Intriguing insight into unanswered questions about Mpox: exploring health policy implications and considerations

The 2022 multi-country Monkeypox (Mpox) outbreak has added concerns to scientific research. However, unanswered questions about the disease remain. These unanswered questions lie in different aspects, such as transmission, the affected community, clinical presentations, infection and prevention control and treatment and vaccination. It is imperative to address these issues to stop the spread and transmission of disease. We documented unanswered questions with Mpox and offered suggestions that could help put health policy into practice. One of those questions is why gay, bisexual or other men who have sex with men (gbMSM) are the most affected community, underscoring the importance of prioritizing this community regarding treatment, vaccination and post-exposure prophylaxis. In addition, destigmatizing gbMSM and implementing community-based gbMSM consultation and action alongside ethical surveillance can facilitate other preventive measures such as ring vaccination to curb disease transmission and track vaccine efficacy. Relevant to that, vaccine and drug side effects have implied the questionability of their use and stimulated the importance of health policy development regarding expanded access and off-label use, expressing the need for safe drug and vaccine development manufacturing. The possibility of reverse zoonotic has also been raised, thus indicating the requirement to screen not only humans, but also their related animals to understand the real magnitude of reverse zoonosis and its potential risks. Implementing infection prevention and control measures to stop the virus circulation at the human-animal interface that includes One Health approach is essential.

Sociodemographic factors associated with acceptance of index case testing among newly diagnosed human immunodeficiency virus-positive clients in southern borno, Nigeria

BACKGROUND

The study aimed to explore the sociodemographic factors associated with the acceptance of index case testing (ICT) among newly diagnosed people living with HIV (PLHIV) in Southern Borno, Nigeria.

METHODS

The study involved four healthcare facilities providing antiretroviral therapy (ART) services in Southern Borno, Nigeria. Secondary data from the index case testing register were collected between April 2022 and April 2023. Categorical variables were analyzed using descriptive statistics, while bivariate and multiple logistic regression analyses was used to determine the factors associated with ICT acceptance, using a 95% confidence interval and significance level of p ≤ .05.

RESULTS

Among the 302 index cases offered ICT, the acceptance rate was 69.5%. Individuals aged 25-49 years (AOR: 0.294, 95% CI: 0.098-0.775) and 50 years and above (AOR: 0.210, 95% CI: 0.046-0.862) were less likely to accept ICT compared to those aged 18-24 years. Married individuals were 38.86 times more likely to accept ICT than those who were single and never married (AOR: 38.856, 95% CI: 12.620-171.674).

CONCLUSION

The study shows high ICT acceptance among newly diagnosed PLHIV in Southern Borno, with age and marital status as significant factors. These findings can guide targeted interventions to enhance ICT acceptance and enhance HIV care and prevention strategies in the region.

Healthcare Workers' Safety; A Necessity for a Robust Health System

It is a prevalent misconception that healthcare professionals are specialists and thus can effectively manage their health. This is probably true, but given recent pandemics and the rise in violence in medical settings, one is compelled to question whether their health and safety are sufficient for a robust healthcare system. This is important because protecting and promoting the health, safety, and well-being of health workers will improve the quality of patient care and increase the resilience of health services in the face of outbreaks and public health emergencies. We thus strive to answer this question and suggest potential remedies to this growing public health issue.

Paucity of Health Data in Africa: An Obstacle to Digital Health Implementation and Evidence-Based Practice

Background: Among the numerous challenges that Africa faces in improving its healthcare systems, the paucity of health data stands out as paramount. This study aims to examine the challenges related to the paucity of health data in Africa and its impact on the implementation of digital health and evidence-based practice. The findings of the study reveal that health data availability in Africa is both limited and frequently of poor quality. Several factors contribute to this concerning situation, encompassing inadequate infrastructure, a shortage of resources, and cultural barriers. Furthermore, the available data, despite its limitations, is often underutilized due to a lack of capacity and expertise in data analysis and interpretation. Policy Options and Recommendations: To improve healthcare delivery in Africa, we recommend implementing novel strategies for data collection. It's important to recognize that effective information technology service is crucial for enhancing healthcare delivery, and a holistic approach is necessary to achieve this. Conclusion: This brief presents information to help policymakers develop long-term solutions to Africa's health data poverty. Taking action based on this evidence can assist in addressing the problem.

Monkeypox vaccination in the global south: Fighting a war without a weapon

Background

The Mpox outbreak awakened countries worldwide to renew efforts in epidemiological surveillance and vaccination of susceptible populations. In terms of Mpox vaccination, various challenges exist in the global south, which impede adequate vaccine coverage, especially in Africa. This paper reviewed the situation of Mpox vaccination in the global south and potential ameliorative approaches.

