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Frimpong SO, Paintsil E. Community engagement in Ebola outbreaks in sub-Saharan Africa and implications for COVID-19 control: A scoping review. Int J Infect Dis 2023; 126:182-192. [PMID: 36462575 DOI: 10.1016/j.ijid.2022.11.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Revised: 10/27/2022] [Accepted: 11/25/2022] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVES There is a paucity of scoping data on the specific roles community engagement played in preventing and managing the Ebola virus disease (EVD) outbreak in sub-Saharan Africa. We assessed the role, benefits, and mechanisms of community engagement to understand its effect on EVD case detection, survival, and mortality in sub-Saharan Africa. The implications for COVID-19 prevention and control were also highlighted. METHODS We searched for articles between 2010 and 2020 in the MEDLINE and Embase databases. The study types included were randomized trials, quasiexperimental studies, observational studies, case series, and reports. RESULTS A total of 903 records were identified for screening. A total of 216 articles met the review criteria, 103 were initially selected, and 44 were included in the final review. Our findings show that effective community involvement during the EVD outbreak depended on the survival rates, testimonials of survivors, risk perception, and the inclusion of community leaders. Community-based interventions improved knowledge and attitudes, case findings, isolation efforts, and treatment uptake. CONCLUSION Although the studies included in this review were of highly variable quality, findings from this review may provide lessons for the role of community engagement in the COVID-19 pandemic's prevention and control in sub-Saharan Africa.
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Affiliation(s)
- Shadrack Osei Frimpong
- Department of Pediatrics, Yale School of Medicine, New Haven, USA; Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK; Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, USA.
| | - Elijah Paintsil
- Department of Pediatrics, Yale School of Medicine, New Haven, USA; Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, USA; Department of Pharmacology, Yale School of Medicine, New Haven, USA; School of Management, Yale University, New Haven, USA
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2
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Sarfraz A, Sarfraz Z, Ashraf M, Ashraf H. Sustained ethical analysis of global dilemmas and country-level decision making during and post the COVID-19 pandemic: A systematic review. Pak J Med Sci 2022; 38:1056-1063. [PMID: 35634626 PMCID: PMC9121969 DOI: 10.12669/pjms.38.4.4755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 09/30/2021] [Indexed: 12/24/2022] Open
Abstract
The COVID-19 pandemic has highlighted the vulnerability of countries worldwide and their abilities to cope with the fast-paced demands of the research and medical community. A key to promoting ethical decision-making frameworks is by calibrating the sustainability at regional, national, and global levels to incorporate coordinated reforms. We performed a sustained ethical analysis and critically reviewed evidence addressing country-level responses to practices during the COVID-19 pandemic using PubMed (MEDLINE), Scopus, and CINAHL. The World Health Organization's ethical framework proposed for the entire population during the pandemic was applied to thematically delineate findings under equality, best outcomes (utility), prioritizing the worst off, and prioritizing those tasked with helping others. The findings demarcate ethical concerns about the validity of drug and vaccine trials in developing and developed countries, hints of unjust healthcare organizational policies, lack of equal allocation of pertinent resources, miscalculated allocation of resources to essential workers and stratified populations.
