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Cénat JM, Moshirian Farahi SMM, Rousseau C, Bukaka J, Darius WP, Derivois D, Dalexis RD, Luyeye N. Prevalence and Factors Related to Post-traumatic Stress Disorder and Depression Symptoms Among Children and Adolescents Survivors and Orphans of Ebola Virus Disease in Democratic Republic of the Congo Eastern Regions During the COVID-19 Pandemic. J Adolesc Health 2023; 73:1019-1029. [PMID: 37737753 DOI: 10.1016/j.jadohealth.2023.07.023] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 07/16/2023] [Accepted: 07/17/2023] [Indexed: 09/23/2023]
Abstract
PURPOSE Although previous studies have shown a high prevalence of mental health problems among adult Ebola virus disease survivors, no studies have yet been conducted on mental health problems among children and adolescents in affected regions. Consequently, the current study aimed to examine the prevalence and factors associated with depression and post-traumatic stress disorder (PTSD) among children and adolescent survivors and orphans by utilizing a cross-sectional survey following the 2018-2020 epidemic in Eastern Democratic Republic of the Congo. METHODS A total of 146 survivors (mean age = 13.62, standard deviation [SD] = 2.50, 49.32% female), 233 orphans (mean age = 13.18, SD = 2.96, 53.32% female), and 34 orphan-survivor participants (mean age = 13.39, SD = 2.87, 44.12% female) were recruited. Participants completed measures assessing depression and PTSD symptoms, traumatic experiences, and stigma related to Ebola and COVID-19. RESULTS The prevalence of depression and PTSD symptoms was 87.32% and 44.42%, respectively. Results showed significant differences in depression and PTSD symptoms between orphan-survivors (100% and 97.06%), survivors (90.21% and 75.86%), and orphans (83.48% and 16.52%; χ2(2) = 9.02; p = .011 and χ2(2) = 168.85; p < .001). Experience of traumatic events, Ebola stigmatization, and COVID-19 stigmatization positively predicted depression and PTSD symptoms. The regression models explained 61%-72% of the variance of depression and PTSD. DISCUSSION The results reveal that the Ebola virus disease and its associated grief severely jeopardize the mental health of children and adolescents in affected regions. Despite the relative paucity of resources, intervention programs may be helpful to minimize associated stigma and promote psychological support.
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Affiliation(s)
- Jude Mary Cénat
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada; Interdisciplinary Centre for Black Health, University of Ottawa, Ottawa, Ontario, Canada; University of Ottawa Research Chair on Black Health, School of Psychology, University of Ottawa, Ottawa, Ontario, Canada.
| | | | - Cécile Rousseau
- Division of Social and Transcultural Psychiatry, McGill University, Montreal, Québec, Canada
| | - Jacqueline Bukaka
- Department of Psychology, University of Kinshasa, Kinshasa, DR of Congo
| | - Wina Paul Darius
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
| | - Daniel Derivois
- Department of Psychology, Université Bourgogne Franche Comté, Bourgogne, France
| | - Rose Darly Dalexis
- Interdisciplinary School of Health Sciences, University of Ottawa, Ontario, Canada
| | - Noble Luyeye
- Department of Psychology, University of Kinshasa, Kinshasa, DR of Congo
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Nkweleko Fankam F, Ugarte W, Akilimali P, Ewane Etah J, Åkerman E. COVID-19 pandemic hits differently: examining its consequences for women's livelihoods and healthcare access - a cross-sectional study in Kinshasa DRC. BMJ Open 2023; 13:e072869. [PMID: 37678942 PMCID: PMC10496687 DOI: 10.1136/bmjopen-2023-072869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Accepted: 08/24/2023] [Indexed: 09/09/2023] Open
Abstract
OBJECTIVES The emergence of the COVID-19 pandemic led to multiple preventive actions as primary interventions to contain the spread of the virus. Globally, countries are facing enormous challenges with consequences for use of social, economic and health services. The Democratic Republic of Congo (DRC) was among the African countries implementing strict lockdown at the start of the pandemic, resulting in shortages and decreased access to services. The adverse effects of the pandemic had unpleasant consequences for the country. This study aimed to examine the association between COVID-19 pandemic-related factors, sociodemographic factors, and the need to visit healthcare facilities, including family planning services, among women aged 15-49 years in the DRC. METHODS We conducted a secondary analysis of a performance monitoring for action (PMA) cross-sectional COVID-19 phone survey in Kinshasa, DRC, which had a response rate of 74.7%. In total, 1325 randomly selected women aged 15-49 years from the Kinshasa province who had previously participated in the PMA baseline survey participated in the survey. Bivariate and multivariate logistic regressions were used to assess associations. RESULTS The COVID-19 pandemic and related factors affected 92% of women in the Kinshasa province socioeconomically. A majority were highly economically dependent on their partner or some other sources for their basic needs to be met, and even more worried about the future impact of the pandemic on their household finances. Over 50% of women did not attempt visiting a health service, with some of the top reasons being fear of being infected with COVID-19 and not being able to afford services. We found a significant association between age groups and contraceptive use. The need for and use of contraceptives was higher among women aged 25-34 years than those aged 15-24 or 35-49 years. CONCLUSION Effective social/economic support to women and girls during pandemics and in crises is essential as it can have lasting beneficial effects on many domains of their lives, including their ability to access health services and the contraceptives of their choice.
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Affiliation(s)
| | - William Ugarte
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Pierre Akilimali
- Kinshasa School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of Congo
| | - Junior Ewane Etah
- Department of Microbiology and Parasitology, Faculty of Science, University of Buea, Buea, Cameroon
| | - Eva Åkerman
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
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Rai A, Khatri G. Resurgence of the Ebola Virus in the Democratic Republic of Congo: A Perspective. Disaster Med Public Health Prep 2023; 17:e327. [PMID: 36799203 DOI: 10.1017/dmp.2022.309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Affiliation(s)
- Aneesh Rai
- Dow University of Health Science, Karachi, Pakistan
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Kashiya Y, Ekofo J, Kabanga C, Agyepong I, Van Damme W, Van Belle S, Mukinda F, Chenge F. Multilevel Governance and Control of the COVID-19 Pandemic in the Democratic Republic of Congo: Learning from the Four First Waves. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1980. [PMID: 36767346 PMCID: PMC9914874 DOI: 10.3390/ijerph20031980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Revised: 01/05/2023] [Accepted: 01/11/2023] [Indexed: 06/18/2023]
Abstract
The COVID-19 pandemic continues to impose a heavy burden on people around the world. The Democratic Republic of the Congo (DRC) has also been affected. The objective of this study was to explore national policy responses to the COVID-19 pandemic in the DRC and drivers of the response, and to generate lessons for strengthening health systems' resilience and public health capacity to respond to health security threats. This was a case study with data collected through a literature review and in-depth interviews with key informants. Data analysis was carried out manually using thematic content analysis translated into a logical and descriptive summary of the results. The management of the response to the COVID-19 pandemic reflected multilevel governance. It implied a centralized command and a decentralized implementation. The centralized command at the national level mostly involved state actors organized into ad hoc structures. The decentralized implementation involved state actors at the provincial and peripheral level including two other ad hoc structures. Non-state actors were involved at both levels. These ad hoc structures had problems coordinating the transmission of information to the public as they were operating outside the normative framework of the health system. Conclusions: Lessons that can be learned from this study include the strategic organisation of the response inspired by previous experiences with epidemics; the need to decentralize decision-making power to anticipate or respond quickly and adequately to a threat such as the COVID-19 pandemic; and measures decided, taken, or adapted according to the epidemiological evolution (cases and deaths) of the epidemic and its effects on the socio-economic situation of the population. Other countries can benefit from the DRC experience by adapting it to their own context.