Methods

A review of online literature from PubMed and Google Scholar concerning Mpox vaccination in countries belonging to the 'global south' category was done between August and September, 2022. The major focus areas included inequity in global vaccine distribution, challenges impeding vaccine coverage in the global south, and potential strategies for bridging the gap in vaccine equity. The papers that met the inclusion criteria were collated and narratively discussed.

Results

Our analysis revealed that, while the high-income countries secured large supplies of the Mpox vaccines, the low- and middle-income countries were unable to independently access substantial quantities of the vaccine and had to rely on vaccine donations from high-income countries, as was the case during the COVID-19 pandemic. The challenges in the global south particularly revolved around inadequate vaccine production capacity due to lack of qualified personnel and specialized infrastructure for full vaccine development and manufacturing, limited cold chain equipment for vaccine distribution, and consistent vaccine hesitancy.

Conclusion

To tackle the trend of vaccine inequity in the global south, African governments and international stakeholders must invest properly in adequate production and dissemination of Mpox vaccines in low- and middle-income countries.

Healthcare workers and monkeypox: The case for risk mitigation

Potentially more at risk of contracting the monkeypox virus are healthcare workers. Most healthcare workers come into direct contact with the disease's infected people, which can spread directly and indirectly. Healthcare professionals must contact patients with the disease and any infected objects or fluids to effectively manage the disease, which further increases the risk of transmission. It is crucial to put safety measures in place and protect healthcare workers. To stop the spread of the monkeypox virus, countries must develop the necessary safeguards and countermeasures. In this emergency, healthcare systems must be strengthened. All healthcare systems should offer staff sufficient personal protective equipment (PPE) and facilitate risk assessment among those with a high risk of exposure. Any suspected case of monkeypox requires caution on the part of healthcare professionals. They must abide by infection control safety rules and protective measures.

Monkeypox: Is the world ready for another pandemic?

As the world continues to endure the impact of the COVID-19 pandemic, an outbreak of Monkeypox occurs and continues to spread unabatedly. The double-stranded DNA monkeypox virus is a sylvatic zoonosis, which occasionally infects humans and is a member of the genus Orthopoxviruses. Although scientists believed the virus to have low transmissibility, the speed and degree with which it spreads is alarming and could land one in a hospital or even kill one. Additionally, the fact that unusual transmissions are occurring among people without travel history to endemic regions suggests undetected transmissions, raising concerns about our preparedness for another pandemic. Contrary to the COVID-19 pandemic, there is a vaccine that could offer some protection against the monkeypox virus. Therefore, there is a need for coordinated efforts among authorities concerned and community-based organizations to raise awareness of the potential pandemic of monkeypox, activate surveillance systems and laboratory capacity, and heighten contact tracing and vaccination of at-risk individuals to stem the outbreak while there is still the opportunity to prevent it from becoming a pandemic.

Conflict, community, and COVID-19: response and implications in Ethiopia

Community transmission of COVID-19 is currently on the rise in Ethiopia, while availability of diagnostic and treatment services remains limited. Impaired access to essential services is affected by the pandemic’s strain on the health system, and as a consequence of the country’s public health response. The ongoing conflict in the Tigray Region provides another obstacle to accessing and providing care for the local population; and has displaced large numbers of people both within and outside the country.

In this commentary we discuss the impact of the conflict on essential services and argue that a coordinated holistic response is essential to mitigate both short and long-term consequences of the conflict, including increased COVID-19 transmission, acute malnutrition, disruption of education services, displacement of people, and food insecurities. We highlight the important role of community engagement in prevention and early detection of these challenges, and the need for comprehensive interventions in the region.

Curbing antimicrobial resistance in post‐COVID Africa: Challenges, actions and recommendations

Background

Antimicrobial self‐medication and use have significantly increased in the COVID‐19 era—increasing antibiotic consumption and resulting in a high prevalence of antimicrobial resistance in Africa (AMR). We conducted a narrative review to investigate challenges associated with curbing AMR in a post‐COVID‐19 setting in Africa, suggesting practical measures applicable for policy‐informed implementation.

Method

A narrative review was performed to pinpoint AMR challenges and actions on the African continent. A comprehensive search was conducted in the scientific databases that include PubMed, PubMed Central and Google Scholar using predetermined search terms.

Results

The emergence of the COVID‐19 outbreak has added to the challenges of tackling AMR on the continent, which has jeopardized AMR interventions' hard‐won gains. Identified challenges have been Health systems disruption, Irrational Antimicrobial Use, Weak Antimicrobials Regulatory Ecosystem, Inefficient Population Infection Prevention, and Control Practices, Inadequate access to Health Services and data challenge on AMR surveillance.

