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Sampa M, Fisa R, Mukuma C, Mwanza M, Hamainza B, Musonda P. The effect of COVID-19 on malaria cases in Zambia: a mixed effect multilevel analysis. Malar J 2024; 23:85. [PMID: 38519929 PMCID: PMC10958942 DOI: 10.1186/s12936-024-04882-6] [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: 10/19/2023] [Accepted: 02/15/2024] [Indexed: 03/25/2024] Open
Abstract
BACKGROUND The burden of Malaria in Zambia remains a challenge, with the entire population at risk of contracting this infectious disease. Despite concerted efforts by African countries, including Zambia, to implement malaria policies and strategies aimed at reducing case incidence, the region faces significant hurdles, especially with emerging pandemics such as COVID-19. The efforts to control malaria were impacted by the constraints imposed to curb its transmission during the COVID-19 pandemic. The aim of the study was to assess the effect of the COVID-19 pandemic on malaria cases in Zambia and the factors associated by comparing the COVID-19 period and the pre-COVID-19 era. METHODS This was a cross-sectional panel study in which routinely collected programmatic data on malaria was used. The data were extracted from the Health Management Information System (HMIS) for the period January 2018 to January 2022. The period 2018 to 2022 was selected purely due to the availability of data and to avoid the problem of extrapolating too far away from the period of interest of the study. A summary of descriptive statistics was performed in which the number of cases were stratified by province, age group, and malaria cases. The association of these variables with the COVID-19 era was checked using the Wilcoxon rank-sum test and Kruskal‒Wallis test as applicable. In establishing the factors associated with the number of malaria cases, a mixed-effect multilevel model using the Poisson random intercept and random slope of the COVID-19 panel. The model was employed to deal with the possible correlation of the number of cases in the non-COVID-19 panel and the expected correlation of the number of cases in the COVID-19 panel. RESULTS A total of 18,216 records were extracted from HMIS from January 2018 to January 2022. Stratifying this by the COVID-19 period/era, it was established that 8,852 malaria cases were recorded in the non-COVID-19 period, whereas 9,364 cases were recorded in the COVID-19 era. Most of the people with malaria were above the age of 15 years. Furthermore, the study found a significant increase in the relative incidence of the COVID-19 panel period compared to the non-COVID-19 panel period of 1.32, 95% CI (1.18, 1.48, p < 0.0001). The observed numbers, as well as the incident rate ratio, align with the hypothesis of this study, indicating an elevated incidence rate ratio of malaria during the COVID-19 period. CONCLUSION This study found that there was an increase in confirmed malaria cases during the COVID-19 period compared to the non-COVID-19 period. The study also found Age, Province, and COVID-19 period to be significantly associated with malaria cases.
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Affiliation(s)
- Mutale Sampa
- School of Public Health, Department of Epidemiology and Biostatistics, The University of Zambia, University of Zambia, Lusaka, Zambia.
- Southern African Institute for Collaborative Research and Innovation Organization (SAICRIO), Lusaka, Zambia.
| | - Ronald Fisa
- School of Public Health, Department of Epidemiology and Biostatistics, The University of Zambia, University of Zambia, Lusaka, Zambia
| | - Chilombo Mukuma
- School of Public Health, Department of Epidemiology and Biostatistics, The University of Zambia, University of Zambia, Lusaka, Zambia
| | - Mercy Mwanza
- National Malaria Elimination Centre, Ministry of Health, Lusaka, Zambia
| | - Busiku Hamainza
- National Malaria Elimination Centre, Ministry of Health, Lusaka, Zambia
| | - Patrick Musonda
- School of Public Health, Department of Epidemiology and Biostatistics, The University of Zambia, University of Zambia, Lusaka, Zambia.
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Katende B, Bresser M, Kamele M, Chere L, Tlahali M, Erhardt RM, Muhairwe J, Ayakaka I, Glass TR, Ruhwald M, van Ginneken B, Murphy K, de Vos M, Amstutz A, Mareka M, Mooko SM, Reither K, González Fernández L. Impact of a multi-disease integrated screening and diagnostic model for COVID-19, TB, and HIV in Lesotho. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001488. [PMID: 37531333 PMCID: PMC10395971 DOI: 10.1371/journal.pgph.0001488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 07/03/2023] [Indexed: 08/04/2023]
Abstract
The surge of the COVID-19 pandemic challenged health services globally, and in Lesotho, the HIV and tuberculosis (TB) services were similarly affected. Integrated, multi-disease diagnostic services were proposed solutions to mitigate these disruptions. We describe and evaluate the effect of an integrated, hospital-based COVID-19, TB and HIV screening and diagnostic model in two rural districts in Lesotho, during the period between December 2020 and August 2022. Adults, hospital staff, and children above 5 years attending two hospitals were pre-screened for COVID-19 and TB symptoms. After a positive pre-screening, participants were offered to enroll in a service model that included clinical evaluation, chest radiography, SARS-CoV-2, TB, and HIV testing. Participants diagnosed with COVID-19, TB, or HIV were contacted after 28 days to evaluate their health status and linkage to HIV and/or TB care services. Of the 179160 participants pre-screened, 6623(3.7%) pre-screened positive, and 4371(66%) were enrolled in this service model. Of the total 458 diagnoses, only 17 happened in children. One positive rapid antigen test for SARS-CoV-2 was found per 11 participants enrolled, one Xpert-positive TB case was diagnosed per 85 people enrolled, and 1 new HIV diagnosis was done per 182 people enrolled. Of the 321(82.9%) participants contacted after 28 days of diagnosis, 304(94.7%) reported to be healthy. Of the individuals that were newly diagnosed with HIV or TB, 18/24(75.0%) and 46/51(90.1%) started treatment within 28 days of the diagnosis. This screening and diagnostic model successfully maintained same-day, integrated COVID-19, TB, and HIV testing services, despite frequent disruptions caused by the surge of COVID-19 waves, healthcare seeking patterns, and the volatile context (social measures, travel restrictions, population lockdowns). There were positive effects in avoiding diagnostic delays and ensuring linkage to services, however, diagnostic yields for adults and children were low. To inform future preparedness plans, research will need to identify essential health interventions and how to optimize them along each phase of the emergency response.
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Affiliation(s)
| | - Moniek Bresser
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | | | - Lebohang Chere
- Butha-Buthe District Health Management Team, Butha-Buthe, Ministry of Health Lesotho, Maseru, Lesotho
| | - Mosa Tlahali
- Mokhotlong District Health Management Team, Mokhotlong, Ministry of Health Lesotho, Maseru, Lesotho
| | - Rahel Milena Erhardt
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | | | - Irene Ayakaka
- SolidarMed, Partnerships for Health, Maseru, Lesotho
| | - Tracy R Glass
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Morten Ruhwald
- FIND, the Global Alliance for Diagnostics, Geneva, Switzerland
| | - Bram van Ginneken
- Diagnostic Image Analysis Group, Radboud UMC, Nijmegen, The Netherlands
| | - Keelin Murphy
- Diagnostic Image Analysis Group, Radboud UMC, Nijmegen, The Netherlands
| | | | - Alain Amstutz
- CLEAR Methods Center, Division of Clinical Epidemiology, Department of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Mathabo Mareka
- National Reference Laboratory, Ministry of Health of Lesotho, Maseru, Lesotho
| | | | - Klaus Reither
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Lucia González Fernández
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
- Division Clinical Epidemiology, Department of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland
- SolidarMed, Partnerships for Health, Lucerne, Switzerland
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Bisen AC, Agrawal S, Sanap SN, Ravi Kumar HG, Kumar N, Gupta R, Bhatta RS. COVID-19 retreats and world recovers: A silver lining in the dark cloud. HEALTH CARE SCIENCE 2023; 2:264-285. [PMID: 38939523 PMCID: PMC11080794 DOI: 10.1002/hcs2.57] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Revised: 05/30/2023] [Accepted: 06/06/2023] [Indexed: 06/29/2024]
Abstract
The coronavirus disease (COVID-19), which the World Health Organization classified as the Sixth Public Health Emergency Of International Concern (PHEIC) on January 30, 2020, is no longer a PHEIC. Millions were affected due to unawareness. The increase in fatalities and shortage of medicine was the first outrage of COVID-19. As per the Johns Hopkins COVID-19 resource center database, it was observed that the disease has spread dynamically across 200+ nations worldwide affecting more than 600 million people from 2019 to 2023, and over thousands of people were victimized regularly at a 2% mortality rate (approx.). In the midway, the mutant variants of concern like omicron, and delta have also created havoc and caused significant impact on public health, global economy, and lifestyle. Since 2019, 3 years now passed and the dynamic disease statistics seem decelerated; moreover, the prevalence of COVID-19 is also fading. The Johns Hopkins resource center has also stopped recording the data of the global pandemic recently from March 10, 2023. Hence, based on the facts, we are presenting a concise report on the pandemic from 2019 to 2023, which includes a brief discussion of the global pandemic. We have highlighted global epidemiology, emphasizing the Indian COVID scenario, vaccination across the globe, and the psychosocial and geopolitical consequences of COVID-19 with a brief background to pathology, clinical management, and the worldwide response against triage. A lot has changed and still needs to change after three tough years of COVID-19. Even though science has progressed and advanced research in medicine is pointing toward future generations, there is no standard care supplied for COVID-19-like calamities. COVID-19 cases might have declined but its influence on the society is still stagnant. This COVID experience has taught us that, despite our bleak beginnings, there is always hope for the future and that we must act with foresight to improve things for future generations.
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Affiliation(s)
- Amol Chhatrapati Bisen
- Pharmaceutics and Pharmacokinetics DivisionCSIR—Central Drug Research InstituteLucknowUttar PradeshIndia
- Academy of Scientific and Innovative Research (AcSIR)GhaziabadUttar PradeshIndia
| | - Sristi Agrawal
- Pharmaceutics and Pharmacokinetics DivisionCSIR—Central Drug Research InstituteLucknowUttar PradeshIndia
- Academy of Scientific and Innovative Research (AcSIR)GhaziabadUttar PradeshIndia
| | - Sachin Nashik Sanap
- Pharmaceutics and Pharmacokinetics DivisionCSIR—Central Drug Research InstituteLucknowUttar PradeshIndia
- Academy of Scientific and Innovative Research (AcSIR)GhaziabadUttar PradeshIndia
| | | | - Nelam Kumar
- Biochemistry and Structural Biology DivisionCSIR—Central Drug Research InstituteLucknowUttar PradeshIndia
- Present address:
International Centre for Translational Eye Research (ICTER)Institute of Physical Chemistry (IChF)Marcina Kasprzaka 44/5201‐224WarsawPoland
| | - Rajdeep Gupta
- Pharmaceutics and Pharmacokinetics DivisionCSIR—Central Drug Research InstituteLucknowUttar PradeshIndia
| | - Rabi Sankar Bhatta
- Pharmaceutics and Pharmacokinetics DivisionCSIR—Central Drug Research InstituteLucknowUttar PradeshIndia
- Academy of Scientific and Innovative Research (AcSIR)GhaziabadUttar PradeshIndia
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Joseph K, Chan PSF, Fang Y, Chen S, Mo PKH, Wang Z. Knowledge and practice of personal protective measures against COVID-19 in Africa: a systematic review. JMIR Public Health Surveill 2023; 9:e44051. [PMID: 37058578 DOI: 10.2196/44051] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 03/29/2023] [Accepted: 04/10/2023] [Indexed: 04/16/2023] Open
Abstract
BACKGROUND The Coronavirus disease 2019 (COVID-19) pandemic being a newly evolving disease, its response measures largely depend on the practice of and compliance with personal protective measures (PPMs). OBJECTIVE This systematic review aimed to examine the knowledge and practice of COVID-19 PPMs in African countries, as documented in the published literature. METHODS A systematic search was conducted on Scopus, PubMed, and Web of Science databases using appropriate keywords and predefined eligibility criteria for the selection of relevant studies. Only population-based original research studies (including qualitative, quantitative, and mixed-method studies) done in Africa, and published in the English language were included. The screening process and data extraction were performed according to a pre-registered protocol in PROSPERO (CRD42022355101) and followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The quality of included studies was assessed using the Mixed-Method Appraisal Tool. Thematic analysis was used to systematically summarise the studies into four predefined domains: i) knowledge and perception about PPMs, ii) mask use, iii) social/physical distancing, and iv) hand washing/hygiene, including their respective levels and associated factors. RESULTS A total of 58 studies across 12 African countries were included, and these were published between 2019 and 2022. African communities, including various population groups, had varying levels of knowledge and practice of COVID-19 PPMs, with lack of personal protective equipment (PPE) (mainly face masks), and side effects (among health care workers) being the major reasons for poor compliance. Lower rates of handwashing/ hygiene were particularly noted in several African countries, especially among the urban poor and slum-dwellers, with the main barrier being the lack of safe and clean water. Various cognitive (knowledge and perception), socio-demographic and economic factors were associated with the practice of COVID-19 PPMs. Moreover, there were evident research inequalities on the regional level, where East Africa contributed 36.2%, West Africa 20.7%, North Africa 17.2%, Southern Africa 6.9%, and no single-country study from Central Africa. Nonetheless, the overall quality of the included studies was generally good, as they satisfied most of the quality assessment criteria. CONCLUSIONS There is a need to enhance local capacity to produce and supply PPE. Consideration of various cognitive, demographic and socioeconomic differences, with extra focus on the most vulnerable, is crucial for inclusive and more effective strategies against the pandemic. Moreover, more focus and involvement in community behavioral research are needed to fully understand and address the dynamics of the current pandemic in Africa. CLINICALTRIAL The study protocol was registered in PROSPERO (CRD42022355101).
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Affiliation(s)
- Kawuki Joseph
- Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China, Room 508, School of Public Health, Prince of Wales Hospital,, Shatin, N.T., HK
| | - Paul Shing-Fong Chan
- Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China, Room 508, School of Public Health, Prince of Wales Hospital,, Shatin, N.T., HK
| | - Yuan Fang
- Department of Health and Physical Education, the Education University of Hong Kong, Hong Kong, China, New Territories, HK
| | - Siyu Chen
- Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China, Room 508, School of Public Health, Prince of Wales Hospital,, Shatin, N.T., HK
| | - Phoenix K H Mo
- Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China, Room 508, School of Public Health, Prince of Wales Hospital,, Shatin, N.T., HK
| | - Zixin Wang
- Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China, Room 508, School of Public Health, Prince of Wales Hospital,, Shatin, N.T., HK
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Onyeaghala AA, Anyiam AF, Husaini DC, Onyeaghala EO, Obi E. Herbal Supplements as Treatment Options for COVID-19: A call for Clinical Development of Herbal Supplements for Emerging and Re-Emerging Viral Threats in Sub-Saharan Africa. SCIENTIFIC AFRICAN 2023; 20:e01627. [PMID: 36974333 PMCID: PMC9985929 DOI: 10.1016/j.sciaf.2023.e01627] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 02/10/2023] [Accepted: 03/02/2023] [Indexed: 03/07/2023] Open
Abstract
The advent of Corona virus Disease 2019 (COVID-19) distorted health systems of many countries. Efforts have been made to either develop new treatment solutions such as vaccines or repurpose previously adopted drugs. Challenges in accessing available treatment, inadequate, non-existent, or overstretched healthcare facilities, long COVID disease, cultural practices and beliefs about vaccination, vaccine hesitancy, availability, accessibility and perceived safety of herbal supplements seem to be major factors propelling individuals to use herbal supplements. Published reports advocating for clinical development of herbal supplements for COVID-19 and other emerging and re-emerging viral diseases are sparse. This paper aims to review the pathogenesis of COVID-19, use of herbal products during the pandemic and make case for clinical development of herbal supplements through the adoption of modern and acceptable technologies and research processes. This was a scoping review. Database searches of Google Scholar, PubMed and ResearchGate among others were performed using related keywords to identify relevant journals and lists of primary articles. Clinical trial databases:-Clinicaltrial.gov, Pan African Clinical Trial Registry (PACTR) and WHO international clinical trial registry (ICTRP) were reviewed to extract data. The use of herbal supplements during COVID-19 was not only peculiar to individuals living in Sub-Saharan Africa, but a global practice. Herbal supplements recommended to manage COVID-19 have not been validated using clinical trials. Available data showed that the number of herbal supplements undergoing clinical trial for COVID-19 indication in Africa was low. The availability of medicinal plants in Sub-Saharan Africa if well explored has great potentials to address various emerging and re-emerging viral diseases confronting the region. The economic potential of clinically validated herbal supplements are huge, and tapping into this opportunity created by preference of population to herbal supplement could increase export of herbal supplement and gross domestic product (GDP) of respective countries in Africa.
