Showing papers in "The Pan African medical journal in 2020"

COVID-19 infection and oxidative stress: an under-explored approach for prevention and treatment?

Abstract: Cite this article: Pan Africa Medical Journal. 2020;35(2):12. DOI: 10.11604/pamj.2020.35.2.22877 Received: 15 Apr 2020 Accepted: 21 Apr 2020 Published: 29 Apr 2020 Domain: Infectious diseases epidemiology

Real-time RT-PCR for COVID-19 diagnosis: challenges and prospects.

Abstract: COVID-19 impacts global public health, economy, education, tourism/hospitality and sports; rapid and accurate testing of clinical samples dictate effective response. So far, the real-time reverse transcriptase-polymerase chain reaction (RT-qPCR) is the assay of choice for COVID-19 diagnosis considering its rapidity and accuracy in informing on active coronavirus (CoV) infection. Presently, several RT-qPCR protocols with differing sensitivity/specificity are used for performing this assay; some of them are known to have generated debatable test results to constitute challenges worthy of consideration. This review provides a critical assessment of various published works on RT-qPCR assays used for COVID-19 diagnosis with their different indicators of positivity i.e., cycle threshold (Ct) cut-off values. Knowledge of diagnostic tests for COVID-19 is still evolving and, as a prospect, underscores the need for local validation of positive-negative Ct cut-off values when establishing RT-qPCR assays for SARS-CoV-2 detection.

Knowledge, risk perception and preparedness towards coronavirus disease-2019 (COVID-19) outbreak among Ghanaians: a quick online cross-sectional survey.

Abstract: Introduction Coronavirus disease 2019 (COVID-19) is recognized as global pandemic, affecting more than 300,000 worldwide. Ghana joined the international community by confirming first two COVID-19 cases on March 12, 2020. The study aimed to assess the public knowledge, risk perception and preparedness to respond the COVID-19 in the early stage of the outbreak in Ghana. Methods A cross-sectional study was conducted to collect information from Ghanaian during the early stage of the outbreak from 12th to 20th March 2020. Electronic based questionnaire was developed to collected information on the public knowledge, risk perceptions and preparedness to respond the COVID-19. All people who were aged 18 years and over were invited to participate in the study. Results A total of 350 participants were recruited into the analysis; 56% were males, with the majority of the study population aged between 18-30 years (61.4%), single (68.9%) and attained tertiary education (95.1%). Regarding COVID-19, 62.7% had “good” knowledge about the outbreak, 68.3% had a high risk of contracting the COVID-19 infection and 81.4% had a moderate preparedness skill to prevent and control the disease. Internet (77.1%) was the major sources of information. Knowledge of COVID-19 was significantly associated with education (p<0.001), age (p=0.018), employment (p=0.011) and health-related occupation (P=0.001) but only religion was associated with risk perception. Conclusion Though overall public knowledge was good, disparity exist among the least educated population, there was high risk perceptions and moderate preparedness skill to respond to COVID-19 among our study population. We recommend that educational campaigns through timely online update on COVID-19, van mobilization and mass media broadcasting should target all groups including those in the rural communities.

COVID-19: a perspective for lifting lockdown in Zimbabwe.

Abstract: The Coronavirus disease 2019 (Covid-19) scourge has challenged the world's health systems and presented multiple socio-economic and public health challenges to the states it has affected. Zimbabwe has been affected by the pandemic, and in response, the government has set up an array of measures, including a national lockdown, to curb transmission. While it is critical to maintain such vigorous containment measures, socio-economic pressures in Zimbabwe will challenge the sustainability of the lockdown. Given the potential for lift of the lockdown before the Covid-19 pandemic ends, we discuss the Covid-19 pandemic situation in Zimbabwe and viewpoints on important considerations and strategies for lifting the lockdown.

Clinical presentation, case management and outcomes for the first 32 COVID-19 patients in Nigeria

Abstract: Introduction Success in curtailing the pandemic coronavirus disease (COVID-19) depends largely on a sound understanding of the epidemiologic and clinical profile of cases in a population as well as the case management approach. This study documents the presenting characteristics, treatment modalities and outcomes of the first 32 COVID-19 patients in Nigeria. Methods This retrospective study used medical records of the first 32 patients admitted and discharged from the Mainland Hospital, Lagos State, southwest Nigeria between February 27 and April 6, 2020. The outcomes of interest were death, promptness of admission process and duration of hospitalization. Results The mean age of the patients was 38.1 years (SD: 15.5) and 66% were male. Three-quarters (75%) of the patients presented in moderately severe condition while 16% were asymptomatic. The most common presenting symptoms were fever (59%) and dry cough (44%). The mean time between a positive test result and admission was 1.63 days (SD: 1.31). Almost all (97%) the patients were treated with lopinavir-ritonavir with no recorded death. The median duration of hospital stay was 12 days (IQR: 9-13.5). Conclusion In this preliminary analysis of the first COVID-19 cases in Nigeria, clinical presentation was mild to moderate with no mortality. Processes to improve promptness of admission and reduce hospital stay are required to enhance the response to COVID-19 in Nigeria.

