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1.
Ann Glob Health ; 86(1): 104, 2020 08 19.
Artículo en Inglés | MEDLINE | ID: mdl-32874935

RESUMEN

Despite predictions that the number of deaths in Africa due to COVID-19 will reach 10 million, overall, the continent has reported relatively few cases compared to the rest of the world. Many African countries have been successful in containing initial outbreaks by rapidly using evidence-based interventions through implementation strategies adapted from other countries' COVID-19 response as well as from prior epidemics. However, it is unclear whether these interventions will lead to long-term and complete success in stopping COVID-19 spread. Implementation research is a tool that can be used by countries to learn how to identify and understand contextual factors impacting COVID-19 prevention and control and select evidence-based interventions and strategies known to reduce spread of the virus. We identify seven key contextual factors that are facilitators or barriers to implementation of these interventions, and several strategies that can be leveraged if the factor is present or ones to strengthen if weak to improve implementation. These factors are: a culture of accountability, national coordination, financial stability of the population, culture of innovation, culture and capacity for research, health systems strength, and cross-border economies. Implementation science methods can serve to develop knowledge at a country and regional level on how to identify, utilize, and address these and other contextual factors, and inform relevant evidence-based interventions and implementation strategies. This approach can support African countries' ability to address key challenges as they arise, both in fighting COVID-19 and future health systems challenges.


Asunto(s)
Control de Enfermedades Transmisibles , Infecciones por Coronavirus , Práctica Clínica Basada en la Evidencia , Pandemias , Neumonía Viral , Investigación/organización & administración , Organizaciones Responsables por la Atención , África/epidemiología , Betacoronavirus/aislamiento & purificación , Control de Enfermedades Transmisibles/métodos , Control de Enfermedades Transmisibles/organización & administración , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/prevención & control , Difusión de Innovaciones , Transmisión de Enfermedad Infecciosa/prevención & control , Práctica Clínica Basada en la Evidencia/métodos , Práctica Clínica Basada en la Evidencia/normas , Humanos , Pandemias/prevención & control , Neumonía Viral/epidemiología , Neumonía Viral/prevención & control , Factores Socioeconómicos
2.
Rev Prat ; 70(3): 312-316, 2020 Mar.
Artículo en Francés | MEDLINE | ID: mdl-32877067

RESUMEN

Yellow fever is still a current threat? Yellow fever is a mosquito-borne disease. Africa is the major endemic zone, although there have been epidemics of concern in South America in the last 3 years, especially in Brazil. The virus causes a febrile hepatitis, which can lead to hemorrhagic complications and death. Diagnosis is based on non-specific serological tests. There is no curative treatment. Prevention relies on protection against mosquito bites and on vaccination with a live attenuated vaccine. WHO recommends only one dose of vaccine but data from the literature about life-long protection are divergent on that point, and travel medicine French authorities still recommend a second dose in most at-risk situations.


Asunto(s)
Vacuna contra la Fiebre Amarilla , Fiebre Amarilla , África/epidemiología , Animales , América del Sur/epidemiología , Medicina del Viajero , Fiebre Amarilla/epidemiología , Fiebre Amarilla/prevención & control
5.
Pan Afr Med J ; 36: 158, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32874422

RESUMEN

Diabetes mellitus is a non-infectious disease and has affected about 425 million adults globally and nearly 15.9 million of them reside in Africa. Moreover, the prevalence of undiagnosed diabetes mellitus is very high in Africa and approximates to around 62%. Nearly 75% of the total deaths due to diabetes are in individuals lesser than 60 years of age. The multifaceted disease of diabetes mellitus produces chronic complications such as, neuropathy, nephropathy, retinopathy, microangiopathy etc. These patients of diabetes mellitus are more susceptible to infections due to compromised immune system. Hence these patients of diabetes mellitus and undiagnosed diabetes mellitus are at greater risk of contracting COVID-19 infections. The dual impact of pathophysiology of COVID-19 infections in diabetes mellitus may increase morbidity and mortality in these patients. Hence there is need of health awareness in diabetics as well in the high-risk group for diabetes such as persons with hypertension and obesity. The scarcity of health resources, shortage of trained medical personnel and disease burden of infectious and non-infectious diseases has laid a heavy impact on the economy in Africa and this has been further strained due to the COVID-19 pandemic. The practice of preventive measures by the risk group of Undiagnosed Diabetes Mellitus patients will prevent them from getting infected by COVID-19 and at the same time decrease mortality rates and hence the undiscovered group that is the patients of undiagnosed diabetes mellitus needs to be vigilant regarding safe preventive practices.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Complicaciones de la Diabetes/epidemiología , Diabetes Mellitus/epidemiología , Neumonía Viral/epidemiología , Adulto , África/epidemiología , Infecciones por Coronavirus/mortalidad , Infecciones por Coronavirus/fisiopatología , Complicaciones de la Diabetes/diagnóstico , Complicaciones de la Diabetes/fisiopatología , Diabetes Mellitus/diagnóstico , Diabetes Mellitus/fisiopatología , Humanos , Pandemias , Neumonía Viral/mortalidad , Neumonía Viral/fisiopatología , Prevalencia , Factores de Riesgo
8.
Nat Commun ; 11(1): 3865, 2020 07 31.
Artículo en Inglés | MEDLINE | ID: mdl-32737319