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Affiliation(s)
- Augustine Anayochukwu Onyeaghala
- Unit of Clinical Chemistry, Department of Medical Laboratory Science, University College Hospital, Ibadan,Unit of Clinical Chemistry, Department of Medical Laboratory Science, Chrisland University, Owode, Abeokuta, Ogun State,Corresponding Author
| | - Arinze Favour Anyiam
- Department of Medical Laboratory Science, Thomas Adewumi University, Oko, Kwara State
| | - Danladi Chiroma Husaini
- Department of Allied Health (Pharmacy), Faculty of Health Sciences, University of Belize, Belize, Central America
| | | | - Ejeatuluchukwu Obi
- Department of Pharmacology and Therapeutics, Faculty of Basic Clinical Science, College of Health Science, Nnamdi Azikiwe University, Nnewi, Campus, Nnewi
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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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LY BA, Ahmed MAAG, TRAORE FB, DIARRA NH, DEMBELE M, DIARRA D, KANDÉ IF, SANGHO H, DOUMBIA S. CHALLENGES AND DIFFICULTIES IN IMPLEMENTING AND ADOPTING ISOLATION AND QUARANTINE MEASURES AMONG INTERNALLY DISPLACED PEOPLE DURING THE COVID-19 PANDEMIC IN MALI (161/250). J Migr Health 2022; 5:100104. [PMID: 35434677 PMCID: PMC8994677 DOI: 10.1016/j.jmh.2022.100104] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 03/19/2022] [Accepted: 04/09/2022] [Indexed: 11/18/2022] Open
Abstract
The lack of facilities for quarantine and isolation in the sites for internally displaced people (IDPs) was found to be a barrier to the adoption of isolation and quarantine measures by IDPs. Changes in social behavior and practices to adopt isolation and quarantine were found to be difficult for IDPs. Financial vulnerability and fear of stigma were identified as barriers to the adoption of isolation and quarantine measures by IDPs. Endogen solutions to adopt isolation and quarantine measures include strengthening IDPs’ awareness on COVID-19 by IDPs.
Introduction Isolation and quarantine are among the key measures that protect internally displaced people (IDPs) against COVID-19. This study aims to identify the challenges encountered by humanitarian actors, and health, political, and administrative stakeholders in implementing these measures. It also describes the difficulties faced by IDPs when adopting them, and the local initiatives developed to overcome those difficulties. Method We conducted a qualitative survey consisting of individual interviews and focus groups among IDPs, humanitarian actors, and health, political, and administrative stakeholders. The data was collected between November and December 2020 in the Bamako and Ségou Regions of Mali. Interviews were recorded with audio recorders, then transcribed and thematically analyzed using the NVivo 13 software. Findings The study involved 36 individual interviews and eight focus groups with 68 participants of whom IDPs represented 72.3%. The main challenges reported on IDP sites included difficulties in contacting positive cases, a lack of facilities for quarantine and isolation, a lack of physical space for building new facilities, and a lack of financial resources to support IDPs during isolation and quarantine. The difficulties reported included: changes in social behavior and practices, fear of stigma, a poor level of literacy, and language barriers. To address those difficulties, the local initiatives developed by IDPs included strengthening the awareness of IDPs on COVID-19, early warning of sites’ leaders about positive and suspected cases, and setting up a toll-free number to facilitate access to appropriate information on COVID-19. Conclusion The findings of this study could be used as evidence to guide policy, adjust current strategies and take into account with more focus IDPs, a group with increased vulnerability, in COVID-19 response, more precisely during the implementation of isolation and quarantine measures. By doing so, they will help improve the response to COVID-19, IDPs health, and population health.
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Orish VN, Boakye-Yiadom E, Ansah EK, Alhassan RK, Duedu K, Awuku YA, Owusu-Agyei S, Gyapong JO. Is malaria immunity a possible protection against severe symptoms and outcomes of COVID-19? Ghana Med J 2022; 55:56-63. [PMID: 35233116 PMCID: PMC8853697 DOI: 10.4314/gmj.v55i2s.9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Malaria-endemic areas of the world are noted for high morbidity and mortality from malaria. Also noted in these areas is the majority of persons in the population having acquired malaria immunity. Though this acquired malaria immunity does not prevent infection, it resists the multiplication of Plasmodium parasites, restricting disease to merely uncomplicated cases or asymptomatic infections. Does this acquired malaria immunity in endemic areas protect against other diseases, especially outbreak diseases like COVID-19? Does malaria activation of innate immunity resulting in trained or tolerance immunity contribute to protection against COVID-19? In an attempt to answer these questions, this review highlights the components of malaria and viral immunity and explores possible links with immunity against COVID-19. With malaria-endemic areas of the world having a fair share of cases of COVID-19, it is important to direct research in this area to evaluate and harness any benefits of acquired malaria immunity to help mitigate the effects of COVID-19 and any possible future outbreaks. Funding None declared.
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Affiliation(s)
- Verner N Orish
- Department of Microbiology and Immunology, School of Medicine, University of Health and Allied Sciences, Ho, Volta Region, Ghana
| | - Emily Boakye-Yiadom
- Department of Microbiology and Immunology, School of Medicine, University of Health and Allied Sciences, Ho, Volta Region, Ghana
| | - Evelyn K Ansah
- Centre for Malaria Research, Institute for Health Research, University of Health and Allied Sciences, Ho, Volta Region, Ghana
| | - Robert K Alhassan
- Institute of Health Research, University of Health and Allied Sciences, Ho, Volta Region, Ghana
| | - Kwabena Duedu
- Department of Biomedical Sciences, School of Basic and Biomedical Sciences, University of Health and Allied Sciences, Ho, Volta Region, Ghana
| | - Yaw A Awuku
- Department of Internal Medicine, School of Medicine, University of Health and Allied Sciences, Ho, Volta Region, Ghana
| | - Seth Owusu-Agyei
- Institute of Health Research, University of Health and Allied Sciences, Ho, Volta Region, Ghana
| | - John O Gyapong
- Institute of Health Research, University of Health and Allied Sciences, Ho, Volta Region, Ghana
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Assefa Y, Gilks CF, Reid S, van de Pas R, Gete DG, Van Damme W. Analysis of the COVID-19 pandemic: lessons towards a more effective response to public health emergencies. Global Health 2022; 18:10. [PMID: 35120537 PMCID: PMC8815718 DOI: 10.1186/s12992-022-00805-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 01/14/2022] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND The pandemic of Coronavirus Disease 2019 (COVID-19) is a timely reminder of the nature and impact of Public Health Emergencies of International Concern. As of 12 January 2022, there were over 314 million cases and over 5.5 million deaths notified since the start of the pandemic. The COVID-19 pandemic takes variable shapes and forms, in terms of cases and deaths, in different regions and countries of the world. The objective of this study is to analyse the variable expression of COVID-19 pandemic so that lessons can be learned towards an effective public health emergency response. METHODS We conducted a mixed-methods study to understand the heterogeneity of cases and deaths due to the COVID-19 pandemic. Correlation analysis and scatter plot were employed for the quantitative data. We used Spearman's correlation analysis to determine relationship strength between cases and deaths and socio-economic and health systems. We organized qualitative information from the literature and conducted a thematic analysis to recognize patterns of cases and deaths and explain the findings from the quantitative data. RESULTS We have found that regions and countries with high human development index have higher cases and deaths per million population due to COVID-19. This is due to international connectedness and mobility of their population related to trade and tourism, and their vulnerability related to older populations and higher rates of non-communicable diseases. We have also identified that the burden of the pandemic is also variable among high- and middle-income countries due to differences in the governance of the pandemic, fragmentation of health systems, and socio-economic inequities. CONCLUSION The COVID-19 pandemic demonstrates that every country remains vulnerable to public health emergencies. The aspiration towards a healthier and safer society requires that countries develop and implement a coherent and context-specific national strategy, improve governance of public health emergencies, build the capacity of their (public) health systems, minimize fragmentation, and tackle upstream structural issues, including socio-economic inequities. This is possible through a primary health care approach, which ensures provision of universal and equitable promotive, preventive and curative services, through whole-of-government and whole-of-society approaches.
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Affiliation(s)
- Yibeltal Assefa
- School of Public Health, the University of Queensland, Brisbane, Australia
| | - Charles F. Gilks
- School of Public Health, the University of Queensland, Brisbane, Australia
| | - Simon Reid
- School of Public Health, the University of Queensland, Brisbane, Australia
| | | | - Dereje Gedle Gete
- School of Public Health, the University of Queensland, Brisbane, Australia
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10
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Gwenzi W. Wastewater, waste, and water-based epidemiology (WWW-BE): A novel hypothesis and decision-support tool to unravel COVID-19 in low-income settings? THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 806:150680. [PMID: 34599955 PMCID: PMC8481624 DOI: 10.1016/j.scitotenv.2021.150680] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 09/22/2021] [Accepted: 09/26/2021] [Indexed: 05/02/2023]
Abstract
Traditional wastewater-based epidemiology (W-BE) relying on SARS-CoV-2 RNA detection in wastewater is attractive for understanding COVID-19. Yet traditional W-BE based on centralized wastewaters excludes putative SARS-CoV-2 reservoirs such as: (i) wastewaters from shared on-site sanitation facilities, (ii) solid waste including faecal sludge from non-flushing on-site sanitation systems, and COVID-19 personal protective equipment (PPE), (iii) raw/untreated water, and (iv) drinking water supply systems in low-income countries (LICs). A novel hypothesis and decision-support tool based on Wastewater (on-site sanitation, municipal sewer systems), solid Waste, and raw/untreated and drinking Water-based epidemiology (WWW-BE) is proposed for understanding COVID-19 in LICs. The WWW-BE conceptual framework, including components and principles is presented. Evidence on the presence of SARS-CoV-2 and its proxies in wastewaters, solid materials/waste (papers, metals, fabric, plastics), and raw/untreated surface water, groundwater and drinking water is discussed. Taken together, wastewaters from municipal sewer and on-site sanitation systems, solid waste such as faecal sludge and COVID-19 PPE, raw/untreated surface water and groundwater, and drinking water systems in LICs act as potential reservoirs that receive and harbour SARS-CoV-2, and then transmit it to humans. Hence, WWW-BE could serve a dual function in estimating the prevalence and potential transmission of COVID-19. Several applications of WWW-BE as a hypothesis and decision support tool in LICs are discussed. WWW-BE aggregates data from various infected persons in a spatial unit, hence, putatively requires less resources (analytical kits, personnel) than individual diagnostic testing, making it an ideal decision-support tool for LICs. The novelty, and a critique of WWW-BE versus traditional W-BE are presented. Potential challenges of WWW-BE include: (i) biohazards and biosafety risks, (ii) lack of expertise, analytical equipment, and accredited laboratories, and (iii) high uncertainties in estimates of COVID-19 cases. Future perspectives and research directions including key knowledge gaps and the application of novel and emerging technologies in WWW-BE are discussed.
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Affiliation(s)
- Willis Gwenzi
- Biosystems and Environmental Engineering Research Group, Department of Agricultural and Biosystems Engineering, Faculty of Agriculture, Environment and Food Systems, University of Zimbabwe, P. O. Box MP 167, Mount Pleasant, Harare, Zimbabwe.
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11
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Potential Contribution of Climate Conditions on COVID-19 Pandemic Transmission over West and North African Countries. ATMOSPHERE 2021. [DOI: 10.3390/atmos13010034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
COVID-19, caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), is a very contagious disease that has killed many people worldwide. According to data from the World Health Organization (WHO), the spread of the disease appears to be slower in Africa. Although several studies have been published on the relationship between meteorological parameters and COVID-19 transmission, the effects of climate conditions on COVID-19 remain largely unexplored and without consensus. However, the transmission of COVID-19 and sensitivity to climate conditions are also not fully understood in Africa. Here, using available epidemiological data over 275 days (i.e., from 1 March to 30 November 2020) taken from the European Center for Disease Prevention and Control of the European Union database and daily data of surface air temperature specific humidity and water vapor from the National Center for Environmental Prediction (NCEP), this paper investigates the potential contribution of climate conditions on COVID-19 transmission over 16 selected countries throughout three climatic regions of Africa (i.e., Sahel, Maghreb, and Gulf of Guinea). The results highlight statistically significant inverse correlations between COVID-19 cases and temperature over the Maghreb and the Gulf of Guinea regions. In contrast, positive correlations are found over the Sahel area, especially in the central part, including Niger and Mali. Correlations with specific humidity and water vapor parameters display significant and positive values over the Sahelian and the Gulf of Guinea countries and negative values over the Maghreb countries. Then, the COVID-19 pandemic transmission is influenced differently across the three climatic regions: (i) cold and dry environmental conditions over the Maghreb; (ii) warm and humid conditions over the Sahel; and (iii) cold and humid conditions over the Gulf of Guinea. In addition, for all three climatic regions, even though the climate impact has been found to be significant, its effect appears to display a secondary role based on the explanatory power variance compared to non-climatic factors assumed to be dominated by socio-economic factors and early strong public health measures.
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12
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Adejumo PO, Nawagi F, Kolawole IO, Ismail MR, Mukalay AW, Nabirye RC, Kazembe A, Ojo IO, Adejumo A, Nachenga JB, Suleman F, Sewankambo NK, Okanlawon FA, Noormahomed EV. Knowledge, preparedness, and attitude towards COVID-19 among health profession students in Sub-Saharan Africa: A cross-sectional survey. IJID REGIONS 2021; 1:150-158. [PMID: 35721773 PMCID: PMC8894130 DOI: 10.1016/j.ijregi.2021.10.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 10/21/2021] [Accepted: 10/22/2021] [Indexed: 04/14/2023]
Abstract
Objective We assessed the knowledge, preparedness, and attitude of health profession students towards COVID-19 outbreak in Sub-Saharan Africa. Methods This cross-sectional study used convenience sampling to recruit participants from institutions under African Forum for Research and Education in Health (AFREhealth). The survey was developed in QuestionPro software covering the participants' socio-demographic characteristics, knowledge, attitude, and preparedness towards the COVID-19 outbreak. Data were analysed and the association between variables was tested. Results The mean age of the 336 students was 25•75 (±7•88) years. Most (99•7%) knew the cause of COVID-19 which could be transmitted via droplets (97•3%). Several participants vowed to adhere to preventive measures (92•3%) and claimed their curriculum equipped them with skills addressing infectious disease outbreaks (63•6%). Nursing students were better prepared than other students (p=0•001). Students from West African regions were more prepared (p=0•001) and aware they could contract COVID-19 if they cared for infected persons (p=0•001). Conclusion Students are knowledgeable about COVID-19, adequately prepared to handle epidemics, have a positive attitude towards infection prevention, and their training institutions and government have taken adequate measures to address the COVID-19 outbreak. Funding AFREhealth.
