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1.
BMC Ophthalmol ; 21(1): 272, 2021 Jul 09.
Artículo en Inglés | MEDLINE | ID: mdl-34243759

RESUMEN

BACKGROUND: This report describes the design and methodology of the "Eyes of Africa: The Genetics of Blindness," a collaborative study funded through the Human Heredity and Health in Africa (H3Africa) program of the National Institute of Health. METHODS: This is a case control study that is collecting a large well phenotyped data set among glaucoma patients and controls for a genome wide association study. (GWAS). Multiplex families segregating Mendelian forms of early-onset glaucoma will also be collected for exome sequencing. DISCUSSION: A total of 4500 cases/controls have been recruited into the study at the end of the 3rd funded year of the study. All these participants have been appropriately phenotyped and blood samples have been received from these participants. Recent GWAS of POAG in African individuals demonstrated genome-wide significant association with the APBB2 locus which is an association that is unique to individuals of African ancestry. This study will add to the existing knowledge and understanding of POAG in the African population.


Asunto(s)
Estudio de Asociación del Genoma Completo , Glaucoma de Ángulo Abierto , Proteínas Adaptadoras Transductoras de Señales , África/epidemiología , Ceguera/epidemiología , Ceguera/genética , Estudios de Casos y Controles , Predisposición Genética a la Enfermedad , Humanos
4.
Viruses ; 13(5)2021 05 18.
Artículo en Inglés | MEDLINE | ID: mdl-34070175

RESUMEN

The ongoing coronavirus disease 2019 (COVID-19) pandemic has had devastating health and socio-economic impacts. Human activities, especially at the wildlife interphase, are at the core of forces driving the emergence of new viral agents. Global surveillance activities have identified bats as the natural hosts of diverse coronaviruses, with other domestic and wildlife animal species possibly acting as intermediate or spillover hosts. The African continent is confronted by several factors that challenge prevention and response to novel disease emergences, such as high species diversity, inadequate health systems, and drastic social and ecosystem changes. We reviewed published animal coronavirus surveillance studies conducted in Africa, specifically summarizing surveillance approaches, species numbers tested, and findings. Far more surveillance has been initiated among bat populations than other wildlife and domestic animals, with nearly 26,000 bat individuals tested. Though coronaviruses have been identified from approximately 7% of the total bats tested, surveillance among other animals identified coronaviruses in less than 1%. In addition to a large undescribed diversity, sequences related to four of the seven human coronaviruses have been reported from African bats. The review highlights research gaps and the disparity in surveillance efforts between different animal groups (particularly potential spillover hosts) and concludes with proposed strategies for improved future biosurveillance.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Monitoreo Epidemiológico/veterinaria , África/epidemiología , Animales , Animales Salvajes/virología , COVID-19/epidemiología , Quirópteros/virología , Coronaviridae/genética , Coronavirus/patogenicidad , Ecosistema , Variación Genética , Genoma Viral , Pandemias , Filogenia , SARS-CoV-2/patogenicidad , Glicoproteína de la Espiga del Coronavirus/genética
7.
Viruses ; 13(5)2021 05 18.
Artículo en Inglés | MEDLINE | ID: covidwho-1234835

RESUMEN

The ongoing coronavirus disease 2019 (COVID-19) pandemic has had devastating health and socio-economic impacts. Human activities, especially at the wildlife interphase, are at the core of forces driving the emergence of new viral agents. Global surveillance activities have identified bats as the natural hosts of diverse coronaviruses, with other domestic and wildlife animal species possibly acting as intermediate or spillover hosts. The African continent is confronted by several factors that challenge prevention and response to novel disease emergences, such as high species diversity, inadequate health systems, and drastic social and ecosystem changes. We reviewed published animal coronavirus surveillance studies conducted in Africa, specifically summarizing surveillance approaches, species numbers tested, and findings. Far more surveillance has been initiated among bat populations than other wildlife and domestic animals, with nearly 26,000 bat individuals tested. Though coronaviruses have been identified from approximately 7% of the total bats tested, surveillance among other animals identified coronaviruses in less than 1%. In addition to a large undescribed diversity, sequences related to four of the seven human coronaviruses have been reported from African bats. The review highlights research gaps and the disparity in surveillance efforts between different animal groups (particularly potential spillover hosts) and concludes with proposed strategies for improved future biosurveillance.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Monitoreo Epidemiológico/veterinaria , África/epidemiología , Animales , Animales Salvajes/virología , COVID-19/epidemiología , Quirópteros/virología , Coronaviridae/genética , Coronavirus/patogenicidad , Ecosistema , Variación Genética , Genoma Viral , Pandemias , Filogenia , SARS-CoV-2/patogenicidad , Glicoproteína de la Espiga del Coronavirus/genética
8.
Pan Afr Med J ; 38: 303, 2021.
Artículo en Inglés | MEDLINE | ID: covidwho-1259743

