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Duedu KO, Gyamfi J, Ayivor-Djanie R, Afenya G, Agbuglah IB, Agbogli HK, Essandoh P, Kugbemanya S, Adiku TK. Co-infections of SARS-CoV-2 with respiratory syncytial virus and human influenza A in patients with symptoms of COVID-19 in Ghana: A retrospective study. New Microbes New Infect 2024; 62:101463. [PMID: 39262675 PMCID: PMC11388198 DOI: 10.1016/j.nmni.2024.101463] [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: 04/27/2024] [Revised: 08/15/2024] [Accepted: 08/19/2024] [Indexed: 09/13/2024] Open
Abstract
Background During the COVID-19 pandemic the aetiology of respiratory illnesses were narrowed to SARS-CoV-2. This prevented diagnosis of other pathogens and patients were not notified of the accurate diagnosis of their illnesses when SARS-CoV-2 was absent. It is therefore important to look back and determine what else was present but was missed. Objective This retrospective study sought to gain insights into prevalence of respiratory syncytial virus (RSV) and influenza A alongside SARS-CoV-2 in patients who reported with clinical symptoms of respiratory illnesses. Methods Samples from patients who had reported of respiratory symptoms were selected at random from a pool. RNA was extracted and RT-PCR was performed for SARS-CoV-2, RSV and Influenza A in parallel. Data on the clinical symptoms was extracted from case-base forms and analysed. Results Of the 400 symptomatic samples tested, prevalence of SARS-CoV-2, influenza A and RSV was 20.3 %, 2.0 % and 0.5 % respectively. Only one sample tested positive for SARS-CoV-2 and influenza A. About 77 % of the symptomatic cases did not test positive for any of the three agents. Cough (79 %) was the most common symptom followed by fever and chills, headache, sore throat and runny nose. Conclusion The large proportion of symptomatic cases that tested negative for all three respiratory viruses raises a flag and a need for more investigations into the actual burden of respiratory aetiologic agents during the pandemic. With the low levels of co-infections, parallel testing may not be needed however, a strong case for multiplex tests for respiratory agents exists.
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Affiliation(s)
- Kwabena Obeng Duedu
- Department of Biomedical Sciences, School of Basic and Biomedical Sciences, University of Health and Allied Sciences, PMB 31, Ho, VH0194, Ghana
- College of Life Sciences, Birmingham City University, City South Campus, Birmingham, United Kingdom
| | - Jones Gyamfi
- Department of Medical Laboratory Sciences, School of Allied Health Sciences, University of Health and Allied Sciences, PMB 31, Ho, VH0194, Ghana
- School of Health & Life Sciences, Teesside University, Middlesbrough, United Kingdom
| | - Reuben Ayivor-Djanie
- Department of Biomedical Sciences, School of Basic and Biomedical Sciences, University of Health and Allied Sciences, PMB 31, Ho, VH0194, Ghana
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), University of Ghana, Legon, Ghana
| | - Godknows Afenya
- Department of Biomedical Sciences, School of Basic and Biomedical Sciences, University of Health and Allied Sciences, PMB 31, Ho, VH0194, Ghana
| | - Isaac Buertey Agbuglah
- Department of Biomedical Sciences, School of Basic and Biomedical Sciences, University of Health and Allied Sciences, PMB 31, Ho, VH0194, Ghana
| | - Hubert Kwame Agbogli
- Department of Biomedical Sciences, School of Basic and Biomedical Sciences, University of Health and Allied Sciences, PMB 31, Ho, VH0194, Ghana
| | - Priscilla Essandoh
- Department of Biomedical Sciences, School of Basic and Biomedical Sciences, University of Health and Allied Sciences, PMB 31, Ho, VH0194, Ghana
| | - Seraphine Kugbemanya
- Department of Biomedical Sciences, School of Basic and Biomedical Sciences, University of Health and Allied Sciences, PMB 31, Ho, VH0194, Ghana
| | - Theophilus Koku Adiku
- Department of Biomedical Sciences, School of Basic and Biomedical Sciences, University of Health and Allied Sciences, PMB 31, Ho, VH0194, Ghana
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Al-Kuraishy HM, Mazhar Ashour MH, Saad HM, Batiha GES. COVID-19 and β-thalassemia: in lieu of evidence and vague nexus. Ann Hematol 2024; 103:1423-1433. [PMID: 37405444 DOI: 10.1007/s00277-023-05346-8] [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: 04/27/2023] [Accepted: 06/27/2023] [Indexed: 07/06/2023]
Abstract
Coronavirus disease 19 (COVID-19) is an infectious disease caused by severe acute respiratory coronavirus 2 (SARS-CoV-2) causing acute systemic disorders and multi-organ damage. β-thalassemia (β-T) is an autosomal recessive disorder leading to the development of anemia. β-T may lead to complications such as immunological disorders, iron overload, oxidative stress, and endocrinopathy. β-T and associated complications may increase the risk of SARS-CoV-2, as inflammatory disturbances and oxidative stress disorders are linked with COVID-19. Therefore, the objective of the present review was to elucidate the potential link between β-T and COVID-19 regarding the underlying comorbidities. The present review showed that most of the β-T patients with COVID-19 revealed mild to moderate clinical features, and β-T may not be linked with Covid-19 severity. Though patients with transfusion-dependent β-T (TDT) develop less COVID-19 severity compared to non-transfusion-depend β-T(NTDT), preclinical and clinical studies are recommended in this regard.
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Affiliation(s)
- Hayder M Al-Kuraishy
- Department of Clinical Pharmacology and Therapeutic Medicine, College of Medicine, Al-Mustansiriyiah University, Box 14132, Baghdad, Iraq
| | | | - Hebatallah M Saad
- Department of Pathology, Faculty of Veterinary Medicine, Matrouh University, Marsa Matruh, 51744, Egypt.
| | - Gaber El-Saber Batiha
- Department of Pharmacology and Therapeutics, Faculty of Veterinary Medicine, Damanhour University, AlBeheira, Damanhour, 22511, Egypt
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Bonnet G, Pearson CAB, Torres-Rueda S, Ruiz F, Lines J, Jit M, Vassall A, Sweeney S. A Scoping Review and Taxonomy of Epidemiological-Macroeconomic Models of COVID-19. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2024; 27:104-116. [PMID: 37913921 DOI: 10.1016/j.jval.2023.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 10/08/2023] [Accepted: 10/22/2023] [Indexed: 11/03/2023]
Abstract
OBJECTIVES The COVID-19 pandemic placed significant strain on many health systems and economies. Mitigation policies decreased health impacts but had major macroeconomic impact. This article reviews models combining epidemiological and macroeconomic projections to enable policy makers to consider both macroeconomic and health objectives. METHODS A scoping review of epidemiological-macroeconomic models of COVID-19 was conducted, covering preprints, working articles, and journal publications. We assessed model methodologies, scope, and application to empirical data. RESULTS We found 80 articles modeling both the epidemiological and macroeconomic outcomes of COVID-19. Model scope is often limited to the impact of lockdown on health and total gross domestic product or aggregate consumption and to high-income countries. Just 14% of models assess disparities or poverty. Most models fall under 4 categories: compartmental-utility-maximization models, epidemiological models with stylized macroeconomic projections, epidemiological models linked to computable general equilibrium or input-output models, and epidemiological-economic agent-based models. We propose a taxonomy comparing these approaches to guide future model development. CONCLUSIONS The epidemiological-macroeconomic models of COVID-19 identified have varying complexity and meet different modeling needs. Priorities for future modeling include increasing developing country applications, assessing disparities and poverty, and estimating of long-run impacts. This may require better integration between epidemiologists and economists.
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Affiliation(s)
- Gabrielle Bonnet
- Department of Disease Control, London School of Hygiene & Tropical Medicine, London, England, UK; Centre for Mathematical Modelling of Infectious Disease, London School of Hygiene & Tropical Medicine, London, England, UK; Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, England, UK.
| | - Carl A B Pearson
- Centre for Mathematical Modelling of Infectious Disease, London School of Hygiene & Tropical Medicine, London, England, UK; Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, England, UK; South African DSI-NRF C1entre of Excellence in Epidemiological Modelling and Analysis, Stellenbosch University, Stellenbosch, South Africa
| | - Sergio Torres-Rueda
- Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, England, UK
| | - Francis Ruiz
- Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, England, UK
| | - Jo Lines
- Department of Disease Control, London School of Hygiene & Tropical Medicine, London, England, UK; Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, London, England, UK
| | - Mark Jit
- Centre for Mathematical Modelling of Infectious Disease, London School of Hygiene & Tropical Medicine, London, England, UK; Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, England, UK
| | - Anna Vassall
- Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, England, UK
| | - Sedona Sweeney
- Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, England, UK; Centre for Health Economics in London, London School of Hygiene & Tropical Medicine, London, England, UK
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Paredes-Ruvalcaba N, Kim AW, Ndaba N, Cele L, Swana S, Bosire E, Moolla A. Coping mechanisms during the COVID-19 pandemic and lockdown in metropolitan Johannesburg, South Africa: A qualitative study. Am J Hum Biol 2023; 35:e23958. [PMID: 37427489 PMCID: PMC10776812 DOI: 10.1002/ajhb.23958] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 06/26/2023] [Accepted: 06/27/2023] [Indexed: 07/11/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has caused prolonged stress on numerous fronts. While the acute health impacts of psychosocial stress due to the pandemic are well-documented, less is known about the resources and mechanisms utilized to cope in response to stresses during the pandemic and lockdown. OBJECTIVE The aim of this study was to identify and describe the coping mechanisms adults utilized in response to the stressors of the COVID-19 pandemic during the 2020 South African lockdown. METHODS This study included adults (n = 47: 32 female; 14 male; 1 non-binary) from the greater Johannesburg region in South Africa. Interviews with both closed and open-ended questions were administered to query topics regarding the COVID-19 pandemic. Data were coded and thematically analyzed to identify coping mechanisms and experiences. RESULTS Adults engaged in a variety of strategies to cope with the pandemic and the ensued lockdown. The ability to access or engage in multiple coping mechanisms were either enhanced or constrained by financial and familial situations. Participants engaged in seven major coping mechanisms: interactions with family and friends, prayer and religion, staying active, financial resources, mindset reframing, natural remedies, and following COVID-19 prevention protocols. CONCLUSIONS Despite the multiple stressors faced during the pandemic and lockdown, participants relied on multiple coping strategies which helped preserve their well-being and overcome pandemic-related adversity. The strategies participants engaged in were impacted by access to financial resources and family support. Further research is needed to examine the potential impacts these strategies may have on people's health.
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Affiliation(s)
| | - Andrew Wooyoung Kim
- Department of Anthropology, University of California, Berkeley, Berkeley, CA, USA
- SAMRC Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Nokubonga Ndaba
- SAMRC Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Lindile Cele
- SAMRC Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Someleze Swana
- SAMRC Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Edna Bosire
- Brain and Mind Institute, Aga Khan University, Nairobi, Kenya
| | - Aneesa Moolla
- Health Economics and Epidemiology Research Office, Wits Health Consortium, Johannesburg, South Africa
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5
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Koanda O, Yonaba R, Tazen F, Karoui H, Sidibé ML, Lèye B, Diop M, Andrianisa HA, Karambiri H. Climate and COVID-19 transmission: a cross-sectional study in Africa. Sci Rep 2023; 13:18702. [PMID: 37907735 PMCID: PMC10618194 DOI: 10.1038/s41598-023-46007-0] [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: 11/04/2022] [Accepted: 10/26/2023] [Indexed: 11/02/2023] Open
Abstract
The role of climate in the Coronavirus disease 2019 (COVID-19) transmission appears to be controversial, as reported in earlier studies. In Africa, the subject is poorly documented. In this study, over the period from January 1st, 2020 to September 31, 2022, the daily variations in cumulative confirmed cases of COVID-19 for each African country (54 countries) are modelled through time-series-based approaches and using meteorological factors as covariates. It is suggested from the findings that climate plays a role in COVID-19 transmission since at least one meteorological factor is found to be significant in 32 countries. In decreasing order, the most often occurring meteorological factors are dewpoint temperature, relative and absolute humidity, average temperature and solar radiation. Most of these factors show a lagged effect with confirmed cases (between 0 and 28 days). Also, some meteorological factors exhibit contrasting effects on COVID-19 transmission, resulting in both positive and negative association with cumulative cases, therefore highlighting the complex nature of the interplay between climate and COVID-19 transmission.
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Affiliation(s)
- Ousmane Koanda
- Laboratoire Eaux, Hydro-Systèmes et Agriculture (LEHSA), Institut International d'Ingénierie de l'Eau et de l'Environnement (2iE), Ouagadougou, Burkina Faso
| | - Roland Yonaba
- Laboratoire Eaux, Hydro-Systèmes et Agriculture (LEHSA), Institut International d'Ingénierie de l'Eau et de l'Environnement (2iE), Ouagadougou, Burkina Faso.
| | - Fowé Tazen
- Laboratoire Eaux, Hydro-Systèmes et Agriculture (LEHSA), Institut International d'Ingénierie de l'Eau et de l'Environnement (2iE), Ouagadougou, Burkina Faso
| | - Héla Karoui
- Laboratoire Eaux, Hydro-Systèmes et Agriculture (LEHSA), Institut International d'Ingénierie de l'Eau et de l'Environnement (2iE), Ouagadougou, Burkina Faso
| | - Mohamed Lamine Sidibé
- Laboratoire Eaux, Hydro-Systèmes et Agriculture (LEHSA), Institut International d'Ingénierie de l'Eau et de l'Environnement (2iE), Ouagadougou, Burkina Faso
| | - Babacar Lèye
- Laboratoire Eaux, Hydro-Systèmes et Agriculture (LEHSA), Institut International d'Ingénierie de l'Eau et de l'Environnement (2iE), Ouagadougou, Burkina Faso
| | - Mamadou Diop
- Laboratoire Eco-Matériaux et Habitat Durable (LEMHaD), Institut International d'Ingénierie de l'Eau et de l'Environnement (2iE), Ouagadougou, Burkina Faso
| | - Harinaivo Anderson Andrianisa
- Laboratoire Eaux, Hydro-Systèmes et Agriculture (LEHSA), Institut International d'Ingénierie de l'Eau et de l'Environnement (2iE), Ouagadougou, Burkina Faso
| | - Harouna Karambiri
- Laboratoire Eaux, Hydro-Systèmes et Agriculture (LEHSA), Institut International d'Ingénierie de l'Eau et de l'Environnement (2iE), Ouagadougou, Burkina Faso
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TAPERA TALENT, ODIMEGWU CLIFFORD, PETLELE REBAONE, SELLO MATSHIDISOVALERIA, DZOMBA ARMSTRONG, ALADEJEBI OLUWATOYIN, PHIRI MILLION. Intersecting epidemics: COVID-19 and HIV in sub-Saharan Africa. A systematic review (2020-2022). J Public Health Afr 2023; 14:2658. [PMID: 37908391 PMCID: PMC10615161 DOI: 10.4081/jphia.2023.2658] [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: 04/19/2023] [Accepted: 05/14/2023] [Indexed: 11/02/2023] Open
Abstract
There has been significant progress with regards to winning the fight against HIV globally, particularly due to the introduction of antiretroviral therapy (ART). COVID-19 threatened to derail gains in the fight against HIV. As we have started to see with studies on COVID-19 and HIV, there is a need to 'provide an in-depth view' in understanding the dynamics between the two epidemics, especially in sub-Saharan Africa. We, therefore, undertook a systemic review of existing literature to synthesize the effects of COVID-19 on the utilization of HIV services in sub-Saharan Africa, the literature on the risks associated with HIV during the COVID-19 pandemic, and lastly, the innovations and strategies adopted to continue receiving treatment in sub-Saharan Africa. We conducted a systematic review of studies published between 2020 and April 2022. We searched for relevant sub-Saharan studies in the following databases: PubMed, Google Scholar, J-STOR, and Science Direct. The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The search identified 647 papers, and after screening, 41 were in line with the inclusion criteria and were included in the review. There was evidence of the negative effects of COVID-19 on reducing HIV testing, ART treatment, and HIV prevention services. There is evidence pointing to the need for people living with HIV to be prioritized for COVID-19 vaccinations. Innovations and strategies implemented to mitigate the effects of COVID-19 on HIV services include community-based ART distribution, multi-month ART dispensing, the use of digital technologies, and the use of the already existing HIV infrastructure to fight COVID-19. It is still imperative that future studies explore the predictors of utilization of HIV services in the advent of COVID-19.