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Affiliation(s)
- Yves Kashiya
- Centre de Connaissances en Santé en République Démocratique du Congo, Kinshasa 3088, Democratic Republic of the Congo
- Kinshasa School of Public Health, University of Kinshasa, Kinshasa 127, Democratic Republic of the Congo
| | - Joel Ekofo
- Centre de Connaissances en Santé en République Démocratique du Congo, Kinshasa 3088, Democratic Republic of the Congo
| | - Chrispin Kabanga
- Centre de Connaissances en Santé en République Démocratique du Congo, Kinshasa 3088, Democratic Republic of the Congo
| | - Irene Agyepong
- Public Health Faculty, Ghana College of Physicians and Surgeons, Accra MB 429, Ghana
| | - Wim Van Damme
- Institute of Tropical Medicine, 2000 Antwerp, Belgium
| | | | - Fidele Mukinda
- School of Public Health, University of Western Cape, Cape Town 7530, South Africa
| | - Faustin Chenge
- Centre de Connaissances en Santé en République Démocratique du Congo, Kinshasa 3088, Democratic Republic of the Congo
- Faculty of Medicine, University of Lubumbashi, Lubumbashi 1825, Democratic Republic of the Congo
- School of Public Health, University of Lubumbashi, Lubumbashi 1825, Democratic Republic of the Congo
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Shayla TA, Paul M, Sayma NJ, Suhee FI, Islam MR. The Dengue Prevalence and Mortality Rate Surpass COVID-19 in Bangladesh: Possible Strategies to Fight Against a Double-Punch Attack. CLINICAL PATHOLOGY (THOUSAND OAKS, VENTURA COUNTY, CALIF.) 2023; 16:2632010X231181954. [PMID: 37377618 PMCID: PMC10291213 DOI: 10.1177/2632010x231181954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 05/24/2023] [Indexed: 06/29/2023]
Abstract
Dengue is a vector-borne viral disease caused by multiple serotypes (DENV-1, DENV-2, DENV-3, and DENV-4) of the dengue virus. It has been a public health concern since 2000 in Bangladesh. However, Bangladesh experienced a higher prevalence and death rate in the year 2022 than the previous year surpassing the COVID-19 situation. While climatic factors had always been a prominent reason for dengue incidence, reports stated that DEN 4 serotype was identified for the first time in the country, which made the dengue cases worse. In this article, we presented the 5 years prevalence of hospitalization and death cases owing to dengue fever and also provided a comparison of death cases caused by dengue and COVID-19 in Bangladesh. We described the possible reasons for the sudden surges of dengue infection and mentioned the actions led by the government to deal with this dengue occurrence. Lastly, we recommend a few strategies to counter the future outbreak of dengue infection in the country.
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Affiliation(s)
| | | | | | | | - Md. Rabiul Islam
- Md. Rabiul Islam, Department of Pharmacy, University of Asia Pacific, 74/A Green Road, Farmgate, Dhaka 1205, Bangladesh.
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Sharma H, Ilyas A, Chowdhury A, Poddar NK, Chaudhary AA, Shilbayeh SAR, Ibrahim AA, Khan S. Does COVID-19 lockdowns have impacted on global dengue burden? A special focus to India. BMC Public Health 2022; 22:1402. [PMID: 35869470 PMCID: PMC9304795 DOI: 10.1186/s12889-022-13720-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 06/27/2022] [Indexed: 12/12/2022] Open
Abstract
Background The world has been battling several vector-borne diseases since time immemorial. Socio-economic marginality, precipitation variations and human behavioral attributes play a major role in the proliferation of these diseases. Lockdown and social distancing have affected social behavioral aspects of human life and somehow impact on the spread of vector borne diseases. This article sheds light into the relationship between COVID-19 lockdown and global dengue burden with special focus on India. It also focuses on the interconnection of the COVID-19 pandemic (waves 1 and 2) and the alteration of human behavioral patterns in dengue cases. Methods We performed a systematic search using various resources from different platforms and websites, such as Medline; Pubmed; PAHO; WHO; CDC; ECDC; Epidemiology Unit Ministry of Health (Sri Lanka Government); NASA; NVBDCP from 2015 until 2021. We have included many factors, such as different geographical conditions (tropical climate, semitropic and arid conditions); GDP rate (developed nations, developing nations, and underdeveloped nations). We also categorized our data in order to conform to COVID-19 duration from 2019 to 2021. Data was extracted for the complete duration of 10 years (2012 to 2021) from various countries with different geographical region (arid region, semitropic/semiarid region and tropical region). Results There was a noticeable reduction in dengue cases in underdeveloped (70–85%), developing (50–90%), and developed nations (75%) in the years 2019 and 2021. The dengue cases drastically reduced by 55–65% with the advent of COVID-19 s wave in the year 2021 across the globe. Conclusions At present, we can conclude that COVID-19 and dengue show an inverse relationship. These preliminary, data-based observations should guide clinical practice until more data are made public and basis for further medical research. • COVID-19 has increased the burden on the health care system across the globe. • COVID-19 has inverse relation with the occurrence of Dengue cases. • Dengue situation is worse in countries with low GDP. • Human behavior and social distancing have direct correlation with the number of Dengue cases. • Cross-reactivity or overlap between Dengue and COVID-19, has proportional effect on each other.
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Manyong V, Bokanga M, Akonkwa Nyamuhirwa DM, Bamba Z, Adeoti R, Mwepu G, Cole SM, Dontsop Nguezet PM. COVID-19 outbreak and rural household food security in the Western Democratic Republic of the Congo. WORLD DEVELOPMENT PERSPECTIVES 2022; 28:100469. [PMID: 36405513 PMCID: PMC9650560 DOI: 10.1016/j.wdp.2022.100469] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 10/20/2022] [Accepted: 11/07/2022] [Indexed: 05/25/2023]
Abstract
Although global assessments of the initial impacts of the coronavirus disease (COVID-19) have focused on income, jobs, and health conditions, this study constitutes one of the first studies that assessed the impact of COVID-19 on food security in DRC and established the short-term implications of the COVID-19 outbreak on rural households' food security in DRC. In addition, the study recommendations contributed to shaping government interventions toward the pandemic in the Country. The study used data from four western provinces of the country on 1339 households. Our results show that 80 % of households experienced an increase in food prices, 61 % a noticeable decrease in the availability of food, and 54 % a decrease in their dietary diversity. Due to changes in food availability, dietary diversity, and food accessibility imposed by the COVID-19 outbreak, >70 % of households experienced either a decrease in the consumption of meat, milk, fish, and cereals or an increase in their consumption of traditional vegetables. In addition, COVID-19 significantly affected food security dimensions in larger households, households with a greater number of members aged 35 years and above, households headed by women, households where members participate in associations or cooperatives, households that depend on crop sales as the major source of income, and in poorer households. These findings highlight the significant implications of the COVID-19 outbreak on household food security in western DRC and underscore the need for emergency interventions to strengthen the resilience of rural people and accelerate their recovery and other long-term measures toward sustainable and inclusive development.