The performance of routine immunization in selected African countries during the first six months of the COVID-19 pandemic

Abstract: Introduction following the declaration of the COVID-19 pandemic on 11 March 2020, countries started implementing strict control measures, health workers were re-deployed and health facilities re-purposed to assist COVID-19 control efforts. These measures, along with the public concerns of getting COVID-19, led to a decline in the utilization of regular health services including immunization. Methods we reviewed the administrative routine immunization data from 15 African countries for the period from January 2018 to June 2020 to analyze the trends in the monthly number of children vaccinated with specific antigens, and compare the changes in the first three months of the COVID-19 pandemic. Results thirteen of the 15 countries showed a decline in the monthly average number of vaccine doses provided, with 6 countries having more than 10% decline. Nine countries had a lower monthly mean of recipients of first dose measles vaccination in the second quarter of 2020 as compared to the first quarter. Guinea, Nigeria, Ghana, Angola, Gabon, and South Sudan experienced a drop in the monthly number of children vaccinated for DPT3 and/or MCV1 of greater than 2 standard deviations at some point in the second quarter of 2020 as compared to the mean for the months January-June of 2018 and 2019. Conclusion countries with lower immunization coverage in the pre-COVID period experienced larger declines in the number of children vaccinated immediately after the COVID-19 pandemic was declared. Prolonged and significant reduction in the number of children vaccinated poses a serious risk for outbreaks such as measles. Countries should monitor coverage trends at national and subnational levels, and undertake catch-up vaccination activities to ensure that children who have missed scheduled vaccines receive them at the earliest possible time.

The impact of COVID-19 pandemic on medicine security in Africa: Nigeria as a case study.

Abstract: COVID-19 is an unprecedented pandemic posing major threat to global public health. In the past decades of years or so, one could have heard of how dangerous it is to be virtually reliant on medicine supply from other countries. Nonetheless, no action was taken because it seemed to many that the global trade system was operational and Nigerians as well as citizens of African countries appear to have sufficient supply of the medications required at quite appealing cost. Currently in 2020, this apprehension has revolved from an imaginary problem to an actual challenge that might have consequences for millions nationwide due to COVID-19 pandemic. Now, African countries can realize that putting all our eggs in one basket was not such a good idea. In Nigeria, over 70% of the prescribed medications are produced from active ingredients (API) primarily sourced from firms in China and India. Access to medicine is an integral part of healthcare systems, uninterrupted access to medicine is much needed and essential for the well-being of the population. We are now approaching the conclusion that it is more reasonable to probably invest a little more to resuscitate a domestic pharmaceutical synthesis and herbal medicine research capacity in Nigeria and across African countries to improve public health.

SARS-CoV-2 diagnostic testing in Africa: needs and challenges.

Abstract: Cite this article: Pan Africa Medical Journal. 2020;35(2):4. DOI: 10.11604/pamj.2020.35.4.22703 Received: 07 Apr 2020 Accepted: 08 Apr 2020 Published: 14 Apr 2020 Domain: Epidemiology,Global health,Public health

Essential health services delivery in Zimbabwe during the COVID-19 pandemic: perspectives and recommendations.

Abstract: Zimbabwe reported its first case of COVID-19 on 20 March 2020, and since then the number has increased to over 4000. To contain the spread of the causative SARS-CoV-2 and prepare the healthcare system, public health interventions, including lockdowns, were imposed on 30 March 2020. These resulted in disruptions in healthcare provision, and movement of people and supply chains. There have been resultant delays in seeking and accessing healthcare by the patients. Additionally, disruption of essential health services in the areas of maternal and child health, sexual and reproductive health services, care for chronic conditions and access to oncological and other specialist services has occurred. Thus, there may be avoidable excess morbidity and mortality from non-COVID-19 causes that is not justifiable by the current local COVID-19 burden. Measures to restore normalcy to essential health services provision as guided by the World Health Organisation and other bodies needs to be considered and implemented urgently, to avoid preventable loss of life and excess morbidity. Adequate infection prevention and control measures must be put in place to ensure continuity of essential services whilst protecting healthcare workers and patients from contracting COVID-19.