RESUMEN

Polygenic scores (PGS) have been widely used to predict disease risk using variants identified from genome-wide association studies (GWAS). To date, most GWAS have been conducted in populations of European ancestry, which limits the use of GWAS-derived PGS in non-European ancestry populations. Here, we derive a theoretical model of the relative accuracy (RA) of PGS across ancestries. We show through extensive simulations that the RA of PGS based on genome-wide significant SNPs can be predicted accurately from modelling linkage disequilibrium (LD), minor allele frequencies (MAF), cross-population correlations of causal SNP effects and heritability. We find that LD and MAF differences between ancestries can explain between 70 and 80% of the loss of RA of European-based PGS in African ancestry for traits like body mass index and type 2 diabetes. Our results suggest that causal variants underlying common genetic variation identified in European ancestry GWAS are mostly shared across continents.


Asunto(s)
Asma/genética , Diabetes Mellitus Tipo 2/genética , Hipertensión/genética , Modelos Genéticos , Herencia Multifactorial , Polimorfismo de Nucleótido Simple , Adulto , África/epidemiología , Anciano , Alelos , Asia/epidemiología , Asma/diagnóstico , Asma/epidemiología , Asma/etnología , Índice de Masa Corporal , Colesterol/sangre , Simulación por Computador , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/epidemiología , Diabetes Mellitus Tipo 2/etnología , Europa (Continente)/epidemiología , Femenino , Frecuencia de los Genes , Estudio de Asociación del Genoma Completo , Humanos , Hipertensión/diagnóstico , Hipertensión/epidemiología , Hipertensión/etnología , Desequilibrio de Ligamiento , Masculino , Persona de Mediana Edad , Pronóstico , Carácter Cuantitativo Heredable , Riesgo
9.
Washington; Organización Panamericana de la Salud; ago. 13, 2020. 4 p.
No convencional en Español | LILACS | ID: biblio-1117252

RESUMEN

Enfrentamos un reto sin precedentes, que requiere sistemas de salud sólidos y bien financiados que nos guíen en la crisis y nos ayuden a recuperarnos. No hay ninguna duda de que los países y las ciudades necesitan intervenciones significativas y sostenidas en todos los sectores para suprimir la COVID-19, proteger los avances en la salud y hacer frente a la pobreza y las desigualdades crecientes. La salud de las comunidades y de la economía depende de ello.


Asunto(s)
Humanos , Neumonía Viral/prevención & control , Sistemas de Salud/organización & administración , Infecciones por Coronavirus/prevención & control , Equidad en Salud/organización & administración , Poblaciones Vulnerables , Pandemias/prevención & control , Betacoronavirus , África/epidemiología , América Latina/epidemiología
10.
Pan Afr Med J ; 36: 80, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32774639

RESUMEN

The coronavirus disease (COVID-19) caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) has become a pandemic. There is currently no vaccine or effective treatment for COVID-19. Early diagnosis and management is key to favourable outcomes. In order to prevent more widespread transmission of the virus, rapid detection and isolation of confirmed cases is of utmost importance. Real time reverse transcriptase polymerase chain reaction (RT-PCR) is currently the "gold standard" for the detection of SARS-COV-2. There are several challenges associated with this test from sample collection to processing and the longer turnaround time for the results to be available. More rapid and faster diagnostic tests that may produce results within minutes to a few hours will be instrumental in controlling the disease. Serological tests that detect specific antibodies to the virus may be such options. In this review, we extensively searched for studies that compared RT-PCR with serological tests for the diagnosis of COVID-19. We extracted the data from the various selected studies that compared the different tests and summarised the available evidence to determine which test is more appropriate especially in Africa. We also reviewed the current evidence and the challenges for the genome sequencing of SARS-COV-2 in Africa. Finally, we discuss the relevance of the different diagnostic tests and the importance of genome sequencing in identifying potential therapeutic options for the control of COVID-19 in Africa.


