Incorporating COVID-19 into Acute Febrile Illness Surveillance Systems, Belize, Kenya, Ethiopia, Peru, and Liberia, 2020-2021.

Existing acute febrile illness (AFI) surveillance systems can be leveraged to identify and characterize emerging pathogens, such as SARS-CoV-2, which causes COVID-19. The US Centers for Disease Control and Prevention collaborated with ministries of health and implementing partners in Belize, Ethiopia, Kenya, Liberia, and Peru to adapt AFI surveillance systems to generate COVID-19 response information. Staff at sentinel sites collected epidemiologic data from persons meeting AFI criteria and specimens for SARS-CoV-2 testing. A total of 5,501 patients with AFI were enrolled during March 2020-October 2021; >69% underwent SARS-CoV-2 testing. Percentage positivity for SARS-CoV-2 ranged from 4% (87/2,151, Kenya) to 19% (22/115, Ethiopia). We show SARS-CoV-2 testing was successfully integrated into AFI surveillance in 5 low- to middle-income countries to detect COVID-19 within AFI care-seeking populations. AFI surveillance systems can be used to build capacity to detect and respond to both emerging and endemic infectious disease threats.

Unsafe abortion - A Risk factor for maternal mortality in Liberia - An analysis of the characteristics of unsafe abortion clients and risk factors for maternal morbidity and mortality.

Worldwide, an estimated 68,000 women die yearly due to unsafe abortion practices. In Liberia, the maternal mortality ratio is 1072 deaths per 100,000 live births. However, there has not been a study conducted to understand the relationship between unsafe abortion and maternal mortality. We conducted a retrospective cohort study at three county hospitals and assessed obstetric data gathered using a defined questionnaire in 2016 - 2018, from maternal-child health units. The results of the study suggest a strong association between unsafe abortion and maternal morbidity and mortality and also provide insight into the characteristics and factors that put women and girls who have unsafe abortions at risk. The results can inform programs and policies on age disaggregation of women and girls who choose abortion. The variation in the association between unsafe abortion and the risk factors, have implications for maternal morbidity and mortality.