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Affiliation(s)
- TALENT TAPERA
- Demography and Population Studies Programme, Schools of Public Health and Social Sciences, University of The Witwatersrand, Johannesburg
| | - CLIFFORD ODIMEGWU
- Demography and Population Studies Programme, Schools of Public Health and Social Sciences, University of The Witwatersrand, Johannesburg
| | - REBAONE PETLELE
- Demography and Population Studies Programme, Schools of Public Health and Social Sciences, University of The Witwatersrand, Johannesburg
| | - MATSHIDISO VALERIA SELLO
- Demography and Population Studies Programme, Schools of Public Health and Social Sciences, University of The Witwatersrand, Johannesburg
- Centre for Social Development in Africa, University of Johannesburg
| | - ARMSTRONG DZOMBA
- MRC/Wits Rural Public Health and Health Transitions Research Unit-Agincourt, Johannesburg, South Africa
| | - OLUWATOYIN ALADEJEBI
- Demography and Population Studies Programme, Schools of Public Health and Social Sciences, University of The Witwatersrand, Johannesburg
| | - MILLION PHIRI
- Demography and Population Studies Programme, Schools of Public Health and Social Sciences, University of The Witwatersrand, Johannesburg
- Department of Population Studies, School of Humanities and Social sciences, University of Zambia, Lusaka, Zambia
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Witter S, Zou G, Cheedella K, Walley J, Wurie H. Learning from implementation of a COVID case management desk guide and training: a pilot study in Sierra Leone. BMC Health Serv Res 2023; 23:1026. [PMID: 37743494 PMCID: PMC10518973 DOI: 10.1186/s12913-023-10024-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 09/12/2023] [Indexed: 09/26/2023] Open
Abstract
BACKGROUND When the COVID pandemic hit the world, there was need for applied guides and training materials to support frontline health care staff to manage patients effectively and safely and to educate themselves and communities. This article reports on the development and piloting of such a set of materials in Sierra Leone, which were based on international evidence but adapted to the local context. Reflecting on this experience, including community and health system barriers and enablers, is important to prepare for future regional shocks. METHODS This study, in Bombali district in 2020, piloted user-friendly COVID guides for frontline health workers (the intervention), which was evaluated using facility checklists (pre and post training), routine data analysis and 32 key informant interviews. RESULTS Key informants at district, hospital and community health centre levels identified gains from the training and desk guides, including improved diagnosis, triaging, infection prevention and management of patients. They also reported greater confidence to share messages on protection with colleagues and community members, which was needed to encourage continued use of essential services during the pandemic. However, important barriers were also revealed, including the lack of testing facilities, which reduced the sense of urgency, as few cases were identified. Actions based on the Ebola experience, such as setting up testing and isolation centres, which the community avoided, were not appropriate to COVID. Stigma and fear were important factors, although these were reduced with outreach activities. Supplies of essential medicines and personal protective equipment were also lacking. CONCLUSION This pilot study demonstrated the relevance and importance of guides adapted to the context, which were able to improve the confidence of health staff to manage their own and the community's fears in the face of a new pandemic and improve their skills. Previous epidemics, particularly Ebola, complicated this by both creating structures that could be revitalised but also assumptions and behaviours that were not adapted to the new disease. Our study documents positive adaptations and resilience by health staff but also chronic system weaknesses (particularly for medicines, supplies and equipment) which must be urgently addressed before the next shock arrives.
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Affiliation(s)
- Sophie Witter
- NIHR Research Unit on Health in Situations of Fragility, Institute for Global Health and Development, Queen Margaret University, Edinburgh, UK
| | - Guanyang Zou
- School of Public Health and Management, Guangzhou University of Chinese Medicine, Guangzhou, China.
| | - Kiran Cheedella
- NIHR Research Unit on Health in Situations of Fragility, Institute for Global Health and Development, Queen Margaret University, Edinburgh, UK
| | - John Walley
- Nuffield Centre for International Health and Development, Leeds Institute for Health Sciences, University of Leeds, Leeds, UK
| | - Haja Wurie
- College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
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Nyamuryekung'e KK, Amour M, Mboya I, Ndumwa H, Kengia J, Njiro BJ, Mhamilawa L, Shayo E, Ngalesoni F, Kapologwe N, Kalolo A, Metta E, Msuya S. Health care workers' self-perceived infection risk and COVID-19 vaccine uptake: A mixed methods study. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001223. [PMID: 37285332 DOI: 10.1371/journal.pgph.0001223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 05/06/2023] [Indexed: 06/09/2023]
Abstract
Vaccination is the most cost-effective way of preventing Coronavirus Disease 2019 (COVID-19) although there was a considerable delay in its institution in Tanzania. This study assessed health care workers' (HCWs) self-perceived infection risk and uptake of COVID-19 vaccines. A concurrent embedded, mixed methods design was utilized to collect data among HCWs in seven Tanzanian regions. Quantitative data was collected using a validated, pre-piloted, interviewer administered questionnaire whereas in-depth interviews (IDIs) and focus group discussions (FGDs) gathered qualitative data. Descriptive analyses were performed while chi-square test and logistic regression were used to test for associations across categories. Thematic analysis was used to analyze the qualitative data. A total of 1,368 HCWs responded to the quantitative tool, 26 participated in the IDIs and 74 in FGDs. About half of the HCW (53.6%) reported to have been vaccinated and three quarters (75.5%) self-perceived to be at a high risk of acquiring COVID-19 infection. High perceived infection risk was associated with increased COVID-19 vaccine uptake (OR 1.535). Participants perceived that the nature of their work and the working environment in the health facilities increased their infection risk. Limited availability and use of personal protective equipment (PPE) was reported to elevate the perceived infection risks. Participants in the oldest age group and from low and mid-level health care facilities had higher proportions with a high-risk perception of acquiring COVID-19 infection. Only about half of the HCWs reported to be vaccinated albeit the majority recounted higher perception of risk to contracting COVID-19 due to their working environment, including limited availability and use of PPE. Efforts to address heightened perceived-risks should include improving the working environment, availability of PPE and continue updating HCWs on the benefits of COVID-19 vaccine to limit their infection risks and consequent transmission to their patients and public.
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Affiliation(s)
- Kasusu Klint Nyamuryekung'e
- Department of Community Dentistry, School of Dentistry, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Maryam Amour
- Department of Community Health, School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Innocent Mboya
- Department of Epidemiology and Biostatistics, Institute of Public Health, Kilimanjaro Christian Medical University College, Moshi, Tanzania
- Community Health Department, Institute of Public Health, Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Harrieth Ndumwa
- Department of Community Health, School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - James Kengia
- Presidents Office Regional Administration and Local Government, Dodoma, Tanzania
| | - Belinda J Njiro
- Department of Community Health, School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Lwidiko Mhamilawa
- Department of Parasitology and Medical Entomology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
- Department of Women's and Children's Health, International Maternal and Child Health (IMCH), Uppsala University, Uppsala, Sweden
| | - Elizabeth Shayo
- National Institute for Medical Research, Dar es Salaam, Tanzania
| | | | - Ntuli Kapologwe
- Presidents Office Regional Administration and Local Government, Dodoma, Tanzania
| | - Albino Kalolo
- Department of Public Health, St. Francis University College of Health and Allied Sciences, Morogoro, Tanzania
| | - Emmy Metta
- Department of Behavioral Sciences, School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Sia Msuya
- Department of Epidemiology and Biostatistics, Institute of Public Health, Kilimanjaro Christian Medical University College, Moshi, Tanzania
- Community Health Department, Institute of Public Health, Kilimanjaro Christian Medical University College, Moshi, Tanzania
- Department of Community Medicine, Kilimanjaro Christian Medical Centre, Moshi, Tanzania
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Kyagambiddwa T, Kintu TM, Miiro E, Nabalamba F, Asiimwe GS, Namutebi AM, Abeya FC, Lumori BA, Ijuka I, Muhindo RK, Mutekanga A, Musinguzi R, Natuhwera F, Ngonzi J, Nuwagira E. Thirty-Day Outcomes of Young and Middle-Aged Adults Admitted with Severe COVID-19 in Uganda: A Retrospective Cohort Study. Infect Drug Resist 2023; 16:2923-2932. [PMID: 37197696 PMCID: PMC10184892 DOI: 10.2147/idr.s405256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 04/28/2023] [Indexed: 05/19/2023] Open
Abstract
Background There is scarcity of data regarding young and middle-aged adults hospitalized with severe Corona Virus Disease 2019 (COVID-19) in Africa. In this study, we describe the clinical characteristics and 30-day survival among adults aged 18 to 49 years admitted with severe COVID-19 in Uganda. Methods We reviewed treatment records of patients admitted with severe COVID-19 across five COVID-19 treatment units (CTU) in Uganda. We included individuals aged 18 to 49 years, who had a positive test or met the clinical criteria for COVID-19. We defined severe COVID-19 as having an oxygen saturation <94%, lung infiltrates >50% on imaging and presence of a co-morbidity that required admission in the CTU. Our main outcome was the 30-day survival from the time of admission. We used a Cox proportional hazards model to determine the factors associated with 30-day survival at a 5% level of significance. Results Of the 246 patient files reviewed, 50.8% (n = 125) were male, the mean ± (standard deviation) age was 39 ± 8 years, majority presented with cough, 85.8% (n = 211) and median C-reactive protein (interquartile range) was 48 (47.5, 178.8) mg/L. The 30-day mortality was 23.9% (59/246). At admission, anemia (hazard ratio (HR): 3.00, 95% confidence interval (CI), 1.32-6.82; p = 0.009) and altered mental state (GCS <15) (HR: 6.89, 95% CI: 1.48-32.08, p = 0.014) were significant predictors of 30-day mortality. Conclusion There was a high 30-day mortality among young and middle-aged adults with severe COVID-19 in Uganda. Early recognition and targeted management of anemia and altered consciousness are needed to improve clinical outcomes.
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Affiliation(s)
- Tonny Kyagambiddwa
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Timothy Mwanje Kintu
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Emmanuel Miiro
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Franchesca Nabalamba
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Gloria Suubi Asiimwe
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | | | - Fardous C Abeya
- Department of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Boniface A Lumori
- Department of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | | | - Rose K Muhindo
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
- Department of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Andrew Mutekanga
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
- Department of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | | | | | - Joseph Ngonzi
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
- Department of Obstetrics and Gynecology, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Edwin Nuwagira
- Department of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
- Tuberculosis Treatment Unit, Mbarara Regional Referral Hospital, Mbarara, Uganda
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Ntambara J, Munyanshongore C, Ndahindwa V. Severity Status of COVID-19 and Its Associated Factors at the Nyarugenge Treatment Center in Rwanda. Cureus 2023; 15:e35627. [PMID: 37007413 PMCID: PMC10064020 DOI: 10.7759/cureus.35627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/28/2023] [Indexed: 03/05/2023] Open
Abstract
Background The COVID-19 pandemic has continued to be a public health emergency currently; on March 11, 2020, the World Health Organization (WHO) declared it a global pandemic. Despite the Rwanda National Health Measures that have been put in place to protect the public including lockdowns, curfew, face mask mandate, handwashing sensitization, etc., severe morbidity and mortality cases of COVID-19 are continued to be seen. Some studies have linked COVID-19 complications to its direct chain of mechanism; however, other studies have linked comorbidity or underlying disease conditions to its poor prognosis. Studies have not yet been conducted in Rwanda on the severe status of COVID-19 and its associated factors among patients. Therefore, this study aimed to assess the severe status of COVID-19 and its associated factors at the Nyarugenge Treatment Center. Methods A descriptive cross-sectional study was done. All patients admitted to the Nyarugenge Treatment Center from January 8, 2021, when the hospital opened, until the end of May 2021 were recruited in the study. The eligible participants were all patients who were admitted and tested positive for COVID-19 by RT-PCR method according to the Rwanda Ministry of Health criteria. Results All data were analyzed using the Statistical Package for the Social Sciences (SPSS) software, version 25 (IBM Corp., Armonk, NY). The number of patients admitted during the study period was 648, with a median age of 53; 45.2% of them were females, and 54.2% were males. Of these, 81.2% (526) were discharged from the hospital, while 18.8% (122) died. The proportion of severe status of COVID-19 was 42.1%. The factors that showed a risk of severe COVID-19 status were age and the number of comorbidities. Patients aged above 60 years (OR = 11.7, 95% CI: 5.35-25.67, p-value < 0.001) and those between the age of 51 and 60 (OR = 6.86, 95% CI: 2.96-15.93, p-value < 0.001) were 12 and seven times more likely to have severe COVID-19 status compared to those aged below 30 years. Having two comorbidities had twice the risk of developing a severe COVID-19 status compared to those with no comorbidity (OR = 2.13, 95% CI: 1.20-3.77, p-value < 0.001). Conclusion Elderly people and those with comorbidities are encouraged to obtain all standard operating procedures and comply with the vaccination program.
