ABSTRACT
The World Health Organization declared the Coronavirus disease of 2019 (COVID-19) a public health emergency of international concern on 30 January 2020, and a pandemic on 11 March 2020. Vaccines have proven to be vital in the effort to control and possibly eventually eradicate this viral infection. There have been reports of thromboembolic events associated with the use of vaccine but from available information, no reported case of atypical Hemolytic Uremic syndrome (HUS) in a black male has been described. We report a case of a 43-year-old black male Sub-Saharan African c5dwho presented with chills, fever, and generalized body aches of 3 days duration after receiving the second booster dose of the COVID-19 vaccine. He developed thrombocytopenia, hemolytic anaemia, and acute kidney injury on admission, and an initial diagnosis of malaria was made. He was managed with parenteral artesunate and then oral artemether/lumefantrine. His hemolytic anaemia was thought to be from malaria-associated hemolysis. This diagnosis was however later re-evaluated to hemolytic uremic syndrome and managed with 50mg daily oral prednisolone which resolved, and he resumed work a week later. Although mass vaccination is a key strategy to control the spread of COVID-19, critical observations should be made to confirm the risk of trigger for abnormal complement activation. Further observations should be made especially if it is a chimpanzee adenovirus-vectored vaccine.
ABSTRACT
Antimicrobial resistance (AMR) is a significant problem in global health today, particularly in low- and middle-income countries (LMICs) where antimicrobial stewardship programmes are yet to be successfully implemented. We established a partnership between AMR pharmacists from a UK NHS hospital and in Ho Teaching Hospital with the aim of enhancing antimicrobial stewardship knowledge and practice among healthcare providers through an educational intervention. We employed a mixed-method approach that included an initial survey on knowledge and awareness before and after training, followed by qualitative interviews with healthcare providers conducted six months after delivery of training. This study was carried out in two phases in Ho Teaching Hospital with healthcare professionals, including pharmacists, medical doctors, nurses and medical laboratory scientists. Ethical approval was obtained prior to data collection. In the first phase, we surveyed 50 healthcare providers, including nurses (33%), pharmacists (29%) and biomedical scientists (23%). Of these, 58% of participants had engaged in continuous professional development on AMR/AMS, and above 95% demonstrated good knowledge on the general use of antibiotics. A total of 18 participants, which included four medical doctors, five pharmacists, four nurses, two midwives and three biomedical scientists, were interviewed in the second phase and demonstrated greater awareness of AMS practices, particularly the role of education for patients, as well as healthcare professionals. We found that knowledge and practice with AMS was markedly improved six months after the training session. There is limited practice of AMS in LMICs; however, through AMR-focused training, we demonstrated improved AMS skills and practice among healthcare providers in Ho Teaching Hospital. There is a need for continuous AMR training sessions for healthcare professionals in resource-limited settings.