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Affiliation(s)
| | - Faith Nawagi
- Ph.D. scholar - Makerere University College of Health sciences Uganda, Global Partnership Development Rep- Africa- ECFMG|FAIMER
| | | | - Mamudo Rafik Ismail
- Associate Professor, Surgical Pathologist Head Pathology Department, Faculty of Medicine, Eduardo Mondlane University (UEM) Avenue Salvador Allende n°702, P.O. Box 257 Maputo, Mozambique
| | - Abdon W. Mukalay
- University of Lubumbashi, Faculty of medicine & School of Public Health, Clinical Epidemiology and Tropical Disease Unit, Nr 111, Cliniques Universitaires de Lubumbashi, Democratic Republic of the Congo
| | | | - Abigail Kazembe
- Faculty of Midwifery, Neonatal and Reproductive Health Studies, Kazumu College of Nursing, University of Malawi
| | | | - Adebayo Adejumo
- Department of Psychology, Faculty of Social Sciences, University of Ibadan, Nigeria
| | - Jean B. Nachenga
- Infectious diseases and Microbiology, Department of Epidemiology and Center for Global Health, University of Pittsburg, Graduate School of Public Health
| | - Fatima Suleman
- Pharmaceutical Sciences, School of Health Sciences, University of KwaZulu-Nata, Durban, South Africa
| | | | | | - Emilia Virginia Noormahomed
- Department of Microbiology, Parasitology Laboratory, Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique
- Department of Medicine, Infectious Diseases Division, University of California, San Diego, USA
- Mozambique Institute for Health Education and Research, Maputo, Mozambique
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13
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Kufa T, Jassat W, Cohen C, Tempia S, Masha M, Wolter N, Walaza S, von Gottburg A, Govender NP, Hunt G, Shonhiwa AM, Ebonwu J, Ntshoe G, Maruma W, Bapela P, Ndhlovu N, Mathema H, Modise M, Shuping L, Manana PN, Moore D, Dangor Z, Verwey C, Madhi SA, Saloojee H, Zar HJ, Blumberg L. Epidemiology of SARS-CoV-2 infection and SARS-CoV-2 positive hospital admissions among children in South Africa. Influenza Other Respir Viruses 2021; 16:34-47. [PMID: 34796674 PMCID: PMC9664941 DOI: 10.1111/irv.12916] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 09/15/2021] [Indexed: 12/15/2022] Open
Abstract
Introduction We describe epidemiology and outcomes of confirmed SARS‐CoV‐2 infection and positive admissions among children <18 years in South Africa, an upper‐middle income setting with high inequality. Methods Laboratory and hospital COVID‐19 surveillance data, 28 January ‐ 19 September 2020 was used. Testing rates were calculated as number of tested for SARS‐CoV‐2 divided by population at risk; test positivity rates were calculated as positive tests divided by total number of tests. In‐hospital case fatality ratio (CFR) was calculated based on hospitalized positive admissions with outcome data who died in‐hospital and whose death was judged SARS‐CoV‐2 related by attending physician. Findings 315 570 children aged <18 years were tested for SARS‐CoV‐2; representing 8.9% of all 3 548 738 tests and 1.6% of all children in the country. Of children tested, 46 137 (14.6%) were positive. Children made up 2.9% (n = 2007) of all SARS‐CoV‐2 positive admissions to sentinel hospitals. Among children, 47 died (2.6% case‐fatality). In‐hospital deaths were associated with male sex [adjusted odds ratio (aOR) 2.18 (95% confidence intervals [CI] 1.08–4.40)] vs female; age <1 year [aOR 4.11 (95% CI 1.08–15.54)], age 10–14 years [aOR 4.20 (95% CI1.07–16.44)], age 15–17 years [aOR 4.86 (95% 1.28–18.51)] vs age 1–4 years; admission to a public hospital [aOR 5.07(95% 2.01–12.76)] vs private hospital and ≥1 underlying conditions [aOR 12.09 (95% CI 4.19–34.89)] vs none. Conclusions Children with underlying conditions were at greater risk of severe SARS‐CoV‐2 outcomes. Children > 10 years, those in certain provinces and those with underlying conditions should be considered for increased testing and vaccination.
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Affiliation(s)
- Tendesayi Kufa
- National Institute for Communicable DiseasesNational Health Laboratory ServicesJohannesburgSouth Africa
- School of Public HealthUniversity of the WitwatersrandJohannesburgSouth Africa
| | - Waasila Jassat
- National Institute for Communicable DiseasesNational Health Laboratory ServicesJohannesburgSouth Africa
| | - Cheryl Cohen
- National Institute for Communicable DiseasesNational Health Laboratory ServicesJohannesburgSouth Africa
- School of Public HealthUniversity of the WitwatersrandJohannesburgSouth Africa
| | - Stefano Tempia
- School of Public HealthUniversity of the WitwatersrandJohannesburgSouth Africa
- Influenza Division, National Center for Immunization and Respiratory DiseasesUS Centers for Disease Control and PreventionAtlantaGeorgiaUSA
- MassGenicsDuluthGeorgiaUSA
| | - Maureen Masha
- National Institute for Communicable DiseasesNational Health Laboratory ServicesJohannesburgSouth Africa
| | - Nicole Wolter
- National Institute for Communicable DiseasesNational Health Laboratory ServicesJohannesburgSouth Africa
- School of PathologyUniversity of the WitwatersrandJohannesburgSouth Africa
| | - Sibongile Walaza
- National Institute for Communicable DiseasesNational Health Laboratory ServicesJohannesburgSouth Africa
| | - Anne von Gottburg
- National Institute for Communicable DiseasesNational Health Laboratory ServicesJohannesburgSouth Africa
- School of PathologyUniversity of the WitwatersrandJohannesburgSouth Africa
| | - Nelesh P. Govender
- National Institute for Communicable DiseasesNational Health Laboratory ServicesJohannesburgSouth Africa
- School of PathologyUniversity of the WitwatersrandJohannesburgSouth Africa
| | - Gillian Hunt
- National Institute for Communicable DiseasesNational Health Laboratory ServicesJohannesburgSouth Africa
- School of PathologyUniversity of the WitwatersrandJohannesburgSouth Africa
| | | | - Joy Ebonwu
- National Institute for Communicable DiseasesNational Health Laboratory ServicesJohannesburgSouth Africa
| | - Genevie Ntshoe
- National Institute for Communicable DiseasesNational Health Laboratory ServicesJohannesburgSouth Africa
- School of Health Systems and Public Health, Faculty of Health SciencesUniversity of PretoriaPretoriaSouth Africa
| | - Wellington Maruma
- National Institute for Communicable DiseasesNational Health Laboratory ServicesJohannesburgSouth Africa
| | - Poncho Bapela
- National Institute for Communicable DiseasesNational Health Laboratory ServicesJohannesburgSouth Africa
| | - Nomathamsanqa Ndhlovu
- National Institute for Communicable DiseasesNational Health Laboratory ServicesJohannesburgSouth Africa
| | - Hlengani Mathema
- National Institute for Communicable DiseasesNational Health Laboratory ServicesJohannesburgSouth Africa
| | - Motshabi Modise
- National Institute for Communicable DiseasesNational Health Laboratory ServicesJohannesburgSouth Africa
| | - Liliwe Shuping
- National Institute for Communicable DiseasesNational Health Laboratory ServicesJohannesburgSouth Africa
| | - Pinky N. Manana
- National Institute for Communicable DiseasesNational Health Laboratory ServicesJohannesburgSouth Africa
- School of PathologyUniversity of the WitwatersrandJohannesburgSouth Africa
| | - David Moore
- Department of Pediatrics and Child HealthUniversity of the WitwatersrandJohannesburgSouth Africa
| | - Ziyaad Dangor
- Department of Pediatrics and Child HealthUniversity of the WitwatersrandJohannesburgSouth Africa
| | - Charl Verwey
- Department of Pediatrics and Child HealthUniversity of the WitwatersrandJohannesburgSouth Africa
| | - Shabir A. Madhi
- South African Medical Research Council: Vaccines and Infectious Diseases Analytical Research Unit (VIDA), Faculty of Health Science JohannesburgUniversity of the WitwatersrandJohannesburgSouth Africa
- Department of Science/National Research Foundation: Vaccine Preventable Diseases, Faculty of Health Science JohannesburgUniversity of the WitwatersrandJohannesburgSouth Africa
| | - Haroon Saloojee
- Department of Pediatrics and Child HealthUniversity of the WitwatersrandJohannesburgSouth Africa
| | - Heather J. Zar
- Dept of Paediatrics and Child Health, Red Cross Children's Hospital, and SA‐MRC Unit on Child and Adolescent HealthUniversity of Cape TownCape TownSouth Africa
| | - Lucille Blumberg
- National Institute for Communicable DiseasesNational Health Laboratory ServicesJohannesburgSouth Africa
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14
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Iroungou BA, Mangouka LG, Bivigou-Mboumba B, Moussavou-Boundzanga P, Obame-Nkoghe J, Nzigou Boucka F, Mouinga-Ondeme A, Aghokeng AF, Tchoua R, Pineau P, Nzenze JR. Demographic and Clinical Characteristics Associated With Severity, Clinical Outcomes, and Mortality of COVID-19 Infection in Gabon. JAMA Netw Open 2021; 4:e2124190. [PMID: 34519768 PMCID: PMC8441589 DOI: 10.1001/jamanetworkopen.2021.24190] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
IMPORTANCE Since the emergence of COVID-19 in central China, sub-Saharan African countries, with the exception of South Africa, have been relatively spared during the COVID-19 pandemic. Consequently, few descriptive studies from this region are available. OBJECTIVE To describe the clinical characteristics and outcomes of patients with COVID-19 infection in Gabon, from March to June 2020. DESIGN, SETTING, AND PARTICIPANTS A single-center, cross-sectional study of 837 patients with COVID-19 was conducted from March to June 2020 in the Armed Forces Hospital in Libreville, Gabon. MAIN OUTCOMES AND MEASURES Demographic and clinical characteristics and imaging findings of hospitalized patients with COVID-19. RESULTS Of the 837 patients enrolled, 572 (68.3%) were men, and 264 (31.5%) were women (male to female ratio, 2:1); the median (interquartile range [IQR]) age was 35 (30-45) years (mean [SD] age, 38.0 [12.2] years. The mortality rate associated with COVID-19 was low (1.4%). Of these 837 patients, 524 (62.6%) were categorized as having no symptoms, 282 (33.7%) as having mild symptoms, and 31 (3.7%) as having severe symptoms. Patients with severe symptoms were older (mean [SD] age, 46.1 [14.7] years) than patients with mild symptoms (mean [SD] age, 41.3 [12.5] years) and those with no symptoms (mean [SD] age, 35.7 [11.3] years) (Kruskal-Wallis χ22 = 53.5; P < .001). History of diabetes was the principal risk factor associated with both severe symptoms in 5 of 31 patients (16.1%) and mild symptoms in 11 of 282 (3.9%) compared with no symptoms in 5 of 524 (0.9%) (Pearson χ22 = 30.9; P < .001). Patients with severe symptoms and a fatal outcome were older (mean [SD] age, 53.4 [15.1] years) than survivors (mean [SD] age, 41.5 [12.9] years) (t20.83 = 2.2; P = .03). CONCLUSIONS AND RELEVANCE In this single-center, cross-sectional study in Libreville, Gabon, the mortality rate associated with COVID-19 infection from March to June 2020 was low, and patients who died of COVID-19 infection were younger on average than reported elsewhere, possibly reflecting a smaller elderly population in Gabon.
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Affiliation(s)
- Berthe Amélie Iroungou
- Unité Mixte de Recherche Centre International de Recherches Médicales de Franceville et le Service de Santé Militaire, Libreville, Gabon
| | | | - Berthold Bivigou-Mboumba
- Unité Mixte de Recherche Centre International de Recherches Médicales de Franceville et le Service de Santé Militaire, Libreville, Gabon
| | - Pamela Moussavou-Boundzanga
- Unité Mixte de Recherche Centre International de Recherches Médicales de Franceville et le Service de Santé Militaire, Libreville, Gabon
- Laboratoire de Biologie Moléculaire et Cellulaire, Université des Sciences et Techniques de Masuku, Franceville, Gabon
| | - Judicaël Obame-Nkoghe
- Laboratoire de Biologie Moléculaire et Cellulaire, Université des Sciences et Techniques de Masuku, Franceville, Gabon
- Unité Écologie des Systèmes Vectoriels, Centre Interdisciplinaire de Recherches Médicales de Franceville, Franceville, Gabon
| | | | - Augustin Mouinga-Ondeme
- Unité Mixte de Recherche Centre International de Recherches Médicales de Franceville et le Service de Santé Militaire, Libreville, Gabon
| | - Avelin Fobang Aghokeng
- Unité Mixte de Recherche Centre International de Recherches Médicales de Franceville et le Service de Santé Militaire, Libreville, Gabon
- Unité Mixite de Recherche, Institut de Recherche pour Developpement 224, Centre National de la Recherche Scientifique 5290, Maladies infectieuses et Vecteurs: Écologie, Génétique, Évolution et Contrôle, Université de Montpellier, Montpellier, France
| | - Romain Tchoua
- Service de Réanimation, Hôpital d’Instruction des Armées Omar Bongo Ondimba, Libreville, Gabon
| | - Pascal Pineau
- Unité “Organisation Nucléaire et Oncogenèse,” INSERM U993, Institut Pasteur, Paris, France
| | - Jean Raymond Nzenze
- Service de Médecine Interne, Hôpital d’Instruction des Armées Omar Bongo Ondimba, Libreville, Gabon
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15
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Buowari D, Ogundipe H. SEVERE ACUTE RESPIRATORY SYNDROME CORONAVIRUS-2 (SARS-COV-2) INFECTION: AN EPIDEMIOLOGICAL REVIEW. Ann Ib Postgrad Med 2021; 19:S68-S76. [PMID: 35095373 PMCID: PMC8791400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND New strains of different organisms, three of which has been caused by betacorona viruses (SARS-CoV, MERS-CoV and SARSCoV- 2) have caused epidemics and pandemics. The COVID-19, caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) started in China in December 2019 has spread globally. Understanding its pattern of spread and how it affects the populace helps to guide formulation of strategies at curbing its spread, managing the disease and allocation of limited resources in tackling the pandemic. METHODOLOGY This is a review article about the epidemiology of the coronavirus disease -2019 (COVID-19). Various search engines were used to accumulate literature on the topic; these include PubMed, Google scholar, Ajol. RESULTS As at October 29, 2020, SARS-CoV2 has spread to all continents except the Antarctica. Though a zoonotic disease, human to human transmission has resulted to this pandemic is via direct and indirect contact of droplets with mucosal surfaces. Most severe cases occur among the elderly, males, and people with co-morbid diseases. The average incubation period is 2-10 days. When compared with SARS-CoV (Ro: 2.3-3.7, mortality rate 11%) and MERS-CoV (Ro: 0.8-1.3, mortality rate: 34.3%), SARS-Cov-2 is a highly infective (Ro: as high as 6.5) with low mortality rates (average range mortality rates 1.83- 6.3%). CONCLUSION COVID-19 is a highly infective novel virus. Older persons and people with medical comorbidities are more susceptible to the severe form of the disease and mortality. As the second wave comes on, a sustainable measure of limiting the spread and consequences of COVID-19 should be more emphasized.