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Folayan M, Shilton S, Undelikwo V, Alaba O, Amusan R, Ibrahim M, Ogbozor PA, Mojisola O, Batheja D, Banerji A, Ivanova Reipold E, Martínez-Pérez GZ. People's willingness to use COVID-19 self-testing in Nigeria: a cross-sectional survey. BMJ Open 2023; 13:e063323. [PMID: 36717135 PMCID: PMC9887470 DOI: 10.1136/bmjopen-2022-063323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 01/16/2023] [Indexed: 01/31/2023] Open
Abstract
OBJECTIVES Nigeria has been badly affected by the COVID-19 pandemic, and the poor testing coverage in the country may make controlling the spread of COVID-19 challenging. The aim of this study was to assess the general public's acceptability of SARS-CoV-2 self-testing as an approach which could help to address this gap. SETTING A household-based survey was conducted in five urban and five rural local government areas in the states of Akwa Ibom, Anambra, Benue, Kaduna and Lagos, in mid-2021. PARTICIPANTS 2126 respondents (969 were female) participated. A five-pronged, probabilistic sampling approach was used to recruit individuals older than 17 years and available to participate when randomly approached in their households by the surveyors. A 35-item questionnaire was used to collect data on their values towards SARS-CoV-2 self-testing. Primary outcomes were: likelihood to use a self-test; willingness to pay for a self-test; and likely actions following a reactive self-test result. RESULTS Of the total 2126 respondents, 14 (0.66%) were aware of COVID-19 self-testing, 1738 (81.80%) agreed with the idea of people being able to self-test for COVID-19, 1786 (84.05%) were likely/very likely to use self-tests if available, 1931 (90.87%) would report a positive result and 1875 (88.28%) would isolate if they self-tested positive. Factors significantly associated with the use of a self-test were having a college education or higher (adjusted Odds Ratio (AOR): 1.55; 95% CI: 1.03 to 2.33), full-time employment (AOR: 1.67; 95% CI: 1.06 to 2.63), feeling at moderate/high risk of COVID-19 (AOR: 2.43; 95% CI: 1.70 to 3.47) and presence of individuals at risk of COVID-19 within the household (AOR: 1.38; 95% CI: 1.06 to 1.78). CONCLUSION A majority of Nigerians agree with the concept of COVID-19 self-testing and would act to protect public health on self-testing positive. Self-test implementation research is necessary to frame how acceptability impacts uptake of preventive behaviours following a positive and a negative self-test result.
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Affiliation(s)
- Morenike Folayan
- Department of Child Dental Health, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria
| | | | | | - Oluwatoyin Alaba
- Institute of Public Health, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria
| | - Ranmilowo Amusan
- Department of Community Health, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria
| | | | - Pamela Adaobi Ogbozor
- Department of Psychology, Enugu State University of Science and Technology, Enugu, Anambra State, Nigeria
| | - Oluyide Mojisola
- Department of Mental Health, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria
| | | | - Abhik Banerji
- Center for Disease Dynamics Economics & Policy, Delhi, India
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12
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Mgbere O, Nwabuko OC, Olateju OA, Adepoju OE, Liaw W, Darkoh C, Essien EJ. Population-based assessment of the burden of COVID-19 infection in African countries: a first-year report card and public health implications. Ther Adv Infect Dis 2023; 10:20499361231202116. [PMID: 37779674 PMCID: PMC10540606 DOI: 10.1177/20499361231202116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 09/02/2023] [Indexed: 10/03/2023] Open
Abstract
Background The COVID-19 pandemic constitutes a global health threat and poses a major burden on the African continent. We assessed the real-world burden of COVID-19 infection in African Union (AU) member states to determine the distributional patterns of epidemiological measures during the first 1 year of the pandemic. Methods This retrospective cross-sectional study utilized COVID-19 data from publicly available data repositories of the African Center for Disease Control and Prevention and Our World in Data for the period February 2020 to January 2021. AU member states were classified into low, medium, and high burdens based on COVID-19 morbidity. We conducted descriptive and inferential analyses of COVID-19-reported cases, deaths, recoveries, active cases, COVID-19 tests, and epidemiological measures that included morbidity and mortality rates, case fatality rate (CFR), and case ratios. Results A total of 3.21 million cases were reported during the 1-year period, with 2.6 million recoveries, 536,784 cases remaining active, and 77,486 deaths. Most countries (49.1%, n = 26) in AU experienced a low burden of COVID-19 infection compared to 28.3% (n = 15) with medium burden and 22.6% (n = 12) with high burden. AU nations with a high burden of the disease were mainly in the northern and southern regions. South Africa recorded the highest number of cases (1.31 million), followed by Morocco with 457,625 and Tunisia with 175,065 cases. Correspondently, death tolls for these countries were 36,467, 7888, and 5528 deaths, respectively. Of the total COVID-19 tests performed (83.8 million) during the first 1 year, 62.43% were from high-burden countries. The least testing occurred in the medium-burden (18.42%) countries. The overall CFR of AU was 2.21%. A morbidity rate of 327.52/105 population and mortality rate of 5.96/105 population were recorded during the first 1-year period with significant variations (p < 0.0001) across burden levels. Continental morbidity and mortality rates of 17,359/105 and 315.933/105 populations were recorded with significant correlation (r = 0.863, p < 0.0001) between them and variations across selected epidemiological measures by COVID-19 burden levels. Conclusion Understanding the true burden of the disease in AU countries is important for establishing the impact of the pandemic in the African continent and for intervention planning, preparedness, and deployment of resources during COVID-19 surges and future pandemics.
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Affiliation(s)
- Osaro Mgbere
- Department of Health Systems and Population Health Sciences, Tilman J. Fertitta Family College of Medicine, University of Houston, 5055 Medical Cir. Houston, TX 77204-5000, USA
- Institute of Community Health, University of Houston College of Pharmacy, Houston, TX, USA
- Department of Pharmaceutical Health Outcomes and Policy, University of Houston, Houston, TX, USA
- Public Health Science and Surveillance Division, Houston Health Department, Houston, TX, USA
| | - Ogbonna Collins Nwabuko
- Department of Haematology and Blood Transfusion, Federal Medical Centre, Umuahia, Abia State, Nigeria
- Department of Haematology and Blood Transfusion, Faculty of Basic Clinical Sciences, University of Calabar, Calabar, Cross River State, Nigeria
| | - Olajumoke A. Olateju
- Department of Pharmaceutical Health Outcomes and Policy, University of Houston, Houston, TX, USA
| | - Omolola E. Adepoju
- Department of Health Systems and Population Health Sciences, Tilman J. Fertitta Family College of Medicine, University of Houston, Houston, TX, USA
| | - Winston Liaw
- Department of Health Systems and Population Health Sciences, Tilman J. Fertitta Family College of Medicine, University of Houston, Houston, TX, USA
| | - Charles Darkoh
- University of Texas Health Science Center, School of Public Health, Department of Epidemiology, Human Genetics, and Environmental Sciences, Center for Infectious Diseases, Houston, TX, USA
- MD Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences, Microbiology and Infectious Diseases Program, Houston, TX, USA
| | - Ekere James Essien
- Institute of Community Health, University of Houston College of Pharmacy, Houston, TX, USA
- Department of Pharmaceutical Health Outcomes and Policy, University of Houston, Houston, TX, USA
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Zinsou BE, Letourneur D, Siko J, de Souza RM, Adjagba F, Pineau P. Main modulators of COVID-19 epidemic in sub-Saharan Africa. Heliyon 2023; 9:e12727. [PMID: 36594042 PMCID: PMC9797222 DOI: 10.1016/j.heliyon.2022.e12727] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 11/18/2022] [Accepted: 12/23/2022] [Indexed: 12/31/2022] Open
Abstract
Background The coronavirus disease 2019 (COVID-19) pandemic is responsible for an important global death toll from which sub-Saharan Africa (SSA) seems mostly protected. The reasons explaining this situation are still poorly understood. Methods We analyzed the correlation between reported COVID-19 data between February 14, 2020 and May 18, 2021, and demographic, socioeconomic, climatic, diagnostic data, and comorbidities in 47 SSA countries. Different databases including the WHO data center, Our World in Data, and the World Bank were used. Findings As of May 17, 2021, SSA reported 2% of COVID-19 cases and 2.9% of deaths, with the southern region being the most affected with 56.4% of cases and 75.0% of deaths. COVID-19 mortality was positively correlated with medical variables (national obesity rate, diabetes prevalence, cancer incidence, and cardiovascular disease mortality rate), socioeconomic characteristics (international tourism, per capita health expenditure, human development index, HDI, and years of schooling), and health system variables (nurse density, number of COVID-19 tests per capita), but negatively correlated with the population under 15 years of age and the malaria index. Interpretation Our study suggests that higher economic status fits with high COVID-19 mortality in SSA. In this regard, it represents primarily a disease of modern and wealthy societies, and can therefore be considered as an exception among infectious diseases that historically affected more severely underserved populations living in low- and middle-income countries. However, it should be made clear that observed correlations do not imply inevitably causation and that additional studies are necessary to confirm our observations.
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Affiliation(s)
- Boris-Enock Zinsou
- Clinical Research Institute of Benin (IRCB), Atlantique, 04 BP: 1114 Abomey Calavi, Benin
| | - Diane Letourneur
- Institut Pasteur, Université Paris Cité, CNRS UMR 6047, INSERM ERL1306, Unité "Toxines Bactériennes", F-75015 Paris, France
| | - Joël Siko
- Clinical Research Institute of Benin (IRCB), Atlantique, 04 BP: 1114 Abomey Calavi, Benin
| | - Raïssa Muriel de Souza
- Centre d’Excellence Africain en Innovations Biotechnologique pour l’Elimination des Maladies à Transmission Vectorielle (CEA/ITECH-MTV), Université Nazi Boni, Burkina Faso,Institut de Recherche en Science de la Santé, Direction Régionale de l’Ouest (IRSS-DRO), Bobo Dioulasso, Burkina Faso
| | | | - Pascal Pineau
- Unité « Organisation nucléaire et oncogenèse », INSERM U993, Institut Pasteur, 28 Rue du Docteur Roux, 75015 Paris, France,Corresponding author
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Ngere P, Onsongo J, Langat D, Nzioka E, Mudachi F, Kadivane S, Chege B, Kirui E, Were I, Mutiso S, Kibisu A, Ihahi J, Mutethya G, Mochache T, Lokamar P, Boru W, Makayotto L, Okunga E, Ganda N, Haji A, Gathenji C, Kariuki W, Osoro E, Kasera K, Kuria F, Aman R, Nabyonga J, Amoth P. Characterization of COVID-19 cases in the early phase (March to July 2020) of the pandemic in Kenya. J Glob Health 2022; 12:15001. [PMID: 36583253 PMCID: PMC9801068 DOI: 10.7189/jogh.12.15001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Background Kenya detected the first case of COVID-19 on March 13, 2020, and as of July 30, 2020, 17 975 cases with 285 deaths (case fatality rate (CFR) = 1.6%) had been reported. This study described the cases during the early phase of the pandemic to provide information for monitoring and response planning in the local context. Methods We reviewed COVID-19 case records from isolation centres while considering national representation and the WHO sampling guideline for clinical characterization of the COVID-19 pandemic within a country. Socio-demographic, clinical, and exposure data were summarized using median and mean for continuous variables and proportions for categorical variables. We assigned exposure variables to socio-demographics, exposure, and contact data, while the clinical spectrum was assigned outcome variables and their associations were assessed. Results A total of 2796 case records were reviewed including 2049 (73.3%) male, 852 (30.5%) aged 30-39 years, 2730 (97.6%) Kenyans, 636 (22.7%) transporters, and 743 (26.6%) residents of Nairobi City County. Up to 609 (21.8%) cases had underlying medical conditions, including hypertension (n = 285 (46.8%)), diabetes (n = 211 (34.6%)), and multiple conditions (n = 129 (21.2%)). Out of 1893 (67.7%) cases with likely sources of exposure, 601 (31.8%) were due to international travel. There were 2340 contacts listed for 577 (20.6%) cases, with 632 contacts (27.0%) being traced. The odds of developing COVID-19 symptoms were higher among case who were aged above 60 years (odds ratio (OR) = 1.99, P = 0.007) or had underlying conditions (OR = 2.73, P < 0.001) and lower among transport sector employees (OR = 0.31, P < 0.001). The odds of developing severe COVID-19 disease were higher among cases who had underlying medical conditions (OR = 1.56, P < 0.001) and lower among cases exposed through community gatherings (OR = 0.27, P < 0.001). The odds of survival of cases from COVID-19 disease were higher among transport sector employees (OR = 3.35, P = 0.004); but lower among cases who were aged ≥60 years (OR = 0.58, P = 0.034) and those with underlying conditions (OR = 0.58, P = 0.025). Conclusion The early phase of the COVID-19 pandemic demonstrated a need to target the elderly and comorbid cases with prevention and control strategies while closely monitoring asymptomatic cases.