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Affiliation(s)
- Victor Manyong
- International Institute of Tropical Agriculture, Dar Es Salaam, Tanzania
| | - Mpoko Bokanga
- International Institute of Tropical Agriculture (iita.org), IITA DRC, Congo
| | | | - Zoumana Bamba
- International Institute of Tropical Agriculture (IITA), Kinshasa, DR, Congo
| | - Razack Adeoti
- International Institute of Tropical Agriculture (IITA), Cotonou, Benin
| | | | - Steven M Cole
- International Institute of Tropical Agriculture, Dar Es Salaam, Tanzania
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8
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Hemmeda L. Third wave of COVID-19 pandemic in Africa: Challenges and recommendations. Ann Med Surg (Lond) 2022; 80:104314. [PMID: 35945972 PMCID: PMC9352644 DOI: 10.1016/j.amsu.2022.104314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 07/27/2022] [Accepted: 07/27/2022] [Indexed: 11/28/2022] Open
Abstract
Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has evolved in different waves and is currently in its third wave for the majority of countries around the world. Each wave emanated with its own set of challenges. Lower- and middle-income countries such as most African countries have faced additional challenges compared to high-income countries. This paper highlights the challenges faced by Africa during the third wave of COVID-19 and proposes recommendations and strategies to contain the spread. We conducted a mini-review for the newly released articles and researches about the challenges faced by Africa during COVID-19. Fragmented healthcare sectors, limited healthcare resources and emergence of co-infections in COVID-19 patients, inadequate vaccination rollout and political conflicts are the major challenges faced by the African countries. Our recommendations to defeat this outbreak and subsequent pandemics is to raise the public's awareness about vaccines through campaigns and social media in order to lessen vaccine hesitancy. Governments as well should focus on under-served and vulnerable populations, patients with comorbidities, and communities living in endemic-striking settings as these people are more prone to the severe form of the disease. Moreover, by adopting socio-ecological perspectives, one can implement multi-level integrated interventions to help control COVID-19 more effectively.
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9
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Bisimwa P, Biamba C, Aborode AT, Cakwira H, Akilimali A. Ebola virus disease outbreak in the Democratic Republic of the Congo: A mini-review. Ann Med Surg (Lond) 2022; 80:104213. [PMID: 35875058 PMCID: PMC9296226 DOI: 10.1016/j.amsu.2022.104213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Accepted: 07/17/2022] [Indexed: 12/03/2022] Open
Abstract
Ebola virus disease is one of the most serious and deadliest infectious diseases in the world with a sufficient number of recorded deaths. Since its discovery in 1976 until its last epidemic (14th), recorded and declared on April 23, 2022 by the National Minister of Public Health of the Democratic Republic of Congo and we have observed a succession of simultaneous epidemics of the disease to Ebola virus. This disease escapes the control of the health system of the Democratic Republic of the Congo, a health system which is already destabilized by the corona virus disease 2019 pandemic. Since the World Health Organization has already classified the Ebola virus disease as a major public health problem at the global level, this epidemic remains an important issue to consider the possible and necessary means at all levels (political as well as health) to put an end to this disease. Despite the seriousness of this disease, the dangers, clinical manifestations and modes of transmission of which are well understood by healthcare personnel. The Congolese population should be informed of the risks of this Ebola virus disease. The World Health Organization, the disease control center in collaboration with the Congolese government are implementing preventive and curative measures to slow the progression of this disease in the affected areas and prevent the areas still spared from being affected. In this present work, we will talk about some characteristics of the Ebola virus disease and show the different efforts and recommendations to be taken to end this disease. The Ebola virus disease is a scourge for the health system of the Democratic Republic of Congo because it escapes health surveillance despite the preventive measures put in place. The Ebola virus disease is very deadly in humans; until now, the entire Congolese population has not yet benefited from vaccination against the Ebola virus disease. In this period of the 14th epidemic of the Ebola virus disease in the Democratic Republic of Congo, a country whose corona virus disease 2019 pandemic has already destabilized its health system.
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Affiliation(s)
- Paterne Bisimwa
- Faculty of Medicine, Catholic University of Bukavu, Bukavu, D.R., Congo
- Standing Committee of Research and Exchange, Medical Student Association, D.R., Congo
| | | | | | - Hugues Cakwira
- Faculty of Medicine, Catholic University of Bukavu, Bukavu, D.R., Congo
- Standing Committee of Research and Exchange, Medical Student Association, D.R., Congo
| | - Aymar Akilimali
- Standing Committee of Research and Exchange, Medical Student Association, D.R., Congo
- Department of Research, Oli Health Magazine Organization, Kigali, Rwanda
- Faculty of Medicine, Official University of Bukavu, Bukavu, D.R., Congo
- Corresponding author. Faculty of Medicine, Official University of Bukavu, Department of Research, Oli Health Magazine Organization, Kigali, Rwanda, Bagira, Kagera rue 16, Bukavu, South Kivu, D.R., Congo.