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Affiliation(s)
- D.Y. Buowari
- Department of Accident and Emergency, University of Port Harcourt Teaching Hospital, Port Harcourt, Rivers State, Nigeria
| | - H.D. Ogundipe
- Department of Accident and Emergency, University of Port Harcourt Teaching Hospital, Port Harcourt, Rivers State, Nigeria
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16
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Park JJH, Mogg R, Smith GE, Nakimuli-Mpungu E, Jehan F, Rayner CR, Condo J, Decloedt EH, Nachega JB, Reis G, Mills EJ. How COVID-19 has fundamentally changed clinical research in global health. Lancet Glob Health 2021; 9:e711-e720. [PMID: 33865476 PMCID: PMC8049590 DOI: 10.1016/s2214-109x(20)30542-8] [Citation(s) in RCA: 112] [Impact Index Per Article: 37.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 12/07/2020] [Accepted: 12/10/2020] [Indexed: 01/07/2023]
Abstract
COVID-19 has had negative repercussions on the entire global population. Despite there being a common goal that should have unified resources and efforts, there have been an overwhelmingly large number of clinical trials that have been registered that are of questionable methodological quality. As the final paper of this Series, we discuss how the medical research community has responded to COVID-19. We recognise the incredible pressure that this pandemic has put on researchers, regulators, and policy makers, all of whom were doing their best to move quickly but safely in a time of tremendous uncertainty. However, the research community's response to the COVID-19 pandemic has prominently highlighted many fundamental issues that exist in clinical trial research under the current system and its incentive structures. The COVID-19 pandemic has not only re-emphasised the importance of well designed randomised clinical trials but also highlighted the need for large-scale clinical trials structured according to a master protocol in a coordinated and collaborative manner. There is also a need for structures and incentives to enable faster data sharing of anonymised datasets, and a need to provide similar opportunities to those in high-income countries for clinical trial research in low-resource regions where clinical trial research receives considerably less research funding.
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Affiliation(s)
- Jay J H Park
- Department of Experimental Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Robin Mogg
- Bill & Melinda Gates Medical Research Institute, Boston, MA, USA
| | - Gerald E Smith
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
| | | | - Fyezah Jehan
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | - Craig R Rayner
- Monash Institute of Pharmaceutical Sciences, Monash University, Melbourne, VIC, Australia; Certara, Princeton, NJ, USA
| | - Jeanine Condo
- School of Public Health, University of Rwanda, Kigali, Rwanda
| | - Eric H Decloedt
- Department of Medicine, Division of Clinical Pharmacology, Stellenbosch University, Cape Town, South Africa
| | - Jean B Nachega
- Department of Medicine and Center for Infectious Diseases, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa; Department of Epidemiology and Department of Infectious Diseases and Microbiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA; Department of Epidemiology and Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Gilmar Reis
- Departamento de Medicina, Pontifícia Universidade Católica de Minas Gerais, Belo Horizonte, Brazil
| | - Edward J Mills
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada; Cytel, Vancouver, BC, Canada; School of Public Health, University of Rwanda, Kigali, Rwanda.
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17
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Abdella S, Riou S, Tessema M, Assefa A, Seifu A, Blachman A, Abera A, Moreno N, Irarrazaval F, Tollera G, Browning D, Tasew G. Prevalence of SARS-CoV-2 in urban and rural Ethiopia: Randomized household serosurveys reveal level of spread during the first wave of the pandemic. EClinicalMedicine 2021; 35:100880. [PMID: 34124630 PMCID: PMC8176122 DOI: 10.1016/j.eclinm.2021.100880] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 04/01/2021] [Accepted: 04/16/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND The spread of SARS-CoV-2 in Sub-Saharan Africa is poorly understood and to date has generally been characterised by a lower number of declared cases and deaths as compared to other regions of the world. Paucity of reliable information, with insights largely derived from limited RT-PCR testing in high-risk and urban populations, has been one of the biggest barriers to understanding the course of the pandemic and informed policy-making. Here we estimate seroprevalence of anti-SARS-CoV-2 antibodies in Ethiopia during the first wave of the pandemic. METHODS We undertook a population-based household seroprevalence serosurvey based on 1856 participants in Ethiopia, in the capital city Addis Ababa, and in Jimma, a middle-sized town in the Oromia region, and its rural surroundings (districts of Seka and Mana), between 22 July and 02 September 2020. We tested one random participant per household for anti-SARS-CoV-2 antibodies using a high specificity rapid diagnostic tests (RDTs) and evaluated population seroprevalence using a Bayesian logistic regression model taking into account test performance as well as age and sex of the participants. FINDINGS In total, 2304 random households were visited, with 1856 individuals consenting to participate. This produced a sample of 956 participants in Addis Ababa and 900 participants in Jimma. IgG prevalence was estimated at 1.9% (95% CI 0.4-3.7%), and combined IgM/IgG prevalence at 3.5% (95% CI 1.7-5.4%) for Addis Ababa in early August 2020, with higher prevalence in central sub-cities. Prevalence in Jimma town was lower at 0.5% (95% CI 0-1.8%) for IgG and 1.6% (95%CI 0-4.1%) for IgM/IgG, while in rural Jimma IgG prevalence was 0.2% and IgM/IgG 0.4% in early September. INTERPRETATION More than four months after the first cases were detected in Ethiopia, Addis Ababa displayed a prevalence under 5% and likely as low as 2%, while rural Jimma displayed a prevalence of 0.2%. A 2% seroprevalence figure for the capital translated to a number of cases at least five times larger than those reported for the country as a whole. At the same time, it contrasts with significantly higher seroprevalence figures in large cities in Europe and America only two to three months after the first cases. This population-based seroepidemiological study thus provides evidence of a slower spread of SARS-CoV-2 in the Ethiopian population during the first wave of the pandemic and does not appear to support the notion that lower case numbers were simply a reflection of limited testing and surveillance. FUNDING Schmidt Family Foundation, Joachim Hertz Foundation, Nespresso, Peet's and Smuckers.
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Affiliation(s)
- Saro Abdella
- HIV/TB Research Directorate, Ethiopian Public Health Institute, Gulelle Arbegnoch street, Addis Ababa, Ethiopia
| | - Samuel Riou
- Enveritas, 24 Innis Lane, Old Greenwich, CT, USA
| | - Masresha Tessema
- Nutrition and Food Sciences Research Directorate, Ethiopian Public Health Institute, Gulelle Arbegnoch street, Addis Ababa, Ethiopia
| | - Ashenafi Assefa
- Bacterial, Parasitic and Zoonotic Diseases Research Directorate, Ethiopian Public Health Institute, Gulelle Arbegnoch street, Addis Ababa, Ethiopia
| | - Albab Seifu
- Enveritas, 24 Innis Lane, Old Greenwich, CT, USA
| | | | - Adugna Abera
- Bacterial, Parasitic and Zoonotic Diseases Research Directorate, Ethiopian Public Health Institute, Gulelle Arbegnoch street, Addis Ababa, Ethiopia
| | | | | | - Getachew Tollera
- HIV/TB Research Directorate, Ethiopian Public Health Institute, Gulelle Arbegnoch street, Addis Ababa, Ethiopia
| | | | - Geremew Tasew
- Bacterial, Parasitic and Zoonotic Diseases Research Directorate, Ethiopian Public Health Institute, Gulelle Arbegnoch street, Addis Ababa, Ethiopia
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18
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Renzaho AMN. Challenges Associated With the Response to the Coronavirus Disease (COVID-19) Pandemic in Africa-An African Diaspora Perspective. RISK ANALYSIS : AN OFFICIAL PUBLICATION OF THE SOCIETY FOR RISK ANALYSIS 2021; 41:831-836. [PMID: 32949030 PMCID: PMC7537049 DOI: 10.1111/risa.13596] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 09/03/2020] [Indexed: 05/08/2023]
Abstract
The 2014-2016 Ebola outbreak in West Africa extracted huge health, social, and economic costs. How can lessons learnt during the 2014-2016 Ebola outbreak in West Africa help to mitigate the likelihood of a long-term devastating effect of the coronavirus disease (COVID-19) outbreak on the African continent? Despite COVID-19 spreading quickly across the globe after being first reported in Wuhan, China on December 31, 2019, African countries remained relatively unaffected until the second week of March 2020. The majority of Africa countries have been at low to moderate risk. However, they have experienced many sociocultural, economic, political, and structural challenges. These have included laboratory capacity and logistical challenges; ill-equipped public health systems; land border permeability, and delayed preparedness to transnational threats; and abject economic deprivation, lack of basic infrastructure, and associated sociocultural implications. There needs to be a strong country-level leadership to coordinate and own all aspects of the responses to the COVID-19 pandemic in a collaborative, transparent, and accountable way. Strategic and sustained response plans to fight the pandemic should incorporate culturally competent strategies that harness different cultural practices and strengthen cultural security. They should also promote and strengthen the implementation of the International Health Regulations.
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Affiliation(s)
- Andre M. N. Renzaho
- School of Social SciencesWestern Sydney UniversityPenrithNew South WalesAustralia
- Translational Health Research InstituteWestern Sydney UniversityPenrithNew South WalesAustralia
- Burnet InstituteMaternal, Child and Adolescent Health ProgramMelbourneVictoriaAustralia
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19
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Aborode AT, Tsagkaris C, Jain S, Ahmad S, Essar MY, Fajemisin EA, Adanur I, Uwishema O. Ebola Outbreak amid COVID-19 in the Republic of Guinea: Priorities for Achieving Control. Am J Trop Med Hyg 2021; 104:1966-1969. [PMID: 33852428 PMCID: PMC8176515 DOI: 10.4269/ajtmh.21-0228] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 03/24/2021] [Indexed: 02/05/2023] Open
Abstract
In February 2021, a new Ebola outbreak occurred amid the coronavirus disease 2019 (COVID-19) pandemic in the Republic of Guinea. Technical committees and Ebola mitigation mechanisms used during the 2014–2016 Ebola epidemics, have been redeployed by the public health organizations and African health organizations. As the burden on the local healthcare system is rising, fears of socioeconomic disruption are growing as well. Strategies used during the previous epidemic need to be reactivated, and new measures taken during the challenges of COVID-19 are being considered. This perspective discusses the available evidence regarding the epidemic of Ebola in Guinea amid the COVID-19 pandemic, highlights the challenges to be prioritized, and provides evidence-based recommendations.
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Affiliation(s)
- Abdullahi Tunde Aborode
- 1Oli Health Magazine Organization, Research and Development, Kigali, Rwanda.,2Healthy African Platform, Research and Development, Ibadan, Nigeria
| | | | - Shubhika Jain
- 4Kasturba Medical College, Manipal, Karnataka, India
| | | | | | - Emmanuel Adebowale Fajemisin
- 8SWIS Africa Platform, Research and Development, Lagos, Nigeria.,8SWIS Africa Platform, Research and Development, Lagos, Nigeria
| | - Irem Adanur
- 9Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
| | - Olivier Uwishema
- 10Department of General Medicine, Karadeniz Technical University, Trabzon, Turkey.,11Oli Health Magazine Organization, Research and Development, Kigali, Rwanda
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20
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Park MB. The effect of advances in transportation on the spread of the coronavirus disease: The last is Africa and endemic. J Public Health Res 2021; 10:2058. [PMID: 33843168 PMCID: PMC8524248 DOI: 10.4081/jphr.2021.2058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 02/22/2021] [Indexed: 11/23/2022] Open
Abstract
For a long time in the future, transportation will be used only by limited systems that are quarantine friendly. Besides, depending on the circumstances, international or inter-regional travel may be restricted. However, the African continent comprises mostly of developing countries with poor healthcare systems and low health literacy. As a result, it is highly likely that Africa could suffer greater damage than any other region once an outbreak occurs. The fact that countries in Africa must be most concerned about is that COVID-19 may become endemic, and the outbreak may continue for a very long time.
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Affiliation(s)
- Myung-Bae Park
- Department of Gerontology Health and Welfare, Pai Chai University, Daejeon.
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21
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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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22
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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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23
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Gesesew HA, Koye DN, Fetene DM, Woldegiorgis M, Kinfu Y, Geleto AB, Melaku YA, Mohammed H, Alene KA, Awoke MA, Birhanu MM, Gebremedhin AT, Gelaw YA, Shifti DM, Muluneh MD, Tegegne TK, Abrha S, Aregay AF, Ayalew MB, Gebre AK, Gebremariam KT, Gebremedhin T, Gebremichael L, Leshargie CT, Kibret GD, Meazaw MW, Mekonnen AB, Tekle DY, Tesema AG, Tesfay FH, Tesfaye W, Wubishet BL, Dachew BA, Adane AA. Risk factors for COVID-19 infection, disease severity and related deaths in Africa: a systematic review. BMJ Open 2021; 11:e044618. [PMID: 33602714 PMCID: PMC7896374 DOI: 10.1136/bmjopen-2020-044618] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 01/20/2021] [Accepted: 01/21/2021] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE The aim of this study was to provide a comprehensive evidence on risk factors for transmission, disease severity and COVID-19 related deaths in Africa. DESIGN A systematic review has been conducted to synthesise existing evidence on risk factors affecting COVID-19 outcomes across Africa. DATA SOURCES Data were systematically searched from MEDLINE, Scopus, MedRxiv and BioRxiv. ELIGIBILITY CRITERIA Studies for review were included if they were published in English and reported at least one risk factor and/or one health outcome. We included all relevant literature published up until 11 August 2020. DATA EXTRACTION AND SYNTHESIS We performed a systematic narrative synthesis to describe the available studies for each outcome. Data were extracted using a standardised Joanna Briggs Institute data extraction form. RESULTS Fifteen articles met the inclusion criteria of which four were exclusively on Africa and the remaining 11 papers had a global focus with some data from Africa. Higher rates of infection in Africa are associated with high population density, urbanisation, transport connectivity, high volume of tourism and international trade, and high level of economic and political openness. Limited or poor access to healthcare are also associated with higher COVID-19 infection rates. Older people and individuals with chronic conditions such as HIV, tuberculosis and anaemia experience severe forms COVID-19 leading to hospitalisation and death. Similarly, high burden of chronic obstructive pulmonary disease, high prevalence of tobacco consumption and low levels of expenditure on health and low levels of global health security score contribute to COVID-19 related deaths. CONCLUSIONS Demographic, institutional, ecological, health system and politico-economic factors influenced the spectrum of COVID-19 infection, severity and death. We recommend multidisciplinary and integrated approaches to mitigate the identified factors and strengthen effective prevention strategies.