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Affiliation(s)
- Philip Ngere
- Department of Disease Surveillance and Epidemic Response, Ministry of Health, Kenya,Washington State University, Global Health, Kenya
| | | | - Daniel Langat
- Department of Disease Surveillance and Epidemic Response, Ministry of Health, Kenya
| | - Elizabeth Nzioka
- Public Health Emergency Operation Centre, Ministry of Health, Kenya
| | - Faith Mudachi
- Department of Promotive and Preventive Health, Ministry of Health, Kenya
| | - Samuel Kadivane
- Department of Disease Surveillance and Epidemic Response, Ministry of Health, Kenya
| | - Bernard Chege
- Public Health Emergency Operation Centre, Ministry of Health, Kenya
| | - Elvis Kirui
- National Public Health Laboratory Services, Ministry of Health, Kenya
| | - Ian Were
- Office of the Director General, Ministry of Health, Kenya
| | - Stephen Mutiso
- Department of Promotive and Preventive Health, Ministry of Health, Kenya
| | - Amos Kibisu
- Public Health Emergency Operation Centre, Ministry of Health, Kenya
| | - Josephine Ihahi
- Public Health Emergency Operation Centre, Ministry of Health, Kenya
| | - Gladys Mutethya
- Public Health Emergency Operation Centre, Ministry of Health, Kenya
| | | | - Peter Lokamar
- National Public Health Laboratory Services, Ministry of Health, Kenya
| | - Waqo Boru
- Field Epidemiology and Laboratory Training Program, Ministry of Health, Kenya
| | - Lyndah Makayotto
- Department of Disease Surveillance and Epidemic Response, Ministry of Health, Kenya
| | - Emmanuel Okunga
- Department of Disease Surveillance and Epidemic Response, Ministry of Health, Kenya
| | | | - Adam Haji
- World Health Organization, Nairobi Kenya
| | | | | | - Eric Osoro
- Washington State University, Global Health, Kenya
| | - Kadondi Kasera
- Public Health Emergency Operation Centre, Ministry of Health, Kenya
| | - Francis Kuria
- Directorate of Public Health, Ministry of Health, Kenya
| | - Rashid Aman
- Cabinet Administrative Secretary, Ministry of Health, Kenya
| | | | - Patrick Amoth
- Office of the Director General, Ministry of Health, Kenya
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Mutua JM, Njeru JM, Musyoki AM. Multidrug resistant bacterial infections in severely ill COVID-19 patients admitted in a national referral and teaching hospital, Kenya. BMC Infect Dis 2022; 22:877. [PMID: 36418990 PMCID: PMC9682719 DOI: 10.1186/s12879-022-07885-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 11/17/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Bacterial infections are a common complication in patients with seasonal viral respiratory tract infections and are associated with poor prognosis, increased risk of intensive care unit admission and 29-55% mortality. Yet, there is limited data on the burden of bacterial infections among COVID-19 patients in Africa, where underdeveloped healthcare systems are likely to play a pertinent role in the epidemiology of the COVID-19 pandemic. Here, we evaluated the etiologies, antimicrobial resistance profiles, risk factors, and outcomes of bacterial infections in severely ill COVID-19 patients. METHODS A descriptive cross-sectional study design was adopted in severely ill COVID-19 patients at Kenyatta National Hospital, Kenya, from October to December 2021. We used a structured questionnaire and case report forms to collect sociodemographics, clinical presentation, and hospitalization outcome data. Blood, nasal/oropharyngeal swabs and tracheal aspirate samples were collected based on the patient's clinical presentation and transported to the Kenyatta National Hospital microbiology laboratory for immediate processing following the standard bacteriological procedures. RESULTS We found at least one bacterial infection in 44.2% (53/120) of the patients sampled, with a 31.7% mortality rate. Pathogens were mainly from the upper respiratory tract (62.7%, 42/67), with gram-negative bacteria dominating (73.1%, 49/67). Males were about three times more likely to acquire bacterial infection (p = 0.015). Those aged 25 to 44 years (p = 0.009), immunized against SARS-CoV-2 (p = 0.027), and admitted to the infectious disease unit ward (p = 0.031) for a short length of stay (0-5 days, p < 0.001) were more likely to have a positive outcome. Multidrug-resistant isolates were the majority (64.3%, 46/67), mainly gram-negative bacteria (69.6%, 32/46). The predominant multidrug-resistant phenotypes were in Enterococcus cloacae (42.9%, 3/7), Klebsiella pneumonia (25%, 4/16), and Escherichia coli (40%, 2/5). CONCLUSION Our findings highlight a high prevalence of multidrug-resistant bacterial infections in severely ill COVID-19 patients, with male gender as a risk factor for bacterial infection. Elderly Patients, non-SARS-CoV-2 vaccination, intensive care unit admission, and long length of hospital stay were associated with poor outcomes. There is a need to emphasize strict adherence to infection and prevention at KNH-IDU and antimicrobial stewardship in line with local and global AMR control action plans.
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Affiliation(s)
- Jeniffer Munyiva Mutua
- grid.415162.50000 0001 0626 737XDepartment of Laboratory Medicine, Kenyatta National Hospital, P.O. Box 20723-00202, Nairobi, Kenya ,grid.9762.a0000 0000 8732 4964Department of Medical Laboratory Sciences, Kenyatta University, P.O. BOX 43844-00100, Nairobi, Kenya
| | - John Mwaniki Njeru
- grid.33058.3d0000 0001 0155 5938Centre for Medical Microbiology, Kenya Medical Research Institute, P.O. Box 19464-00200, Nairobi, Kenya
| | - Abednego Moki Musyoki
- grid.9762.a0000 0000 8732 4964Department of Medical Laboratory Sciences, Kenyatta University, P.O. BOX 43844-00100, Nairobi, Kenya
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Hirako IC, Antunes MM, Rezende RM, Hojo-Souza NS, Figueiredo MM, Dias T, Nakaya H, Menezes GB, Gazzinelli RT. Uptake of Plasmodium chabaudi hemozoin drives Kupffer cell death and fuels superinfections. Sci Rep 2022; 12:19805. [PMID: 36396745 PMCID: PMC9671901 DOI: 10.1038/s41598-022-23858-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 11/07/2022] [Indexed: 11/18/2022] Open
Abstract
Kupffer cells (KCs) are self-maintained tissue-resident macrophages that line liver sinusoids and play an important role on host defense. It has been demonstrated that upon infection or intense liver inflammation, KCs might be severely depleted and replaced by immature monocytic cells; however, the mechanisms of cell death and the alterations on liver immunity against infections deserves further investigation. We explored the impact of acute Plasmodium infection on KC biology and on the hepatic immune response against secondary infections. Similar to patients, infection with Plasmodium chabaudi induced acute liver damage as determined by serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) elevation. This was associated with accumulation of hemozoin, increased of proinflammatory response and impaired bacterial and viral clearance, which led to pathogen spread to other organs. In line with this, mice infected with Plasmodium had enhanced mortality during secondary infections, which was associated with increased production of mitochondrial superoxide, lipid peroxidation and increased free iron within KCs-hallmarks of cell death by ferroptosis. Therefore, we revealed that accumulation of iron with KCs, triggered by uptake of circulating hemozoin, is a novel mechanism of macrophage depletion and liver inflammation during malaria, providing novel insights on host susceptibility to secondary infections. Malaria can cause severe liver damage, along with depletion of liver macrophages, which can predispose individuals to secondary infections and enhance the chances of death.
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Affiliation(s)
- Isabella C Hirako
- Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, MG, Brazil
- Division of Infectious Diseases and Immunology, Department of Medicine, University of Massachusetts Medical School, 364 Plantation Street, Lazare Research Building, 3rd Floor, Worcester, MA, USA
| | - Maísa Mota Antunes
- Center for Gastrointestinal Biology, Departamento de Morfologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Rafael Machado Rezende
- Ann Romney Center for Neurologic Diseases, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | | | | | - Thomaz Dias
- Escola de Ciências Farmacêuticas - Universidade de São Paulo, São Paulo, SP, Brazil
| | - Helder Nakaya
- Escola de Ciências Farmacêuticas - Universidade de São Paulo, São Paulo, SP, Brazil
| | - Gustavo Batista Menezes
- Center for Gastrointestinal Biology, Departamento de Morfologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Ricardo Tostes Gazzinelli
- Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, MG, Brazil.
- Division of Infectious Diseases and Immunology, Department of Medicine, University of Massachusetts Medical School, 364 Plantation Street, Lazare Research Building, 3rd Floor, Worcester, MA, USA.
- Departamento de Bioquímica E Imunologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
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Unpacking the Land and Socio-Economic Effects of the COVID-19 Pandemic in Rural Kenya. SOCIAL SCIENCES 2022. [DOI: 10.3390/socsci11100452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Following its outbreak in late 2019, the Coronavirus disease (COVID-19) has been reported to have had devastating human health, health systems, and socioeconomic impacts across the globe. Countries in the Global South are known to have been hit harder given the low level of resilience to crises amid high levels of poverty and limited social protection programmes. This includes countries in sub-Saharan Africa (SSA). Most of the existing studies on the COVID-19 pandemic in SSA, however, have focused on the puzzling nature of the considerably low rate at which the virus spread over the continent, the low level of hospitalisation, and the corresponding low morbidity rate. As such, little focus has been given to the social and economic effects of the pandemic in the local communities. Carried out in two rural communities in Kenya—Kilifi and Murang’a—the present study adopts a case study approach for an in-depth, real-life context and explores the socioeconomic (including land-related) effects of the COVID-19 pandemic on the vulnerable rural population and the social group of smallholder farmers. Outcomes of the study show that the local effects of the pandemic are context specific. The findings demonstrate that the pandemic has had far-reaching impact on access to and control over land for some households in the rural communities. It was also accompanied with other negative social and economic effects, including a notable rise in teenage pregnancy, intra-household conflicts, job losses, and businesses closures. Positively, it is also claimed to have contributed to food and nutrition security in some rural regions, following increased availability of nutritious food that could have, otherwise, been sold.
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Usui R, Kanamori S, Aomori M, Watabe S. Analysis of COVID-19 mortality in patients with comorbidities in Côte d'Ivoire. J Public Health Afr 2022; 13:1748. [PMID: 36405523 PMCID: PMC9667576 DOI: 10.4081/jphia.2022.1748] [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: 11/25/2020] [Accepted: 05/15/2022] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND Although COVID-19 has spread in Côte d'Ivoire, there is no report that summarizes the comorbidities of COVID-19 death cases. OBJECTIVE To verify the types and prevalence of commodities associated with recorded COVID-19 deaths compared with the general adult population in Côte d'Ivoire. METHODS Data on the comorbidities of COVID-19 deaths and the country's disease structure were collected from official government reports and WHO's reports. RESULTS Among 67 patients studied, the biggest age group was 60-69 years old with 23 people (34%). Fifty-four patients (81%) had non-communicable diseases (NCDs) as comorbidities. The prevalence ratio between COVID-19 deaths and general adult population was 8.96 [95% Confidence Interval: 6.86-11.68] for diabetes, 1.74 [1.27-2.37] for hypertension, and 2.16 [1.32-3.51] for obesity. CONCLUSIONS To reduce the risk of death from COVID-19 in Côte d'Ivoire, focused infection prevention measures for elderly and diabetic patients are needed.
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Affiliation(s)
- Rui Usui
- Department of Nursing, Graduate School of Medicine, The Yokohama City University, Yokohama, Kanagawa, Japan
- Department of Critical and Invasive-Palliative Care Nursing, Graduate School of Health Care Sciences, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
| | - Shogo Kanamori
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Maki Aomori
- Department of Nursing, Graduate School of Medicine, The Yokohama City University, Yokohama, Kanagawa, Japan
| | - Setsuko Watabe
- Department of Nursing, Graduate School of Medicine, The Yokohama City University, Yokohama, Kanagawa, Japan
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Kilonzo CM, Wamalwa M, Whegang SY, Tonnang HEZ. Assessing the impact of non-pharmaceutical interventions (NPIs) and BCG vaccine cross-protection in the transmission dynamics of SARS-CoV-2 in eastern Africa. BMC Res Notes 2022; 15:283. [PMID: 36059028 PMCID: PMC9440862 DOI: 10.1186/s13104-022-06171-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 08/10/2022] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVE The outbreak of the novel coronavirus disease 2019 (COVID-19) is still affecting African countries. The pandemic presents challenges on how to measure governmental, and community responses to the crisis. Beyond health risks, the socio-economic implications of the pandemic motivated us to examine the transmission dynamics of COVID-19 and the impact of non-pharmaceutical interventions (NPIs). The main objective of this study was to assess the impact of BCG vaccination and NPIs enforced on COVID-19 case-death-recovery counts weighted by age-structured population in Ethiopia, Kenya, and Rwanda. We applied a semi-mechanistic Bayesian hierarchical model (BHM) combined with Markov Chain Monte Carlo (MCMC) simulation to the age-structured pandemic data obtained from the target countries. RESULTS The estimated mean effective reproductive number (Rt) for COVID-19 was 2.50 (C1: 1.99-5.95), 3.51 (CI: 2.28-7.28) and 3.53 (CI: 2.97-5.60) in Ethiopia, Kenya and Rwanda respectively. Our results indicate that NPIs such as lockdowns, and curfews had a large effect on reducing Rt. Current interventions have been effective in reducing Rt and thereby achieve control of the epidemic. Beyond age-structure and NPIs, we found no significant association between COVID-19 and BCG vaccine-induced protection. Continued interventions should be strengthened to control transmission of SARS-CoV-2.
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Affiliation(s)
- Chelsea Mbeke Kilonzo
- International Centre of Insect Physiology and Ecology (Icipe), P.O. Box 30772-00100, Nairobi, Kenya
| | - Mark Wamalwa
- International Centre of Insect Physiology and Ecology (Icipe), P.O. Box 30772-00100, Nairobi, Kenya.
- Department of Biochemistry, Microbiology and Biotechnology, Kenyatta University, Nairobi, Kenya.
| | - Solange Youdom Whegang
- Department of Public Health, Faculty of Medicine and Pharmaceutical Sciences, University of Dschang, P.O Box: 96, Dschang, Cameroon
| | - Henri E Z Tonnang
- International Centre of Insect Physiology and Ecology (Icipe), P.O. Box 30772-00100, Nairobi, Kenya
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20
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Somda SM, Bado AR, Sow A, Lokossou VK, Ossei-A-Yeboah S, Ca T, Ogbureke N, Okolo S, Sombie I. The first year of the COVID-19 pandemic in the ECOWAS region. Ghana Med J 2022; 56:61-73. [PMID: 38322748 PMCID: PMC10630033 DOI: 10.4314/gmj.v56i3s.8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2024] Open
Abstract
Objective to analyse the pandemic after one year in terms of the evolution of morbidity and mortality and factors that may contribute to this evolution. Design This is a secondary analysis of data gathered to respond to the COVID-19 pandemic. The number of cases, incidence rate, cumulative incidence rate, number of deaths, case fatality rate and their trends were analysed during the first year of the pandemic. Testing and other public health measures were also described according to the information available. Settings The 15 States members of the Economic Community of West African States (ECOWAS) were considered. Results As of 31st March 2021, the ECOWAS region reported 429,760 COVID-19 cases and 5,620 deaths. In the first year, 1,110.75 persons were infected per million, while 1.31% of the confirmed patients died. The ECOWAS region represents 30% of the African population. One year after the start of COVID-19 in ECOWAS, this region reported 10% of the cases and 10% of the deaths in the continent. Cumulatively, the region has had two major epidemic waves; however, countries show different patterns. The case fatality rate presented a fast growth in the first months and then decreased to a plateau. Conclusion We learn that the context of COVID-19 is specific to each country. This analysis shows the importance of better understanding each country's response. During this first year of the pandemic, the problem of variants of concern and the vaccination were not posed. Funding The study was funded by the International Development Research Centre (IDRC) under CATALYSE project.