The impact of a prolonged ebola outbreak on measles elimination activities in Guinea, Liberia and Sierra Leone, 2014-2015.

Abstract: Introduction Guinea, Sierra Leone and Liberia have attained significant reduction in measles incidence between 2004 and 2013. The Ebola outbreak in 2014-2015 in West Africa caused significant disruption of the health service delivery in the three worst affected countries. The magnitude of the impact on the immunization program has not been well documented. Methods We reviewed national routine immunization administrative coverage data as well as measles surveillance performance and measles epidemiology in the years before, during and after the EVD outbreak in Guinea, Liberia, Sierra Leone. Results Both Liberia and Guinea experienced a sharp decline of more than 25% in the monthly number of children vaccinated against measles in 2014 and 2015 as compared to the previous years, while there was no reported decline in Sierra Leone. Guinea and Liberia experienced a decline in measles surveillance activity and performance indicators in 2014 and 2015. During this period, there was an increase in measles incidence and a decline in the mean age of measles cases reported in Liberia and Sierra Leone. Guinea started reporting high measles incidence in 2016. All three countries organized measles supplemental immunization activities by June 2015. Liberia achieved 99% administrative coverage, while Guinea and Sierra Leone attained 90.6% and 97.2% coverage respectively. There were no severe adverse events reported during these mass vaccination activities. The disruptive effect of the Ebola outbreak on immunization services was especially evident in Guinea and Liberia. Our review of the reported administrative vaccination coverage at national level does not show significant decline in measles first dose vaccination coverage in Sierra Leone as compared to other reports. This may be due to inaccuracies in coverage monitoring and data quality problems. The increases in measles transmission and incidence in these three countries can be explained by the rapid accumulation of susceptible children. Despite the organization of mass vaccination activities, measles incidence through 2017 has remained higher than the pre-Ebola period in all three countries. Conclusion The Ebola outbreak in West Africa significantly affected measles vaccination coverage rates in two of the three worst affected countries, and led to persistent gaps in coverage, along with high measles incidence that was documented until two years after the end of the Ebola outbreak. Liberia and Sierra Leone have demonstrated coverage improvements after the end of the Ebola outbreak.

COVID-19 knowledge, attitudes and practices in a conflict affected area of the South West Region of Cameroon

Abstract: Introduction since December 2019, the world is experiencing, the COVID-19 pandemic caused by the Virus SARS-CoV-2. It is feared that the pandemic maybe more devastating in conflict affected areas in the world. This study assessed the knowledge, attitudes and practices with regard to the COVID-19 in Buea municipality, Cameroon. Methods this was a cross-sectional study carried out in communities selected from 5 health areas of the Buea Health District. A questionnaire was administered to collect data on the knowledge, attitudes and practices on COVID-19. The knowledge was measured using a 26-points Liker scale on awareness, mode of transmission, clinical manifestation, site of the infection and prevention. The data was analyzed in SPSS version 25. Results of the 545 particpants who consented, 21.9% had a correct knowledge of COVID-19, 43.8% had intermediate knowledge, 34.4% had poor knowledge and 11.93% had no knowledge. Majority of the participants (73.3%) knew they were at risk of contacting the infection. They were aware that cleaning and disinfecting the environment (78.8%), reducing contact with animals (56.3%) could help prevent the infection. Even though participants knew about the face mask (93.5%) and hand sanitizers (88.8%), only 21.7% and 32.9% had purchased them respectively. Few participants reported that they will go to a man of God (6.0%), native doctor (3.5%) and auto-medication (25.8%) if infected. Conclusion There is still a knowledge gap in the Buea population with respect to COVID-19. The population is aware of the disease and preventive measures, but few have taken steps to procure essential tools for the prevention. There is need to intensify sensitization to fill the knowledge gap the population has with regards to COVID-19.

Continuity of health service delivery during the COVID-19 pandemic: the role of digital health technologies in Uganda.

Abstract: In response to coronavirus disease-2019 pandemic (COVID-19), the government of Uganda instituted movement restrictions to curb disease spread. However, this affected accessibility to medical services in a setting where the healthcare system is not equipped to handle most healthcare needs of the populace outside hospital premises. This gap led to the prominence and unprecedented rise in the use of digital health technologies to deliver health information and services at a distance (telehealth) during the COVID-19 outbreak. The use of telehealth modalities including tele-consultation, tele-psychiatry, call centers and mobile phone health information dissemination increased. The COVID-19 pandemic augmented the rising role of digital health technologies as a much needed aspect of medical service delivery in our times. However, the efficacy and impact on clinical outcomes across various healthcare thematic areas need to be explored further and more evidence generated.