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10
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Ariza-Vioque E, Ello F, Andriamamonjisoa H, Machault V, González-Martín J, Calvo-Cortés MC, Eholié S, Tchabert GA, Ouassa T, Raberahona M, Rakotoarivelo R, Razafindrakoto H, Rahajamanana L, Wilkinson RJ, Davis A, Maxebengula M, Abrahams F, Muzoora C, Nakigozi N, Nyehangane D, Nanjebe D, Mbega H, Kaitano R, Bonnet M, Debeaudrap P, Miró JM, Anglaret X, Rakotosamimanana N, Calmy A, Bonnet F, Ambrosioni J. Capacity Building in Sub-Saharan Africa as Part of the INTENSE-TBM Project During the COVID-19 Pandemic. Infect Dis Ther 2022; 11:1327-1341. [PMID: 35767219 PMCID: PMC9244532 DOI: 10.1007/s40121-022-00667-z] [Citation(s) in RCA: 2] [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: 05/04/2022] [Accepted: 06/13/2022] [Indexed: 02/04/2023] Open
Abstract
Tuberculous meningitis (TBM) is the most severe and disabling form of tuberculosis (TB), with at least 100,000 cases per year and a mortality rate of up to 50% in individuals co-infected with human immunodeficiency virus type 1 (HIV-1). To evaluate the efficacy and safety of an intensified anti-tubercular regimen and an anti-inflammatory treatment, the INTENSE-TBM project includes a phase III randomised clinical trial (TBM-RCT) in four countries in sub-Saharan Africa (SSA). Within this framework, we designed a comprehensive capacity-building work package ensuring all centres had, or would acquire, the ability to conduct the TBM-RCT and developing a network of skilled researchers, clinical centres and microbiology laboratories. Here, we describe these activities, identify strengths/challenges and share tools adaptable to other projects, particularly in low- and lower-middle income countries with heterogeneous settings and during the coronavirus disease 2019 (COVID-19) pandemic. Despite major challenges, TBM-RCT initiation was achieved in all sites, promoting enhanced local healthcare systems and encouraging further clinical research in SSA. In terms of certified trainings, the achievement levels were 95% (124/131) for good clinical practice, 91% (39/43) for good clinical laboratory practice and 91% (48/53) for infection prevention and control. Platform-based research, developed as part of capacity-building activities for specific projects, may be a valuable tool in fighting future infectious diseases and in developing high-level research in Africa. The INTENSE-TBM project aimed to design a comprehensive work-package on capacity building, ensuring all centres would acquire the ability to conduct a phase III randomised clinical trial on TBM in sub-Saharan Africa, to reduce tuberculous meningitis mortality and morbidity in patients with/without HIV-1 co-infection. Therefore, the INTENSE-TBM project is an example of how an international clinical research consortium can provide opportunities to enhance local capacity building and promote centres without previous experience in clinical research. This article provides practical approaches for implementing effective capacity-building programmes. We highlight how to overcome limitations imposed by the COVID-19 pandemic to successfully complete clinics, laboratory set-ups and personnel training, so as to optimise resources and empower African institutions on a local level. At the same time, our experience shows how capacity-building programmes can deliver long-lasting impact that extends beyond the original aims of the project (e.g. HIV and TB), and support local health systems in fighting other infectious disease (e.g. COVID-19). Research projects in low- and lower-middle income countries with heterogeneous settings could stand to benefit the most.
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Affiliation(s)
- E Ariza-Vioque
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - F Ello
- Programme ANRS Coopération Côte d'Ivoire (PAC-CI), Abidjan, Ivory Coast
| | | | - V Machault
- INSERM U1219, Bordeaux Population Health (BPH), Université de Bordeaux, Bordeaux, France
| | - J González-Martín
- Servei de Microbiologia, Centre de Diagnòstic Biomèdic (CDB), Hospital Clínic de Barcelona, Barcelona, Spain
- Institut de Salut Global (ISGlobal), Barcelona, Spain
- Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain
| | - M C Calvo-Cortés
- Agence Nationale de Recherche sur le SIDA et les Hépatites Virales (ANRS), Maladies Infectieuses Émergentes, Paris, France
| | - S Eholié
- Centre Hospitalier Universitaire (CHU) Treichville, Abidjan, Ivory Coast
| | - G A Tchabert
- Programme ANRS Coopération Côte d'Ivoire (PAC-CI), Abidjan, Ivory Coast
| | - T Ouassa
- Centre de Diagnostic et de Research sur le SIDA et les autres maladies infectieuses (CeDReS), Abidjan, Ivory Coast
| | - M Raberahona
- Centre d'Infectiologie Charles Mérieux (CICM), Antananarivo, Madagascar
- Université d'Antananarivo, Antananarivo, Madagascar
- Centre Hospitalier Universitaire (CHU) Joseph Raseta Befalatanana, Antananarivo, Madagascar
| | - R Rakotoarivelo
- Université de Fianarantsoa, Fianarantsoa, Madagascar
- Centre Hospitalier Universitaire (CHU) Tambohobe, Fianarantsoa, Madagascar
| | - H Razafindrakoto
- Centre d'Infectiologie Charles Mérieux (CICM), Antananarivo, Madagascar
| | - L Rahajamanana
- Centre d'Infectiologie Charles Mérieux (CICM), Antananarivo, Madagascar
| | - R J Wilkinson
- Wellcome Centre for Infectious Diseases Research in Africa, Cape Town, Republic of South Africa
- Francis Crick Institute, London, UK
- Department Infectious Diseases, Imperial College London, London, UK
| | - A Davis
- Wellcome Centre for Infectious Diseases Research in Africa, Cape Town, Republic of South Africa
| | - M Maxebengula
- Wellcome Centre for Infectious Diseases Research in Africa, Cape Town, Republic of South Africa
| | - F Abrahams
- Wellcome Centre for Infectious Diseases Research in Africa, Cape Town, Republic of South Africa
| | - C Muzoora
- Médecins Sans Frontières (MSF) Epicentre, Mbarara, Uganda
- Mbarara University of Science and Technology (MUST), Mbarara, Uganda
| | - N Nakigozi
- Médecins Sans Frontières (MSF) Epicentre, Mbarara, Uganda
| | - D Nyehangane
- Médecins Sans Frontières (MSF) Epicentre, Mbarara, Uganda
| | - D Nanjebe
- Médecins Sans Frontières (MSF) Epicentre, Mbarara, Uganda
| | - H Mbega
- Médecins Sans Frontières (MSF) Epicentre, Mbarara, Uganda
| | - R Kaitano
- Médecins Sans Frontières (MSF) Epicentre, Mbarara, Uganda
| | - M Bonnet
- Université de Montpellier, Montpellier, France
- Recherches Translationnelles sur le VIH et les Maladies Infectieuses (TransVIHMI), Institut de Recherche pour le Développement (IRD), INSERM, Paris, France
| | - P Debeaudrap
- Recherches Translationnelles sur le VIH et les Maladies Infectieuses (TransVIHMI), Institut de Recherche pour le Développement (IRD), INSERM, Paris, France
| | - J M Miró
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain
- HIV Unit, Infectious Diseases Service, Hospital Clínic de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
| | - X Anglaret
- Programme ANRS Coopération Côte d'Ivoire (PAC-CI), Abidjan, Ivory Coast
- INSERM U1219, Bordeaux Population Health (BPH), Université de Bordeaux, Bordeaux, France
| | | | - A Calmy
- Université de Genève (UNIGE), Geneva, Switzerland
| | - F Bonnet
- INSERM U1219, Bordeaux Population Health (BPH), Université de Bordeaux, Bordeaux, France
- Service de Médecine Interne et Maladies Infectieuses, Saint-André Hospital, Centre Hospitalier Universitaire (CHU) de Bordeaux, Bordeaux, France
| | - J Ambrosioni
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
- Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain.
- HIV Unit, Infectious Diseases Service, Hospital Clínic de Barcelona, Barcelona, Spain.
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain.