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Affiliation(s)
- Azza Sarfraz
- Azza Sarfraz, Aga Khan University, Karachi, Pakistan
| | - Zouina Sarfraz
- Zouina Sarfraz, Fatima Jinnah Medical University, Lahore, Pakistan,Correspondence: Dr. Zouina Sarfraz, Fatima Jinnah Medical University, Queen’s Road, Mozang Chungi, Lahore, Punjab 54000, Pakistan. E-mail:
| | - Mohammad Ashraf
- Mohammad Ashraf, Wolfson School of Medicine, University of Glasgow, United Kingdom
| | - Huma Ashraf
- Huma Ashraf CMH Lahore Medical College, Lahore, Pakistan
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3
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Assefa N, Hassen JY, Admassu D, Brhane M, Deressa M, Marami D, Teklemariam Z, Dessie Y, Oundo J. COVID-19 Testing Experience in a Resource-Limited Setting: The Use of Existing Facilities in Public Health Emergency Management. Front Public Health 2021; 9:675553. [PMID: 34195170 PMCID: PMC8236620 DOI: 10.3389/fpubh.2021.675553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 05/12/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: Coronavirus disease 2019 (COVID-19) is a public health emergency with little testing and treatment experiences at its occurrence. Diagnostic and treatment rapidly changed in the world including Ethiopia. Haramaya University has strived to change its diagnostic capacity using existing facilities in response to the national call to the pandemic. Objective: This summary aims to detail experiences of setting up COVID-19 testing in Haramaya University laboratories, Eastern Ethiopia. Methods: Desktop exercise was conducted to understand the start-up and implementations of COVID-19 testing in two Haramaya University laboratories, Hararghe Health Research Partnership and Campylobacter Genomics and Environmental Enteric Dysfunction laboratories. Communication, formats, guidelines, and standards were reviewed and summarized. Discussion with those involved in the start-up and implementation of the testing were also held. Ideas were summarized to learn the experiences the COVID-19 testing exercises. Lesson Learned: This is a huge experience for Haramaya University to participate in the national call to increase the testing platform in the management of COVID19. Close work relationship with the public health authorities at all levels demonstrated the university's commitment to public service. The university has used the opportunity to advance its molecular testing capability by training its staff and students. The University has also contributed to the capacity development for laboratories in the surrounding areas of Harar, Somali, Oromia, and Dire Dawa. The pandemic has been an opportunity in harnessing existing resource for the benefit of the public during such times of dire needs to provide critical public health laboratory interventions.
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Affiliation(s)
- Nega Assefa
- College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.,Hararghe Health Research Partnerships, Haramaya University, Harar, Ethiopia
| | - Jemal Yousuf Hassen
- College of Agriculture and Environmental Sciences, Haramaya University, East Hararghe, Ethiopia
| | - Desalegn Admassu
- College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Mussie Brhane
- Hararghe Health Research Partnerships, Haramaya University, Harar, Ethiopia
| | - Mersen Deressa
- Hararghe Health Research Partnerships, Haramaya University, Harar, Ethiopia
| | - Dadi Marami
- College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.,Hararghe Health Research Partnerships, Haramaya University, Harar, Ethiopia
| | - Zelalem Teklemariam
- College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.,Hararghe Health Research Partnerships, Haramaya University, Harar, Ethiopia
| | - Yadeta Dessie
- College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Joseph Oundo
- Hararghe Health Research Partnerships, Haramaya University, Harar, Ethiopia
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4
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A Descriptive-Multivariate Analysis of Community Knowledge, Confidence, and Trust in COVID-19 Clinical Trials among Healthcare Workers in Uganda. Vaccines (Basel) 2021; 9:vaccines9030253. [PMID: 33809269 PMCID: PMC8000597 DOI: 10.3390/vaccines9030253] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 03/05/2021] [Accepted: 03/08/2021] [Indexed: 12/22/2022] Open
Abstract
Background—misinformation and mistrust often undermines community vaccine uptake, yet information in rural communities, especially of developing countries, is scarce. This study aimed to identify major challenges associated with coronavirus disease 2019 (COVID-19) vaccine clinical trials among healthcare workers and staff in Uganda. Methods—a rapid exploratory survey was conducted over 5 weeks among 260 respondents (66% male) from healthcare centers across the country using an online questionnaire. Twenty-seven questions assessed knowledge, confidence, and trust scores on COVID-19 vaccine clinical trials from participants in 46 districts in Uganda. Results—we found low levels of knowledge (i.e., confusing COVID-19 with Ebola) with males being more informed than females (OR = 1.5, 95% CI: 0.7–3.0), and mistrust associated with policy decisions to promote herbal treatments in Uganda and the rushed international clinical trials, highlighting challenges for the upcoming Oxford–AstraZeneca vaccinations. Knowledge, confidence and trust scores were higher among the least educated (certificate vs. bachelor degree holders). We also found a high level of skepticism and possible community resistance to DNA recombinant vaccines, such as the Oxford–AstraZeneca vaccine. Preference for herbal treatments (38/260; 14.6%, 95% CI: 10.7–19.3) currently being promoted by the Ugandan government raises major policy concerns. High fear and mistrust for COVID-19 vaccine clinical trials was more common among wealthier participants and more affluent regions of the country. Conclusion—our study found that knowledge, confidence, and trust in COVID-19 vaccines was low among healthcare workers in Uganda, especially those with higher wealth and educational status. There is a need to increase transparency and inclusive participation to address these issues before new trials of COVID-19 vaccines are initiated.