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Affiliation(s)
- Hailay Abrha Gesesew
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
- Scool of Public Health, Mekelle University, Mekelle, Ethiopia
| | - Digsu Negese Koye
- Department of Medicine at Royal Melbourne Hospital and Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | | | | | - Yohannes Kinfu
- Faculty of Health, University of Canberra, Canberra, Australian Capital Territory, Australia
- College of Medicine, Doha, Qatar
| | - Ayele Bali Geleto
- Research Centre for Generational Health and Ageing, University of Newcastle, Newcastle, New South Wales, Australia
- School of Public Health, Haramaya University, College of Health and Medical Sciences, Harar, Ethiopia
| | - Yohannes Adama Melaku
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
| | - Hassen Mohammed
- Vaccinology and Immunology Research Trials Unit, Women's and Children's Hospital, Adelaide, South Australia, Australia
- Robinson Research Institute, Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia
| | - Kefyalew Addis Alene
- School of Population Health, Curtin University, Perth, Western Australia, Australia
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, Western Australia, Australia
- Institute of Public Health, University of Gondar, Gondar, Ethiopia
| | - Mamaru Ayenew Awoke
- School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia
| | - Mulugeta Molla Birhanu
- Department of Medicine, Monash University, Melbourne, Victoria, Australia
- Saint Paul's Hospital, Millennium Medical College, Addis Ababa, Ethiopia
| | - Amanuel Tesfay Gebremedhin
- School of Population Health, Curtin University, Perth, Western Australia, Australia
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, Western Australia, Australia
| | - Yalemzewod Assefa Gelaw
- Institute of Public Health, University of Gondar, Gondar, Ethiopia
- Population Child Health Research Group, School of Women's & Children's Health, UNSW, Sydney, New South Wales, Australia
| | - Desalegn Markos Shifti
- Saint Paul's Hospital, Millennium Medical College, Addis Ababa, Ethiopia
- Faculty of Health and Medicine, The University of Newcastle, Callaghan, New South Wales, Australia
| | - Muluken Dessalegn Muluneh
- School of Nursing and Midwifery, Western Sydney University, Penrith South, New South Wales, Australia
- Amref Health Africa in Ethiopia, Addis Ababa, Ethiopia
| | - Teketo Kassaw Tegegne
- Faculty of Health and Medicine, The University of Newcastle, Callaghan, New South Wales, Australia
- College of Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Solomon Abrha
- Faculty of Health, University of Canberra, Canberra, Australian Capital Territory, Australia
- Department of Pharmacology, Mekelle University, Mekelle, Ethiopia
| | - Atsede Fantahun Aregay
- School of Nursing and Midwifery, Monash University, Melbourne, Victoria, Australia
- School of Nursing, Mekelle University, Mekelle, Ethiopia
| | - Mohammed Biset Ayalew
- Department of Pharmacy, University of New England, Armidale, New South Wales, Australia
- Department of Clinical Pharmacy, University of Gondar, Gondar, Ethiopia
| | - Abadi Kahsu Gebre
- School of Pharmacy, Mekelle University, Mekelle, Ethiopia
- School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia
| | - Kidane Tadesse Gebremariam
- Scool of Public Health, Mekelle University, Mekelle, Ethiopia
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, Queensland, Australia
- Lifelong Health, South Australia Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - Tesfaye Gebremedhin
- Canberra School of Politics, University of Canberra, Canberra, Australian Capital Territory, Australia
| | - Lemlem Gebremichael
- Department of Pharmacology, Mekelle University, Mekelle, Ethiopia
- Clinical and Health Sciences, University of South Australia, Adelaide, South Australia, Australia
| | - Cheru Tesema Leshargie
- College of Health Science, Debre Markos University, Debre Markos, Ethiopia
- School of Public Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Getiye Dejenu Kibret
- College of Health Science, Debre Markos University, Debre Markos, Ethiopia
- Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Maereg Wagnew Meazaw
- Research Centre for Generational Health and Ageing, University of Newcastle, Newcastle, New South Wales, Australia
| | - Alemayehu Berhane Mekonnen
- Institute for Health Transformation, Deakin University, Burwood, Victoria, Australia
- School of Pharmacy, University of Sydney, Sydney, New South Wales, Australia
| | - Dejen Yemane Tekle
- Scool of Public Health, Mekelle University, Mekelle, Ethiopia
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Azeb Gebresilassie Tesema
- Scool of Public Health, Mekelle University, Mekelle, Ethiopia
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Fisaha Haile Tesfay
- Scool of Public Health, Mekelle University, Mekelle, Ethiopia
- School of Health and Social development, Deakin University, Melbourne, Victoria, Australia
| | - Wubshet Tesfaye
- Health research Institute, University of Canberra, Canberra, Australian Capital Territory, Australia
| | - Befikadu Legesse Wubishet
- Research Centre for Generational Health and Ageing, University of Newcastle, Newcastle, New South Wales, Australia
| | - Berihun Assefa Dachew
- School of Population Health, Curtin University, Perth, Western Australia, Australia
- Department of Epidemiology and Biostatistics, University of Gondar, Gondar, Ethiopia
| | - Akilew Awoke Adane
- Department of Epidemiology and Biostatistics, University of Gondar, Gondar, Ethiopia
- Telethon Kids Institute, The University of Western Australia, Nedlands, Western Australia, Australia
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24
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Nachega JB, Atteh R, Ihekweazu C, Sam-Agudu NA, Adejumo P, Nsanzimana S, Rwagasore E, Condo J, Paleker M, Mahomed H, Suleman F, Ario AR, Kiguli-Malwadde E, Omaswa FG, Sewankambo NK, Viboud C, Reid MJA, Zumla A, Kilmarx PH. Contact Tracing and the COVID-19 Response in Africa: Best Practices, Key Challenges, and Lessons Learned from Nigeria, Rwanda, South Africa, and Uganda. Am J Trop Med Hyg 2021; 104:1179-1187. [PMID: 33571138 PMCID: PMC8045625 DOI: 10.4269/ajtmh.21-0033] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Accepted: 01/25/2021] [Indexed: 01/05/2023] Open
Abstract
Most African countries have recorded relatively lower COVID-19 burdens than Western countries. This has been attributed to early and strong political commitment and robust implementation of public health measures, such as nationwide lockdowns, travel restrictions, face mask wearing, testing, contact tracing, and isolation, along with community education and engagement. Other factors include the younger population age strata and hypothesized but yet-to-be confirmed partially protective cross-immunity from parasitic diseases and/or other circulating coronaviruses. However, the true burden may also be underestimated due to operational and resource issues for COVID-19 case identification and reporting. In this perspective article, we discuss selected best practices and challenges with COVID-19 contact tracing in Nigeria, Rwanda, South Africa, and Uganda. Best practices from these country case studies include sustained, multi-platform public communications; leveraging of technology innovations; applied public health expertise; deployment of community health workers; and robust community engagement. Challenges include an overwhelming workload of contact tracing and case detection for healthcare workers, misinformation and stigma, and poorly sustained adherence to isolation and quarantine. Important lessons learned include the need for decentralization of contact tracing to the lowest geographic levels of surveillance, rigorous use of data and technology to improve decision-making, and sustainment of both community sensitization and political commitment. Further research is needed to understand the role and importance of contact tracing in controlling community transmission dynamics in African countries, including among children. Also, implementation science will be critically needed to evaluate innovative, accessible, and cost-effective digital solutions to accommodate the contact tracing workload.
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Affiliation(s)
- Jean B Nachega
- 1Department of Medicine and Center for Infectious Diseases, Stellenbosch University Faculty of Medicine and Health Sciences, Cape Town, South Africa.,2Department of Epidemiology, Infectious Diseases and Microbiology, Center for Global Health, University of Pittsburgh, Pittsburgh, Pennsylvania.,3Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.,4Department of International Health, Johns Hopkins University, Bloomberg School of Public Health, Baltimore, Maryland
| | - Rhoda Atteh
- 5Surveillance and Epidemiology, Nigeria Centre for Disease Control, Abuja, Nigeria
| | - Chikwe Ihekweazu
- 6Office of the Director-General, Nigeria Centre for Disease Control, Abuja, Nigeria
| | - Nadia A Sam-Agudu
- 7International Research Center of Excellence, Institute of Human Virology Nigeria, Abuja, Nigeria.,8Department of Pediatrics, Institute of Human Virology, University of Maryland School of Medicine, Baltimore, Maryland.,9Department of Pediatrics and Child Health, School of Medical Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Prisca Adejumo
- 10Department of Nursing, University of Ibadan, Ibadan, Nigeria
| | | | - Edson Rwagasore
- 11Rwanda Biomedical Centre, Ministry of Health, Kigali, Rwanda
| | - Jeanine Condo
- 12University of Rwanda, School of Public Health, Kigali, Rwanda.,13School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana
| | - Masudah Paleker
- 14South African Department of Health, Western Cape Province, Cape Town, South Africa.,15Division of Health Systems and Public Health, Department of Global Health, Stellenbosch Faculty of Medicine and Health Sciences and Western Cape Department of Health, Cape Town, South Africa
| | - Hassan Mahomed
- 14South African Department of Health, Western Cape Province, Cape Town, South Africa.,15Division of Health Systems and Public Health, Department of Global Health, Stellenbosch Faculty of Medicine and Health Sciences and Western Cape Department of Health, Cape Town, South Africa
| | - Fatima Suleman
- 16Discipline of Pharmaceutical Sciences, University of KwaZulu Natal, Durban, South Africa
| | - Alex Riolexus Ario
- 17Uganda National Institute of Public Health, Ministry of Health, Kampala, Uganda
| | | | - Francis G Omaswa
- 18African Centre for Global Health and Social Transformation, Kampala, Uganda
| | - Nelson K Sewankambo
- 19Department of Internal Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Cecile Viboud
- 20Fogarty International Center, National Institutes of Health, Bethesda, Maryland
| | - Michael J A Reid
- 21University of California San Francisco, San Francisco, California
| | - Alimuddin Zumla
- 22Division of Infection and Immunity, University College London, London, United Kingdom.,23NIHR Biomedical Research Centre, University College London Hospitals, London, United Kingdom
| | - Peter H Kilmarx
- 20Fogarty International Center, National Institutes of Health, Bethesda, Maryland
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25
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Olayanju O, Bamidele O, Edem F, Eseile B, Amoo A, Nwaokenye J, Udeh C, Oluwole G, Odok G, Awah N. SARS-CoV-2 Seropositivity in Asymptomatic Frontline Health Workers in Ibadan, Nigeria. Am J Trop Med Hyg 2021; 104:91-94. [PMID: 33185181 PMCID: PMC7790104 DOI: 10.4269/ajtmh.20-1235] [Citation(s) in RCA: 56] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Global health has been thrown into turmoil by the COVID-19 pandemic, which has caused devastating morbidity and unprecedented loss of life in almost all continents of the world. It was predicted that the magnitude of the pandemic in Africa will be high because of poor health structure and intensely poor living condition, but that has not happened, surprisingly. It was hypothesized that the youthful population and a vastly primed immune system were protective, and many people may have been exposed without coming down with the severe disease. Most of them would have presented in hospitals with other medical conditions and possibly transmit COVID-19 to health workers inadvertently. This study is designed to measure serum SARS-CoV-2 IgG levels in health workers as a marker of latent exposure. Asymptomatic frontline health workers were randomly selected from the University College Hospital Ibadan, Nigeria; venous blood samples were obtained from them, and the serum SARS-CoV-2 IgG level was determined using ELISA techniques. A proportion of participants with seropositivity were obtained, and factors associated with seropositivity were determined. A total of 133 participants were recruited for this study, and 60 (45.1%) of them were seropositive for SARS-CoV-2. Among the seropositive participants were doctors, nurses, health assistants, laboratory scientists and technicians, and nonmedical staff. Obstetrics, gynecology, and emergency departments had higher odds of seropositivity. Seroprevalence of SARS-CoV-2 is very high among frontline health workers, though asymptomatic. This calls for a more stringent precaution against further spread within the hospital environment.
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Affiliation(s)
- Olatunde Olayanju
- 1Chemical Pathology Department, University College Hospital, Ibadan, Nigeria.,2Medicine Department, University of Cape Town, Cape Town, South Africa
| | - Olabisi Bamidele
- 1Chemical Pathology Department, University College Hospital, Ibadan, Nigeria
| | - Fabian Edem
- 3Immunology Department, University College Hospital, Ibadan, Nigeria
| | - Bola Eseile
- 1Chemical Pathology Department, University College Hospital, Ibadan, Nigeria
| | - Abimbola Amoo
- 4Medical Microbiology Department, University College Hospital, Ibadan, Nigeria
| | - Jude Nwaokenye
- 4Medical Microbiology Department, University College Hospital, Ibadan, Nigeria
| | - Chioma Udeh
- 1Chemical Pathology Department, University College Hospital, Ibadan, Nigeria
| | - Gabriel Oluwole
- 5Medicine Department, University College Hospital, Ibadan, Nigeria
| | - Gabriel Odok
- 1Chemical Pathology Department, University College Hospital, Ibadan, Nigeria
| | - Nnaemeka Awah
- 1Chemical Pathology Department, University College Hospital, Ibadan, Nigeria
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26
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Mukhtar NB, Abdullahi A, Abba MA, Mohammed J. Views and experiences of discharged COVID-19 patients in Kano, Nigeria: a qualitative study. Pan Afr Med J 2021; 37:38. [PMID: 33456662 DOI: 10.11604/pamj.supp.2020.37.38.26609] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 11/16/2020] [Indexed: 12/24/2022] Open
Abstract
Introduction COVID-19 has spread globally, thereby contributing to substantial hospitalisation rates and morbidity. However, little or no information is available on the experiences of patients with COVID-19 in an African-setting. The study aimed to explore the experiences of patients with COVID-19. Methods semi-structured interviews were conducted via telephone with eleven individuals who were managed and discharged due to COVID-19. A descriptive phenomenological approach to qualitative research was employed and participants were mainly asked about their experiences before, during and after hospitalisation for COVID-19. Data were analysed using thematic analysis. Results patients' viewpoints were suggestive of community and secondary transmission of COIVD-19 in the study area. A few participants experienced severe symptoms. Most participants tend to resign their condition to fate; while some displayed unfounded conspiracy theories. Nevertheless, precautionary measures to prevent infection were largely observed. COVID-19 also negatively affected activities of daily living of the participants. Furthermore, the participants were generally satisfied with quality of care provided. However, areas of patients' education, isolation centre set-up and caregiver-patient interaction needed further improvements. Lastly, experience of fear and stigma during post-hospitalisation were common. Conclusion COVID-19 impacted negatively on the lives of the studied population. However, their experience during hospitalisation was generally positive.