Conclusion

The COVID‐19 pandemic fueled AMR in Africa. There is a need for AMR control post‐COVID, such as measures for ongoing antimicrobial stewardship and good infection control practices. Further, curbing AMR requires rigorous regulatory enforcement and efficient AMR Surveillance. There should be a body to raise AMR awareness among the population. Research, Innovation and Technology could play an essential role supported by capacity building and global partnership.

The challenges of addressing the cholera outbreak in Cameroon

Cholera is an enteric disease caused by the ingestion of food or water contaminated by the toxins of the bacteria - Vibrio Cholerae. Its transmission is exacerbated by poor sanitary conditions and poor hygiene practices. Affected individuals may present with severe symptoms such as watery diarrhoea and vomiting that can lead to death within few hours. Cameroon is experiencing its worst cholera outbreak in decades. The outbreak is severest in the South-West and the Littoral regions. As of the time of writing, in six regions of the country, 6652 suspected cases of cholera including 134 deaths (CFR 2%) have been reported and the number is rising. Shortage of safe drinking water and contamination of rivers has exacerbated the outbreak, especially in the rural and hard to reach communities. The trans-border movement at the South-West region, defecation in the open and on rivers, and overcrowding at the Littoral region have been particularly challenging towards curbing the outbreak. Despite the challenges, Cameroon's health authorities have been working to bring the situation under control by engaging in community sensitization on good hygiene habits, disinfection of houses and vaccination campaigns. In the light of these, it is recommended that Cameroon should improve and strengthen its vaccination campaign across the country. Adequate health systems should be established at the point of entry to prevent cross-border cholera transmission and retransmission. Access to hard to reach communities should be improved so that vaccines and basic health care and sanitation services such as provision of safe drinking water can be provided.

COVID-19 AND INSECURITY IN NORTHERN NIGERIA

Northern Nigeria is currently facing a twin crisis of both COVID-19 and insecurity. They have made it difficult for the people to follow government containment efforts to control the pandemic and also have impacted on the socioeconomic and health aspects of the society. We have discussed on the impact of insecurity amid COVID-19 in Northern Nigeria. It is opined that if the insecurity in Northern Nigeria is not tackled, it will expose the region to more escalation of cases and deaths. Thus, it is recommended that proactive steps should be implemented by all stakeholders concerned to tackle insecurity, particularly the government to revive the security architecture, provide an environment for training and retraining of all security personnel and enhancing intelligence gathering to pave the way for resolving this issue.

Early marriage and teenage pregnancy: The unspoken consequences of COVID-19 pandemic in Nigeria

Early marriage and its sad consequences to the girl child and socio-economic development of the nation has been an age-long issue being advocated against in many parts of Nigeria. At the onset of COVID-19, the teeming efforts to curb this issue almost got jeopardized with harsh economic situations in many households due to the lockdown and the willingness to marry off their girls to reduce this burden. Closure of schools and cases of sexual gender based violence also impacted the prevalence of early marriage during the pandemic in Nigeria. We also argue in this commentary that the pandemic has so much impacted on programs aimed at ending early marriage in the nation. Therefore, if serious and concerted efforts are not taken by relevant stakeholders, more girls will be at risk of early marriage and teenage pregnancy with their related health consequences. They will also be left behind in fulfilling their potentials and their aspirations cut off with early marriage, thus sustainable development cannot be achieved.

COVID-19 and its impacts: The situation in Niger republic

COVID-19 being a public health emergency of international concern has emerged in most African countries including Niger. Niger, a landlocked country, is tasked with controlling the pandemic. However, of the big challenges the country faced is the fragility of healthcare system which posed limitations to the fight against the virus. The virus overwhelmed the fragile healthcare system which led to inaccessibility of quality healthcare to the citizens coupled with issues of flooding and economic recession that happened during the pandemic. The healthcare sectored has further been crippled by exposure and infection of the already insufficient healthcare workers. In addition to this, there was the burden of NTDs and other communicable and non-communicable diseases that subverted the country in the depths of difficulties. As per the predictions of World Bank, the poverty curve is likely to escalate due to the outrageous impacts of COVID-19. Adding on to this, the occurrence of natural disasters such as flooding has further stretched the country. It's no coincidence that the country would confront plethora of challenges amidst the second wave. Therefore, timely decision and necessary interventions are needed to strengthen the country's fight against the pandemic. However, this is only feasible when Nigerien government, international allies and other wealthy nations work closely to ensure that the challenges faced by the healthcare system are tackled.