Asunto(s)
Técnicas de Laboratorio Clínico , Infecciones por Coronavirus/diagnóstico , Genoma Humano , Neumonía Viral/diagnóstico , África/epidemiología , Betacoronavirus/aislamiento & purificación , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/genética , Humanos , Pandemias , Neumonía Viral/epidemiología , Neumonía Viral/genética , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Pruebas Serológicas , Factores de Tiempo
12.
J Infect Dev Ctries ; 14(7): 691-695, 2020 07 31.
Artículo en Inglés | MEDLINE | ID: mdl-32794455

RESUMEN

As the incidence of Coronavirus Disease 19 (COVID-19) continues to rise, many countries have been seeking for medical assistance such as donation or procurement of laboratory test kits and strips. These consumables are largely intended for use in the laboratory investigations of COVID-19 cases, suspected contacts, asymptomatic persons and in discharging cured persons. Thus, this article was instigated to update and remind healthcare providers and policymakers (especially those in developing countries) on the principles of sample collections, storage, transportation, laboratory protocols and networks needed for appropriate public health response against COVID-19 pandemic in Africa and other developing countries. In addition, this article presents challenges that hinder adequate COVID-19 laboratory response and discuss some possible solutions that could ameliorate these constrains.


Asunto(s)
Betacoronavirus , Técnicas de Laboratorio Clínico/métodos , Infecciones por Coronavirus/diagnóstico , Laboratorios , Neumonía Viral/diagnóstico , Manejo de Especímenes , África/epidemiología , Betacoronavirus/química , Betacoronavirus/genética , Betacoronavirus/inmunología , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/virología , Monitoreo Epidemiológico , Humanos , Pandemias , Neumonía Viral/epidemiología , Neumonía Viral/virología , Salud Pública , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa/métodos , Pruebas Serológicas
13.
Nat Commun ; 11(1): 4353, 2020 08 28.
Artículo en Inglés | MEDLINE | ID: mdl-32859908

RESUMEN

Continental-scale models of malaria climate suitability typically couple well-established temperature-response models with basic estimates of vector habitat availability using rainfall as a proxy. Here we show that across continental Africa, the estimated geographic range of climatic suitability for malaria transmission is more sensitive to the precipitation threshold than the thermal response curve applied. To address this problem we use downscaled daily climate predictions from seven GCMs to run a continental-scale hydrological model for a process-based representation of mosquito breeding habitat availability. A more complex pattern of malaria suitability emerges as water is routed through drainage networks and river corridors serve as year-round transmission foci. The estimated hydro-climatically suitable area for stable malaria transmission is smaller than previous models suggest and shows only a very small increase in state-of-the-art future climate scenarios. However, bigger geographical shifts are observed than with most rainfall threshold models and the pattern of that shift is very different when using a hydrological model to estimate surface water availability for vector breeding.


Asunto(s)
Cambio Climático , Hidrología/métodos , Malaria/transmisión , África/epidemiología , Animales , Anopheles/fisiología , Ecología , Ecosistema , Mapeo Geográfico , Geografía , Malaria/epidemiología , Mosquitos Vectores/fisiología , Ríos , Estaciones del Año , Temperatura
14.
BMC Infect Dis ; 20(1): 589, 2020 Aug 08.
Artículo en Inglés | MEDLINE | ID: mdl-32770958

RESUMEN

BACKGROUND: Estimating prevalence of Chlamydia trachomatis (CT) worldwide is necessary in designing control programs and allocating health resources. We performed a meta-analysis to calculate the prevalence of CT in the general population. METHODS: The Pubmed and Embase databases were searched for eligible population-based studies from its inception through June 5, 2019. Q test and I2 statistic were used to calculate the heterogeneity between studies. Random effects models were used to pool the prevalence of CT. Meta regression was performed to explore the possible sources of heterogeneity. Publication bias was evaluated using a funnel plot and "trim and fill" method. RESULTS: Twenty nine studies that reported prevalence of CT infection from 24 countries were identified, including a total population of 89,886 persons. The pooled prevalence of CT among the general population was 2.9% (95% CI, 2.4-3.5%), and females had a higher CT prevalence (3.1, 95% CI, 2.5-3.8%) than males (2.6, 95% CI, 2.0-3.2%) (χ2 = 10.38, P <  0.01). Prevalence of CT was highest in region of America (4.5, 95% CI, 3.1-5.9%), especially in Latin America (6.7, 95% CI, 5.0-8.4%), followed by females in region of Africa (3.8, 95% CI, 0.7-6.9%), while South-East Asia had a lowest CT prevalence 0.8% (95% CI, 0.3-1.3%). CONCLUSIONS: This study provided the updated prevalence of CT among general population worldwide. General population from Latin America, especially females, and women in Africa should be given priority by WHO when design and delivery CT control programs.