RESUMEN

As of March 11, 2021, 3,992,044 coronavirus disease 2019 (COVID-19) cases and 106,615 deaths (case fatality rate 2.67%) have been reported on the African continent. In March 2020, even before the first case of COVID-19 was registered, some African countries implemented total lockdown measures, which limited movement of people, banned mass gatherings, and closed schools and borders. However, these control measures, which affect individuals and society's well-being, cannot be implemented for a long time. There is an urgent need for a robust framework to guide African countries to make evidence-based decisions on easing these restrictive measures and reapply them when the infection rates increase significantly. This article presents a proposed framework to guide lockdown easing while limiting the community spread of COVID-19 in Africa. Due to lack of information on the impact of relaxing restrictions on peoples' movement on the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, the causative agent for COVID-19) and how businesses will respond, it is almost clear that there is no single grand lockdown exit strategy. African governments should develop flexible, iterative lockdown exit plans based on epidemiological disease data, economic indicators, and peoples' views to inform decisions, all of which are paramount for success. A phased approach of changes and willingness to adapt methods will allow governments to minimize the pandemic's adverse impact and respond accordingly as new control tools become available.


Asunto(s)
COVID-19/prevención & control , Control de Enfermedades Transmisibles/métodos , Cuarentena , África/epidemiología , COVID-19/epidemiología , COVID-19/transmisión , Humanos
9.
BMJ Glob Health ; 6(6)2021 06.
Artículo en Inglés | MEDLINE | ID: covidwho-1259005

RESUMEN

Healthcare workers (HCWs) are at increased risk of infection from SARS-CoV-2 and other disease pathogens, which take a disproportionate toll on HCWs, with substantial cost to health systems. Improved infection prevention and control (IPC) programmes can protect HCWs, especially in resource-limited settings where the health workforce is scarcest, and ensure patient safety and continuity of essential health services. In response to the COVID-19 pandemic, we collaborated with ministries of health and development partners to implement an emergency initiative for HCWs at the primary health facility level in 22 African countries. Between April 2020 and January 2021, the initiative trained 42 058 front-line HCWs from 8444 health facilities, supported longitudinal supervision and monitoring visits guided by a standardised monitoring tool, and provided resources including personal protective equipment (PPE). We documented significant short-term improvements in IPC performance, but gaps remain. Suspected HCW infections peaked at 41.5% among HCWs screened at monitored facilities in July 2020 during the first wave of the pandemic in Africa. Disease-specific emergency responses are not the optimal approach. Comprehensive, sustainable IPC programmes are needed. IPC needs to be incorporated into all HCW training programmes and combined with supportive supervision and mentorship. Strengthened data systems on IPC are needed to guide improvements at the health facility level and to inform policy development at the national level, along with investments in infrastructure and sustainable supplies of PPE. Multimodal strategies to improve IPC are critical to make health facilities safer and to protect HCWs and the communities they serve.