Current self-medication practices in the Kingdom of Saudi Arabia: an observational study.

Abstract: Introduction: medication without prescription is a growing public health concern or phenomenon worldwide. This cross-sectional study was designed to study the trends of self-medication among Saudi population. Methods: a prospective, cross-sectional study including 2004 participants was carried out from different family clinics across the Kingdom of Saudi Arabia (KSA). The clinicians used a self-designed questionnaire to collect the data, using stringent inclusion criteria and exclusion criteria. The questionnaire recorded participants' demographics and included several closed-ended and open-ended questions with options to choose from. The results were gathered, inserted into an excel spreadsheet and analyzed using SPSS version 23. The analyzed information was presented as frequencies and percentages. Results: our research showed that 924 respondents (46.1%) found it difficult to reach a hospital. Another 45.2% considered the inefficiency of health centers in providing necessary care as the main reason for self-medication. Other causes of self-medication included a lack of medical insurance, insurance not covering the costs for the drugs, and symptoms of the disease being mild enough for not going to the hospital. Analgesics were the most commonly self-administered drugs (84.58%), followed by antipyretics (71.26%), cough syrups (46.86%), eye drops (35.98%), antibiotics (35.28%), flu medication (32.83%), heartburn medication (23.15%), medicines for joint pain (15.02%), and so on. Conclusion: the majority of Saudi Arabians engage in self-medication and rely on advice from friends and family most of the time, instead of consulting a health professional.

Assessment of burnout among primary teachers in confinement during the covid-19 period in morocco: Case of the kenitra

Abstract: Introduction Confinement, because of the COVID-19 pandemic, could have problems on the mental health of the population Teachers responsible for giving distance courses during this period could be psychologically stressed The aim is to assess the magnitude results of burnout and associated factors among primary school teachers in Kenitra in Morocco during this confinement period Methods This is a cross-sectional study, which was conducted during the two months of April and May 2020 Burnout was evaluated by the Maslach Burnout Inventory MBI with 16 items, specific to the context of Moroccan teachers and the factors of stress were assessed using a questionnaire developed by the research team We used the Chi-square test to determine the association between two qualitative variables anda logistic regression for an overall statistical analysis Results The average age was 386 ± 99 years The MBI revealed that 68 teachers (54%) were victims of burnout, of which 47 (38%) had a low level; 15 (12%) had a moderate level and six (5%) had a severe burnout Logistic regression analysis has shown that the risk factors for burnout during this confinement period are: the use and development of skills in new information and communication technologies (p<0,05); work/family conflict (p<0,05); social support (p<0,05); and the workload related to distance education (p≤0,05) Conclusion In light of these results, interventions aimed at promoting mental well-being teachers during and after confinement should be implemented immediately

Knowledge, preventive behavior and risk perception regarding COVID-19: a self-reported study on college students.

Abstract: Introduction There are a limited number of studies on the issues associated with the knowledge and self-practice preventive measures for COVID-19 among medical students. We aimed to determine the extent of knowledge, self-reported preventive behavior, and risk perception of the COVID-19 outbreak among college students in Libya. Methods A cross-sectional study was conducted from April 20 to April 30, 2020. The participants were students of medical and non-medical subjects from Libyan educational institutes. Data on participants’ characteristics, knowledge, preventive behavior, and risk perception were collected. Results Approximately 3669 participants completed the questionnaire, of which 2547 (69.4) were medical students and 1122 (30.6%) were non-medical students. The mean knowledge score on COVID-19 was 8.62 (SD: 1.26, range: 0-12), corresponding to 71.8% correct answers. A significant difference was observed between medical and non-medical students in terms of knowledge (p < 0.001). Overall, the knowledge score of the students differed significantly with respect to age, current year of study, and financial source (p < 0.05). The mean score of preventive behavioral measures toward COVID-19 (out of 8) was 7.42 (SD: 0.95, range: 0-8), and the overall preventive measure score was estimated to be approximately 7.42/8*100, which corresponds to 92.7% for both medical and non-medical students. Conclusion Notably, college students were observed to have substantial knowledge, preventive behavior, and a positive attitude toward COVID-19. Government programs should aim to educate individuals from other sectors of the society to ensure the proper dissemination of knowledge on preventive safety measures, as this will help restrict and control the pandemic.