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Affiliation(s)
- Naziru Bashir Mukhtar
- Department of Physiotherapy, Faculty of Allied Health Sciences, Bayero University Kano, Kano, Nigeria.,Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
| | - Auwal Abdullahi
- Department of Physiotherapy, Faculty of Allied Health Sciences, Bayero University Kano, Kano, Nigeria.,Department of Rehabilitation Sciences and Physiotherapy, University of Antwerp, Movant, Wilrijk, Belgium
| | - Muhammad Aliyu Abba
- Department of Physiotherapy, Faculty of Allied Health Sciences, Bayero University Kano, Kano, Nigeria.,Department of Physiotherapy, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Jibril Mohammed
- Department of Physiotherapy, Faculty of Allied Health Sciences, Bayero University Kano, Kano, Nigeria
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Gwenzi W. Dangerous liaisons? As the COVID-19 wave hits Africa with potential for novel transmission dynamics: a perspective. ZEITSCHRIFT FUR GESUNDHEITSWISSENSCHAFTEN = JOURNAL OF PUBLIC HEALTH 2021; 30:1353-1366. [PMID: 33425657 PMCID: PMC7778499 DOI: 10.1007/s10389-020-01467-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 12/15/2020] [Indexed: 01/31/2023]
Affiliation(s)
- Willis Gwenzi
- Biosystems and Environmental Engineering Research Group, Department of Soil Science and Agricultural Engineering, Faculty of Agriculture, University of Zimbabwe, P.O. Box MP 167, Mount Pleasant, Harare, Zimbabwe
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28
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Tcheutchoua DN, Tankeu AT, Angong DLW, Agoons BB, Nguemnang NYY, Djeunga HCN, Kamgno J. Unexpected low burden of coronavirus disease 2019 (COVID-19) in sub-Saharan Africa region despite disastrous predictions: reasons and perspectives. Pan Afr Med J 2020; 37:352. [PMID: 33796166 PMCID: PMC7992902 DOI: 10.11604/pamj.2020.37.352.25254] [Citation(s) in RCA: 5] [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: 07/29/2020] [Accepted: 11/08/2020] [Indexed: 01/13/2023] Open
Abstract
The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is responsible for the development of a highly contagious disease called coronavirus disease (COVID-19). Ten months after the onset of the pandemic, America and Europe remain the most affected regions. Initially, experts predicted that Africa, the poorest continent with the most vulnerable population and health system, would be greatly affected by the ongoing outbreak. However, 240days after the first confirmed case, Africa is among the least affected region, with lower than expected incident cases and mortality. In this review, we discuss possible explanations and reasons for this unexpected low burden of COVID-19 in Africa. We focus on the characteristics of the virus, specificities of the sub-Saharan African population and local environment.
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Affiliation(s)
- Daryl Nzokou Tcheutchoua
- Public Health Department, Faculty of Medical and Paramedical Sciences, Aix-Marseille University, Marseille, France
| | - Aurel Tiakouang Tankeu
- Department of Biomedical Sciences, University of Lausanne, Lausanne, Switzerland
- Centre for Research on Filariasis and Other Tropical Diseases, Yaoundé, Cameroon
| | - Dominic Leandry Wouna Angong
- Public Health Department, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
| | - Batakeh Ba Agoons
- Public Health Department, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
| | - Nathan Yves Yanwou Nguemnang
- Public Health Department, Faculty of Medical and Paramedical Sciences, Aix-Marseille University, Marseille, France
| | | | - Joseph Kamgno
- Centre for Research on Filariasis and Other Tropical Diseases, Yaoundé, Cameroon
- Public Health Department, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
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29
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Haug N, Geyrhofer L, Londei A, Dervic E, Desvars-Larrive A, Loreto V, Pinior B, Thurner S, Klimek P. Ranking the effectiveness of worldwide COVID-19 government interventions. Nat Hum Behav 2020. [PMID: 33199859 DOI: 10.1101/2020.07.06.20147199] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
Assessing the effectiveness of non-pharmaceutical interventions (NPIs) to mitigate the spread of SARS-CoV-2 is critical to inform future preparedness response plans. Here we quantify the impact of 6,068 hierarchically coded NPIs implemented in 79 territories on the effective reproduction number, Rt, of COVID-19. We propose a modelling approach that combines four computational techniques merging statistical, inference and artificial intelligence tools. We validate our findings with two external datasets recording 42,151 additional NPIs from 226 countries. Our results indicate that a suitable combination of NPIs is necessary to curb the spread of the virus. Less disruptive and costly NPIs can be as effective as more intrusive, drastic, ones (for example, a national lockdown). Using country-specific 'what-if' scenarios, we assess how the effectiveness of NPIs depends on the local context such as timing of their adoption, opening the way for forecasting the effectiveness of future interventions.
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Affiliation(s)
- Nina Haug
- Medical University of Vienna, Section for Science of Complex Systems, CeMSIIS, Vienna, Austria
- Complexity Science Hub Vienna, Vienna, Austria
| | | | | | - Elma Dervic
- Medical University of Vienna, Section for Science of Complex Systems, CeMSIIS, Vienna, Austria
- Complexity Science Hub Vienna, Vienna, Austria
| | - Amélie Desvars-Larrive
- Complexity Science Hub Vienna, Vienna, Austria
- Unit of Veterinary Public Health and Epidemiology, Institute of Food Safety, Food Technology and Veterinary Public Health, University of Veterinary Medicine, Vienna, Austria
| | - Vittorio Loreto
- Complexity Science Hub Vienna, Vienna, Austria
- Sony Computer Science Laboratories, Paris, France
- Physics Department, Sapienza University of Rome, Rome, Italy
| | - Beate Pinior
- Complexity Science Hub Vienna, Vienna, Austria
- Unit of Veterinary Public Health and Epidemiology, Institute of Food Safety, Food Technology and Veterinary Public Health, University of Veterinary Medicine, Vienna, Austria
| | - Stefan Thurner
- Medical University of Vienna, Section for Science of Complex Systems, CeMSIIS, Vienna, Austria
- Complexity Science Hub Vienna, Vienna, Austria
- Santa Fe Institute, Santa Fe, NM, USA
| | - Peter Klimek
- Medical University of Vienna, Section for Science of Complex Systems, CeMSIIS, Vienna, Austria.
- Complexity Science Hub Vienna, Vienna, Austria.
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30
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Doraiswamy S, Abraham A, Mamtani R, Cheema S. Use of Telehealth During the COVID-19 Pandemic: Scoping Review. J Med Internet Res 2020; 22:e24087. [PMID: 33147166 PMCID: PMC7710390 DOI: 10.2196/24087] [Citation(s) in RCA: 333] [Impact Index Per Article: 83.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 10/26/2020] [Accepted: 10/30/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND With over 37.8 million cases and over 1 million deaths worldwide, the COVID-19 pandemic has created a societal and economic upheaval of unparalleled magnitude. A positive transformation has been brought about by innovative solutions in the health care sector that aim to mitigate the impact of COVID-19 on human health. For instance, the use of telehealth has been on the rise amidst this public health emergency. OBJECTIVE Given the unprecedented scale of the pandemic with no definitive endpoint, we aimed to scope the existing telehealth-related literature during a defined period of the ongoing pandemic (ie, January to June 2020). METHODS Our scoping review was guided by the Joanna Briggs Institute Reviewer Manual. We systematically searched PubMed and Embase databases with specific eligibility criteria. Data extracted from the shortlisted articles included first author and affiliation, journal title, publication type, terminologies used to describe telehealth and their accompanying definitions, health discipline or medical specialties and subspecialties wherein telehealth had been applied, the purpose of telehealth use, and the authors' overall sentiment on telehealth use. We collated the available information and used descriptive statistics to analyze the synthesized data. RESULTS In all, 543 articles published across 331 different journals were included in this scoping review. The Journal of Medical Internet Research and its sister journals featured the highest number of articles (25/543, 4.6%). Nearly all (533/543, 98.2%) articles were in English. The majority of the articles were opinions, commentaries, and perspectives (333/543, 61.3%). Most authors of the articles reviewed were from high-income countries (470/543, 86.6%), especially from the United States of America (237/543, 43.6%). In all, 39 different definitions were used to describe terms equivalent to telehealth. A small percentage (42/543, 7.7%) of the articles focused on the provision of COVID-19-related care. Moreover, 49.7% (270/543) of the articles primarily focused on the provision of multiple components of clinical care, and 23% (125/543) of the articles focused on various specialties and subspecialties of internal medicine. For a vast majority (461/543, 84.9%) of the articles, the authors expressed a celebratory sentiment about the use of telehealth. CONCLUSIONS This review identified considerable emerging literature on telehealth during the first six months of the COVID-19 pandemic, albeit mostly from high-income countries. There is compelling evidence to suggest that telehealth may have a significant effect on advancing health care in the future. However, the feasibility and application of telehealth in resource-limited settings and low- and middle-income countries must be established to avail its potential and transform health care for the world's population. Given the rapidity with which telehealth is advancing, a global consensus on definitions, boundaries, protocols, monitoring, evaluation, and data privacy is urgently needed.
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Affiliation(s)
| | - Amit Abraham
- Institute for Population Health, Weill Cornell Medicine, Doha, Qatar
| | - Ravinder Mamtani
- Institute for Population Health, Weill Cornell Medicine, Doha, Qatar
| | - Sohaila Cheema
- Institute for Population Health, Weill Cornell Medicine, Doha, Qatar
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31
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Bates BR, Moncayo AL, Costales JA, Herrera-Cespedes CA, Grijalva MJ. Knowledge, Attitudes, and Practices Towards COVID-19 Among Ecuadorians During the Outbreak: An Online Cross-Sectional Survey. J Community Health 2020. [PMID: 32915380 DOI: 10.1080/17538068.2020.1842843] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Preventing the transmission of SARS-CoV-2 (causative agent for COVID-19) requires implementing contact and respiratory precautions. Modifying human behavior is challenging and requires understanding knowledge, attitudes, and practices (KAPs) regarding health threats. This study explored KAPs among people in Ecuador. A cross-sectional, internet-based questionnaire was used to assess knowledge about COVID-19, attitudes toward ability to control COVID-19, self-reported practices related to COVID-19, and demographics. A total of 2399 individuals participated. Participants had moderate to high levels of knowledge. Participants expressed mixed attitudes about the eventual control of COVID-19 in Ecuador. Participants reported high levels of adoption of preventive practices. Binomial regression analysis suggests unemployed individuals, househusbands/housewives, or manual laborers, as well as those with an elementary school education, have lower levels of knowledge. Women, people over 50 years of age, and those with higher levels of schooling were the most optimistic. Men, individuals 18-29, single, and unemployed people took the riskiest behaviors. Generally, knowledge was not associated with optimism or with practices. Our findings indicate knowledge about COVID-19 is insufficient to prompt behavioral change among Ecuadorians. Since current COVID-19 control campaigns seek to educate the public, these efforts' impacts are likely to be limited. Given attitudes determine people's actions, further investigation into the factors underlying the lack of confidence in the ability of the world, and of Ecuador, to overcome COVID-19, is warranted. Edu-communicational campaigns should be accompanied by efforts to provide economically disadvantaged populations resources to facilitate adherence to recommendations to prevent the spread of the virus.
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Affiliation(s)
- Benjamin R Bates
- School of Communication Studies, Ohio University, Athens, OH, 45701, USA
- Infectious and Tropical Disease Institute, Department of Biomedical Sciences, Heritage College of Osteopathic Medicine, Ohio University, Athens, OH, 45701, USA
| | - Ana L Moncayo
- Facultad de Ciencias Exactas y Naturales, Centro de Investigación para la Salud en América Latina, Escuela de Ciencias Biológicas, Pontificia Universidad Católica del Ecuador, Quito, Ecuador
| | - Jaime A Costales
- Facultad de Ciencias Exactas y Naturales, Centro de Investigación para la Salud en América Latina, Escuela de Ciencias Biológicas, Pontificia Universidad Católica del Ecuador, Quito, Ecuador
| | - Carolina A Herrera-Cespedes
- Facultad de Ciencias Exactas y Naturales, Centro de Investigación para la Salud en América Latina, Escuela de Ciencias Biológicas, Pontificia Universidad Católica del Ecuador, Quito, Ecuador
| | - Mario J Grijalva
- Facultad de Ciencias Exactas y Naturales, Centro de Investigación para la Salud en América Latina, Escuela de Ciencias Biológicas, Pontificia Universidad Católica del Ecuador, Quito, Ecuador.
- Infectious and Tropical Disease Institute, Department of Biomedical Sciences, Heritage College of Osteopathic Medicine, Ohio University, Athens, OH, 45701, USA.
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32
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Haug N, Geyrhofer L, Londei A, Dervic E, Desvars-Larrive A, Loreto V, Pinior B, Thurner S, Klimek P. Ranking the effectiveness of worldwide COVID-19 government interventions. Nat Hum Behav 2020; 4:1303-1312. [DOI: 10.1038/s41562-020-01009-0] [Citation(s) in RCA: 655] [Impact Index Per Article: 163.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 10/28/2020] [Indexed: 12/11/2022]
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33
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Osunsanmi TO, Aigbavboa CO, Oke A, Onyia ME. Making a case for smart buildings in preventing corona-virus: focus on maintenance management challenges. INTERNATIONAL JOURNAL OF CONSTRUCTION MANAGEMENT 2020. [DOI: 10.1080/15623599.2020.1842960] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Temidayo O. Osunsanmi
- Sustainable Human Settlement and Leadership in the Built Environment Faculty of Engineering and the Built Environment, University of Johannesburg, Johannesburg, South Africa
| | - Clinton O. Aigbavboa
- Sustainable Human Settlement and Leadership in the Built Environment Faculty of Engineering and the Built Environment, University of Johannesburg, Johannesburg, South Africa
| | - Ayodeji Oke
- Sustainable Human Settlement and Leadership in the Built Environment Faculty of Engineering and the Built Environment, University of Johannesburg, Johannesburg, South Africa
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34
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Bates BR, Moncayo AL, Costales JA, Herrera-Cespedes CA, Grijalva MJ. Knowledge, Attitudes, and Practices Towards COVID-19 Among Ecuadorians During the Outbreak: An Online Cross-Sectional Survey. J Community Health 2020; 45:1158-1167. [PMID: 32915380 PMCID: PMC7483492 DOI: 10.1007/s10900-020-00916-7] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Preventing the transmission of SARS-CoV-2 (causative agent for COVID-19) requires implementing contact and respiratory precautions. Modifying human behavior is challenging and requires understanding knowledge, attitudes, and practices (KAPs) regarding health threats. This study explored KAPs among people in Ecuador. A cross-sectional, internet-based questionnaire was used to assess knowledge about COVID-19, attitudes toward ability to control COVID-19, self-reported practices related to COVID-19, and demographics. A total of 2399 individuals participated. Participants had moderate to high levels of knowledge. Participants expressed mixed attitudes about the eventual control of COVID-19 in Ecuador. Participants reported high levels of adoption of preventive practices. Binomial regression analysis suggests unemployed individuals, househusbands/housewives, or manual laborers, as well as those with an elementary school education, have lower levels of knowledge. Women, people over 50 years of age, and those with higher levels of schooling were the most optimistic. Men, individuals 18–29, single, and unemployed people took the riskiest behaviors. Generally, knowledge was not associated with optimism or with practices. Our findings indicate knowledge about COVID-19 is insufficient to prompt behavioral change among Ecuadorians. Since current COVID-19 control campaigns seek to educate the public, these efforts’ impacts are likely to be limited. Given attitudes determine people’s actions, further investigation into the factors underlying the lack of confidence in the ability of the world, and of Ecuador, to overcome COVID-19, is warranted. Edu-communicational campaigns should be accompanied by efforts to provide economically disadvantaged populations resources to facilitate adherence to recommendations to prevent the spread of the virus.
