[Study analysis evaluating the management and epidemiological aspects of the COVID-19 pandemic in Senegal one year on]. / Analyse de la gestion et des aspects épidémiologiques de l'épidémie COVID-19 au Sénégal à un an d'évolution.

Introduction: after a year of evolution, the COVID-19 pandemic continues to be a burden. The African continent has not had the high case and death rates from COVID-19 as was predicted early in the pandemic. However, coronavirus is placing severe strains on Africa´s health and economic sectors. Senegal, like other African countries, continues to face this pandemic. The purpose of this study is to evaluate the management strategy and the epidemiological profile of the pandemic in Senegal one year on. Methods: we listed all patients who tested positive for COVID-19 by RT-PCR throughout the country during the first year of the pandemic, from 2 March 2020 (first case date) to 1st March 2021. Epidemiological data were analysed. Results: a total of 34,732 positive cases were diagnosed and recorded in one year, with a case-fatality rate of 2.5%. All the country´s administrative regions had been affected. Dakar, the capital, was the epicentre of the pandemic. Male predominance was established on the basis of the number of positive cases and deaths. The average age of subjects was 47 years and the cure rate was 83.5%. People over 60 were the most vulnerable, particularly those with cardiovascular co-morbidities. Conclusion: Senegal´s strategy for managing COVID-19 has received international recognition. It has been dynamic, drawing on experience from previous management of public health events such as Ebola. The COVID-19 pandemic has put a strain on our fragile health systems. However, the response and the results achieved highlight the significant progress made by our country, helping to ensure the resilience of the health system.

First wave COVID-19 pandemic in Senegal: Epidemiological and clinical characteristics.

BACKGROUND: The novel coronavirus disease 2019 (COVID-19) pandemic has spread from China to the rest of the world. Africa seems less impacted with lower number of cases and deaths than other continents. Senegal recorded its first case on March 2, 2020. We present here data collected from March 2 to October 31, 2020 in Senegal. METHODS: Socio-demographic, epidemiological, clinical and virological information were collected on suspected cases. To determine factors associated with diagnosed infection, symptomatic disease and death, multivariable binary logistic regression and log binomial models were used. Epidemiological parameters such as the reproduction number and growth rate were estimated. RESULTS: 67,608 suspected cases were tested by the IPD laboratories (13,031 positive and 54,577 negative). All age categories were associated with SARS-CoV-2 infection, but also patients having diabetes or hypertension or other cardiovascular diseases. With diagnosed infection, patients over 65 years and those with hypertension and cardiovascular disease and diabetes were highly associated with death. Patients with co-morbidities were associated with symptomatic disease, but only the under 15 years were not associated with. Among infected, 27.67% were asymptomatic (40.9% when contacts were systematically tested; 12.11% when only symptomatic or high-risk contacts were tested). Less than 15 years-old were mostly asymptomatic (63.2%). Dakar accounted for 81.4% of confirmed cases. The estimated mean serial interval was 5.57 (± 5.14) days. The average reproduction number was estimated at 1.161 (95%CI: 1.159-1.162), the growth rate was 0.031 (95%CI: 0.028-0.034) per day. CONCLUSIONS: Our findings indicated that factors associated with symptomatic COVID-19 and death are advanced age (over 65 years-old) and comorbidities such as diabetes and hypertension and cardiovascular disease.

Multifoci and multiserotypes circulation of dengue virus in Senegal between 2017 and 2018.

BACKGROUND: Dengue fever is a mosquito born disease associated with self-limited to life threatening illness. First detected in Senegal in the nineteenth century, and despite its growing incidence this last decade, significant knowledge gaps exist in our knowledge of genetic diversity of circulating strains. This study highlights the circulating serotypes and genotypes between January 2017 and December 2018 and their spatial and temporal distribution throughout all regions of Senegal. METHODS: We used 56 dengue virus (DENV) strains for the analysis collected from 11 sampling areas: 39 from all regions of Senegal, and 17 isolates from Thiès, a particular area of the country. Two real time RT-qPCR systems were used to confirm dengue infection and corresponding serotypes. For molecular characterization, CprM gene was sequenced and submitted to phylogenetic analysis for serotypes and genotypes assignment. RESULTS: Three dengue virus serotypes (DENV-1-3) were detected by all used methods. DENV-3 was detected in 50% (28/56) of the isolates, followed by DENV-1 and DENV-2, each representing 25% (14/56) of the isolates. DENV-3 belongs to genotype III, DENV-1 to genotype V and DENV-2 to Cosmopolitan genotype. Serotype 3 was detected in 7 sampling locations and a co-circulation of different serotypes was observed in Thiès, Fatick and Richard-toll. CONCLUSIONS: These results emphasize the need of continuous DENV surveillance in Senegal to detect DENV cases, to define circulating serotypes/genotypes and to prevent the spread and the occurrence of severe cases.

Field Deployment of a Mobile Biosafety Laboratory Reveals the Co-Circulation of Dengue Viruses Serotype 1 and Serotype 2 in Louga City, Senegal, 2017.