Digital technologies in the COVID-19 responses in sub-Saharan Africa: Policies, problems and promises

Abstract: The gains made five years after the adoption of the 2030 Agenda for Sustainable Development will be lost if the threats presented by the COVID-19 pandemic are not countered in a timely manner. The threat is worse in sub Saharan Africa where poverty and poor health and limited access to services present challenges to even the most robust of health systems on the continent. In light of the requisite public-private collaboration and multi-sectoral approach, digital technologies offer opportunities to support the COVID-19 responses. This commentary reviews the policy environment and the challenges presented by digital illiteracy, poor infrastructure, the high cost of installing ICT infrastructure, the volatile political environment and limited electricity supply as well as the opportunities that digital technologies provide to ensure that people and communities are still able to access goods and services. It highlights how digital technologies are being used by the governments, parliaments, judiciaries, schools, health service providers, transport authorities and marketers to reach their targeted audiences. The commentary concludes with recommendations on possible interventions that emphasize the need to address infrastructural limitations, promote public private partnerships and tackle the digital divide in all its dimensions, including from a gender and rural/urban perspective.

Population risk factors for COVID-19 deaths in Nigeria at sub-national level.

Abstract: Introduction Nigeria is the most populous country in the African continent. The aim of this study was to analyze risk factors for COVID-19 prevalence and deaths in all 6 geopolitical regions and 37 States in Nigeria. Methods we analyzed the data retrieved from various sources, including Nigeria CDC, Nigeria National Bureau of Statistics, Unicef-Nigeria multiple indicator cluster survey and the Institute of Health Metrics and Evaluation, University of Washington. We examined 4 clinical risk factors (prevalence of TB, HIV, smoking and BCG vaccination coverage) and 5 sociodemographic factors (age ≥65, population density, literacy rate, unemployment and GDP per capita). Multivariate modeling was conducted using generalized linear model. Results our analysis showed that the incidence of confirmed COVID-19 cases differed widely across the 37 States, from 0.09 per 100,000 in Kogi to 83.7 in Lagos. However, more than 70% of confirmed cases were concentrated in just 7 States: Lagos, Abuja, Oyo, Kano, Edo, Rivers and Delta. Case mortality rate (CMR) also varied considerably, with Lagos, Abuja and Edo having CMR above 9 per million population. On bivariate analysis, higher CMR correlated positively with GDP (r=0.53) and to a lesser extent with TB (r=0.36) and population density (r=0.38). On multivariate analysis, which is more definitive, States with higher HIV prevalence and BCG coverage had lower CMR, while high GDP States had a greater CMR. Conclusion this study indicates that COVID-19 has disproportionately affected certain States in Nigeria. Population susceptibility factors include higher economic development but not literacy or unemployment. Death rates were mildly lower in States with higher HIV prevalence and BCG vaccination coverage.

Guillain- Barré syndrome associated with COVID-19 infection

Abstract: We are reporting a case of Acute Post-Infectious Flaccid paralysis also commonly known as Guillain-Barre Syndrome (GBS) in a patient with confirmed COVID-19 infection. GBS often occurs following an infectious trigger which induces autoimmune reaction causing damage to peripheral nerves. So far, only 8 cases have been described in association with COVID-19. This is the first to be described in Tanzania in an African Child, and probably the first in the continent. This report is presented for clinicians to be aware and for the medical fraternity to look into this unusual presentation which may shed some more light on possible pathways of the pathogenesis and clinical manifestations. We recommend that the presentation of GBS with acute respiratory distress should warrant extra precaution and a testing for COVID-19 especially when the symptoms of COVID-19 are protean.

The barriers to initiating lung cancer care in low-and middle-income countries.

Abstract: Lung cancer in low-and middle-income countries is the leading and the second leading cause of cancer deaths in males and females, respectively. This, in part, is due to late presentation of patients in health facilities and late diagnosis, thereby compromising the effectiveness of treatment and resulting in poor treatment outcomes. Investigating patients' late presentation to health facilities and late diagnosis, as barriers to achieving good treatment outcomes, is an important step towards improving the existing pathways of care. Therefore, the aim of this paper is to critically review the published and unpublished literature, including government reports on lung cancer care, with regards to the barriers to patient access, referral, diagnosis and treatment in low-and middle-income countries. The emphasis is on access point and the primary care continuum. This review has been packaged into themes in order to efficiently inform researchers and cancer health professionals, on the existing gaps necessary for developing appropriate intervention strategies and policy guidelines. This review has revealed that the timeous and correct diagnosis of lung cancer enables lung specialists to engage on options for improved patient care. Currently, there are variations in lung cancer management in low-and middle-income countries. Many of the factors impacting on health care outcomes are a function of patient circumstances and/or understanding, leading to delays in presentation to health facilities. Factors pertaining to individual patient circumstances are further compounded by inefficiencies within the health care system. Therefore, limited health system capacities and competing health priorities in these settings require action.