Asunto(s)
Infecciones por Chlamydia/epidemiología , África/epidemiología , Infecciones por Chlamydia/microbiología , Infecciones por Chlamydia/prevención & control , Chlamydia trachomatis/aislamiento & purificación , Bases de Datos Factuales , Femenino , Humanos , América Latina/epidemiología , Masculino , Prevalencia , Organización Mundial de la Salud
15.
Afr J Prim Health Care Fam Med ; 12(1): e1-e3, 2020 Aug 05.
Artículo en Inglés | MEDLINE | ID: mdl-32787398

RESUMEN

The use of SARS-CoV-2 rapid diagnostic test (RDT) kits by some African countries for screening has raised serious concerns over their role in malaria areas. Coupled with a lack of adequate personal protective equipment and the scarcity of knowledge on the possible interaction between malaria and COVID-19 both in terms of presentations and shared symptoms, this has left many frontline health workers with fears and anxieties. Several anecdotal reports have already raised questions pertaining to possible false-positive COVID-19 results in proven malaria cases by use of SARS-CoV-2 RDT kits with huge costs to already constrained budgets. The report raises concerns on the use of SARS-CoV-2 kits in malaria areas in terms of cost, to prompt research, allay fears and guide policy during this pandemic and beyond.


Asunto(s)
Infecciones por Coronavirus/diagnóstico , Malaria/diagnóstico , Neumonía Viral/diagnóstico , África/epidemiología , Técnicas de Laboratorio Clínico , Infecciones por Coronavirus/epidemiología , Diagnóstico Diferencial , Reacciones Falso Positivas , Humanos , Malaria/epidemiología , Tamizaje Masivo , Pandemias , Neumonía Viral/epidemiología , Juego de Reactivos para Diagnóstico/economía
16.
Afr J Prim Health Care Fam Med ; 12(1): e1-e3, 2020 Jul 27.
Artículo en Inglés | MEDLINE | ID: mdl-32787397

RESUMEN

The treatment of severely ill coronavirus disease 2019 (COVID-19) patients has brought the worldwide shortage of oxygen and ventilator-related resources to public attention. Ventilators are considered as the vital equipment needed to manage these patients, who account for 3% - 5% of patients with Covid-19. Most patients need oxygen and supportive therapy. In Africa, the shortage of oxygen is even more severe and needs equipment that is simpler to use than a ventilator. Different models of generating oxygen locally at hospitals, including at provincial and district levels, are required. In some countries, hospitals have established small oxygen production plants to supply themselves and neighbouring hospitals. Oxygen concentrators have also been explored but require dependable power supply and are influenced by local factors such as ambient temperature and humidity. By attaching a reservoir tank, the effect of short power outages or high demands can be smoothed over. The local and regional energy unleashed in the citizens to respond to the COVID-19 pandemic should now be directed towards developing appropriate infrastructure for oxygen and critical care. This infrastructure is education and technology intensive, requiring investment in these areas.


Asunto(s)
Infecciones por Coronavirus/terapia , Cuidados Críticos , Terapia por Inhalación de Oxígeno/instrumentación , Neumonía Viral/terapia , África/epidemiología , Infecciones por Coronavirus/epidemiología , Hospitales , Humanos , Pandemias , Neumonía Viral/epidemiología , Índice de Severidad de la Enfermedad , Ventiladores Mecánicos
17.
BMC Infect Dis ; 20(1): 598, 2020 Aug 13.
Artículo en Inglés | MEDLINE | ID: mdl-32791999

