EMERGENCE OF NEW STRAINS OF SARS-COV-2: AFRICA'S FATE AND ITS PREPAREDNESS AGAINST COVID-19 INFECTION WAVES.

Background: Severe acute respiratory syndrome coronavirus-2(SARS-CoV-2) has infected over 100million individuals worldwide with diverse impacts on nations. The rising cases of new strains and resultant infection waves create an urgent need to assess the readiness of countries especially in Africa to mitigate the impact on community transmission. This paper delivers a brief synopsis of the novel SARS-CoV-2, emerging cases of new variants reported worldwide, and implications for genetic surveillance of disease transmission in low- and middle-income countries (LMICs) especially Africa. Materials and Methods: Literature search used keywords like SARS-CoV-2; COVID-19 epidemiology; pandemic waves; corona outbreak, clinical syndromes, treatments, prevention and control. Cross-sectional and observational studies published on COVID-19 from 2019 till date of study provided main information sources. Databases such as Web of Science, Embase, PubMed and Google Scholar were utilised. Main findings: Over 220 countries have documented COVID-19 cases with varied severity till date. Before the spikes in resurgence, a highly virulent mutated (>90% fatality rate) novel strain of COVID-19 had been documented. There is very little data to ascertain the impact of the COVID-19 infection waves in LMICs. Discussion: LMICs especially African countries still grapple with significant challenges like inefficient surveillance mechanisms, inadequate vaccination coverage, inadequate enforcement of environmental health strategies, poor health systems etc. Hence, Africa's fate remains dicey in the face of the dynamic evolution of the SARS-CoV-2 and other identified challenges. Conclusion: The adoption of a multidisciplinary approach to mitigate the impact of emergence of mutant SARS-CoV-2 variants and resurgence of infection spike is recommended.

COVID-19 and Nigeria: putting the realities in context.

BACKGROUND: Coronavirus disease 2019 (COVID-19), which was previously known as 2019-novel coronavirus (2019-nCoV), was first reported in Wuhan, China in December 2019. The disease evolved into a serious global emergency, leading to its declaration as a pandemic. DISCUSSION: On the African continent, Nigeria is just experiencing the direct effects of this pandemic, having recorded her index case in February 2020, with an increasing number of cases every day and a current case fatality ratio of 0.03 as at 13 April 2020. Although the recorded cases may seem low, it has been forecast that Africa will have some of the worst effects of this disease by the end of the pandemic. Generally, African countries have fragile health systems and this remains a source of concern, especially in the event of increased outbreaks. Nigeria's current national health systems cannot effectively respond to the growing needs of already infected patients requiring admission into intensive care units for acute respiratory diseases and severe acute respiratory syndrome (SARS COV-2) pneumonia. This has grim implications for Nigeria, especially as increased cases loom that may require critical care. Provision of quarantine or isolation facilities and availability of rapid diagnostic kits for fast and reliable testing and diagnosis of the disease can also be a challenge in Africa. CONCLUSION: There is an urgent need to put into perspective these realities peculiar to Africa including Nigeria and explore available collective measures and interventions to address the COVID-19 pandemic.

COVID-19 pandemic and civil unrests in Africa: implication of recent #EndSARS protests for increased community transmission in Nigeria.

The recent Coronavirus disease (COVID-19) caused by the novel strain of coronavirus (SARS-CoV-2 virus) has become a worldwide public health crisis with associated high mortality rates globally. Human to human transmission of the infection emphasizes the importance of adhering to public and social measure to halt its spread. However, the recent #ENDSARS protests led by angry youths in Nigeria resulted to complete flouting of all WHO guidelines meted to curb the spread of the virus. Given that the nation is the most populous African country with over 50 percent of her population been youths, this situation has huge implications for the country and Africa as a whole. The risk of community transmission occasioned by the protest, coupled with travels and active mobility across countries within the continent increases the risk of community transmission with possible increases in new cases over the next few weeks to months. From the foregoing, it is expedient to increase awareness and enforcement of the use of personal protective equipment especially use of nose masks, face shields and frequent hand washing or sanitizing in public places. These individual-targeted measures will go a long way to curtail the imminent community transmission of COVID-19 across Nigeria. It is therefore recommended that Government and non-governmental agencies across the region actively engage to increase collaborative efforts; screening facilities and access to these services across the country, as well as accentuate regular adherence to preventive measures to the general public.

Treatment outcome of tuberculosis patients under directly observed treatment short course and its determinants in Shangla, Khyber-Pakhtunkhwa, Pakistan: A retrospective study.

BACKGROUND: Tuberculosis (TB) is one of the leading causes of morbidity and mortality in Pakistan. Assessment of TB treatment outcomes, monitoring and evaluation of its risk factors in Directly Observed Treatment Short Course (DOTS) are among the major indicators of the performance of a national TB control program. Even though Pakistan ranks 5th among the 22 high-TB burden countries, there are no available data in this regard. METHODS: Institution-based retrospective study was conducted to determine the treatment outcome of TB patients and investigate associated risk factors at District Head Quarter Hospital Shangla, Khyber-Pakhtunkhwa, Pakistan. Two-year record (January 2011 to December 2012) of TB clinic of the hospital was reviewed. A total of 493 patients' complete information was reviewed in the study period. RESULTS: Of these, 42.19% were smear-positive pulmonary TB (PTB), 35.09% were smear-negative PTB, and 22.72% were extra-PTB (EPTB). The overall prevalence of smear-positive PTB was 42.19% (95% confidence interval [CI]: 37.9-46.2). Records of the treatment outcome showed that 192 (38.94%) were cured, 276 (55.98%) completed treatment, 13 (2.6%) defaulted, 9 (1.8%) died, 1 (0.2%) treatment failure, and 1 (0.2%) had transferred to other facilities. The overall mean treatment success rate of the TB patients was 94.93%. TB age and TB form or baseline smear were significantly associated with unsuccessful treatment outcome. The risk of unsuccessful outcome was significantly lower among TB patients age Conclusion: The treatment success rate was high and match the World Health Organization criteria. To sustain the effective implementation of DOTS in the area, effective management, and diagnosis should be given for EPTB.