The covid-19 pandemic and social distancing in nigeria: Ignorance or defiance

Abstract: The severity of the novel 2019 Coronavirus leaves much trepidation, anxiety and desperate measures are taken to curb the pandemic. Such measures according to WHO include hygiene, isolation and social distancing. If clustering of people is considered a major catalyst in the spread of corona virus, social distancing is therefore important for its control. But compliance has remained a concern, especially in Nigeria. We examine the concept and global trends in social distancing in infectious disease control and the negative feedback on public health as revealed in current body of knowledge from news media and other literatures. The risks associated with failure to comply with social distancing as a result of ignorance or defiance are highlighted.

Ninety days post-hospitalization evaluation of residual COVID-19 symptoms through a phone call check list.

Abstract: An observational and descriptive study including patients discharged for COVID-19 was carried out by the COVID-19 Working Group of the Hospital Clinico San Carlos (HCSC). We aimed to identify the main symptoms after 90 days of hospital discharged. A structured interview was conducted, through a "checklist" that included symptoms within the 90 days post-discharge. A total of 134 patients were enrolled. The most frequently referred symptoms were asthenia, dyspnea and weight loss. Anxiety was the most frequent psychological symptom found through the GAD-7 scale.

COVID-19 pandemic response fatigue in Africa: causes, consequences, and counter-measures.

Abstract: A notable decline in adherence to COVID-19 preventive measures has been observed despite the increasing number of cases following the suspension of lockdown measures. The African governments have positively responded to the COVID-19 pandemic in previous times, however presently the COVID-19 response on the African continent is in a state of fatigue. Therefore, public vigilance on COVID-19 needs to be reinvigorated through behavioral change communication via different channels of disseminating information. In addition, support systems and social protection should be established to address the COVID-19 pandemic fatigue. Also, increased funding should be made available for enhancing the COVID-19 outbreak response.

The case of pulmonary tuberculosis with COVID-19 in an Indian male-a first of its type case ever reported from south Asia

Abstract: We report the first case of tuberculosis with COVID-19 from South Asia. The patient was a 43 years old Indian male. He reported to us in the outpatient department with chief complaints of cough with expectoration associated with fever, chest pain, and night sweats. The diagnosis of tuberculosis in the current pandemic of COVID-19 required a high degree of suspicion to rule out the SARS-CoV-2 infection along with the infection of Mycobacterium tuberculosis. The clinical presentations in the two diseases are quite similar and thus the present case will serve as a tool to help the clinicians handling cases of both the viral and bacterial infection across the globe.

How prepared is Africa to face COVID-19?

Abstract: The epidemic of Coronavirus disease 2019 (COVID-19) in China caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has become a global concern and subsequently labeled a pandemic by the World Health Organization on March 11th. As the world mobilizes to contain the COVID-19, scientists and public health experts are increasingly alarmed about the potentially catastrophic effects of an outbreak in Africa. The establishment of Africa Centres for Disease Control and Prevention by the Africa Union in 2017 was an unprecedented move toward strengthening national responses, so far enabling all fifty member states with confirmed cases of COVID-19 to adequately respond, break chains of transmission and effectively contain the spread of SARS-CoV-2. We enter an uncertain and challenging period that may severely test the preparedness, organizational resource and resilience of African states and the fabric of their societies. However, we speculate that the fear associated with COVID-19 may also lead to some of the long-standing messages about simple measures to reduce the spread, such as hand washing, finally becoming absorbed and more universally adopted by health workers and the public. Is it possible that regardless of the terrible threat posed by SARS-CoV-2, the increased adoption of these health protection measures may result in a reduction in the spread of other infectious diseases?

Malaria and COVID-19: commonalities, intersections and implications for sustaining malaria control.