Asunto(s)
COVID-19 , Personal de Salud , Transmisión de Enfermedad Infecciosa de Paciente a Profesional , Pandemias , Atención Primaria de Salud , África/epidemiología , COVID-19/epidemiología , COVID-19/prevención & control , COVID-19/transmisión , Humanos , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/prevención & control , Atención Primaria de Salud/organización & administración
10.
Elife ; 102021 06 24.
Artículo en Inglés | MEDLINE | ID: mdl-34165077

RESUMEN

Background: Childhood immunisation services have been disrupted by the COVID-19 pandemic. WHO recommends considering outbreak risk using epidemiological criteria when deciding whether to conduct preventive vaccination campaigns during the pandemic. Methods: We used two to three models per infection to estimate the health impact of 50% reduced routine vaccination coverage in 2020 and delay of campaign vaccination from 2020 to 2021 for measles vaccination in Bangladesh, Chad, Ethiopia, Kenya, Nigeria, and South Sudan, for meningococcal A vaccination in Burkina Faso, Chad, Niger, and Nigeria, and for yellow fever vaccination in the Democratic Republic of Congo, Ghana, and Nigeria. Our counterfactual comparative scenario was sustaining immunisation services at coverage projections made prior to COVID-19 (i.e. without any disruption). Results: Reduced routine vaccination coverage in 2020 without catch-up vaccination may lead to an increase in measles and yellow fever disease burden in the modelled countries. Delaying planned campaigns in Ethiopia and Nigeria by a year may significantly increase the risk of measles outbreaks (both countries did complete their supplementary immunisation activities (SIAs) planned for 2020). For yellow fever vaccination, delay in campaigns leads to a potential disease burden rise of >1 death per 100,000 people per year until the campaigns are implemented. For meningococcal A vaccination, short-term disruptions in 2020 are unlikely to have a significant impact due to the persistence of direct and indirect benefits from past introductory campaigns of the 1- to 29-year-old population, bolstered by inclusion of the vaccine into the routine immunisation schedule accompanied by further catch-up campaigns. Conclusions: The impact of COVID-19-related disruption to vaccination programs varies between infections and countries. Planning and implementation of campaigns should consider country and infection-specific epidemiological factors and local immunity gaps worsened by the COVID-19 pandemic when prioritising vaccines and strategies for catch-up vaccination. Funding: Bill and Melinda Gates Foundation and Gavi, the Vaccine Alliance.


Asunto(s)
COVID-19/epidemiología , Programas de Inmunización/estadística & datos numéricos , Sarampión/prevención & control , Infecciones Meningocócicas/prevención & control , Fiebre Amarilla/prevención & control , Adolescente , Adulto , África/epidemiología , Bangladesh/epidemiología , Niño , Preescolar , Brotes de Enfermedades , Humanos , Programas de Inmunización/métodos , Lactante , Sarampión/epidemiología , Vacuna Antisarampión/uso terapéutico , Infecciones Meningocócicas/epidemiología , Vacunas Meningococicas/uso terapéutico , Pandemias , Medición de Riesgo , SARS-CoV-2 , Vacunación/estadística & datos numéricos , Fiebre Amarilla/epidemiología , Vacuna contra la Fiebre Amarilla/uso terapéutico , Adulto Joven
11.
Proc Natl Acad Sci U S A ; 118(28)2021 07 13.
Artículo en Inglés | MEDLINE | ID: mdl-34187879

RESUMEN

The coronavirus disease 2019 (COVID-19) pandemic is heterogeneous throughout Africa and threatening millions of lives. Surveillance and short-term modeling forecasts are critical to provide timely information for decisions on control strategies. We created a strategy that helps predict the country-level case occurrences based on cases within or external to a country throughout the entire African continent, parameterized by socioeconomic and geoeconomic variations and the lagged effects of social policy and meteorological history. We observed the effect of the Human Development Index, containment policies, testing capacity, specific humidity, temperature, and landlocked status of countries on the local within-country and external between-country transmission. One-week forecasts of case numbers from the model were driven by the quality of the reported data. Seeking equitable behavioral and social interventions, balanced with coordinated country-specific strategies in infection suppression, should be a continental priority to control the COVID-19 pandemic in Africa.