RESUMEN

BACKGROUND: The emergence of a novel coronavirus (SARS-CoV-2) in Wuhan, China, at the end of 2019 has caused widespread transmission around the world. As new epicentres in Europe and America have arisen, of particular concern is the increased number of imported coronavirus disease 2019 (COVID-19) cases in Africa, where the impact of the pandemic could be more severe. We aim to estimate the number of COVID-19 cases imported from 12 major epicentres in Europe and America to each African country, as well as the probability of reaching 10,000 cases in total by the end of March, April, May, and June following viral introduction. METHODS: We used the reported number of cases imported from the 12 major epicentres in Europe and America to Singapore, as well as flight data, to estimate the number of imported cases in each African country. Under the assumption that Singapore has detected all the imported cases, the estimates for Africa were thus conservative. We then propagated the uncertainty in the imported case count estimates to simulate the onward spread of the virus, until 10,000 cases are reached or the end of June, whichever is earlier. Specifically, 1,000 simulations were run separately under four different combinations of parameter values to test the sensitivity of our results. RESULTS: We estimated Morocco, Algeria, South Africa, Egypt, Tunisia, and Nigeria as having the largest number of COVID-19 cases imported from the 12 major epicentres. Based on our 1,000 simulation runs, Morocco and Algeria's estimated probability of reaching 10,000 cases by end of March was close to 100% under all scenarios. In particular, we identified countries with less than 1,000 cases in total reported by end of June whilst the estimated probability of reaching 10,000 cases by then was higher than 50% even under the most optimistic scenario. CONCLUSIONS: Our study highlights particular countries that are likely to reach (or have reached) 10,000 cases far earlier than the reported data suggest, calling for the prioritization of resources to mitigate the further spread of the epidemic.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/transmisión , Neumonía Viral/epidemiología , Neumonía Viral/transmisión , África/epidemiología , Betacoronavirus/aislamiento & purificación , Infecciones por Coronavirus/virología , Humanos , Modelos Estadísticos , Pandemias , Neumonía Viral/virología , Probabilidad
19.
BMC Infect Dis ; 20(1): 513, 2020 Jul 16.
Artículo en Inglés | MEDLINE | ID: mdl-32677899

RESUMEN

BACKGROUND: Imported falciparum malaria from Africa has become a key public health challenge in Guizhou Province since 2012. Understanding the polymorphisms of molecular markers of drug resistance can guide selection of antimalarial drugs for the treatment of malaria. This study was aimed to analyze the polymorphisms of pfcrt, pfmdr1, and K13-propeller among imported falciparum malaria cases in Guizhou Province, China. METHOD: Fifty-five imported falciparum malaria cases in Guizhou Province during 2012-2016 were included in this study. Their demographic information and filter paper blood samples were collected. Genomic DNA of Plasmodium falciparum was extracted from the blood samples, and polymorphisms of pfcrt, pfmdr1, and K13-propeller were analyzed with nested PCR amplification followed by sequencing. Data were analyzed with the SPSS17.0 software. RESULTS: The prevalence of pfcrt K76T, pfmdr1 N86Y, and pfmdr1 Y184F mutation was 56.6, 22.2, and 72.2%, respectively, in imported falciparum malaria cases in Guizhou Province. We detected two mutant haplotypes of pfcrt, IET and MNT, with IET being more commonly found (54.7%), and five mutant haplotypes of pfmdr1, of which NFD was the most frequent (53.7%). There were totally 10 combined haplotypes of pfcrt and pfmdr1, of which the haplotype IETNFD possessed a predominance of 28.8%. In addition, three nonsynonymous mutations (S459T, C469F, and V692L) and two synonymous mutations (R471R and V589V) were detected in K13-propeller, all having prevalence less than 6.0%. In particular, a candidate K13 resistance mutation, C469F, was identified for the first time from Democratic Republic of the Congo with the prevalence of 2.0%. CONCLUSIONS: The high prevalence of IET haplotype of pfcrt and NFD haplotype of pfmdr1 suggests the presence of chloroquine, artemether/lumefantrine, and dihydroartemisinin/piperaquine resistance in these cases. Therefore cautions should be made to artemisinin therapy for P. falciparum in Africa. Continuous monitoring of anti-malarial drug efficacy in imported malaria cases is helpful for optimizing antimalarial drug therapy in Guizhou Province, China.


Asunto(s)
Enfermedades Transmisibles Importadas/parasitología , Resistencia a Medicamentos/genética , Malaria Falciparum/parasitología , Plasmodium falciparum/genética , Polimorfismo Genético , Proteínas Protozoarias/genética , Adulto , África/epidemiología , Sustitución de Aminoácidos/genética , Antimaláricos/uso terapéutico , China/epidemiología , Estudios de Cohortes , Femenino , Humanos , Malaria Falciparum/tratamiento farmacológico , Malaria Falciparum/epidemiología , Masculino , Proteínas de Transporte de Membrana/genética , Persona de Mediana Edad , Proteínas Asociadas a Resistencia a Múltiples Medicamentos/genética , Mutación , Plasmodium falciparum/aislamiento & purificación , Enfermedad Relacionada con los Viajes
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