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11
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Sun J, Uwishema O, Kassem H, Abbass M, Uweis L, Rai A, El Saleh R, Adanur I, Onyeaka H. Ebola virus outbreak returns to the Democratic Republic of Congo: An urgent rising concern. Ann Med Surg (Lond) 2022; 79:103958. [PMID: 35757313 PMCID: PMC9218350 DOI: 10.1016/j.amsu.2022.103958] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 06/05/2022] [Indexed: 11/21/2022] Open
Abstract
On April 23, 2022, the Ministry of Health of the Democratic Republic of the Congo announced an EVD outbreak after discovering 2 confirmed cases and identifying 267 contacts. With collaboration from the WHO, the MoH are taking many interventions to prevent further expansion of this outbreak. Forty-six years ago, the Ebola virus was first discovered in 1976 near the Ebola River in the DRC. Since then, 13 outbreaks of EVD have occurred in the DRC and, in 2020, it witnessed the second largest EVD outbreak in the world, resulting in 3481 cases and 2299 mortalities. This article discusses the epidemiology of the current DRC outbreak by examining the etiology of EVD, the number of affected cases, and the subsequent case index. Considering these data, this paper discusses measures taken by the MoH, WHO, CDC, and UNICEF to mitigate the Ebola outbreak, such as supporting local teams to provide essential care, training medical staff, and raising awareness for vaccination. Finally, by comparing the gravity of the situation to current measures, this article provides recommendations for individuals and governments to protect themselves and mitigate future outbreaks.
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12
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Tang B, Zhang X, Li Q, Bragazzi NL, Golemi-Kotra D, Wu J. The minimal COVID-19 vaccination coverage and efficacy to compensate for a potential increase of transmission contacts, and increased transmission probability of the emerging strains. BMC Public Health 2022; 22:1258. [PMID: 35761216 PMCID: PMC9235129 DOI: 10.1186/s12889-022-13429-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 05/13/2022] [Indexed: 11/17/2022] Open
Abstract
Background Mass immunization is a potentially effective approach to finally control the local outbreak and global spread of the COVID-19 pandemic. However, it can also lead to undesirable outcomes if mass vaccination results in increased transmission of effective contacts and relaxation of other public health interventions due to the perceived immunity from the vaccine. Methods We designed a mathematical model of COVID-19 transmission dynamics that takes into consideration the epidemiological status, public health intervention status (quarantined/isolated), immunity status of the population, and strain variations. Comparing the control reproduction numbers and the final epidemic sizes (attack rate) in the cases with and without vaccination, we quantified some key factors determining when vaccination in the population is beneficial for preventing and controlling future outbreaks. Results Our analyses predicted that there is a critical (minimal) vaccine efficacy rate (or a critical quarantine rate) below which the control reproduction number with vaccination is higher than that without vaccination, and the final attack rate in the population is also higher with the vaccination. We also predicted the worst case scenario occurs when a high vaccine coverage rate is achieved for a vaccine with a lower efficacy rate and when the vaccines increase the transmission efficient contacts. Conclusions The analyses show that an immunization program with a vaccine efficacy rate below the predicted critical values will not be as effective as simply investing in the contact tracing/quarantine/isolation implementation. We reached similar conclusions by considering the final epidemic size (or attack rates). This research then highlights the importance of monitoring the impact on transmissibility and vaccine efficacy of emerging strains.
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13
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Ishola D. Asymptomatic Malaria Infection and the Immune Response to the 2-Dose Ad26.ZEBOV, MVA-BN-Filo Ebola Vaccine Regimen in Adults and Children. Clin Infect Dis 2022; 75:1585-1593. [PMID: 35640636 PMCID: PMC9617582 DOI: 10.1093/cid/ciac209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Indexed: 11/14/2022] Open
Abstract
Background Malaria infection affects the immune response to some vaccines. As Ebola virus (EBOV) outbreaks have occurred mainly in malaria-endemic countries, we have assessed whether asymptomatic malaria affects immune responses to the 2-dose Ad26.ZEBOV, MVA-BN-Filo Ebola vaccine regimen. Methods In this sub-study of the EBOVAC-Salone Ebola vaccine trial in Sierra Leone, malaria microscopy was performed at the time of Ebola vaccination. Participants with symptomatic malaria were treated before vaccination. Ebola vaccine responses were assessed post-dose 1 (day 57) and post-dose 2 (day 78) by the EBOV glycoprotein FANG enzyme-linked immunosorbent assay (ELISA), and responses expressed as geometric mean concentrations (GMCs). Geometric mean ratios (GMRs) of the GMCs in malaria-positive versus malaria-negative participants were derived with 95% confidence intervals (CIs). Results A total of 587 participants were studied, comprising 188 adults (≥18 years) and 399 children (in age groups of 12–17, 4–11, and 1–3 years). Asymptomatic malaria was observed in 47.5% of adults and 51.5% of children on day 1. Post-dose 1, GMCs were lower in 1–3-year-old malaria-positive compared with malaria-negative children (age group–specific GMR, .56; 95% CI, .39–.81) but not in older age groups. Post-dose 2, there was no consistent effect of malaria infection across the different age groups but there was a trend toward a lower response (GMR, .82; 95% CI, .67–1.02). Conclusions The Ad26.ZEBOV, MVA-BN-Filo Ebola vaccine regimen is immunogenic in participants with asymptomatic malaria. Therefore, it is not necessary to screen for asymptomatic malaria infection prior to vaccination with this regimen.
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Affiliation(s)
- D Ishola
- Correspondence: D. Ishola, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK ()
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14
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Irene C, Elba M, Jiménez JL, Mellado MJ, Muñoz-Fernández MÁ. HIV HGM biobank as a research platform for paediatric infectious diseases and COVID-19 pandemic. AIDS Res Ther 2022; 19:22. [PMID: 35614512 PMCID: PMC9130977 DOI: 10.1186/s12981-022-00448-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 04/07/2022] [Indexed: 12/28/2022] Open
Abstract
AIM The initial cases of COVID-19 appeared in December 2019 and Spain was one of the most affected countries during the first wave (March to June). Since then, HIV HGM BioBank has been restructured as an established Paediatrics and Adults HIV_COVID-19 BioBank that aims at the long-term storage of samples obtained from not only HIV-1, but also from COVID-19 patients and HIV-1_COVID-19 coinfected patients. METHODS HIV HGM BioBank holds high quality biological samples from newborns, children, adolescents and adults with their associated clinical data. Research groups trying to establish large networks focused on research on specific clinical problems in epidemiology, biology, routes of transmission and therapies, are potential users of the clinical samples and of associated data of HIV-1_COVID-19 HGM BioBank. RESULTS The HIV HGM BioBank is an academic and ethical enterprise complying with all the legal regulatory rules to provide service to the society. HIV_COVID-19 HGM BioBank has been repurposed to offer an important resource for global research of COVID-19 in newborns, children, adolescents, adults and elders to study the biological effect of the pandemic. CONCLUSION Herein, we present a description of how HIV HGM BioBank has rapidly become an indispensable structure in modern biomedical research, including COVID-19 research.
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Affiliation(s)
- Consuegra Irene
- Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
- HIV HGM BioBank, Madrid, Spain
| | - Mauleón Elba
- Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
- HIV HGM BioBank, Madrid, Spain
| | - José Luis Jiménez
- Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
- HIV HGM BioBank, Madrid, Spain
- Plataforma-Laboratorio (IiSGM), Madrid, Spain
| | - María José Mellado
- General Pediatrics, Infectious and Tropical Diseases Department Hospital, Universitario La Paz, Madrid, Spain
| | - María Ángeles Muñoz-Fernández
- Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain.