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Affiliation(s)
- Benjamin R Bates
- School of Communication Studies, Ohio University, Athens, OH, 45701, USA.,Infectious and Tropical Disease Institute, Department of Biomedical Sciences, Heritage College of Osteopathic Medicine, Ohio University, Athens, OH, 45701, USA
| | - Ana L Moncayo
- Facultad de Ciencias Exactas y Naturales, Centro de Investigación para la Salud en América Latina, Escuela de Ciencias Biológicas, Pontificia Universidad Católica del Ecuador, Quito, Ecuador
| | - Jaime A Costales
- Facultad de Ciencias Exactas y Naturales, Centro de Investigación para la Salud en América Latina, Escuela de Ciencias Biológicas, Pontificia Universidad Católica del Ecuador, Quito, Ecuador
| | - Carolina A Herrera-Cespedes
- Facultad de Ciencias Exactas y Naturales, Centro de Investigación para la Salud en América Latina, Escuela de Ciencias Biológicas, Pontificia Universidad Católica del Ecuador, Quito, Ecuador
| | - Mario J Grijalva
- Facultad de Ciencias Exactas y Naturales, Centro de Investigación para la Salud en América Latina, Escuela de Ciencias Biológicas, Pontificia Universidad Católica del Ecuador, Quito, Ecuador. .,Infectious and Tropical Disease Institute, Department of Biomedical Sciences, Heritage College of Osteopathic Medicine, Ohio University, Athens, OH, 45701, USA.
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35
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Zawawi A, Alghanmi M, Alsaady I, Gattan H, Zakai H, Couper K. The impact of COVID-19 pandemic on malaria elimination. Parasite Epidemiol Control 2020; 11:e00187. [PMID: 33102823 PMCID: PMC7574840 DOI: 10.1016/j.parepi.2020.e00187] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Revised: 08/26/2020] [Accepted: 10/15/2020] [Indexed: 01/06/2023] Open
Abstract
SARS-CoV-2 has spread throughout the world and become the cause of the infectious coronavirus disease 2019 (COVID-19). As low- and middle-income countries shift increasingly to focus on identifying and treating COVID-19, questions are emerging about the impact this shift in focus will have on ongoing efforts to control other infectious diseases, such as malaria. This review discusses how the spread of SARS-CoV-2 in low- and middle-income countries might impact these efforts, focusing in particular on the effects of co-infection and the use of antimalarial drugs used to treat malaria as therapeutic interventions for COVID-19.
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Affiliation(s)
- Ayat Zawawi
- Faculty of Applied Medical Sciences, Department of Medical Laboratory Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Maimonah Alghanmi
- Faculty of Applied Medical Sciences, Department of Medical Laboratory Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
- Special Infectious Agents Unit, King Fahad Medical Research center, Jeddah, Saudi Arabia
| | - Isra Alsaady
- Faculty of Applied Medical Sciences, Department of Medical Laboratory Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
- Special Infectious Agents Unit, King Fahad Medical Research center, Jeddah, Saudi Arabia
| | - Hattan Gattan
- Faculty of Applied Medical Sciences, Department of Medical Laboratory Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
- Special Infectious Agents Unit, King Fahad Medical Research center, Jeddah, Saudi Arabia
| | - Haytham Zakai
- Faculty of Applied Medical Sciences, Department of Medical Laboratory Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Kevin Couper
- Lydia Becker Institute of Immunology and Inflammation, School of Biological Sciences, Faculty of Biology, Medicine, and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester M13 9PT, United Kingdom
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36
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Admou B, Hazime R, Brahim I, El Adib AR. Influencing factors of SARS-Cov2 spread in Africa. J Glob Health 2020; 10:020331. [PMID: 33110531 PMCID: PMC7561272 DOI: 10.7189/jogh.10.020331] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Affiliation(s)
- Brahim Admou
- Center of Clinical Research, Laboratory of Immunology, University Hospital Mohammed VI, Marrakech, Morocco.,Bioscience Research Laboratory, Faculty of Medicine, Cadi Ayyad University, Marrakech, Morocco
| | - Raja Hazime
- Center of Clinical Research, Laboratory of Immunology, University Hospital Mohammed VI, Marrakech, Morocco
| | - Imane Brahim
- Center of Clinical Research, Laboratory of Immunology, University Hospital Mohammed VI, Marrakech, Morocco
| | - Ahmed Rhassane El Adib
- Bioscience Research Laboratory, Faculty of Medicine, Cadi Ayyad University, Marrakech, Morocco.,Department of Anesthesiology, Intensive Care and Emergency Medicine, University Hospital Mohammed VI, Marrakech, Morocco
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37
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Abate SM, Mantefardo B, Basu B. Postoperative mortality among surgical patients with COVID-19: a systematic review and meta-analysis. Patient Saf Surg 2020; 14:37. [PMID: 33062056 PMCID: PMC7549731 DOI: 10.1186/s13037-020-00262-6] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 09/18/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic puts perioperative providers and staff at risk of viral exposure to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) during aerosol-generating procedures, particularly in asymptomatic carriers.However, the perioperative risk for adverse outcomes in SARS-CoV-2 infected patients remain uncertain and the topic of debate. The current study was designed to determine the postoperative mortality in COVID-19 patients based on a systematic review and meta-analysis of the global published peer-reviewed literature. METHODS A comprehensive search was conducted in PubMed/Medline; Science direct and LILACS from December 29, 2019, to August15, 2020, without language restriction. All observational studies reporting the prevalence of mortality were included while case reports and reviews were excluded. The data from each study were extracted with two independent authors with a customized format excel sheet and the disagreements were resolved by the third author. The methodological quality of included studies was evaluated using a standardized critical appraisal Tool adapted from the Joanna Briggs Institute. RESULTS A total of 715 articles were identified from different databases and 45 articles were selected for evaluation after the successive screening. Twenty-three articles with 2947 participants were included. The meta-analysis revealed a very high global rate of postoperative mortality among COVID-19 patients of 20% (95% CI: 15 to 26) and a postoperative ICU admission rate of 15% (95% confidence interval (CI):10 to 21). CONCLUSION The unexpected high postoperative mortality rate in SARS-CoV-2 infected patients of 20% in the global literature mandates further scrutiny in assuring appropriate surgical indications and perioperative surgical safety measures in this vulnerable cohort of patients. REGISTRATION This systematic review and meta-analysis was registered in Prospero's international prospective register of systematic reviews (CRD42020203362) on August 10, 2020.
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Affiliation(s)
- Semagn Mekonnen Abate
- Department of Anesthesiology, College of Health Sciences and Medicine, Dilla University, PO.BOX:419, Dilla, Ethiopia
| | - Bahiru Mantefardo
- Department of Internal Medicine, College of Health Sciences and Medicine, Dilla University, Dilla, Ethiopia
| | - Bivash Basu
- Department of Anesthesiology, College of Health Sciences, University of Calcutta, Kolkata, India
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38
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Nachega JB, Ishoso DK, Otokoye JO, Hermans MP, Machekano RN, Sam-Agudu NA, Bongo-Pasi Nswe C, Mbala-Kingebeni P, Madinga JN, Mukendi S, Kolié MC, Nkwembe EN, Mbuyi GM, Nsio JM, Mukeba Tshialala D, Tshiasuma Pipo M, Ahuka-Mundeke S, Muyembe-Tamfum JJ, Mofenson L, Smith G, Mills EJ, Mellors JW, Zumla A, Mavungu Landu DJ, Kayembe JM. Clinical Characteristics and Outcomes of Patients Hospitalized for COVID-19 in Africa: Early Insights from the Democratic Republic of the Congo. Am J Trop Med Hyg 2020; 103:2419-2428. [PMID: 33009770 PMCID: PMC7695108 DOI: 10.4269/ajtmh.20-1240] [Citation(s) in RCA: 70] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Little is known about the clinical features and outcomes of SARS-CoV-2 infection in Africa. We conducted a retrospective cohort study of patients hospitalized for COVID-19 between March 10, 2020 and July 31, 2020 at seven hospitals in Kinshasa, Democratic Republic of the Congo (DRC). Outcomes included clinical improvement within 30 days (primary) and in-hospital mortality (secondary). Of 766 confirmed COVID-19 cases, 500 (65.6%) were male, with a median (interquartile range [IQR]) age of 46 (34-58) years. One hundred ninety-one (25%) patients had severe/critical disease requiring admission in the intensive care unit (ICU). Six hundred twenty patients (80.9%) improved and were discharged within 30 days of admission. Overall in-hospital mortality was 13.2% (95% CI: 10.9-15.8), and almost 50% among those in the ICU. Independent risk factors for death were age < 20 years (adjusted hazard ratio [aHR] = 6.62, 95% CI: 1.85-23.64), 40-59 years (aHR = 4.45, 95% CI: 1.83-10.79), and ≥ 60 years (aHR = 13.63, 95% CI: 5.70-32.60) compared with those aged 20-39 years, with obesity (aHR = 2.30, 95% CI: 1.24-4.27), and with chronic kidney disease (aHR = 5.33, 95% CI: 1.85-15.35). In marginal structural model analysis, there was no statistically significant difference in odds of clinical improvement (adjusted odds ratio [aOR] = 1.53, 95% CI: 0.88-2.67, P = 0.132) nor risk of death (aOR = 0.65, 95% CI: 0.35-1.20) when comparing the use of chloroquine/azithromycin versus other treatments. In this DRC study, the high mortality among patients aged < 20 years and with severe/critical disease is of great concern, and requires further research for confirmation and targeted interventions.
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Affiliation(s)
- Jean B Nachega
- Department of Epidemiology, Infectious Diseases and Microbiology, Center for Global Health, University of Pittsburgh, Pittsburgh, Pennsylvania.,Department of Medicine, Centre for Infectious Diseases, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.,Department of Epidemiology and International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Daniel Katuashi Ishoso
- Community Health Department, Kinshasa School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - John Otshudiema Otokoye
- Epidemiological Surveillance Team, COVID-19 Response, Health Emergencies Program, World Health Organization, Kinshasa, Democratic Republic of the Congo
| | - Michel P Hermans
- Department of Endocrinology and Nutrition, Cliniques Universitaires St-Luc, Brussels, Belgium
| | - Rhoderick Neri Machekano
- African Center of Biostatistics Excellence (ACBE), Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Nadia A Sam-Agudu
- Department of Paediatrics, University of Cape Coast School of Medical Sciences, Cape Coast, Ghana.,International Research Center of Excellence, Institute of Human Virology Nigeria, Abuja, Nigeria.,Department of Pediatrics, Institute of Human Virology, University of Maryland School of Medicine, Baltimore, Maryland
| | - Christian Bongo-Pasi Nswe
- Faculty of Public Health, Université Moderne de Kinkole, Kinshasa, Democratic Republic of the Congo.,Department of Public Health, Centre Interdisciplinaire de Recherche en Ethnopharmacologie, Faculty of Medicine, Université Notre-Dame du Kasayi, Kananga, Democratic Republic of the Congo
| | - Placide Mbala-Kingebeni
- Department of Medical Microbiology and Virology, Faculty of Medicine, University of Kinshasa, National Institute of Biomedical Research (INRB), Kinshasa, Democratic Republic of the Congo
| | - Joule Ntwan Madinga
- Epidemiological Surveillance Team, COVID-19 Response, Health Emergencies Program, World Health Organization, Kinshasa, Democratic Republic of the Congo
| | - Stéphane Mukendi
- Department of Internal Medicine, School of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of Congo
| | - Marie Claire Kolié
- Epidemiological Surveillance Team, COVID-19 Response, Health Emergencies Program, World Health Organization, Kinshasa, Democratic Republic of the Congo
| | - Edith N Nkwembe
- Department of Medical Microbiology and Virology, Faculty of Medicine, University of Kinshasa, National Institute of Biomedical Research (INRB), Kinshasa, Democratic Republic of the Congo
| | - Gisele M Mbuyi
- Direction Surveillance Épidémiologique (DSE), Direction Générale de Lutte contre la Maladie (DGLM), Ministère de la Santé Publique et Riposte COVID-19, Kinshasa, Democratic Republic of the Congo
| | - Justus M Nsio
- Direction Surveillance Épidémiologique (DSE), Direction Générale de Lutte contre la Maladie (DGLM), Ministère de la Santé Publique et Riposte COVID-19, Kinshasa, Democratic Republic of the Congo
| | | | - Michel Tshiasuma Pipo
- Department of Public Health, Centre Interdisciplinaire de Recherche en Ethnopharmacologie, Faculty of Medicine, Université Notre-Dame du Kasayi, Kananga, Democratic Republic of the Congo
| | - Steve Ahuka-Mundeke
- Department of Medical Microbiology and Virology, Faculty of Medicine, University of Kinshasa, National Institute of Biomedical Research (INRB), Kinshasa, Democratic Republic of the Congo
| | - Jean-Jacques Muyembe-Tamfum
- Department of Medical Microbiology and Virology, Faculty of Medicine, University of Kinshasa, National Institute of Biomedical Research (INRB), Kinshasa, Democratic Republic of the Congo
| | - Lynne Mofenson
- Elizabeth Glaser Pediatric AIDS Foundation, Washington, District of Columbia
| | - Gerald Smith
- Department of Real World & Advanced Analytics, Cytel, Vancouver, Canada
| | - Edward J Mills
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada
| | - John W Mellors
- Division of Infectious Diseases, Department of Medicine, University of Pittsburgh, School of Medicine, Pittsburgh, Pennsylvania
| | - Alimuddin Zumla
- National Institute for Health Research Biomedical Research Centre, University College London Hospitals NHS Foundation Trust, London, United Kingdom.,Division of Infection and Immunity, Centre for Clinical Microbiology, University College London, London, United Kingdom
| | - Don Jethro Mavungu Landu
- Faculty of Public Health, Université Moderne de Kinkole, Kinshasa, Democratic Republic of the Congo.,Department of Public Health, Centre Interdisciplinaire de Recherche en Ethnopharmacologie, Faculty of Medicine, Université Notre-Dame du Kasayi, Kananga, Democratic Republic of the Congo
| | - Jean-Marie Kayembe
- Department of Internal Medicine, School of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of Congo
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39
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Papadimos TJ, Soghoian SE, Nanayakkara P, Singh S, Miller AC, Saddikuti V, Jayatilleke AU, Dubhashi SP, Firstenberg MS, Dutta V, Chauhan V, Sharma P, Galwankar SC, Garg M, Taylor N, Stawicki SP. COVID-19 Blind Spots: A Consensus Statement on the Importance of Competent Political Leadership and the Need for Public Health Cognizance. J Glob Infect Dis 2020; 12:167-190. [PMID: 33888955 PMCID: PMC8045535 DOI: 10.4103/jgid.jgid_397_20] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 11/11/2020] [Accepted: 11/25/2020] [Indexed: 02/07/2023] Open
Abstract
As the COVID-19 pandemic continues, important discoveries and considerations emerge regarding the SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) pathogen; its biological and epidemiological characteristics; and the corresponding psychological, societal, and public health (PH) impacts. During the past year, the global community underwent a massive transformation, including the implementation of numerous nonpharmacological interventions; critical diversions or modifications across various spheres of our economic and public domains; and a transition from consumption-driven to conservation-based behaviors. Providing essential necessities such as food, water, health care, financial, and other services has become a formidable challenge, with significant threats to the existing supply chains and the shortage or reduction of workforce across many sectors of the global economy. Food and pharmaceutical supply chains constitute uniquely vulnerable and critically important areas that require high levels of safety and compliance. Many regional health-care systems faced at least one wave of overwhelming COVID-19 case surges, and still face the possibility of a new wave of infections on the horizon, potentially in combination with other endemic diseases such as influenza, dengue, tuberculosis, and malaria. In this context, the need for an effective and scientifically informed leadership to sustain and improve global capacity to ensure international health security is starkly apparent. Public health "blind spotting," promulgation of pseudoscience, and academic dishonesty emerged as significant threats to population health and stability during the pandemic. The goal of this consensus statement is to provide a focused summary of such "blind spots" identified during an expert group intense analysis of "missed opportunities" during the initial wave of the pandemic.