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Koff WC, Schenkelberg T, Williams T, Baric RS, McDermott A, Cameron CM, Cameron MJ, Friemann MB, Neumann G, Kawaoka Y, Kelvin AA, Ross TM, Schultz-Cherry S, Mastro TD, Priddy FH, Moore KA, Ostrowsky JT, Osterholm MT, Goudsmit J. Development and deployment of COVID-19 vaccines for those most vulnerable. Sci Transl Med 2021; 13:13/579/eabd1525. [PMID: 33536277 DOI: 10.1126/scitranslmed.abd1525] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 01/15/2021] [Indexed: 12/20/2022]
Abstract
Development of safe and effective COVID-19 vaccines is a global priority and the best hope for ending the COVID-19 pandemic. Remarkably, in less than 1 year, vaccines have been developed and shown to be efficacious and are already being deployed worldwide. Yet, many challenges remain. Immune senescence and comorbidities in aging populations and immune dysregulation in populations living in low-resource settings may impede vaccine effectiveness. Distribution of vaccines among these populations where vaccine access is historically low remains challenging. In this Review, we address these challenges and provide strategies for ensuring that vaccines are developed and deployed for those most vulnerable.
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Affiliation(s)
- Wayne C Koff
- Human Vaccines Project, New York, NY 10119, USA. .,Human Immunomics Initiative, Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA 02115, USA
| | - Theodore Schenkelberg
- Human Vaccines Project, New York, NY 10119, USA.,Human Immunomics Initiative, Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA 02115, USA
| | - Tere Williams
- Department of Pathology, Albert Einstein College of Medicine Bronx, NY 10461, USA
| | - Ralph S Baric
- Department of Epidemiology, University of North Carolina, Chapel Hill, NC 27599, USA
| | - Adrian McDermott
- Vaccine Immunology Program, Vaccine Research Center, National Institutes of Health, Bethesda, MD 20814, USA
| | - Cheryl M Cameron
- School of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Mark J Cameron
- School of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Matthew B Friemann
- Department of Microbiology and Immunology, University of Maryland at Baltimore, Baltimore, MD School of Medicine, Baltimore, MD 21201, USA
| | - Gabriele Neumann
- Influenza Research Institute, Department of Pathobiological Sciences, School of Veterinary Medicine, University of Wisconsin, Madison, WI 53706, USA
| | - Yoshihiro Kawaoka
- Influenza Research Institute, Department of Pathobiological Sciences, School of Veterinary Medicine, University of Wisconsin, Madison, WI 53706, USA.,Institute of Medical Science, University of Tokyo, Bunkyo City, Tokyo 113-8654, Japan
| | - Alyson A Kelvin
- Departments of Pediatrics, Microbiology and Immunology, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - Ted M Ross
- Animal Health Research Center, Center for Vaccines, Immunology and Infectious Disease, College of Veterinary Medicine, University of Georgia, Athens, GA 30602, USA
| | - Stacey Schultz-Cherry
- Infectious Diseases Research, St. Jude Children's Research Hospital, Memphis, TN 38105, USA
| | | | - Frances H Priddy
- Vaccine Alliance Aotearoa New Zealand, Malaghan Institute of Medical Research, Wellington 6242, New Zealand
| | - Kristine A Moore
- Center for Infectious Disease Research and Policy (CIDRAP), University of Minnesota, Minneapolis MN 55455, USA
| | - Julia T Ostrowsky
- Center for Infectious Disease Research and Policy (CIDRAP), University of Minnesota, Minneapolis MN 55455, USA
| | - Michael T Osterholm
- Center for Infectious Disease Research and Policy (CIDRAP), University of Minnesota, Minneapolis MN 55455, USA
| | - Jaap Goudsmit
- Human Vaccines Project, New York, NY 10119, USA.,Human Immunomics Initiative, Departments of Epidemiology, Immunology and Infectious Diseases, Harvard TH Chan School of Public Health, Boston, MA 02115, USA