- HIV HGM BioBank, Madrid, Spain.
- Laboratorio InmunoBiología Molecular (HGUGM), Madrid, Spain.
- Head Immunology Section, Hospital General Universitario Gregorio Marañón, C/Dr. Esquerdo 46, 28007, Madrid, Spain.
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15
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Kawale P, Kalitsilo L, Mphande J, Romeo Adegbite B, Grobusch MP, Jacob ST, Rylance J, Madise NJ. On prioritising global health's triple crisis of sepsis, COVID-19 and antimicrobial resistance: a mixed-methods study from Malawi. BMC Health Serv Res 2022; 22:613. [PMID: 35524209 PMCID: PMC9076498 DOI: 10.1186/s12913-022-08007-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 04/25/2022] [Indexed: 12/18/2022] Open
Abstract
Sepsis causes 20% of global deaths, particularly among children and vulnerable populations living in developing countries. This study investigated how sepsis is prioritised in Malawi’s health system to inform health policy. In this mixed-methods study, twenty multisectoral stakeholders were qualitatively interviewed and asked to quantitatively rate the likelihood of sepsis-related medium-term policy outcomes being realised. Respondents indicated that sepsis is not prioritised in Malawi due to a lack of local sepsis-related evidence and policies. However, they highlighted strong linkages between sepsis and maternal health, antimicrobial resistance and COVID-19, which are already existing national priorities, and offers opportunities for sepsis researchers as policy entrepreneurs. To address the burden of sepsis, we recommend that funding should be channelled to the generation of local evidence, evidence uptake, procurement of resources and treatment of sepsis cases, development of appropriate indicators for sepsis, adherence to infection prevention and control measures, and antimicrobial stewardship.
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Affiliation(s)
- Paul Kawale
- African Institute for Development Policy, Lilongwe, Malawi.
| | - Levi Kalitsilo
- African Institute for Development Policy, Lilongwe, Malawi
| | - Jessie Mphande
- African Institute for Development Policy, Lilongwe, Malawi
| | - Bayode Romeo Adegbite
- Centre de Recherches Médicales de Lambaréné (CERMEL) and African Partner Institution, Lambarene, Gabon.,Centre of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Amsterdam Infection & Immunity, Amsterdam University Medical Centres, Amsterdam Public Health, University of Amsterdam, location AMC, Amsterdam, The Netherlands.,Institut für Tropenmedizin, Universität Tübingen, Tübingen, Germany
| | - Martin P Grobusch
- Centre de Recherches Médicales de Lambaréné (CERMEL) and African Partner Institution, Lambarene, Gabon.,Centre of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Amsterdam Infection & Immunity, Amsterdam University Medical Centres, Amsterdam Public Health, University of Amsterdam, location AMC, Amsterdam, The Netherlands.,Institut für Tropenmedizin, Universität Tübingen, Tübingen, Germany.,Institute of Infectious Diseases and Molecular Medicine, University of Cape Town, Cape Town, South Africa.,Masanga Medical Research Unit, Masanga, Sierra Leone
| | - Shevin T Jacob
- Liverpool School of Tropical Medicine, Liverpool, UK.,, Walimu, Uganda
| | - Jamie Rylance
- Liverpool School of Tropical Medicine, Liverpool, UK.,Malawi-Liverpool-Welcome Trust, Blantyre, Malawi
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16
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Aborode A, Awuah WA, Mehta A, Toufik AR, Ahmad S, Corriero AC, Costa ACDS, Nansubuga EP, Gecer E, Namaal Bel-Nono K, Akilimali A, Oko CI, H Zuñiga YM. COVID-19, bubonic and meningitis in Democratic Republic of Congo: the confluence of three plagues at a challenging time. Postgrad Med J 2022; 99:postgradmedj-2021-141433. [PMID: 35444065 DOI: 10.1136/postgradmedj-2021-141433] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 04/07/2022] [Indexed: 01/16/2023]
Affiliation(s)
| | | | - Aashna Mehta
- Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | | | - Shahzaib Ahmad
- Faculty of Medicine, King Edward Medical University, Lahore, Pakistan
| | | | | | | | - Elif Gecer
- School of Medicine, Anglia Ruskin University, Chelmsford, UK
| | | | - Aymar Akilimali
- Faculty of Medicine, Official University of Bakavu, South Kivu, Congo (the Democratic Republic of the)
| | - Christian Inya Oko
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
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17
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Plotkin MK, Williams KM, Mbinda A, Oficiano VN, Nyauchi B, Walugembe P, Keyes E, Rawlins B, McCarraher D, Chabikuli ON. Keeping essential reproductive, maternal and child health services available during COVID-19 in Kenya, Mozambique, Uganda and Zimbabwe: analysis of early-pandemic policy guidelines. BMC Public Health 2022; 22:577. [PMID: 35321675 PMCID: PMC8942058 DOI: 10.1186/s12889-022-12851-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Accepted: 02/21/2022] [Indexed: 11/10/2022] Open
Abstract
Background The COVID-19 pandemic has disrupted the provision of essential reproductive, maternal, newborn, and child health (RMNCH) services in sub-Saharan Africa to varying degrees. Original models estimated as many as 1,157,000 additional child and 56,700 maternal deaths globally due to health service interruptions. To reduce potential impacts to populations related to RMNCH service delivery, national governments in Kenya, Mozambique, Uganda, and Zimbabwe swiftly issued policy guidelines related to essential RMNCH services during COVID-19. The World Health Organization (WHO) issued recommendations to guide countries in preserving essential health services by June of 2020. Methods We reviewed and extracted content related to family planning (FP), antenatal care (ANC), intrapartum and postpartum care and immunization in national policies from Kenya, Uganda, Mozambique, and Zimbabwe from March 2020 to February 2021, related to continuation of essential RMNCH services during the COVID-19 pandemic. Using a standardized tool, two to three analysts independently extracted content, and in-country experts reviewed outputs to verify observations. Findings were entered into NVivo software and categorized using pre-defined themes and codes. The content of each national policy guideline was compared to WHO guidance related to RMNCH essential services during COVID-19. Results All four country policy guidelines considered ANC, intrapartum care, FP, and immunization to be essential services and issued policy guidance for continuation of these services. Guidelines were issued in April 2020 by Mozambique, Kenya, and Uganda, and in June 2020 by Zimbabwe. Many elements of WHO’s 2020 recommendations were included in country policies, with some notable exceptions. Each policy guideline was more detailed in some aspects than others — for example, Kenya’s guidelines were particularly detailed regarding FP service provision, while Uganda’s guidelines were explicit about immediate breastfeeding. All policy guidance documents contained a balance of measures to preserve essential RMNCH services while reducing COVID-19 transmission risk within these services. Conclusions The national policy guidelines to preserve essential RMNCH services in these four countries reflected WHO recommendations, with some notable exceptions for ANC and birth companionship. Ongoing revision of country policy guidelines to adapt to changing pandemic conditions is recommended, as is further analysis of subnational-level policies.