Abstract: The devastating impact of infectious disease outbreaks and pandemics on health systems could be overwhelming especially when there is an overlap in clinical presentations with other disease conditions. A case in point is the disruptive effect of the Ebola Virus Disease outbreak on health service delivery and its consequences for malaria management in the affected West and Central African countries between 2014 and 2016. This could be the case with the current infectious disease pandemic (COVID-19) the world is experiencing as malaria illness shares many symptoms with COVID-19 illness. Caused by a novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), COVID-19 is reported to have originated from Wuhan city, China in December 2019. COVID-19 was declared a Public Health Emergency of International Concern on 30 January 2020 and declared a pandemic on March 11, 2020 by the World Health Organization (WHO). Practically, all community infrastructure has been activated in affected countries in response to COVID-19. However, the deployment of huge resources in combating COVID-19 pandemic should not be a missed opportunity for the advancement of infectious diseases control including malaria. This calls for conscious and heightened effort to sustain the gains in malaria control. The WHO has emphasized that the response to the COVID-19 pandemic must utilize and strengthen existing infrastructure for addressing malaria and other infectious diseases globally. Leveraging these to maintain malaria control activities in endemic countries could boost and help to sustain the gains in malaria control in accordance with the 2016-2030 Global technical strategy for malaria (GTS) milestones. In addition, it will help to keep the "High burden to high impact" (HBHI) and other initiatives on track. This article highlights the commonalities of the two diseases, discusses implications and recommendations to support decision making strategies to keep malaria control on track in the COVID-19 pandemic era.

Novel coronavirus disease 2019: Knowledge, practice and preparedness: A survey of healthcare workers in the offinso-north district, Ghana

Abstract: Introduction Ever since World Health Organization declared COVID-19 as a public health emergency of international concern, Ghana is one of the most affected countries in Africa. However, the knowledge, practice, and preparedness of healthcare providers on the novel COVID-19 in the country has not been studied. This study assessed health workers’ knowledge, practice, and preparedness on the current pandemic in three Ghanaian hospitals. Methods This multi-centre cross-sectional survey recruited 261 healthcare workers in Offinso North district between April and May, 2020, through self-administered questionnaire. SPSS version 22.0 was used for the analysis and statistical significance set at p < 0.05. Results We identified that 65.1% of the healthcare providers had adequate knowledge, 27.6% of them had received appropriate in-service training, 57.5% had adequately prepared themselves and willing to care for affected patients and 63.0% were duly aware of their facility’s preparedness for the situation. Again, only 57.5% of the health workers adhered strictly to the practice of precautionary measures, and 62.5% had varying forms of misconceptions about the aetiology of the novel COVID-19. Majority (77.1%) of the respondents received regular information on the COVID-19 from the Ministry of Health, Ghana. Conclusion The overall knowledge, practice and willingness of healthcare workers to handle COVID-19 were encouraging; however, this study still elucidates the knowledge gap of the professionals on the pandemic. We advocate for progressive training of staff on COVID-19, to advance the appreciation of the risks and precautionary measures and clear the misconceptions. This, we believe, would boost the confidence and increase their willingness to deliver efficiently.

The formidable task of fighting COVID-19 in Sudan.

Abstract: Sudan is facing a formidable task of fighting COVID-19. The country is suddenly challenged by this health issue that will test its path towards peace, stability, and development. The fragile task of handling COVID-19 epidemic in Sudan is brought about by several factors such as the weak healthcare system and political conflicts, that have been intertwined with the recent regime. Even before the COVID-19 pandemic, there was already high unemployment, soaring inflation and lack of social protection and safety nets for its populace. The government has been trying its best to address the pandemic, however, much still needs to be done. Neglecting Sudan by the international community in terms of support towards containment of COVID-19 has grievous implications for transition out of military dictatorship and efforts to curb the pandemic globally. As no country is safe if all is not safe. It is essential that Sudan should leverage on innovations, country-compatible measures, and other tailor-made strategies for effective responses.

Profil clinique, biologique et radiologique des patients Algériens hospitalisés pour COVID-19: données préliminaires.