Asunto(s)
COVID-19/epidemiología , COVID-19/transmisión , África/epidemiología , COVID-19/diagnóstico , COVID-19/prevención & control , Predicción , Humanos , Modelos Estadísticos , Política Pública , SARS-CoV-2/aislamiento & purificación , Tiempo (Meteorología)
12.
Proc Natl Acad Sci U S A ; 118(28)2021 07 13.
Artículo en Inglés | MEDLINE | ID: covidwho-1287856

RESUMEN

The coronavirus disease 2019 (COVID-19) pandemic is heterogeneous throughout Africa and threatening millions of lives. Surveillance and short-term modeling forecasts are critical to provide timely information for decisions on control strategies. We created a strategy that helps predict the country-level case occurrences based on cases within or external to a country throughout the entire African continent, parameterized by socioeconomic and geoeconomic variations and the lagged effects of social policy and meteorological history. We observed the effect of the Human Development Index, containment policies, testing capacity, specific humidity, temperature, and landlocked status of countries on the local within-country and external between-country transmission. One-week forecasts of case numbers from the model were driven by the quality of the reported data. Seeking equitable behavioral and social interventions, balanced with coordinated country-specific strategies in infection suppression, should be a continental priority to control the COVID-19 pandemic in Africa.


Asunto(s)
COVID-19/epidemiología , COVID-19/transmisión , África/epidemiología , COVID-19/diagnóstico , COVID-19/prevención & control , Predicción , Humanos , Modelos Estadísticos , Política Pública , SARS-CoV-2/aislamiento & purificación , Tiempo (Meteorología)
15.
BMJ Glob Health ; 6(6)2021 06.
Artículo en Inglés | MEDLINE | ID: mdl-34083244

RESUMEN

Healthcare workers (HCWs) are at increased risk of infection from SARS-CoV-2 and other disease pathogens, which take a disproportionate toll on HCWs, with substantial cost to health systems. Improved infection prevention and control (IPC) programmes can protect HCWs, especially in resource-limited settings where the health workforce is scarcest, and ensure patient safety and continuity of essential health services. In response to the COVID-19 pandemic, we collaborated with ministries of health and development partners to implement an emergency initiative for HCWs at the primary health facility level in 22 African countries. Between April 2020 and January 2021, the initiative trained 42 058 front-line HCWs from 8444 health facilities, supported longitudinal supervision and monitoring visits guided by a standardised monitoring tool, and provided resources including personal protective equipment (PPE). We documented significant short-term improvements in IPC performance, but gaps remain. Suspected HCW infections peaked at 41.5% among HCWs screened at monitored facilities in July 2020 during the first wave of the pandemic in Africa. Disease-specific emergency responses are not the optimal approach. Comprehensive, sustainable IPC programmes are needed. IPC needs to be incorporated into all HCW training programmes and combined with supportive supervision and mentorship. Strengthened data systems on IPC are needed to guide improvements at the health facility level and to inform policy development at the national level, along with investments in infrastructure and sustainable supplies of PPE. Multimodal strategies to improve IPC are critical to make health facilities safer and to protect HCWs and the communities they serve.


Asunto(s)
COVID-19 , Personal de Salud , Transmisión de Enfermedad Infecciosa de Paciente a Profesional , Pandemias , Atención Primaria de Salud , África/epidemiología , COVID-19/epidemiología , COVID-19/prevención & control , COVID-19/transmisión , Humanos , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/prevención & control , Atención Primaria de Salud/organización & administración
17.
J Pak Med Assoc ; 71(4): 1200-1205, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-34125772

RESUMEN

OBJECTIVE: To determine the prevalence rate of diabetes mellitus among active tuberculosis patients, and to assess the impact of age in this regard. METHODS: The meta-analysis comprised studies conducted in Asian and African countries from 2012 to 2018. Data was extracted from the selected studies and was analyzed using the Meta extension of Excel. Comprised studies conducted in Asian and African countries from 2012 to 2018. Data was extracted from the selected studies and was analyzed using the Meta extension of Excel. RESULTS: Of the 200 studies reviewed, 15(7.5%) were selected for further analyses. The selected studies involved a total of 28,055 patients. Of the selected studies, 8(53%) were from Asia and 7(47%) were from Africa. The overall pooled prevalence of diabetes among tuberculosis patients was 26% (95% confidence interval: 14.62 to 35.34). Age had a significant negative effect on the prevalence rate (95% confidence interval: -0.634 to 4.179). CONCLUSIONS: Diabetes was found to be widely spreading among Asian and African people, and age was found to be a significant negative factor.