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Anjorin AA, Odetokun IA, Abioye AI, Elnadi H, Umoren MV, Damaris BF, Eyedo J, Umar HI, Nyandwi JB, Abdalla MM, Tijani SO, Awiagah KS, Idowu GA, Fabrice SNA, Maisara AMO, Razouqi Y, Mhgoob ZE, Parker S, Asowata OE, Adesanya IO, Obara MA, Jaumdally S, Kitema GF, Okuneye TA, Mbanzulu KM, Daitoni H, Hallie EF, Mosbah R, Fasina FO. Will Africans take COVID-19 vaccination? PLoS One 2021; 16:e0260575. [PMID: 34851998 PMCID: PMC8635331 DOI: 10.1371/journal.pone.0260575] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Accepted: 11/12/2021] [Indexed: 02/05/2023] Open
Abstract
The economic and humanistic impact of COVID-19 pandemic is enormous globally. No definitive treatment exists, hence accelerated development and approval of COVID-19 vaccines, offers a unique opportunity for COVID-19 prevention and control. Vaccine hesitancy may limit the success of vaccine distribution in Africa, therefore we assessed the potentials for coronavirus vaccine hesitancy and its determinants among Africans. An online cross-sectional African-wide survey was administered in Arabic, English, and French languages. Questions on demographics, self-reported health status, vaccine literacy, knowledge and perception on vaccines, past experience, behavior, infection risk, willingness to receive and affordability of the SARS-COV-2 vaccine were asked. Data were subjected to descriptive and inferential statistics. A total of 5,416 individuals completed the survey. Approximately, 94% were residents of 34 African countries while the other Africans live in the Diaspora. Only 63% of all participants surveyed were willing to receive the COVID-19 vaccination as soon as possible and 79% were worried about its side effects. Thirty-nine percent expressed concerns of vaccine-associated infection. The odds of vaccine hesitancy was 0.28 (95% CI: 0.22, 0.30) among those who believed their risk of infection was very high, compared to those who believed otherwise. The odds of vaccine hesitancy was one-fifth (OR = 0.21, 95% CI: 0.16, 0.28) among those who believed their risk of falling sick was very high, compared to those who believed their risk of falling very sick was very low. The OR of vaccine hesitancy was 2.72 (95% CI: 2.24, 3.31) among those who have previously refused a vaccine for themselves or their child compared to counterparts with no self-reported history of vaccine hesitancy. Participants want the vaccines to be mandatory (40%), provided free of charge (78%) and distributed in homes and offices (44%). COVID-19 vaccine hesitancy is substantial among Africans based on perceived risk of coronavirus infection and past experiences.
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Affiliation(s)
- AbdulAzeez A. Anjorin
- Department of Microbiology (Virology Research), Lagos State University, Lagos, Nigeria
| | - Ismail A. Odetokun
- Department of Veterinary Public Health & Preventive Medicine, University of Ilorin, Ilorin, Nigeria
| | | | | | | | | | - Joseph Eyedo
- Department of Microbiology (Virology Research), Lagos State University, Lagos, Nigeria
| | - Haruna I. Umar
- Department of Biochemistry, Federal University of Technology, Akure, Ondo State, Nigeria
| | - Jean B. Nyandwi
- Department of Pharmacy, University of Rwanda & Department of Pharmacology, College of Medicine, Gyeongsang National University, Gyeongsang, Republic of Korea
| | - Mena M. Abdalla
- Department of Obstetrics and Gynaecology, Minya Health Insurance Hospital, Minya, Egypt
| | - Sodiq O. Tijani
- Department of Medical Microbiology and Parasitology, College of Medicine University of Lagos, Idi Araba, Lagos, Nigeria
| | - Kwame S. Awiagah
- Accident and Emergency Centre, Korle Bu Teaching Hospital, Accra, Ghana
| | | | | | - Aala M. O. Maisara
- Department of Nephrology and Hemodialysis Center, Bahre Teaching Hospital, & Faculty of Medicine, International University of Africa, Khartoum, Sudan
| | - Youssef Razouqi
- Biological Engineering Laboratory, Sultan Moulay Slimane University Beni Mellal, Beni Mellal, Morocco