Dengue virus (DENV) is the most prevalent arboviral threat worldwide. This virus belonging to genus Flavivirus, Flaviviridae family, is responsible for a wide spectrum of clinical manifestations, ranging from asymptomatic or mild febrile illness (dengue fever) to life-threatening infections (severe dengue). Many sporadic cases and outbreaks have occurred in Senegal since 1970. Nevertheless, this article describes a field investigation of suspected dengue cases, between 05 September 2017 and 17 December 2017 made possible by the deployment of a Mobile Biosafety Laboratory (MBS-Lab). Overall, 960 human sera were collected and tested in the field for the presence of viral RNA by real-time RT-PCR. Serotyping, sequencing of complete E gene, and phylogenetic analysis were also performed. Out of 960 suspected cases, 131 were confirmed dengue cases. The majority of confirmed cases were from Louga community. Serotyping revealed two serotypes, Dengue 1 (100/104; 96, 15%) and Dengue 2 (04/104; 3, 84%). Phylogenetic analysis of the sequences obtained indicated that the Dengue 1 strain was closely related to strains isolated, respectively, in Singapore (Asia) in 2013 (KX380803.1) outbreak and it cocirculated with a Dengue 2 strain closely related to strains from a Burkina Faso dengue outbreak in 2016 (KY62776.1). Our results showed the co-circulation of two dengue virus serotypes during a single outbreak in a short time period. This co-circulation highlighted the need to improve surveillance in order to prevent future potential severe dengue cases through antibody-dependent enhancement (ADE). Interestingly, it also proved the reliability and usefulness of the MBS-Lab for expedient outbreak response at the point of need, which allows early cases management.

Detection of Crimean Congo haemorrhagic fever virus in North-eastern Senegal, Bokidiawé 2019.

We diagnosed a human case of Crimean Congo hemorrhagic fever (CCHF) in Bokidiawe (North-eastern Senegal), 2019. The phylogenetic analysis revealed that the isolate belongs to genotype III and is closely related to a strain reported in Mauritania in 1984 and Spain in 2016. Distribution area of CCHF in Senegal is progressively increasing.

COVID-19 Outbreak, Senegal, 2020.

The spread of severe acute respiratory syndrome coronavirus 2 began later in Africa than in Asia and Europe. Senegal confirmed its first case of coronavirus disease on March 2, 2020. By March 4, a total of 4 cases had been confirmed, all in patients who traveled from Europe.

Field evaluation of a mobile biosafety laboratory in Senegal to strengthen rapid disease outbreak response and monitoring.

BACKGROUND: Past and recent outbreaks have highlighted the vulnerability of humans to infectious diseases, which represent serious economic and health security threats. A paradigm shift in the management of sanitary crises is urgently needed. Based on lessons from the 2014 Ebola outbreak, the Praesens Foundation has developed an all-terrain mobile biosafety laboratory (MBS-Lab) for effective field diagnostics capabilities. OBJECTIVE: The aim of the study was to train African teams and run a field evaluation of the MBS-Lab, including robustness, technical and operational sustainability, biosafety, connectivity, turn-around times for testing and result delivery. METHODS: The MBS-Lab was deployed in Senegal in October 2017 for a six-month field assessment under various ecological conditions and was mobilised during the dengue outbreaks in 2017 and 2018. RESULTS: The MBS-Lab can be considered an off-grid solution that addresses field challenges with regard to working conditions, mobility, deployment, environment and personnel safety. Blood (n = 398) and nasal swab (n = 113) samples were collected from 460 study participants for molecular screening for acute febrile illnesses and respiratory infections. The results showed that malaria (particularly in Kédougou) and upper respiratory tract infections remain problematic. Suspected dengue samples were tested on board during the dengue outbreaks in 2017 (882 tests; 128 confirmed cases) and 2018 (1736 tests; 202 confirmed cases). CONCLUSION: The MBS-Lab is an innovative solution for outbreak response, even in remote areas. The study demonstrated successful local ownership and community engagement. The MBS-Lab can also be considered an open mobile healthcare platform that offers various opportunities for field-deployable, point-of-care technologies for surveillance programmes.

Health emergency operation centers implementation challenges in Africa.

The African continent faced to many public health events. An effective organization is the key element for managing public health events. Health Emergency Operations Centers (HEOC) are strategic bodies that can help control such situations. We would like to share our experience about the HEOC implementation in Senegal, which is among the first in Africa while highlighting the challenges we have the HEOC concept is quite common in other continents, it is an innovation in Africa. And yet, Africa is the most affected by emergency situations and disasters and very few of its country possess HEOC. Consequently, emergency and disaster management interventions are done in a nonsystematic manner. The comprehension of the concept, the mission and organization need to be well understood for setting up a HEOC the added value of HEOC is great for African country to face public health events.

Health emergency operation centers implementation challenges in Africa

The African continent faced to many public health events. An effective organization is the key element for managing public health events. Health Emergency Operations Centers (HEOC) are strategic bodies that can help control such situations. We would like to share our experience about the HEOC implementation in Senegal, which is among the first in Africa while highlighting the challenges we have the HEOC concept is quite common in other continents, it is an innovation in Africa. And yet, Africa is the most affected by emergency situations and disasters and very few of its country possess HEOC. Consequently, emergency and disaster management interventions are done in a nonsystematic manner. The comprehension of the concept, the mission and organization need to be well understood for setting up a HEOC the added value of HEOC is great for African country to face public health events