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Affiliation(s)
- Serge Ma Somda
- Department of Planning and Health Information, West African Health Organisation, Bobo-Dioulasso, Hauts-Bassins, Burkina Faso
| | - Aristide R Bado
- Department of Planning and Health Information, West African Health Organisation, Bobo-Dioulasso, Hauts-Bassins, Burkina Faso
| | - Abdourahmane Sow
- Department Public Health and Research, West African Health Organisation, Bobo-Dioulasso, Hauts-Bassins, Burkina Faso
| | - Virgil K Lokossou
- Regional Centre for Disease Surveillance and Control, West African Health Organisation, Bobo-Dioulasso, Hauts-Bassins, Burkina Faso
| | - Sybil Ossei-A-Yeboah
- Department Public Health and Research, West African Health Organisation, Bobo-Dioulasso, Hauts-Bassins, Burkina Faso
| | - Tome Ca
- Department of Planning and Health Information, West African Health Organisation, Bobo-Dioulasso, Hauts-Bassins, Burkina Faso
| | - Nanlop Ogbureke
- General Directorate, West African Health Organisation, Bobo-Dioulasso, Hauts-Bassins, Burkina Faso
| | - Stanley Okolo
- General Directorate, West African Health Organisation, Bobo-Dioulasso, Hauts-Bassins, Burkina Faso
| | - Issiaka Sombie
- Department Public Health and Research, West African Health Organisation, Bobo-Dioulasso, Hauts-Bassins, Burkina Faso
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21
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Sidibé ML, Yonaba R, Tazen F, Karoui H, Koanda O, Lèye B, Andrianisa HA, Karambiri H. Understanding the COVID-19 pandemic prevalence in Africa through optimal feature selection and clustering: evidence from a statistical perspective. ENVIRONMENT, DEVELOPMENT AND SUSTAINABILITY 2022; 25:1-29. [PMID: 36061268 PMCID: PMC9424840 DOI: 10.1007/s10668-022-02646-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 08/18/2022] [Indexed: 06/15/2023]
Abstract
The COVID-19 pandemic, which outbroke in Wuhan (China) in December 2019, severely hit almost all sectors of activity in the world as a consequence of the restrictive measures imposed. Two years later, Africa still emerges as the least affected continent by the pandemic. This study analyzed COVID-19 prevalence across African countries through country-level variables prior to clustering. Using Spearman-rank correlation, multicollinearity analysis and univariate filtering, 9 country-level variables were identified from an initial set of 34 variables. These variables relate to socioeconomic status, population structure, healthcare system and environment and the climatic setting. A clustering of the 54 African countries is further carried out through the use of agglomerative hierarchical clustering (AHC) method, which generated 3 distinctive clusters. Cluster 1 (11 countries) is the most affected by COVID-19 (median of 63,508.6 confirmed cases and 946.5 deaths per million) and is composed of countries with the highest socioeconomic status. Cluster 2 (27 countries) is the least affected (median of 4473.7 confirmed cases and 81.2 deaths per million), and mainly features countries with the least socioeconomic features and international exposure. Cluster 3 (16 countries) is intermediate in terms of COVID-19 prevalence (median of 2569.3 confirmed cases and 35.7 deaths per million) and features countries the least urbanized and geographically close to the equator, with intermediate international exposure and socioeconomic features. These findings shed light on the main features of COVID-19 prevalence in Africa and might help refine effectively coping management strategies of the ongoing pandemic. Supplementary Information The online version contains supplementary material available at 10.1007/s10668-022-02646-3.
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Affiliation(s)
- Mohamed Lamine Sidibé
- Laboratoire Eaux, Hydro-Systèmes Et Agriculture (LEHSA), Institut International d’Ingénierie de l’Eau Et de l’Environnement (2iE), 1 Rue de la Science, 01 BP 594, Ouagadougou 01, Burkina Faso
| | - Roland Yonaba
- Laboratoire Eaux, Hydro-Systèmes Et Agriculture (LEHSA), Institut International d’Ingénierie de l’Eau Et de l’Environnement (2iE), 1 Rue de la Science, 01 BP 594, Ouagadougou 01, Burkina Faso
| | - Fowé Tazen
- Laboratoire Eaux, Hydro-Systèmes Et Agriculture (LEHSA), Institut International d’Ingénierie de l’Eau Et de l’Environnement (2iE), 1 Rue de la Science, 01 BP 594, Ouagadougou 01, Burkina Faso
| | - Héla Karoui
- Laboratoire Eaux, Hydro-Systèmes Et Agriculture (LEHSA), Institut International d’Ingénierie de l’Eau Et de l’Environnement (2iE), 1 Rue de la Science, 01 BP 594, Ouagadougou 01, Burkina Faso
| | - Ousmane Koanda
- Laboratoire Eaux, Hydro-Systèmes Et Agriculture (LEHSA), Institut International d’Ingénierie de l’Eau Et de l’Environnement (2iE), 1 Rue de la Science, 01 BP 594, Ouagadougou 01, Burkina Faso
| | - Babacar Lèye
- Laboratoire Eaux, Hydro-Systèmes Et Agriculture (LEHSA), Institut International d’Ingénierie de l’Eau Et de l’Environnement (2iE), 1 Rue de la Science, 01 BP 594, Ouagadougou 01, Burkina Faso
| | - Harinaivo Anderson Andrianisa
- Laboratoire Eaux, Hydro-Systèmes Et Agriculture (LEHSA), Institut International d’Ingénierie de l’Eau Et de l’Environnement (2iE), 1 Rue de la Science, 01 BP 594, Ouagadougou 01, Burkina Faso
| | - Harouna Karambiri
- Laboratoire Eaux, Hydro-Systèmes Et Agriculture (LEHSA), Institut International d’Ingénierie de l’Eau Et de l’Environnement (2iE), 1 Rue de la Science, 01 BP 594, Ouagadougou 01, Burkina Faso
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22
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Liu Z, Gao L, Xue C, Zhao C, Liu T, Tia A, Wang L, Sun J, Li Z, Harding D. Epidemiological Trends of Coronavirus Disease 2019 in Sierra Leone From March 2020 to October 2021. Front Public Health 2022; 10:949425. [PMID: 35844842 PMCID: PMC9276960 DOI: 10.3389/fpubh.2022.949425] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 06/06/2022] [Indexed: 11/23/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19), a serious public health challenge the world over, has led to significant health concerns in Sierra Leone. In the present study, epidemic indices, such as the number of cases, positivity rate, reproduction rate (R0), case fatality rate (CFR), age, and sex, were used to characterize the epidemiological trends of COVID-19. As of October 31, 2021, a total of 6,398 cases and 121 related deaths had been confirmed. The total number of COVID-19 reverse transcription polymerase chain reaction (RT-PCR) tests conducted to October 31, 2021, was 249,534, and the average positivity rate was 2.56%. Three waves of COVID-19 were recorded, occurring during weeks 15–46 in 2020 (2,369 cases), week 47 in 2020 to week 16 in 2021 (1,665 cases), and weeks 17–43 in 2021 (2,364 cases), respectively. Remarkably, there was no increase in the numbers of confirmed COVID-19 cases despite rising test numbers throughout the three waves. Moreover, three high R0 values were observed before each wave. The number of positive cases significantly correlated with positive numbers of international arrivals (P < 0.01), deaths (P < 0.01), and the positivity rate of tested samples (P < 0.01). Moreover, all of the deaths occurred during the peak of the three waves. Our results indicate that there was a low level of COVID-19 epidemic in Sierra Leone and that COVID-19's introduction led to local transmission. It is vital to fight against the spread of SARS-CoV-2 from the source of origin by strengthening testing and management of people entering the country. Our findings will provide important clues for expanding sample screening and will contribute to the reasonable allocation of medical resources.
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Affiliation(s)
- Zhiguo Liu
- National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
- Sierra Leone-China Friendship Biological Safety Laboratory, Freetown, Sierra Leone
| | - Liping Gao
- Sierra Leone-China Friendship Biological Safety Laboratory, Freetown, Sierra Leone
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Chuizhao Xue
- Sierra Leone-China Friendship Biological Safety Laboratory, Freetown, Sierra Leone
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Centre for Tropical Diseases, National Center for International Research on Tropical Diseases, Shanghai, China
| | - Chunchun Zhao
- National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
- Sierra Leone-China Friendship Biological Safety Laboratory, Freetown, Sierra Leone
| | - Tiezhu Liu
- Sierra Leone-China Friendship Biological Safety Laboratory, Freetown, Sierra Leone
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Alie Tia
- Sierra Leone-China Friendship Biological Safety Laboratory, Freetown, Sierra Leone
| | - Lili Wang
- Key Laboratory of Surveillance and Early-Warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Junling Sun
- Key Laboratory of Surveillance and Early-Warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
- *Correspondence: Junling Sun
| | - Zhenjun Li
- National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
- Zhenjun Li
| | - Doris Harding
- Central Public Health Reference Laboratories, Ministry of Health and Sanitation, Freetown, Sierra Leone
- Doris Harding
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23
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Sacco PL. The vaccine equity crisis is a stress test for all future major environmental challenges. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 825:154073. [PMID: 35202684 DOI: 10.1016/j.scitotenv.2022.154073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Revised: 02/15/2022] [Accepted: 02/17/2022] [Indexed: 06/14/2023]
Abstract
The vaccine equity crisis has an extra element that makes it crucial for our capacity to tackle future major societal challenges. Unlike most of these, including the climate one, the current pandemic causes major damage that is directly observable in the very short term, that is, within the political cycle of the incumbent policymakers. If not even this kind of crisis with directly observable damage is able to influence the incentive structure of policymakers and lead to the adoption of timely and effective measures, there is no reason to expect that this would ever happen for crises whose effects largely materialize in future political cycles. As a consequence, if we fail to tackle this particular crisis effectively now, we are creating an enormous credibility problem for future crises that could seriously undermine our capacity to reach binding agreements in the future.
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Affiliation(s)
- Pier Luigi Sacco
- DiSFiPEQ, University of Chieti-Pescara, viale Pindaro, 42, 65127 Pescara, Italy; metaLAB (at) Harvard, 42 Kirkland St, Cambridge, MA 02138, USA; ISPC-CNR, Via Cardinale Guglielmo Sanfelice 8, 80134 Naples, Italy.
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24
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Wamalwa M, Tonnang HEZ. Using outbreak data to estimate the dynamic COVID-19 landscape in Eastern Africa. BMC Infect Dis 2022; 22:531. [PMID: 35681129 PMCID: PMC9178551 DOI: 10.1186/s12879-022-07510-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 05/27/2022] [Indexed: 12/13/2022] Open
Abstract
Background The emergence of COVID-19 as a global pandemic presents a serious health threat to African countries and the livelihoods of its people. To mitigate the impact of this disease, intervention measures including self-isolation, schools and border closures were implemented to varying degrees of success. Moreover, there are a limited number of empirical studies on the effectiveness of non-pharmaceutical interventions (NPIs) to control COVID-19. In this study, we considered two models to inform policy decisions about pandemic planning and the implementation of NPIs based on case-death-recovery counts.
Methods We applied an extended susceptible-infected-removed (eSIR) model, incorporating quarantine, antibody and vaccination compartments, to time series data in order to assess the transmission dynamics of COVID-19. Additionally, we adopted the susceptible-exposed-infectious-recovered (SEIR) model to investigate the robustness of the eSIR model based on case-death-recovery counts and the reproductive number (R0). The prediction accuracy was assessed using the root mean square error and mean absolute error. Moreover, parameter sensitivity analysis was performed by fixing initial parameters in the SEIR model and then estimating R0, β and γ. Results We observed an exponential trend of the number of active cases of COVID-19 since March 02 2020, with the pandemic peak occurring around August 2021. The estimated mean R0 values ranged from 1.32 (95% CI, 1.17–1.49) in Rwanda to 8.52 (95% CI: 3.73–14.10) in Kenya. The predicted case counts by January 16/2022 in Burundi, Ethiopia, Kenya, Rwanda, South Sudan, Tanzania and Uganda were 115,505; 7,072,584; 18,248,566; 410,599; 386,020; 107,265, and 3,145,602 respectively. We show that the low apparent morbidity and mortality observed in EACs, is likely biased by underestimation of the infected and mortality cases. Conclusion The current NPIs can delay the pandemic pea and effectively reduce further spread of COVID-19 and should therefore be strengthened. The observed reduction in R0 is consistent with the interventions implemented in EACs, in particular, lockdowns and roll-out of vaccination programmes. Future work should account for the negative impact of the interventions on the economy and food systems. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-022-07510-3.
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Affiliation(s)
- Mark Wamalwa
- International Centre of Insect Physiology and Ecology (Icipe), P.O. Box 30772-00100, Nairobi, Kenya.
| | - Henri E Z Tonnang
- International Centre of Insect Physiology and Ecology (Icipe), P.O. Box 30772-00100, Nairobi, Kenya
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25
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Anjorin AA, Odetokun IA, Nyandwi JB, Elnadi H, Awiagah KS, Eyedo J, Abioye AI, Gachara G, Maisara AM, Razouqi Y, Yusuf Mohamud MF, Mhgoob ZE, Ajayi T, Ntirenganya L, Saibu M, Salako BL, Elelu N, Wright KO, Fasina FO, Mosbah R. Public Health Surveillance for Adverse Events Following COVID-19 Vaccination in Africa. Vaccines (Basel) 2022; 10:546. [PMID: 35455295 PMCID: PMC9032114 DOI: 10.3390/vaccines10040546] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 03/09/2022] [Accepted: 03/21/2022] [Indexed: 02/05/2023] Open
Abstract
Local, national, and international health agencies have advocated multi-pronged public health strategies to limit infections and prevent deaths. The availability of safe and effective vaccines is critical in the control of a pandemic. Several adverse events have been reported globally following reception of different vaccines, with limited or no data from Africa. This cross-sectional epidemiological study investigated adverse events following COVID-19 vaccination in Africans from April-June, 2021 using a structured online questionnaire. Out of 1200 participants recruited, a total of 80.8% (n = 969) respondents from 35 countries, including 22 African countries and 13 countries where Africans live in the diaspora, reported adverse events. Over half of the vaccinees were male (53.0%) and frontline healthcare workers (55.7%), respectively. A total of 15.6% (n = 151) reported previous exposure to SARS-CoV-2, while about one-fourth, 24.8% (n = 240), reported different underlying health conditions prior to vaccination. Fatal cases were 5.1% (n = 49), while other significant heterogenous events were reported in three categories: very common, common, and uncommon, with the latter including enlarged lymph nodes 2.4% (n = 23), menstrual disorder 0.5% (n = 5), and increased libido 0.2% (n = 2). The study provided useful data for concerned authorities and institutions to prepare plans that will address issues related to COVID-19 vaccines.