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18
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Hasan MM, Sahito AM, Muzzamil M, Mohanan P, Islam Z, Billah MM, Islam MJ, Essar MY. Devastating dengue outbreak amidst COVID-19 pandemic in Bangladesh: an alarming situation. Trop Med Health 2022; 50:11. [PMID: 35078540 PMCID: PMC8786620 DOI: 10.1186/s41182-022-00401-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 01/12/2022] [Indexed: 11/28/2022] Open
Abstract
Dengue fever is a viral infection caused by Aedes mosquitoes that has recently expanded fast in many of the WHO member states globally. Female mosquitoes, mostly Aedes aegypti and, to a smaller degree, Aedes albopictus, disseminate dengue virus. Dengue fever has been more common in recent decades all across the world, and Bangladesh is no exception. As the COVID-19 outbreak wreaks havoc, the following rise in dengue illnesses has been a source of considerable concern. As the health care has been stretched thin in these dangerous times, the vulnerable population has been left at the mercy of these two viral infections. Lack of knowledge, major legislative changes, poor eradication initiatives, and a lack of financing resources have all contributed to the increase in numbers. Stakeholders and policymakers must begin taking meaningful actions and implementing well-thought-out adjustments immediately, or the situation will worsen, resulting in the loss of thousands of innocent lives.
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Affiliation(s)
- Mohammad Mehedi Hasan
- Department of Biochemistry and Molecular Biology, Faculty of Life Science, Mawlana Bhashani Science and Technology University, Tangail, Bangladesh
| | | | | | - Parvathy Mohanan
- Department of General Medicine, Medical University Sofia, Sofia, Bulgaria
| | - Zarmina Islam
- Dow University of Health Sciences, Karachi, Pakistan
| | - Md Masum Billah
- Department of Pharmacy, Faculty of Life Science, Mawlana Bhashani Science and Technology University, Tangail, Bangladesh
| | - Mohammod Johirul Islam
- Department of Biochemistry and Molecular Biology, Faculty of Life Science, Mawlana Bhashani Science and Technology University, Tangail, Bangladesh
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19
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Meningitis during COVID -19 pandemic in the Democratic Republic of Congo: A call for concern. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2022; 13:100955. [PMID: 35005300 PMCID: PMC8721923 DOI: 10.1016/j.cegh.2021.100955] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 12/21/2021] [Accepted: 12/30/2021] [Indexed: 11/19/2022] Open
Abstract
Meningitis is a severe infection and a major public health challenge. The meningitis outbreak which had resurfaced amid the coronavirus disease 2019 (COVID-19) pandemic in the Democratic Republic of Congo (DRC) has been further stressing the health care systems that are already overburdened with detecting, preventing, and treating the current coronavirus disease. The recent meningitis outbreak in the DRC has resulted in a high case fatality ratio of 50% - an extremely worrying concern. Robust strategies are hence needed to curb the spread of the disease amid the COVID-19 pandemic, to prevent further adverse health outcomes and to mitigate the compounding burden on the country's healthcare systems. Several measures such as vaccination campaigns, adherence to sanitation and hygiene, improved surveillance and diagnostic capabilities could help prevent future epidemics in the country.
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20
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Nnaji ND, Onyeaka H, Reuben RC, Uwishema O, Olovo CV, Anyogu A. The deuce-ace of Lassa Fever, Ebola virus disease and COVID-19 simultaneous infections and epidemics in West Africa: clinical and public health implications. Trop Med Health 2021; 49:102. [PMID: 34965891 PMCID: PMC8716304 DOI: 10.1186/s41182-021-00390-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 12/09/2021] [Indexed: 01/08/2023] Open
Abstract
Globally, the prevailing COVID-19 pandemic has caused unprecedented clinical and public health concerns with increasing morbidity and mortality. Unfortunately, the burden of COVID-19 in Africa has been further exacerbated by the simultaneous epidemics of Ebola virus disease (EVD) and Lassa Fever (LF) which has created a huge burden on African healthcare systems. As Africa struggles to contain the spread of the second (and third) waves of the COVID-19 pandemic, the number of reported cases of LF is also increasing, and recently, new outbreaks of EVD. Before the pandemic, many of Africa's frail healthcare systems were already overburdened due to resource limitations in staffing and infrastructure, and also, multiple endemic tropical diseases. However, the shared epidemiological and pathophysiological features of COVID-19, EVD and LF as well their simultaneous occurrence in Africa may result in misdiagnosis at the onset of infection, an increased possibility of co-infection, and rapid and silent community spread of the virus(es). Other challenges include high population mobility across porous borders, risk of human-to-animal transmission and reverse zoonotic spread, and other public health concerns. This review highlights some major clinical and public health challenges toward responses to the COVID-19 pandemic amidst the deuce-ace of recurrent LF and EVD epidemics in Africa. Applying the One Health approach in infectious disease surveillance and preparedness is essential in mitigating emerging and re-emerging (co-)epidemics in Africa and beyond.
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Affiliation(s)
| | - Helen Onyeaka
- School of Chemical Engineering, University of Birmingham, Edgbaston, Birmingham, B15 2TT UK
| | - Rine Christopher Reuben
- German Centre for Integrative Biodiversity Research (iDiv), Halle-Jena-Leipzig, Leipzig, Germany
| | - Olivier Uwishema
- Oli Health Magazine Organization, Research and Education, Kigali, Rwanda
- Clinton Global Initiative University, New York, USA
- Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
| | - Chinasa Valerie Olovo
- Department of Microbiology, University of Nigeria, Nsukka, Nigeria
- Department of Biochemistry and Molecular Biology, School of Medicine, Jiangsu University Zhenjiang, Zhenjiang, 212013 Jiangsu People’s Republic of China
| | - Amarachukwu Anyogu
- School of Biomedical Sciences, University of West London, London, W5 5RF UK
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21
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Okonji OC, Okonji EF, Mohanan P, Babar MS, Saleem A, Khawaja UA, Essar MY, Hasan MM. Marburg virus disease outbreak amidst COVID-19 in the Republic of Guinea: A point of contention for the fragile health system? CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2021; 13:100920. [PMID: 34901523 PMCID: PMC8651525 DOI: 10.1016/j.cegh.2021.100920] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Revised: 11/24/2021] [Accepted: 12/01/2021] [Indexed: 02/07/2023] Open
Abstract
In August 2021, the Marburg virus disease (MVD) outbreak was confirmed amid the coronavirus disease 2019 (COVID-19) pandemic in the Republic of Guinea. This is the first time it is detected in Guinea and West Africa. Marburg virus is one of the world's most threatening diseases, causing severe haemorrhagic fever, with a case fatality rate of 90%. Currently, there are no vaccines and specific antiviral drugs for MVD. Technical teams and community health care workers that were set up as part of the recent Ebola virus disease (EVD) outbreak that was declared over on June 19, 2021, are now redeployed to support governments response activities of the MVD outbreak in the country. The MVD is an added burden to the fragile healthcare systems that are already overburdened with multiple reoccurring epidemics and the COVID-19 pandemic. Previous epidermic strategies are needed to contain the spread of the disease, amid the COVID-19 pandemic, so the health care systems are not overwhelmed. This commentary discusses the available evidence regarding the epidemic of MVD in Guinea amid the COVID-19 pandemic, and highlights the efforts, challenges to be prioritized, and provides evidence-based recommendations.