Abstract: Introduction Aucune etude anterieure n’a elabore le profil des patients Algeriens hospitalises pour COVID-19. L’objectif de cette etude etait de determiner le profil clinique, biologique et tomodensitometrique des patients Algeriens hospitalises pour COVID-19. Methodes Une etude prospective etait menee aupres des patients hospitalises pour COVID-19 (periode: 19 mars-30 avril 2020). Les donnees cliniques, biologiques et radiologiques, le type de traitement recu et la duree de l’hospitalisation etaient notes. Resultats Le profil clinique des 86 patients atteints de COVID-19 etait un homme non-fumeur, âge de 53 ans, qui etait dans 42% des cas en contact avec un cas suspect/confirme de COVID-19 et ayant une comorbidite dans 70% des cas (hypertension arterielle, diabete sucre, pathologie respiratoire chronique et allergie, cardiopathie). Les plaintes cliniques etaient dominees par la triade «asthenie-fievre-toux» dans plus de 70% des cas. Les anomalies biologiques les plus frequentes etaient: syndrome inflammatoire biologique (90,1%), basocytemie (70,8%), lymphopenie (53,3%), augmentation de la lactico-deshydrogenase (52,2%), anemie (38,7%), augmentation de la phosphokinase (28,8%) et cytolyse hepatique (27,6%). Les signes tomodensitometriques les plus frequents etaient: verre depoli (91,8%), condensations alveolaires (61,2%), verre depoli en plage (60,0%), et verre depoli nodulaire (55,3%). Un traitement a base de «chloroquine, azithromycine, zinc, vitamine C, enoxaparine, double antibiotherapie et ± corticoides» etait prescrit chez 34,9% des patients. La moyenne de la duree d’hospitalisation etait de 7±3 jours. Conclusion La connaissance des profils des formes moderees et severes du COVID-19 contribuerait a faire progresser les strategies de controle de l’infection en Algerie.

Adolescent girls, a forgotten population in resource-limited settings in the COVID-19 pandemic: implications for sexual and reproductive health outcomes.

Abstract: Adolescent sexual and reproductive health is an essential aspect that may be forgotten in the COVID-19 pandemic. Valuable insights gained from previous humanitarian crises indicate undesirable short and long-term adolescent maternal consequences in low resource settings. Young girls are at a higher risk of dropping out of school and being forced into early child marriages and high-risk jobs that predispose them to sexual exploitation and sexual and gender-based violence. Economic recessions, supply chain disruptions and reallocation of resources may limit access and utilisation of services and commodities. The COVID-19 pandemic thus indirectly exposes adolescent girls to multiplied risks of unintended pregnancies, sexually transmitted infections including HIV and Human Papilloma Virus. Sexual and gender-based violence, including female genital mutilation cases may increase as intervention programmes to avert these are disrupted, and the resultant psychosocial and socioeconomic consequences may be devastating. Thus, a pro-active approach is required to come up with frameworks to ensure the minimum initial service package for reproductive health. A multi-sectoral collaborative intersection of relevant stakeholders in adolescent sexual and reproductive health is therefore urgently desired.

Dietary habits and nutritional status of medical school students: the case of three state universities in Cameroon.

Abstract: Introduction Malnutrition is a major risk factor of cardiovascular and metabolic diseases and therefore the importance of good dietary practices and balanced diet cannot be overemphasized. University students tend to have poor eating practices which is related to nutritional status. The objective of our study was to assess the dietary practices of medical students, determine the prevalence of malnutrition among medical students and factors associated with malnutrition. Methods We carried out a cross-sectional study from December 2013 to March 2014 involving 203 consenting students in the Faculty of Medicine and Biomedical Sciences of the University of Yaounde I, Faculties of Health Sciences of the Universities of Bamenda and Buea. A three-part questionnaire (socio-demographic profile, eating practices, and anthropometric parameters). Data was analysed using SPSS 18.0. Frequencies and percentages were determined for categorical variables. Means and standard deviations (mean ± SD) were calculated for continuous variables. Fischer's exact test was used to compare the categorical variables. Statistical significance was set at p ≤ 0.05. Results Males constituted 44.3% of respondents. The mean age was 20.8 ± 1.6yrs. Most students had a monthly allowance of less than 20 000frs (34 USD) and 59.1% lived alone. Most students (49.8%) reported taking two meals a day with breakfast being the most skipped meal while supper was the meal most consumed by students. Snacking was common among these students as 40.8% admitted consuming snacks daily. Daily intake of milk, fruits, vegetable and meat were low (6.2%, 4.3%, 20.0% and 21.3% respectively). The BMI status of students was associated with gender (p=0.026). Conclusion Our findings showed a high prevalence of malnutrition of 29.4% based on BMI (underweight 4.9%, overweight 21.6% and obesity 3.0%) among second year medical students of these three state universities. Irregular meals, meal skipping, low fruit, vegetable and milk consumption, high candy, fried foods and alcohol intakes were found to be poor eating practices frequent among these students. Our findings therefore suggest the need for coordinated efforts to promote healthy eating habits among medical students in general and female medical students in particular (and by extension youths in general) as a means of curbing malnutrition among youths.