Asunto(s)
Diabetes Mellitus , Tuberculosis , África/epidemiología , Asia/epidemiología , Diabetes Mellitus/epidemiología , Humanos , Prevalencia , Tuberculosis/epidemiología
18.
Pan Afr Med J ; 38: 303, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34178221

RESUMEN

As of March 11, 2021, 3,992,044 coronavirus disease 2019 (COVID-19) cases and 106,615 deaths (case fatality rate 2.67%) have been reported on the African continent. In March 2020, even before the first case of COVID-19 was registered, some African countries implemented total lockdown measures, which limited movement of people, banned mass gatherings, and closed schools and borders. However, these control measures, which affect individuals and society's well-being, cannot be implemented for a long time. There is an urgent need for a robust framework to guide African countries to make evidence-based decisions on easing these restrictive measures and reapply them when the infection rates increase significantly. This article presents a proposed framework to guide lockdown easing while limiting the community spread of COVID-19 in Africa. Due to lack of information on the impact of relaxing restrictions on peoples' movement on the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, the causative agent for COVID-19) and how businesses will respond, it is almost clear that there is no single grand lockdown exit strategy. African governments should develop flexible, iterative lockdown exit plans based on epidemiological disease data, economic indicators, and peoples' views to inform decisions, all of which are paramount for success. A phased approach of changes and willingness to adapt methods will allow governments to minimize the pandemic's adverse impact and respond accordingly as new control tools become available.


Asunto(s)
COVID-19/prevención & control , Control de Enfermedades Transmisibles/métodos , Cuarentena , África/epidemiología , COVID-19/epidemiología , COVID-19/transmisión , Humanos
19.
J Glob Health ; 11: 04031, 2021 May 29.
Artículo en Inglés | MEDLINE | ID: mdl-34131486

RESUMEN

Background: This review assessed the case definitions, diagnostic criteria, antimicrobial resistance, and methods used for enteric fever outbreaks and utilization of any unified outbreak score or checklist for early identification and response in Asia and Africa from 1965-2019. Methods: We searched enteric fever outbreaks using PubMed, Google Scholar, and the Cochrane library. Studies describing a single outbreak event of enteric fever in Asia and Africa from 1965-2019 were reviewed. We excluded case reports, letter to editors, studies reporting typhoid in conjunction with other diseases, the Centers for Disease Control and Prevention (CDC) trip reports, the World Health Organization (WHO) bulletins report, data from mathematical modeling and simulation studies, reviews and ProMed alert. Also, non-typhoidal salmonella outbreaks were excluded. Results: A total of 5063 articles were identified using the key terms and 68 studies were selected for data extraction. Most (48, 71%) outbreaks were from Asian countries, 20 (29%) were reported from Africa. Only 15 studies reported the case definition used for case identification during an outbreak and 8 of those were from Asia. A third (20, 29%) of the studies described antibiotic resistance pattern. 43 (63%) studies contained information regarding the source of the outbreak. Outcomes (hospitalization and deaths) were reported in a quarter of studies. Only 23 (29%) of the studies reported outbreak control strategies while none reported any unified outbreak score or a checklist to identify the outbreak. Conclusion: This review highlights the variability in detection and reporting methods for enteric fever outbreaks in Asia and Africa. No standardized case definitions or laboratory methods were reported. Only a few studies reported strategies for outbreak control. There is a need for the development of a unified outbreak score or a checklist to identify and report enteric fever outbreaks globally.


Asunto(s)
Brotes de Enfermedades , Fiebre Tifoidea/diagnóstico , Fiebre Tifoidea/epidemiología , África/epidemiología , Asia/epidemiología , Humanos
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