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Affiliation(s)
- Thomas J. Papadimos
- On Behalf of the Multidisciplinary ACAIM-WACEM COVID-19 Consensus Group, Bethlehem, PA, USA
| | - Samara E. Soghoian
- On Behalf of the Multidisciplinary ACAIM-WACEM COVID-19 Consensus Group, Bethlehem, PA, USA
| | - Prabath Nanayakkara
- On Behalf of the Multidisciplinary ACAIM-WACEM COVID-19 Consensus Group, Bethlehem, PA, USA
| | - Sarman Singh
- On Behalf of the Multidisciplinary ACAIM-WACEM COVID-19 Consensus Group, Bethlehem, PA, USA
| | - Andrew C. Miller
- On Behalf of the Multidisciplinary ACAIM-WACEM COVID-19 Consensus Group, Bethlehem, PA, USA
| | | | | | - Siddharth P. Dubhashi
- On Behalf of the Multidisciplinary ACAIM-WACEM COVID-19 Consensus Group, Bethlehem, PA, USA
| | - Michael S. Firstenberg
- On Behalf of the Multidisciplinary ACAIM-WACEM COVID-19 Consensus Group, Bethlehem, PA, USA
| | - Vibha Dutta
- On Behalf of the Multidisciplinary ACAIM-WACEM COVID-19 Consensus Group, Bethlehem, PA, USA
| | - Vivek Chauhan
- On Behalf of the Multidisciplinary ACAIM-WACEM COVID-19 Consensus Group, Bethlehem, PA, USA
| | - Pushpa Sharma
- On Behalf of the Multidisciplinary ACAIM-WACEM COVID-19 Consensus Group, Bethlehem, PA, USA
| | - Sagar C. Galwankar
- On Behalf of the Multidisciplinary ACAIM-WACEM COVID-19 Consensus Group, Bethlehem, PA, USA
| | - Manish Garg
- On Behalf of the Multidisciplinary ACAIM-WACEM COVID-19 Consensus Group, Bethlehem, PA, USA
| | - Nicholas Taylor
- On Behalf of the Multidisciplinary ACAIM-WACEM COVID-19 Consensus Group, Bethlehem, PA, USA
| | - Stanislaw P. Stawicki
- On Behalf of the Multidisciplinary ACAIM-WACEM COVID-19 Consensus Group, Bethlehem, PA, USA
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40
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Hoummadi L, Hafid J, Machraoui S, Admou B. [To what extent Africa can limit the impact of the COVID-19 pandemic?]. Rev Epidemiol Sante Publique 2020; 68:302-305. [PMID: 32948360 PMCID: PMC7480264 DOI: 10.1016/j.respe.2020.08.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Revised: 08/14/2020] [Accepted: 08/19/2020] [Indexed: 12/23/2022] Open
Abstract
Suite au déclenchement de la pandémie COVID-19 et aux alertes lancées par l’Organisation mondiale de la santé, l’attention s’est concentrée depuis plusieurs mois sur l’Afrique en tant que zone gravement menacée par la pandémie. Un grand nombre de pays africains, en particulier ceux à revenu faible et moyen seraient confrontés au risque de débordement de leurs systèmes de santé déjà fragiles, souffrant de la limitation des ressources de soins et de la disponibilité des moyens de base. Pour mieux gérer cette crise multidimensionnelle, l’enjeu va au-delà de la mise à niveau des infrastructures de santé publique, il s’agit aussi de savoir comment anticiper et agir activement sur les facteurs susceptibles de limiter la propagation du SRAS-CoV2 pour amortir le choc de cette pandémie sur le continent. Certains de ces facteurs sont naturels et non maîtrisables (climat, géographie…), mais beaucoup d’autres seraient à la portée des gouvernements et des populations africaines tels que les facteurs socioculturels, audiovisuels et même politiques.
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Affiliation(s)
- L Hoummadi
- Laboratoire aliments, environnement et santé, faculté des sciences et techniques, université Cadi Ayyad, Marrakech, Maroc
| | - J Hafid
- Laboratoire aliments, environnement et santé, faculté des sciences et techniques, université Cadi Ayyad, Marrakech, Maroc
| | - S Machraoui
- Centre de recherche clinique, CHU Mohammed VI, BP2360, principal, avenue Ibn Sina, 40080 Marrakech, Maroc
| | - B Admou
- Centre de recherche clinique, CHU Mohammed VI, BP2360, principal, avenue Ibn Sina, 40080 Marrakech, Maroc; Laboratoire de recherche B2S, faculté de médecine et de pharmacie, université Cadi Ayyad, Marrakech, Maroc.
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41
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Chakafana G, Mutithu D, Hoevelmann J, Ntusi N, Sliwa K. Interplay of COVID-19 and cardiovascular diseases in Africa: an observational snapshot. Clin Res Cardiol 2020; 109:1460-1468. [PMID: 32809116 PMCID: PMC7433683 DOI: 10.1007/s00392-020-01720-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 07/23/2020] [Indexed: 12/19/2022]
Abstract
The COVID-19 pandemic, which started around December 2019 has, at present, resulted in over 450,000 deaths globally, and approximately 1% of these deaths have been reported in Africa. Despite the high prevalence of COVID-19 risk factors, namely: hypertension, diabetes, chronic pulmonary disease, cardiovascular diseases (CVDs) such as rheumatic heart disease, compromised immunity and obesity, low case fatality rates have been recorded in many parts of Africa so far. COVID-19 severity has previously been shown to be worse in patients with CVD and hypertension. We observed the severity of COVID-19 and mortality rates in Africa, and compared outcomes with prevalence of established risk factors (hypertension and CVD). We stratified data as per the United Nations’ 5 African subregions. North African countries show a positive association between the risk factors and the mortality rates from COVID-19. However, we observed discordant patterns in the relationship between COVID-19, and either CVD or hypertension, in sub-Saharan African countries. In this paper, we also review the pathogenesis of SARS-CoV-2 infection and how it worsens CVD and postulate that the differences in modulation of the renin–angiotensin–aldosterone system (RAAS) axis which controls angiotensin-converting enzyme (ACE)/ACE2 balance may be an important determinant of COVID-19 outcomes in Africa.
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Affiliation(s)
- Graham Chakafana
- Hatter Institute for Cardiovascular Research in Africa, Faculty of Health Sciences, University of Cape Town, Cape Town, RSA.,Division of Cardiology, Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, RSA
| | - Daniel Mutithu
- Hatter Institute for Cardiovascular Research in Africa, Faculty of Health Sciences, University of Cape Town, Cape Town, RSA.,Division of Cardiology, Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, RSA
| | - Julian Hoevelmann
- Hatter Institute for Cardiovascular Research in Africa, Faculty of Health Sciences, University of Cape Town, Cape Town, RSA.,Klinik für Innere Medizin III - Kardiologie, Angiologie Und Internistische Intensivmedizin, Universitätsklinikum Des Saarlandes, Homburg (Saar), Deutschland
| | - Ntobeko Ntusi
- Hatter Institute for Cardiovascular Research in Africa, Faculty of Health Sciences, University of Cape Town, Cape Town, RSA.,Division of Cardiology, Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, RSA.,Cape Universities Body Imaging Centre, Faculty of Health Sciences, University of Cape Town, Cape Town, RSA
| | - Karen Sliwa
- Hatter Institute for Cardiovascular Research in Africa, Faculty of Health Sciences, University of Cape Town, Cape Town, RSA. .,Division of Cardiology, Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, RSA.
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42
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Obasa AE, Singh S, Chivunze E, Burgess T, Masiye F, Mtande T, Ochieng J, Chalwe V, Mokgatla B, Rennie S, Moodley K. Comparative strategic approaches to COVID-19 in Africa: Balancing public interest with civil liberties. S Afr Med J 2020; 110:858-863. [PMID: 32880268 PMCID: PMC8066401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 08/13/2020] [Indexed: 11/16/2022] Open
Abstract
As COVID-19 spreads rapidly across Africa, causing havoc to economies and disruption to already fragile healthcare systems, it is becoming clear that despite standardised global health strategies, national and local government responses must be tailored to their individual settings. Some African countries have adopted stringent measures such as national lockdown, quarantine or isolation, in combination with good hand hygiene, mandatory wearing of masks and physical distancing, to prevent an impending healthcare crisis. The impact of stringent measures in low- to middle-income African countries has bought time for healthcare facilities to prepare for the onslaught of COVID-19 cases, but some measures have been challenging to implement. In some settings, public health measures have been associated with serious violations of individual rights owing to abuse of power and gaps in implementation of well-intentioned policy. Collateral damage with regard to non-COVID-19 diseases that were suboptimally managed in pre-pandemic times may mean that lives lost from other diseases could exceed those saved from COVID-19. While individuals complying with lockdown regulations have embraced an acceptance of the concept of the common good, at a broad community level many are finding the transition from individualism to collective thinking required during a pandemic difficult to navigate. In this article, we look at government responses to the pandemic in six African countries (Malawi, South Africa, Uganda, Zambia, Zimbabwe and Botswana), and highlight ethical concerns arising in these contexts.
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Affiliation(s)
- A E Obasa
- Centre for Medical Ethics and Law, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
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43
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Nachega JB, Leisegang R, Kallay O, Mills EJ, Zumla A, Lester RT. Mobile Health Technology for Enhancing the COVID-19 Response in Africa: A Potential Game Changer? Am J Trop Med Hyg 2020; 103:3-5. [PMID: 32476643 PMCID: PMC7356462 DOI: 10.4269/ajtmh.20-0506] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 05/21/2020] [Indexed: 01/19/2023] Open
Affiliation(s)
- Jean B. Nachega
- Department of Medicine and Centre for Infectious Diseases, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- Departments of Epidemiology and International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
- Departments of Epidemiology, Infectious Diseases and Microbiology, Center for Global Health, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania
| | - Rory Leisegang
- Family Clinical Research Unit (FAMCRU), Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- Division of Pharmacometrics, Department of Pharmaceutical Biosciences, Uppsala University, Uppsala, Sweden
| | - Oscar Kallay
- School of Public Health, University of Rwanda, Kigali, Rwanda
| | - Edward J. Mills
- Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - Alimuddin Zumla
- Division of Infection and Immunity, Centre for Clinical Microbiology, University College London, London, United Kingdom
- National Institute for Health Research Biomedical Research Centre, University College London Hospitals, London, United Kingdom
| | - Richard T. Lester
- Division of Infectious Diseases, Department of Medicine, University of British of Columbia, Vancouver, Canada
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Abstract
The recently emerged novel coronavirus, “severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2)”, caused a highly contagious disease called coronavirus disease 2019 (COVID-19). The virus was first reported from Wuhan city in China in December, 2019, which in less than three months spread throughout the globe and was declared a global pandemic by the World Health Organization (WHO) on 11th of March, 2020. So far, the ongoing pandemic severely damaged the world's most developed countries and is becoming a major threat for low- and middle-income countries. The poorest continent, Africa with the most vulnerable populations to infectious diseases, is predicted to be significantly affected by the ongoing COVID-19 outbreak. Therefore, in this review we collected and summarized the currently available literature on the epidemiology, etiology, vulnerability, preparedness and economic impact of COVID-19 in Africa, which could be useful and provide necessary information on ongoing COVID-19 pandemics in the continent. We also briefly summarized the concomitance of the COVID-19 pandemic and global warming.
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Affiliation(s)
- Shabir Ahmad Lone
- Clinical Microbiology and Infectious Diseases, School of Pathology, Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Aijaz Ahmad
- Clinical Microbiology and Infectious Diseases, School of Pathology, Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.,Infection Control, Charlotte Maxeke Johannesburg Academic Hospital, National Health Laboratory Service, Johannesburg, South Africa
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45
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Nachega JB, Mbala-Kingebeni P, Otshudiema J, Mobula LM, Preiser W, Kallay O, Michaels-Strasser S, Breman JG, Rimoin AW, Nsio J, Ahuka-Mundeke S, Zumla A, Muyembe Tam-Fum JJ. Responding to the Challenge of the Dual COVID-19 and Ebola Epidemics in the Democratic Republic of Congo-Priorities for Achieving Control. Am J Trop Med Hyg 2020; 103:597-602. [PMID: 32563272 PMCID: PMC7410434 DOI: 10.4269/ajtmh.20-0642] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
As of June 11, 2020, the Democratic Republic of the Congo (DRC) has reported 4,258 COVID-19 cases with 90 deaths. With other African countries, the DRC faces the challenge of striking a balance between easing public health lockdown measures to curtail the spread of SARS-CoV-2 and minimizing both economic hardships for large sectors of the population and negative impacts on health services for other infectious and noninfectious diseases. The DRC recently controlled its tenth Ebola virus disease (EVD) outbreak, but COVID-19 and a new EVD outbreak beginning on June 1, 2020 in the northwest Équateur Province have added an additional burden to health services. Although the epidemiology and transmission of EVD and COVID-19 differ, leveraging the public health infrastructures and experiences from coordinating the EVD response to guide the public health response to COVID-19 is critical. Building on the DRC’s 40 years of experience with 10 previous EVD outbreaks, we highlight the DRC’s multi-sectoral public health approach to COVID-19, which includes community-based screening, testing, contact-tracing, risk communication, community engagement, and case management. We also highlight remaining challenges and discuss the way forward for achieving control of both COVID-19 and EVD in the DRC.
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Affiliation(s)
- Jean B Nachega
- Department of Epidemiology and International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.,Department of Medicine, Centre for Infectious Diseases, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.,Department of Epidemiology, Infectious Diseases and Microbiology, Center for Global Health, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Placide Mbala-Kingebeni
- Department of Medical Microbiology and Virology, National Institute of Biomedical Research (INRB), Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - John Otshudiema
- Health Emergencies Program, COVID-19 Response, Epidemiological Surveillance Team, World Health Organisation, Kinshasa, Democratic Republic of the Congo
| | - Linda M Mobula
- Ebola Response Team, Health, Nutrition and Population, Global Practice, World Bank Group, Washington, District of Columbia
| | - Wolfgang Preiser
- National Health Laboratory Service (NHLS), Cape Town, South Africa.,Division of Medical Virology, Department of Pathology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Oscar Kallay
- Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | | | - Joel G Breman
- American Society of Tropical Medicine and Hygiene and United States National Institutes of Health, Fogarty International Center, Bethesda, Maryland
| | - Anne W Rimoin
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles (UCLA), Los Angeles, California
| | - Justus Nsio
- Department of Medical Microbiology and Virology, National Institute of Biomedical Research (INRB), Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Steve Ahuka-Mundeke
- Department of Medical Microbiology and Virology, National Institute of Biomedical Research (INRB), Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Alimuddin Zumla
- National Institute for Health Research Biomedical Research Centre, University College London Hospitals, London, United Kingdom.,Division of Infection and Immunity, Department of Infection, Centre for Clinical Microbiology, University College London, London, United Kingdom
| | - Jean-Jacques Muyembe Tam-Fum
- Department of Medical Microbiology and Virology, National Institute of Biomedical Research (INRB), Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
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