudio Tadeu Daniel-Ribeiro
- Laboratório de Pesquisa em Malária, Instituto Oswaldo Cruz, Fiocruz, Rio de Janeiro and Centro de Pesquisa Diagnóstico e Treinamento em Malária, Fiocruz e Secretaria de Vigilância em Saúde, Brazil
| | - Paulo Ferrinho
- Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Portugal
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50
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Musanabaganwa C, Cubaka V, Mpabuka E, Semakula M, Nahayo E, Hedt-Gauthier BL, Ng KCS, Murray MB, Kateera F, Mutesa L, Nsanzimana S. One hundred thirty-three observed COVID-19 deaths in 10 months: unpacking lower than predicted mortality in Rwanda. BMJ Glob Health 2021; 6:e004547. [PMID: 33627363 PMCID: PMC7907833 DOI: 10.1136/bmjgh-2020-004547] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 01/22/2021] [Accepted: 01/26/2021] [Indexed: 02/06/2023] Open
Abstract
The African region was predicted to have worse COVID-19 infection and death rates due to challenging health systems and social determinants of health. However, in the 10 months after its first case, Rwanda recorded 10316 cases and 133 COVID-19-related deaths translating to a case fatality rate (CFR) of 1.3%, which raised the question: why does Rwanda have a low COVID-19 CFR? Here we analysed COVID-19 data and explored possible explanations to better understand the disease burden in the context of Rwanda's infection control strategies.We investigated whether the age distribution plays a role in the observed low CFR in Rwanda by comparing the expected number of deaths for 10-year age bands based on the CFR reported in other countries with the observed number of deaths for each age group. We found that the age-specific CFRs in Rwanda are similar to or, in some older age groups, slightly higher than those in other countries, suggesting that the lower population level CFR reflects the younger age structure in Rwanda, rather than a lower risk of death conditional on age. We also accounted for Rwanda's comprehensive SARS-CoV-2 testing strategies and reliable documentation of COVID-19-related deaths and deduced that these measures may have allowed them to likely identify more asymptomatic or mild cases than other countries and reduced their reported CFR.Overall, the observed low COVID-19 deaths in Rwanda is likely influenced by the combination of effective infection control strategies, reliable identification of cases and reporting of deaths, and the population's young age structure.
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Affiliation(s)
| | - Vincent Cubaka
- Department of Research and Training, Partners in Health Rwanda, Kigali, Rwanda
| | - Etienne Mpabuka
- Medical Research Center, Rwanda Biomedical Center, Kigali, Rwanda
| | | | - Ernest Nahayo
- Rwanda Military Hospital, Kigali, Kigali City, Rwanda
| | - Bethany L Hedt-Gauthier
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Kamela C S Ng
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Megan B Murray
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Fredrick Kateera
- Department of Research and Training, Partners in Health Rwanda, Kigali, Rwanda
| | - Leon Mutesa
- Center of Human Genetics, University of Rwanda College of Medicine and Health Sciences, Kigali, Rwanda
| | - Sabin Nsanzimana
- Medical Research Center, Rwanda Biomedical Center, Kigali, Rwanda
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