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Affiliation(s)
| | - Emeka Francis Okonji
- School of Public Health, University of the Western Cape, Bellville, South Africa
| | - Parvathy Mohanan
- Department of General Medicine, Medical University of Sofia, Bulgaria
| | | | - Amna Saleem
- Jinnah Medical and Dental College, Karachi, Pakistan
| | | | | | - Mohammad Mehedi Hasan
- Department of Biochemistry and Molecular Biology, Faculty of Life Science, Mawlana Bhashani Science and Technology University, Tangail, Bangladesh
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22
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Atim MG, Kajogoo VD, Amare D, Said B, Geleta M, Muchie Y, Tesfahunei HA, Assefa DG, Manyazewal T. COVID-19 and Health Sector Development Plans in Africa: The Impact on Maternal and Child Health Outcomes in Uganda. Risk Manag Healthc Policy 2021; 14:4353-4360. [PMID: 34703344 PMCID: PMC8541793 DOI: 10.2147/rmhp.s328004] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 10/08/2021] [Indexed: 12/05/2022] Open
Abstract
INTRODUCTION Health Sector Development Plans (HSDPs) aim to accelerate movement towards achieving sustainable development goals for health, reducing inequalities, and ending poverty. Reproductive, maternal, newborn and child health (RMNCH) services are vulnerable to economic imbalances, including health insecurity, unmet need for healthcare, and low health expenditure. The same vulnerability influences the potential of a country to combat global outbreaks such as the COVID-19. We aimed to provide some important insights into the impacts of COVID-19 on RMNCH indicators and outcomes of the HSDP in Uganda. METHODS We conducted a descriptive study of secondary data obtained from the Ugandan government-led portals, supplemented by analyses of relevant articles published up to 06 May 2021 and deposited in PubMed. RESULTS Through synthesizing actionable and relevant evidence, we realized that RMNCH in Uganda is highly affected by the COVID-19 pandemic and the lockdown measures. The impact was across immunization, antenatal, sexual and reproductive health, emergency and obstetric, and postnatal care services. There was a decline sharply by 9.6% for under-five vitamin A coverage, 9% for DPT3HibHeb3 coverage, 6.8% for measles vaccination coverage, 6% for isoniazid preventive therapy coverage, and 3% for facility-based deliveries. Maternal and under-five deaths increased by 7.6% and 4%, respectively. Outreaches were rarely conducted in the lockdown period. CONCLUSION The COVID-19 pandemic has created a multitude of questions regarding the optimal policies to mitigate the disease while minimizing the unintended detrimental consequences of RMNCH. The lockdown restrictions threatened to reverse the progress made on the national HSDP for RMNCH. In Uganda, where young women are vulnerable to early marriage, unintended pregnancies, and unsafe abortion, access to RMNCH services should continue regardless of the COVID-19 status in the country. We urge that Uganda and other African countries should build resilient and sustainable health systems that can withstand emerging diseases like the COVID-19.
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Affiliation(s)
- Mary Gorret Atim
- Center for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Department of Public Health, Busitema University Faculty of Health Sciences, Mbale, Uganda
| | - Violet Dismas Kajogoo
- Center for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Mafie District Hospital, Mafia Island, Pwani Region, Tanzania
| | - Demeke Amare
- Center for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Ethiopian Food and Drug Administration Authority (EFDA), Addis Ababa, Ethiopia
| | - Bibie Said
- Center for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Kibong’oto National Tuberculosis Hospital, Kilimanjaro, Tanzania
| | - Melka Geleta
- Center for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Federal Ministry of Health, Addis Ababa, Ethiopia
| | - Yilkal Muchie
- Center for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- All Africa Leprosy and Rehabilitation Training (ALERT) Centre, Addis Ababa, Ethiopia
| | - Hanna Amanuel Tesfahunei
- Center for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Hager Biomedical Research Institute, Asmara, Eritrea
| | - Dawit Getachew Assefa
- Center for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Department of Nursing, College of Medical and Health Sciences, Dilla University, Dilla, Ethiopia
| | - Tsegahun Manyazewal
- Center for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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23
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Aborode AT, Sukaina M, Kumar H, Farooqui T, Faheem S, Chahal P, Alkazmi L, Hetta HF, Batiha GES. Zika virus endemic challenges during COVID-19 pandemic in Africa. Trop Med Health 2021; 49:82. [PMID: 34645524 PMCID: PMC8512648 DOI: 10.1186/s41182-021-00372-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 09/22/2021] [Indexed: 12/13/2022] Open
Abstract
Zika virus remains endemic and opportunistic of high transmission in the tropical region of Africa, and the repeated cases of the Zika virus in Africa made it public health emergency in 2016. Amidst the COVID-19 pandemic, the catastrophic cases of unknown and unreported deaths overwhelming the region of Africa could not give health attention to respond to other endemic diseases. Here, we present the possible complication and challenges associated with the Zika virus in Africa and COVID-19 predominance, shifting the attention from the Zika virus surveillance. This paper determines to enlighten the reader about the situation, the efforts to curb the transmission of both the Zika virus and the COVID-19 pandemic. Therefore, the report recommends sustainable solutions that can lessen the threat to public health.
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Affiliation(s)
- Abdullahi Tunde Aborode
- Health Africans Platform, Research and Development, Ibadan, Nigeria.,West African Academy of Public Health, Research and Development, Abuja, Nigeria
| | | | | | | | - Samar Faheem
- Dow University of Health Sciences, Karachi, Pakistan
| | | | - Luay Alkazmi
- Department of Biology, Faculty of Applied Sciences, Umm Al-Qura University, Makkah, 21955, Saudi Arabia
| | - Helal F Hetta
- Department of Medical Microbiology and Immunology, Faculty of Medicine, Assiut University, Assiut, 71515, Egypt.,Department of Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, 45267-0595, USA
| | - Gaber El-Saber Batiha
- Department of Pharmacology and Toxicology, Faculty of Veterinary Medicine, Damanhour University, Damanhour, Egypt
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24
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Newfield TP. Syndemics and the history of disease: Towards a new engagement. Soc Sci Med 2021; 295:114454. [PMID: 34627635 DOI: 10.1016/j.socscimed.2021.114454] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 09/30/2021] [Indexed: 12/23/2022]
Abstract
Historians of medicine and disease have yet to think through a syndemic lens. This commentary aims to point out why they should. Although there are several hurdles to overcome, our histories of disease and our understanding of current syndemics both stand to gain should historians begin to explore episodes of cooccurring diseases that share root causes.
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Affiliation(s)
- Timothy P Newfield
- Department of History, Department of Biology, Georgetown University, 37th and O Streets NW, ICC 600, Washington, DC, 20057, USA.
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