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Affiliation(s)
| | - Ismail A. Odetokun
- Department of Veterinary Public Health & Preventive Medicine, University of Ilorin, Ilorin 200213, Kwara State, Nigeria; (I.A.O.); (N.E.)
| | | | - Hager Elnadi
- Infectious Diseases and One Health Department, Universite de Tours, 37000 Tours, France;
| | - Kwame Sherrif Awiagah
- Training and Research Unit, Korle Bu Teaching Hospital, Accra P.O. Box KB 77, Ghana;
| | - Joseph Eyedo
- Department of Microbiology (Virology Research), Lagos State University, Ojo 102101, Lagos, Nigeria;
| | | | - George Gachara
- Department of Medical Laboratory Science, Kenyatta University, Nairobi 00609, Kenya;
| | - Aala MohmedOsman Maisara
- Department of Nephrology and Hemodialysis Center, Bahre Teaching Hospital and Faculty of Medicine, International University of Africa, Khartoum 12223, Sudan;
| | - Youssef Razouqi
- Laboratory of Biological Engineering, Faculty of Science and Technology, Sultan Moulay Slimane University, Mghilla Campus, BP 523, Beni Mellal 23000, Morocco;
| | | | | | - Tunde Ajayi
- Lagos State Ministry of Health, Ikeja 100271, Lagos, Nigeria;
| | - Lazare Ntirenganya
- Pharmacovigilance and Safety Monitoring Division, Rwanda Food and Drugs Authority, Kigali P.O. Box 1948, Rwanda;
| | - Morounke Saibu
- Department of Biochemistry, Lagos State University, Ojo 102101, Lagos, Nigeria;
- Walter Sisulu University, Mthatha Campus, Mthatha 5117, South Africa
| | - Babatunde Lawal Salako
- Department of Medicine, University of Ibadan, Ibadan 200132, Oyo State, Nigeria;
- Office of the Director General, Nigerian Institute of Medical Research, Yaba, Lagos 101212, Lagos, Nigeria
| | - Nusirat Elelu
- Department of Veterinary Public Health & Preventive Medicine, University of Ilorin, Ilorin 200213, Kwara State, Nigeria; (I.A.O.); (N.E.)
- Kwara State COVID-19 Technical Working Group, Ilorin 240241, Kwara State, Nigeria
| | - Kikelomo Ololade Wright
- Department of Community Health and Primary Health Care, Lagos State University College of Medicine, Ikeja 100271, Lagos, Nigeria;
- Lagos State University Teaching Hospital, Ikeja 100271, Lagos, Nigeria
| | - Folorunso O. Fasina
- Emergency Centre for Transboundary Animal Diseases (ECTAD), Food and Agricultural Organization of the United Nations (FAO), Nairobi 00100, Kenya;
- Department of Veterinary Tropical Diseases, University of Pretoria, Pretoria 0182, South Africa
| | - Rasha Mosbah
- Infection Control Unit, Zagazig University Hospitals, Zagazig 44511, Egypt;
- Faculty of Oral and Dental Medicine, Ahram Canadian University, Giza 12578, Egypt
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26
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Formenti B, Gregori N, Crosato V, Marchese V, Tomasoni LR, Castelli F. The impact of COVID-19 on communicable and non-communicable diseases in Africa: a narrative review. LE INFEZIONI IN MEDICINA 2022; 30:30-40. [PMID: 35350264 DOI: 10.53854/liim-3001-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 02/20/2022] [Indexed: 01/06/2023]
Abstract
The global pandemic of coronavirus disease 2019 (COVID-19) has disproportionately impacted global human health, economy, and security. Because of weaker health-care systems, existing comorbidities burden (HIV, malaria, tuberculosis, and non-communicable conditions), and poor socioeconomic determinants, initial predictive models had forecast a disastrous impact of COVID-19 in Africa in terms of transmission, severity, and deaths. Nonetheless, current epidemiological data seem not to have matched expectations, showing lower SARS-CoV-2 infection and fatality rates compared to Europe, the Americas and Asia. However, only few studies were conducted in low- and middle-income African settings where high poverty and limited access to health services worsen underlying health conditions, including endemic chronic infectious diseases such as HIV and tuberculosis. Furthermore, limited, and heterogeneous research was conducted to evaluate the indirect impact of the pandemic on general health services and on major diseases across African countries. International mitigation measures, such as resource reallocation, lockdowns, social restrictions, and fear from the population have had multi-sectoral impacts on various aspects of everyday life, that shaped the general health response. Despite the vast heterogeneity of data across African countries, available evidence suggests that the COVID-19 pandemic has severely impacted the control and prevention programs, the diagnosis capacity and the adherence to treatment of major infectious diseases (HIV, TB, and Malaria) - including neglected diseases - and non-communicable diseases. Future research and efforts are essential to deeply assess the medium- and long-term impact of the pandemic, and to implement tailored interventions to mitigate the standstill on decades of improvement on public health programs.
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Affiliation(s)
- Beatrice Formenti
- UNESCO Training and Empowering Human Resources for Health Development in Resource-Limited Countries, University of Brescia, Italy
| | - Natalia Gregori
- Department of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili of Brescia, Italy
| | - Verena Crosato
- Department of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili of Brescia, Italy
| | - Valentina Marchese
- Department of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili of Brescia, Italy
| | | | - Francesco Castelli
- UNESCO Training and Empowering Human Resources for Health Development in Resource-Limited Countries, University of Brescia, Italy.,Department of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili of Brescia, Italy
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Folayan MO, Ibigbami O, Brown B, El Tantawi M, Uzochukwu B, Ezechi OC, Aly NM, Abeldaño GF, Ara E, Ayanore MA, Ayoola OO, Osamika BE, Ellakany P, Gaffar B, Idigbe I, Ishabiyi AO, Jafer M, Khan ATA, Khalid Z, Lawal FB, Lusher J, Nzimande NP, Popoola BO, Quadri MFA, Rashwan M, Roque M, Shamala A, Al-Tammemi AB, Yousaf MA, Abeldaño Zuñiga RA, Okeibunor JC, Nguyen AL. Differences in COVID-19 Preventive Behavior and Food Insecurity by HIV Status in Nigeria. AIDS Behav 2022; 26:739-751. [PMID: 34387776 PMCID: PMC8360820 DOI: 10.1007/s10461-021-03433-3] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/07/2021] [Indexed: 01/21/2023]
Abstract
The aim of the study was to assess if there were significant differences in the adoption of COVID-19 risk preventive behaviors and experience of food insecurity by people living with and without HIV in Nigeria. This was a cross-sectional study that recruited a convenience sample of 4471 (20.5% HIV positive) adults in Nigeria. Binary logistic regression analysis was conducted to test the associations between the explanatory variable (HIV positive and non-positive status) and the outcome variables-COVID-19 related behavior changes (physical distancing, isolation/quarantine, working remotely) and food insecurity (hungry but did not eat, cut the size of meals/skip meals) controlling for age, sex at birth, COVID-19 status, and medical status of respondents. Significantly fewer people living with HIV (PLWH) reported a positive COVID-19 test result; and had lower odds of practicing COVID-19 risk preventive behaviors. In comparison with those living without HIV, PLWH had higher odds of cutting meal sizes as a food security measure (AOR: 3.18; 95% CI 2.60-3.88) and lower odds of being hungry and not eating (AOR: 0.24; 95% CI 0.20-0.30). In conclusion, associations between HIV status, COVID-19 preventive behaviors and food security are highly complex and warrant further in-depth to unravel the incongruities identified.
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Affiliation(s)
- Morenike Oluwatoyin Folayan
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria.
- Department of Child Dental Health, Obafemi Awolowo University, Ile-Ife, Nigeria.
| | | | - Brandon Brown
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria
- Department of Social Medicine, Population and Public Health, Center for Healthy Communities, UCR School of Medicine, Riverside, CA, USA
| | - Maha El Tantawi
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Benjamin Uzochukwu
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria
- Department of Community Medicine, University of Nigeria Nsukka (Enugu Campus), Nsukka, Nigeria
| | - Oliver C Ezechi
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria
- Department of Clinical Sciences, Nigerian Institute of Medical Research, Lagos, Nigeria
| | - Nourhan M Aly
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Giuliana Florencia Abeldaño
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria
- School of Medicine, University of Sierra Sur, Oaxaca, Mexico
| | - Eshrat Ara
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria
- Department of Psychology, Government College for Women, Moulana Azad Road, Srinagar, Kashmir (J&K), 190001, India
| | - Martin Amogre Ayanore
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria
- Department of Health Policy Planning and Management, University of Health and Allied Sciences, Ho, Ghana
| | - Oluwagbemiga O Ayoola
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria
- Department of Radiology, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Bamidele Emmanuel Osamika
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria
- Department of Psychology, Lead City University, Ibadan, Nigeria
| | - Passent Ellakany
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria
- Department of Substitutive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Balgis Gaffar
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria
- Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Kingdom of Saudi Arabia
| | - Ifeoma Idigbe
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria
- Department of Clinical Sciences, Nigerian Institute of Medical Research, Lagos, Nigeria
| | - Anthonia Omotola Ishabiyi
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria
- Centre for Rural Health, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
| | - Mohammed Jafer
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria
- Department of Health Promotion, Faculty of Health, Medicine, and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Abeedha Tu-Allah Khan
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria
- School of Biological Sciences, University of the Punjab, Quaid-i-Azam Campus, Lahore, 54590, Pakistan
| | - Zumama Khalid
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria
- School of Biological Sciences, University of the Punjab, Lahore, 54590, Pakistan
| | - Folake Barakat Lawal
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria
- Department of Periodontology and Community Dentistry, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Joanne Lusher
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria
- School of Health and Life Sciences, University of the West of Scotland, London, UK
| | - Ntombifuthi P Nzimande
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria
- Department of Economic and Human Geography, University of Szeged, Szeged, 6722, Hungary
| | - Bamidele Olubukola Popoola
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria
- Department of Child Oral Health, University of Ibadan, Ibadan, Nigeria
| | - Mir Faeq Ali Quadri
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria
- Department of Preventive Dental Sciences, Jazan University, Jizan, Saudi Arabia
| | - Maher Rashwan
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria
- Centre for Oral Bioengineering, Barts and the London, School of Medicine and Dentistry, Queen Mary University of London, Mile End Road, London, E1 4NS, UK
- Department of Conservative Dentistry, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Mark Roque
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria
- Maternity & Childhood Department, College of Nursing, Taibah University, Madinah, 42356, Kingdom of Saudi Arabia
| | - Anas Shamala
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria
- Department of Preventive and Biomedical Science, College of Dentistry, University of Science & Technology, Sanaa, Yemen
| | - Ala'a B Al-Tammemi
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria
- Department of Family and Occupational Medicine, Faculty of Medicine, Doctoral School of Health Sciences, University of Debrecen, Debrecen, Hungary
| | - Muhammad Abrar Yousaf
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria
- Institute of Zoology, University of the Punjab, Quaid-i-Azam Campus, Lahore, 54590, Pakistan
| | - Roberto Ariel Abeldaño Zuñiga
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria
- Postgraduate Department, University of Sierra Sur, Oaxaca, Mexico
| | - Joseph Chukwudi Okeibunor
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria
- World Health Organisation, AFRO, Addis Ababa, Ethiopia
| | - Annie Lu Nguyen
- Mental Health and Wellness Study Group, Ile-Ife, Nigeria
- Department of Family Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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COVID-19 pandemic-related mortality, infection, symptoms, complications, comorbidities, and other aspects of physical health among healthcare workers globally: An umbrella review. Int J Nurs Stud 2022; 129:104211. [PMID: 35278750 PMCID: PMC8855608 DOI: 10.1016/j.ijnurstu.2022.104211] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 01/05/2022] [Accepted: 02/14/2022] [Indexed: 12/13/2022]
Abstract
Background The COVID-19 pandemic has continued to cause unprecedented concern across the globe since the beginning of the outbreak. Healthcare workers, particularly those working on the front line, remain one of the most affected groups. Various studies have investigated different aspects of the physical health of healthcare workers; however, limited evidence on the overall physical health of healthcare workers has been collectively examined. Aim To examine the various aspects of physical health and well-being of healthcare workers during the COVID-19 pandemic. Design An umbrella review. Methods We conducted a comprehensive literature search on Academic Search Premier, CINAHL, Cochrane Library and MEDLINE and supplemented the search with Google Scholar. Key terms related to ‘COVID-19’, ‘physical health’, ‘healthcare worker’ and ‘systematic review’ were used in the search. Systematic reviews with or without meta-analyses were included if they were published in the English language, could be obtained in full-text format, and assessed the physical health impacts of the COVID-19 pandemic on healthcare workers were included. The methodological quality of eligible studies was assessed using the Joanna Briggs Institute's checklist for systematic reviews. The data were narratively synthesised in line with the ‘Synthesis Without Meta-analysis’ guideline. Results Thirteen systematic reviews (represented as K = 13) that synthesized data from 1230 primary studies/reports and 1,040,336 participants met the inclusion criteria. The findings indicate a death rate of between 0.3 and 54.2 per 100 infections (K = 4). The overall case-fatality rate was estimated to be 0.87% (approximately 9 deaths per 1000 infections, K = 3). The overall infection rate among healthcare workers ranged from 3.9% to 11% (K = 5), with the highest rate associated with healthcare workers involved in screening. Considering geographic regions, the highest number of infections was reported in Europe (78.2% of 152,888 infected healthcare workers, K = 1). More nurses and female healthcare workers were infected, while deaths occurred mainly among men and medical doctors. The commonly reported symptoms included cough (56–80%, K = 3), fever (57–85%, K = 3), and headache (7–81%, K = 3), while hypertension was the most prevalent comorbidity (7%, K = 1). Additionally, a high prevalence of poor sleep quality (41–43%, K = 2), work-related stress (33–44.86%, K = 5) and personal protective equipment-associated skin injuries (48.2–97%, K = 2) affected the healthcare workers. The most reported preventive measures included laboratory testing, clinical diagnosis, adequate personal protective equipment, self-isolation, and training/orientation for infection control. Conclusion Healthcare workers experienced considerable COVID-19-related physical health issues, including mortalities. This requires targeted interventions and health policies to support healthcare workers worldwide to ensure timely management of the pandemic. Tweetable abstract: This umbrella review highlights the global mortalities, infections, and other aspects of physical health of healthcare workers during the COVID-19 pandemic.