| | - Zuhal E. Mhgoob
- Department of Public Health & Infection Control, Aljawda Hospital & El Nileen University Community Development College, Khartoum, Sudan
| | - Salim Parker
- Division of Infectious Disease & HIV Medicine, University of Cape Town, Cape Town, South Africa
| | - Osaretin E. Asowata
- Africa Health Research Institute, University of KwaZulu-Natal, Durban, South Africa
| | - Ismail O. Adesanya
- US Army Reserve & Hospitalist, BayouCity Physicians, Spring, Texas, United States of America
| | | | | | - Gatera F. Kitema
- Department of Ophthalmology, University of Rwanda, Kigali, Rwanda
- St-Andrews University, St Andrews, United Kingdom
| | - Taofik A. Okuneye
- Department of Family Medicine, General Hospital Odan, Lagos, Nigeria
| | - Kennedy M. Mbanzulu
- Department of Tropical Medicine, Parasitic and Infectious Diseases, University of Kinshasa, Kinshasa, Democratic Republic of Congo
| | - Hajj Daitoni
- HIV and Malaria Research Unit, Malawi and Islamic Health Association of Malawi, Limbe, Malawi
| | - Ezekiel F. Hallie
- Department of Pharmacology and Toxicology, School of Pharmacy, University of Liberia, Monrovia, Liberia
| | - Rasha Mosbah
- Infection Control Unit, Zagazig University, Zagazig, Egypt
- Faculty of Oral and Dental Medicine, Ahram Canadian University, 6th of October City, Egypt
| | - Folorunso O. Fasina
- Department of Veterinary Tropical Diseases, Emergency Centre for Transboundary Animal Diseases (ECTAD), Food and Agricultural Organization of the United Nations (FAO), University of Pretoria, Pretoria, South Africa
- * E-mail:
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Abstract
The persistent influence of coloniality both from external actors and from within threatens the response to COVID-19 in Africa. This essay presents historical context for the colonial inheritance of modern global health and analyses two controversies related to COVID-19 that illustrate facets of coloniality: comments made by French researchers regarding the testing of BCG vaccine in Africa, and the claims by Madagascar's president Andry Rajoelina that the country had developed an effective traditional remedy named Covid-Organics. Leveraging both historical sources and contemporary documentary sources, I demonstrate how the currents of exploitation, marginalisation, pathologisation and saviourism rooted in coloniality are manifested via these events. I also discuss responses to coloniality, focussing on the misuse and co-optation of pan-Africanist rhetoric. In particular, I argue that the scandal surrounding Covid-Organics is a reflection of endogenised coloniality, whereby local elites entrench and benefit from inequitable power structures at the intersubjective (rather than trans-national) scale. I conclude with a reflection on the need for equity as a guiding principle to dismantle global health colonialism.
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Affiliation(s)
- Mariam O Fofana
- Harvard-Affiliated Emergency Medicine Residency (HAEMR), Boston, MA, USA
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Dai H, Han J, Lichtfouse E. Who is running faster, the virus or the vaccine? ENVIRONMENTAL CHEMISTRY LETTERS 2020; 18:1761-1766. [PMID: 33082737 PMCID: PMC7561242 DOI: 10.1007/s10311-020-01110-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Affiliation(s)
- Han Dai
- Department of Environmental Science and Engineering, Xi’an Jiaotong University, Xi’an, 710049 Shaanxi People’s Republic of China
| | - Jie Han
- Department of Environmental Science and Engineering, Xi’an Jiaotong University, Xi’an, 710049 Shaanxi People’s Republic of China
| | - Eric Lichtfouse
- CNRS, IRD, INRAE, Coll France, CEREGE, Aix-Marseille University, 13100 Aix en Provence, France
- State Key Laboratory of Multiphase Flow in Power Engineering, Xi’an Jiaotong University, Xi’an, 710049 Shaanxi People’s Republic of China
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