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Uwishema O, Onyeaka H, Alshareif BAA, Omer MEA, Sablay ALR, Tariq R, Mohamed RIH, Zahabioun A, Yousif MYE, Chalhoub E, Tovani‐Palone MR. Pneumonia amidst the COVID-19 pandemic in Africa: Challenges and possible solutions. Health Sci Rep 2022; 5:e493. [PMID: 35036583 PMCID: PMC8745033 DOI: 10.1002/hsr2.493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 11/24/2021] [Accepted: 12/15/2021] [Indexed: 11/10/2022] Open
Affiliation(s)
- Olivier Uwishema
- Oli Health Magazine Organization, Research and EducationKigaliRwanda
- Clinton Global Initiative UniversityNew YorkNew YorkUSA
- Faculty of MedicineKaradeniz Technical UniversityTrabzonTurkey
| | - Helen Onyeaka
- School of Chemical EngineeringUniversity of BirminghamEdgbastonUK
| | | | | | | | - Rabeet Tariq
- Liaquat National Hospital and Medical CollegeKarachiPakistan
| | | | - Amirsaman Zahabioun
- Clinton Global Initiative UniversityNew YorkNew YorkUSA
- College of Arts and Sciences: Department of BiologyUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | | | - Elie Chalhoub
- Oli Health Magazine Organization, Research and EducationKigaliRwanda
- Faculty of MedicineUniversity of Saint Joseph of BeirutBeirutLebanon
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El-Krab R, Kalichman S, Govindasamy D, Banas E, Kalichman M, Mathews C. Subjective well-being and COVID-19 prevention practices among people living with HIV in Cape Town, South Africa. Glob Public Health 2021; 17:1-12. [PMID: 34882525 DOI: 10.1080/17441692.2021.2005113] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
COVID-19 poses significant threats to the health of people with underlying chronic conditions, including people living with HIV. The association between subjective well-being and practicing COVID-19 preventive behaviours among people living with HIV is yet to be empirically tested. The objective of the current study was to test the hypothesis that subjective well-being would be associated with engaging in greater COVID-19 preventive behaviours. A sample of 200 women and 72 men (mean age 38.1, SD = 10.4) receiving HIV treatment at a clinic in Cape Town, South Africa completed interview administered surveys of health behaviours and three dimensions of subjective well-being: emotional, social and psychological well-being. Hierarchical regression models were performed to test subjective well-being as predictors of COVID-19 preventive behaviours adjusting for age, sex, education, TB history, antiretroviral therapy adherence, and concern about contracting COVID-19. Results showed that psychological well-being, along with concerns over COVID-19, predicted greater COVID-19 preventive behaviours over and above the other variables in the model, accounting for 9.2% of the variance. Results support incorporating interventions to foster psychological well-being into existing clinical services for people living with HIV to improve clusters of health behaviours.
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Affiliation(s)
- Renee El-Krab
- Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, CT, USA
| | - Seth Kalichman
- Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, CT, USA
| | - Darshini Govindasamy
- Health Systems Research Unit, South African Medical Research Council, Tygerberg, South Africa
| | - Ellen Banas
- Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, CT, USA.,Health Systems Research Unit, South African Medical Research Council, Tygerberg, South Africa
| | - Moira Kalichman
- Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, CT, USA
| | - Catherine Mathews
- Health Systems Research Unit, South African Medical Research Council, Tygerberg, South Africa
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Uwamahoro C, Gonzalez Marques C, Beeman A, Mutabazi Z, Twagirumukiza FR, Jing L, Ndebwanimana V, Uwamahoro D, Nkeshimana M, Tang OY, Naganathan S, Jarmale S, Stephen A, Aluisio AR. Injury burdens and care delivery in relation to the COVID-19 pandemic in Kigali, Rwanda: A prospective interrupted cross-sectional study. Afr J Emerg Med 2021; 11:422-428. [PMID: 34513579 PMCID: PMC8415735 DOI: 10.1016/j.afjem.2021.06.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 05/07/2021] [Accepted: 06/26/2021] [Indexed: 12/24/2022] Open
Abstract
Introduction Injuries cause significant burdens in sub-Saharan Africa. In Rwanda, national regulations to reduce COVID-19 altered population mobility and resource allocations. This study evaluated epidemiological trends and care among injured patients preceding and during the COVID-19 pandemic at the Centre Hospitalier Universitaire de Kigali (CHUK) in Kigali, Rwanda. Methods This prospective interrupted cross-sectional study enrolled injured adult patients (≥15 years) presenting to the CHUK emergency department (ED) from January 27th-March 21st (pre-COVID-19 period) and June 1st-28th (intra-COVID-19 period). Trained study personnel continuously collected standardized data on enrolled participants through the first six-hours of ED care. The Kampala Trauma Score (KTS) was calculated as a metric of injury severity. Case characteristics prior to and during the pandemic were compared, statistical differences were assessed using χ2 or Fisher's exact tests. Results Data were collected from 409 pre-COVID-19 and 194 intra-COVID-19 cases. Median age was 32, with a male predominance (74.3%). Road traffic injuries (RTI) were the most common injury mechanism pre-COVID-19 (47.8%) and intra-COVID-19 (53.6%) (p = 0.27). There was a significant increase in the number of transfer cases during the intra-COVID-19 period (52.1%) versus pre-COVID-19 (41.3%) (p = 0.01). KTS was significantly lower among intra-COVID-19 patients (p = 0.04), indicating higher severity of presentation. In the intra-COVID-19 period, there was a significant increase in the number of surgery consultations (40.7%) versus pre-COVID-19 (26.7%) (p < 0.001). The number of hospital admissions increased from 35.5% pre-COVID-19 to 46.4% intra-COVID-19 (p = 0.01). There was no significant mortality difference pre-COVID-19 as compared to the intra-COVID-19 period among injured patients (p = 0.76). Conclusion Emergency injury care showed increased injury burden, inpatient admission and resource requirements during the pandemic period. This suggests the spectrum of disease may be more severe and that greater resources for injury management may continue to be needed during the ongoing COVID-19 pandemic in Rwanda and other similar settings.
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Affiliation(s)
- Chantal Uwamahoro
- Department of Anaesthesia, Emergency Medicine and Critical Care, University of Rwanda, Kigali, Rwanda
| | | | - Aly Beeman
- Department of Emergency Medicine, Brown University Warren Alpert Medical School, Providence, RI, USA
| | - Zeta Mutabazi
- Department of Anaesthesia, Emergency Medicine and Critical Care, University of Rwanda, Kigali, Rwanda
| | | | - Ling Jing
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Vincent Ndebwanimana
- Department of Anaesthesia, Emergency Medicine and Critical Care, University of Rwanda, Kigali, Rwanda
| | - Doris Uwamahoro
- Department of Anaesthesia, Emergency Medicine and Critical Care, University of Rwanda, Kigali, Rwanda
| | - Menelas Nkeshimana
- Department of Anaesthesia, Emergency Medicine and Critical Care, University of Rwanda, Kigali, Rwanda
| | - Oliver Y. Tang
- Brown University Warren Alpert Medical School, Providence, RI, USA
| | - Sonya Naganathan
- Department of Emergency Medicine, Brown University Warren Alpert Medical School, Providence, RI, USA
| | - Spandana Jarmale
- Brown University Warren Alpert Medical School, Providence, RI, USA
| | - Andrew Stephen
- Brown University Warren Alpert Medical School, Department of Surgery, Providence, RI, USA
| | - Adam R. Aluisio
- Department of Emergency Medicine, Brown University Warren Alpert Medical School, Providence, RI, USA
- Brown University Warren Alpert Medical School, Providence, RI, USA
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Kirk T, Green D, Allen T, Carayannis T, Bazonzi J, Ndala J, Stys P, Muzuri P, Nyenyezi A, Vlassenroot K, Nyuon ADA, Macdonald A, Owor A, Storer L, Okello J, Hopwood J, Porter H, Oryem R, Parker M, Akello G. Crisis responses, opportunity, and public authority during Covid-19's first wave in Uganda, the Democratic Republic of Congo, and South Sudan. DISASTERS 2021; 45 Suppl 1:S195-S215. [PMID: 34553404 PMCID: PMC8652749 DOI: 10.1111/disa.12513] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Discussions on African responses to Covid-19 have focused on the state and its international backers. Far less is known about a wider range of public authorities, including chiefs, humanitarians, criminal gangs, and armed groups. This paper investigates how the pandemic provided opportunities for claims to and contests over power in Uganda, the Democratic Republic of the Congo, and South Sudan. Ethnographic research is used to contend that local forms of public authority can be akin to miniature sovereigns, able to interpret dictates, policies, and advice as required. Alongside coping with existing complex protracted emergencies, many try to advance their own agendas and secure benefits. Those they seek to govern, though, do not passively accept the new normal, instead often challenging those in positions of influence. This paper assesses which of these actions and reactions will have lasting effects on local notions of statehood and argues for a public authorities lens in times of crisis.
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Affiliation(s)
- Tom Kirk
- Researcher at the London School of Economics and Political ScienceUnited Kingdom
| | - Duncan Green
- Professor in Practice at the London School of Economics and Political ScienceUnited Kingdom
| | - Tim Allen
- Professor at the London School of Economics and Political ScienceUnited Kingdom
| | | | - José Bazonzi
- Researcher at the University of KinshasaDemocratic Republic of the Congo
| | - José Ndala
- Researcher at the University of GbadoliteDemocratic Republic of the Congo
| | - Patrycja Stys
- Researcher at the London School of Economics and Political ScienceUnited Kingdom
| | - Papy Muzuri
- Independent ResearcherDemocratic Republic of the Congo
| | | | | | | | - Anna Macdonald
- Assistant Professor at the University of East AngliaUnited Kingdom
| | - Arthur Owor
- Researcher at the London School of Economics and Political ScienceUnited Kingdom
- Researcher at the Centre for African ResearchUganda
| | - Liz Storer
- Researcher at the London School of Economics and Political ScienceUnited Kingdom
| | - Joseph Okello
- Researcher at the London School of Economics and Political ScienceUnited Kingdom
| | - Julian Hopwood
- Researcher at the London School of Economics and Political ScienceUnited Kingdom
| | - Holly Porter
- Assistant Professor at the University of CambridgeUnited Kingdom
| | - Robin Oryem
- Researcher at the London School of Economics and Political ScienceUnited Kingdom
| | - Melissa Parker
- Professor at the London School of Hygiene and Tropical MedicineUnited Kingdom
| | - Grace Akello
- Researcher at the London School of Economics and Political ScienceUnited Kingdom
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33
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Al-Kuraishy HM, Al-Gareeb AI, Faidah H, Alexiou A, Batiha GES. Testosterone in COVID-19: An Adversary Bane or Comrade Boon. Front Cell Infect Microbiol 2021; 11:666987. [PMID: 34568081 PMCID: PMC8455954 DOI: 10.3389/fcimb.2021.666987] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 08/16/2021] [Indexed: 12/17/2022] Open
Abstract
COVID-19 is a pandemic disease caused by severe acute respiratory coronavirus 2 (SARS-CoV-2), which leads to pulmonary manifestations like acute lung injury (ALI) and acute respiratory distress syndrome (ARDS). In addition, COVID-19 may cause extra-pulmonary manifestation such as testicular injury. Both high and low levels of testosterone could affect the severity of COVID-19. Herein, there is substantial controversy regarding the potential role of testosterone in SARS-CoV-2 infection and COVID-19 severity. Therefore, the present study aimed to review and elucidate the assorted view of preponderance regarding the beneficial and harmful effects of testosterone in COVID-19. A related literature search in PubMed, Scopus, Web of Science, Google Scholar, and Science Direct was done. All published articles related to the role of testosterone and COVID-19 were included in this mini-review. The beneficial effects of testosterone in COVID-19 are through inhibition of pro-inflammatory cytokines, augmentation of anti-inflammatory cytokines, modulation of the immune response, attenuation of oxidative stress, and endothelial dysfunction. However, its harmful effects in COVID-19 are due to augmentation of transmembrane protease serine 2 (TMPRSS2), which is essential for cleaving and activating SARS-CoV-2 spike protein during acute SARS-CoV-2 infection. Most published studies illustrated that low testosterone levels are linked to COVID-19 severity. A low testosterone level in COVID-19 is mainly due to testicular injury, the primary source of testosterone.
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Affiliation(s)
- Hayder M Al-Kuraishy
- Department of Clinical Pharmacology and Medicine, College of Medicine, ALmustansiriyia University, Baghdad, Iraq
| | - Ali I Al-Gareeb
- Department of Clinical Pharmacology and Medicine, College of Medicine, ALmustansiriyia University, Baghdad, Iraq
| | - Hani Faidah
- Faculty of Medicine, Umm Al Qura University, Mecca, Saudi Arabia
| | - Athanasios Alexiou
- Department of Science and Engineering, Novel Global Community Educational Foundation, Hebersham, NSW, Australia.,AFNP Med Austria, Wien, Austria
| | - Gaber El-Saber Batiha
- Department of Pharmacology and Therapeutics, Faculty of Veterinary Medicine, Damanhour University, Damanhour, Egypt
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34
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Zheng W, Kämpfen F, Huang Z. Health-seeking and diagnosis delay and its associated factors: a case study on COVID-19 infections in Shaanxi Province, China. Sci Rep 2021; 11:17331. [PMID: 34462494 PMCID: PMC8405662 DOI: 10.1038/s41598-021-96888-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Accepted: 08/17/2021] [Indexed: 12/17/2022] Open
Abstract
This time-to-event study examines social factors associated with health-seeking and diagnosis of 165 COVID-19 cases in response to the pandemic spread in Shaanxi Province, China. In particular, we investigate the differential access to healthcare in terms of delayed time from symptom onset to first medical visit and subsequently to diagnosis by factors such as sex, age, travel history, and type of healthcare utilization. We show that it takes more time for patients older than 60 (against those under 30) to seek healthcare after developing symptoms (+ 2.5 days, [Formula: see text]), surveillance on people with living or travel history to Wuhan helps shorten the time to the first doctor visit (- 0.8 days) and diagnosis (- 2.2 days, [Formula: see text]). A delay cut is associated with the adoption of intermediary and large hospitals rather than community-based care as primary care choices (- 1.6 days, [Formula: see text] and - 2.2 days, [Formula: see text]). One unit increase of healthcare workers per 1000 people saves patients 0.5 days ([Formula: see text]) for diagnosis from the first doctor visit and 0.6 days ([Formula: see text]) in total. Our analysis of factors associated with the time delay for diagnosis may provide a better understanding of the health-seeking behaviors of patients and the diagnosis capacity of healthcare providers during the COVID-19 pandemic.
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Affiliation(s)
- Wenyuan Zheng
- School of Insurance, Southwestern University of Finance and Economics, Chengdu, 611130, China
| | - Fabrice Kämpfen
- Population Studies Center, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Zhiyong Huang
- Center of Health Governance and Policy, Southwestern University of Finance and Economics, Chengdu, 611130, China.
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35
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Ismail Z, Aborode AT, Oyeyemi AA, Khan H, Hasan MM, Saha A, Akah B. Impact of COVID-19 pandemic on viral hepatitis in Africa: Challenges and way forward. Int J Health Plann Manage 2021; 37:547-552. [PMID: 34462959 PMCID: PMC8653283 DOI: 10.1002/hpm.3317] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Revised: 08/18/2021] [Accepted: 08/19/2021] [Indexed: 12/22/2022] Open
Abstract
With the overwhelming COVID‐19 pandemic in Africa, many other severe epidemics have been given low priority, such as viral hepatitis. Patient mortality due to viral hepatitis has raised concern to COVID‐19 patients due to compromise with undiagnosed hepatitis in Africa. The pandemic has worsened the control of the viral hepatitis epidemic as healthcare control facilities have moved their focus towards curbing COVID‐19 infections. However, different challenges have arisen to viral hepatitis patients because of low health attention that declines the progress of already diagnosed hepatitis patients. Follow‐up plans, routine testing and treatment plans for viral hepatitis are no longer as strict with the human resources transferred towards combating the pandemic. Thus, a global effort is required to abide by renewed recommendations to eradicate viral hepatitis in Africa that also fit the current picture of the COVID‐19 pandemic. The article discusses the current challenges viral hepatitis patients faced during the COVID‐19 pandemic and important recommendations that can see through these challenges in Africa.
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Affiliation(s)
- Zainab Ismail
- Faculty of Medicine, Menoufia University, Menoufia, Egypt
| | - Abdullahi Tunde Aborode
- Healthy Africans Platform, Research and Development, Ibadan, Nigeria.,West African Academy of Public Health, Research and Development, Abuja, Nigeria
| | | | | | - Mohammad Mehedi Hasan
- Department of Biochemistry and Molecular Biology, Faculty of Life Science, Mawlana Bhashani Science and Technology University, Tangail, Bangladesh.,Division of Infectious Diseases, The Red-Green Research Centre, BICCB, Dhaka, Bangladesh
| | - Anwesha Saha
- Department of Biotechnology, Heritage Institute of Technology, Kolkata, West Bengal, India
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Heuschen AK, Lu G, Razum O, Abdul-Mumin A, Sankoh O, von Seidlein L, D'Alessandro U, Müller O. Public health-relevant consequences of the COVID-19 pandemic on malaria in sub-Saharan Africa: a scoping review. Malar J 2021; 20:339. [PMID: 34380494 PMCID: PMC8355579 DOI: 10.1186/s12936-021-03872-2] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 08/03/2021] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has resulted in unprecedented challenges to health systems worldwide, including the control of non-COVID-19 diseases. Malaria cases and deaths may increase due to the direct and indirect effects of the pandemic in malaria-endemic countries, particularly in sub-Saharan Africa (SSA). This scoping review aims to summarize information on public health-relevant effects of the COVID-19 pandemic on the malaria situation in SSA. METHODS Review of publications and manuscripts on preprint servers, in peer-reviewed journals and in grey literature documents from 1 December, 2019 to 9 June, 2021. A structured search was conducted on different databases using predefined eligibility criteria for the selection of articles. RESULTS A total of 51 papers have been included in the analysis. Modelling papers have predicted a significant increase in malaria cases and malaria deaths in SSA due to the effects of the COVID-19 pandemic. Many papers provided potential explanations for expected COVID-19 effects on the malaria burden; these ranged from relevant diagnostical and clinical aspects to reduced access to health care services, impaired availability of curative and preventive commodities and medications, and effects on malaria prevention campaigns. Compared to previous years, fewer country reports provided data on the actual number of malaria cases and deaths in 2020, with mixed results. While highly endemic countries reported evidence of decreased malaria cases in health facilities, low endemic countries reported overall higher numbers of malaria cases and deaths in 2020. CONCLUSIONS The findings from this review provide evidence for a significant but diverse impact of the COVID-19 pandemic on malaria in SSA. There is the need to further investigate the public health consequences of the COVID-19 pandemic on the malaria burden. Protocol registered on Open Science Framework: https://doi.org/10.17605/OSF.IO/STQ9D.
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Affiliation(s)
| | - Guangyu Lu
- Department of Public Health, Medical College, Yangzhou University, Yangzhou, China
| | - Oliver Razum
- Department of Epidemiology and International Public Health, School of Public Health, Bielefeld University, Bielefeld, Germany
| | - Alhassan Abdul-Mumin
- Department of Paediatrics and Child Health, School of Medicine, University for Development Studies, Tamale, Ghana
| | - Osman Sankoh
- Institute of Global Health, Medical School, Ruprecht-Karls-University, Heidelberg, Germany
- Statistics Sierra Leone, Tower Hill, Freetown, Sierra Leone
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Lorenz von Seidlein
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | | | - Olaf Müller
- Institute of Global Health, Medical School, Ruprecht-Karls-University, Heidelberg, Germany
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Abstract
In this Comment article, Sofonias Tessema and John Nkengasong provide an overview of the current state of the COVID-19 pandemic in Africa and the challenges posed by the triple burden of emerging, endemic and non-communicable diseases.
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Affiliation(s)
- Sofonias K Tessema
- Africa Centres for Disease Control and Prevention, Addis Ababa, Ethiopia
| | - John N Nkengasong
- Africa Centres for Disease Control and Prevention, Addis Ababa, Ethiopia.
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Hasan MZ, Neill R, Das P, Venugopal V, Arora D, Bishai D, Jain N, Gupta S. Integrated health service delivery during COVID-19: a scoping review of published evidence from low-income and lower-middle-income countries. BMJ Glob Health 2021; 6:bmjgh-2021-005667. [PMID: 34135071 PMCID: PMC8210663 DOI: 10.1136/bmjgh-2021-005667] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 05/19/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Integrated health service delivery (IHSD) is a promising approach to improve health system resilience. However, there is a lack of evidence specific to the low/lower-middle-income country (L-LMIC) health systems on how IHSD is used during disease outbreaks. This scoping review aimed to synthesise the emerging evidence on IHSD approaches adopted in L-LMIC during the COVID-19 pandemic and systematically collate their operational features. METHODS A systematic scoping review of peer-reviewed literature, published in English between 1 December 2019 and 12 June 2020, from seven electronic databases was conducted to explore the evidence of IHSD implemented in L-LMICs during the COVID-19 pandemic. Data were systematically charted, and key features of IHSD systems were presented according to the postulated research questions of the review. RESULTS The literature search retrieved 1487 published articles from which 18 articles met the inclusion criteria and included in this review. Service delivery, health workforce, medicine and technologies were the three most frequently integrated health system building blocks during the COVID-19 pandemic. While responding to COVID-19, the L-LMICs principally implemented the IHSD system via systematic horizontal integration, led by specific policy measures. The government's stewardship, along with the decentralised decision-making capacity of local institutions and multisectoral collaboration, was the critical facilitator for IHSD. Simultaneously, fragmented service delivery structures, fragile supply chain, inadequate diagnostic capacity and insufficient workforce were key barriers towards integration. CONCLUSION A wide array of context-specific IHSD approaches were operationalised in L-LMICs during the early phase of the COVID-19 pandemic. Emerging recommendations emphasise the importance of coordination and integration across building blocks and levels of the health system, supported by a responsive governance structure and stakeholder engagement strategies. Future reviews can revisit this emerging evidence base at subsequent phases of COVID-19 response and recovery in L-LMICs to understand how the approaches highlighted here evolve.
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Affiliation(s)
- Md Zabir Hasan
- School of Population and Public Health, The University of British Columbia, Vancouver, British Columbia, Canada .,Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Rachel Neill
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Priyanka Das
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Vasuki Venugopal
- Department of Health and Family Welfare, Government of Gujarat, Gandhinagar, India
| | - Dinesh Arora
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - David Bishai
- Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Nishant Jain
- Deutsche Gesellschaft für Internationale Zusammenarbeit GmbH India Office, New Delhi, India
| | - Shivam Gupta
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
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39
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Fronteira I, Sidat M, Magalhães JP, de Barros FPC, Delgado AP, Correia T, Daniel-Ribeiro CT, Ferrinho P. The SARS-CoV-2 pandemic: A syndemic perspective. One Health 2021; 12:100228. [PMID: 33614885 PMCID: PMC7887445 DOI: 10.1016/j.onehlt.2021.100228] [Citation(s) in RCA: 55] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 02/10/2021] [Accepted: 02/11/2021] [Indexed: 01/07/2023] Open
Abstract
The SARS-CoV-2 pandemic has affected communities, populations, and countries throughout the world. As the SARS-CoV-2 pandemic developed, the extent to which the disease interacted with already existing endemic, non-communicable and infectious diseases became evident, hence deeply influencing health outcomes. Additionally, a synergistic effect has been demonstrated also with socio-economic, cultural, and contextual determinants of health which seem to contribute to poorer health and accumulating social disadvantages. In this essay, using as a starting point the syndemic theory that translates the cumulative and intertwined factors between different epidemics, we argue that the SARS-CoV-2 is a one health issue of a syndemic nature and that the failure to acknowledge this contributes to weakened policy-making processes and public health responses and ineffective health policies and programs.
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Affiliation(s)
- Inês Fronteira
- Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Portugal,Corresponding author.
| | - Mohsin Sidat
- Community Health Department, Faculty of Medicine, University Eduardo Mondlane, Mozambique
| | - João Paulo Magalhães
- Public Health Unit, Group of Primary Care Centers of Porto Oriental, North Health Regional Administration, Ministry of Health, Portugal
| | | | - António Pedro Delgado
- University of Cabo Verde, Cabo Verde, Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Portugal
| | - Tiago Correia
- Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Portugal
| | - Cláudio Tadeu Daniel-Ribeiro
- Laboratório de Pesquisa em Malária, Instituto Oswaldo Cruz, Fiocruz, Rio de Janeiro and Centro de Pesquisa Diagnóstico e Treinamento em Malária, Fiocruz e Secretaria de Vigilância em Saúde, Brazil
| | - Paulo Ferrinho
- Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Portugal
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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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Owusu M, Sylverken AA, Ankrah ST, El-Duah P, Ayisi-Boateng NK, Yeboah R, Gorman R, Asamoah J, Binger T, Acheampong G, Bekoe FA, Ohene SA, Larsen-Reindorf R, Awuah AAA, Amuasi J, Owusu-Dabo E, Adu-Sarkodie Y, Phillips RO. Epidemiological profile of SARS-CoV-2 among selected regions in Ghana: A cross-sectional retrospective study. PLoS One 2020; 15:e0243711. [PMID: 33301533 PMCID: PMC7728229 DOI: 10.1371/journal.pone.0243711] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 11/28/2020] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Global cases of COVID-19 continue to rise, causing havoc to several economies. So far, Ghana has recorded 48,643 confirmed cases with 320 associated deaths. Although summaries of data are usually provided by the Ministry of Health, detailed epidemiological profile of cases are limited. This study sought to describe the socio-demographic features, pattern of COVID-19 spread and the viral load dynamics among subjects residing in northern, middle and part of the southern belt of Ghana. METHODS This was a cross-sectional retrospective study that reviewed records of samples collected from February to July, 2020. Respiratory specimens such as sputum, deep-cough saliva and nasopharyngeal swabs were collected from suspected COVID-19 subjects in 12 regions of Ghana for laboratory analysis and confirmation by real-time reverse transcription polymerase chain reaction (RT-PCR). RESULTS A total of 72,434 samples were collected during the review period, with majority of the sampled individuals being females (37,464; 51.9%). The prevalence of SARS-CoV-2 identified in the study population was 13.2% [95%CI: 12.9, 13.4). Males were mostly infected (4,897; 51.5%) compared to females. Individuals between the ages 21-30 years recorded the highest number of infections (3,144, 33.4%). Symptomatic subjects had higher viral loads (1479.7 copies/μl; IQR = 40.6-178919) than asymptomatic subjects (49.9; IQR = 5.5-3641.6). There was significant association between gender or age and infection with SARS-CoV-2 (p<0.05). Among all the suspected clinical presentations, anosmia was the strongest predictor of SARS-CoV-2 infection (Adj. OR (95%CI): 24.39 (20.18, 29.49). We observed an average reproductive number of 1.36 with a minimum of 1.28 and maximum of 1.43. The virus trajectory shows a gradual reduction of the virus reproductive number. CONCLUSION This study has described the epidemiological profile of COVID-19 cases in northern, middle and part of the southern belt of Ghana, with males and younger individuals at greater risk of contracting the disease. Health professionals should be conscious of individuals presenting with anosmia since this was seen as the strongest predictor of virus infection.
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Affiliation(s)
- Michael Owusu
- Department of Medical Diagnostics, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- Kumasi Centre for Collaborative Research in Tropical Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Augustina Angelina Sylverken
- Kumasi Centre for Collaborative Research in Tropical Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- Department of Theoretical and Applied Biology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Sampson Twumasi Ankrah
- Department of Statistics and Actuarial Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Philip El-Duah
- Kumasi Centre for Collaborative Research in Tropical Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- Institute of Virology, Charite, Universitätsmedizin Berlin, Berlin, Germany
| | | | - Richmond Yeboah
- Kumasi Centre for Collaborative Research in Tropical Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Richmond Gorman
- Kumasi Centre for Collaborative Research in Tropical Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Jesse Asamoah
- Kumasi Centre for Collaborative Research in Tropical Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Tabea Binger
- Kumasi Centre for Collaborative Research in Tropical Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | | | | | | | | | - Anthony Afum-Adjei Awuah
- Kumasi Centre for Collaborative Research in Tropical Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- Department of Molecular Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - John Amuasi
- Kumasi Centre for Collaborative Research in Tropical Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- Department of Global and International Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Ellis Owusu-Dabo
- Department of Global and International Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Yaw Adu-Sarkodie
- Department of Clinical Microbiology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Richard Odame Phillips
- Kumasi Centre for Collaborative Research in Tropical Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- Department of Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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