scholarly journals The potential effects of widespread community transmission of SARS-CoV-2 infection in the World Health Organization African Region: a predictive model

2020 ◽  
Vol 5 (5) ◽  
pp. e002647 ◽  
Author(s):  
Joseph Waogodo Cabore ◽  
Humphrey Cyprian Karamagi ◽  
Hillary Kipruto ◽  
James Avoka Asamani ◽  
Benson Droti ◽  
...  

The spread of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has been unprecedented in its speed and effects. Interruption of its transmission to prevent widespread community transmission is critical because its effects go beyond the number of COVID-19 cases and deaths and affect the health system capacity to provide other essential services. Highlighting the implications of such a situation, the predictions presented here are derived using a Markov chain model, with the transition states and country specific probabilities derived based on currently available knowledge. A risk of exposure, and vulnerability index are used to make the probabilities country specific. The results predict a high risk of exposure in states of small size, together with Algeria, South Africa and Cameroon. Nigeria will have the largest number of infections, followed by Algeria and South Africa. Mauritania would have the fewest cases, followed by Seychelles and Eritrea. Per capita, Mauritius, Seychelles and Equatorial Guinea would have the highest proportion of their population affected, while Niger, Mauritania and Chad would have the lowest. Of the World Health Organization's 1 billion population in Africa, 22% (16%–26%) will be infected in the first year, with 37 (29 – 44) million symptomatic cases and 150 078 (82 735–189 579) deaths. There will be an estimated 4.6 (3.6–5.5) million COVID-19 hospitalisations, of which 139 521 (81 876–167 044) would be severe cases requiring oxygen, and 89 043 (52 253–106 599) critical cases requiring breathing support. The needed mitigation measures would significantly strain health system capacities, particularly for secondary and tertiary services, while many cases may pass undetected in primary care facilities due to weak diagnostic capacity and non-specific symptoms. The effect of avoiding widespread and sustained community transmission of SARS-CoV-2 is significant, and most likely outweighs any costs of preventing such a scenario. Effective containment measures should be promoted in all countries to best manage the COVID-19 pandemic.

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0259874
Author(s):  
Bedilu Alamirie Ejigu ◽  
Manalebish Debalike Asfaw ◽  
Lisa Cavalerie ◽  
Tilahun Abebaw ◽  
Mark Nanyingi ◽  
...  

The World Health Organization (WHO) declared COVID-19 a pandemic on March 11, 2020 and by November 14, 2020 there were 53.3M confirmed cases and 1.3M reported deaths in the world. In the same period, Ethiopia reported 102K cases and 1.5K deaths. Effective public health preparedness and response to COVID-19 requires timely projections of the time and size of the peak of the outbreak. Currently, Ethiopia under the COVAX facility has begun vaccinating high risk populations but due to vaccine supply shortages and the absence of an effective treatment, the implementation of NPIs (non-pharmaceutical interventions), like hand washing, wearing face coverings or social distancing, still remain the most effective methods of controlling the pandemic as recommended by WHO. This study proposes a modified Susceptible Exposed Infected and Recovered (SEIR) model to predict the number of COVID-19 cases at different stages of the disease under the implementation of NPIs at different adherence levels in both urban and rural settings of Ethiopia. To estimate the number of cases and their peak time, 30 different scenarios were simulated. The results indicated that the peak time of the pandemic is different in urban and rural populations of Ethiopia. In the urban population, under moderate implementation of three NPIs the pandemic will be expected to reach its peak in December, 2020 with 147,972 cases, of which 18,100 are symptomatic and 957 will require admission to an Intensive Care Unit (ICU). Among the implemented NPIs, increasing the coverage of wearing masks by 10% could reduce the number of new cases on average by one-fifth in urban-populations. Varying the coverage of wearing masks in rural populations minimally reduces the number of cases. In conclusion, the models indicate that the projected number of hospital cases during the peak time is higher than the Ethiopian health system capacity. To contain symptomatic and ICU cases within the health system capacity, the government should pay attention to the strict implementation of the existing NPIs or impose additional public health measures.


2020 ◽  
Author(s):  
Bedilu Alamirie Ejigu ◽  
Manalebish Debalike Asfaw ◽  
Lisa Cavalerie ◽  
Tilahun Abebaw ◽  
Mark Nanyingi ◽  
...  

AbstractThe World Health Organisation (WHO) declared COVID-19 a pandemic on March 11, 2020 and by November 14, 2020 there were 53.3M confirmed cases and 1.3M reported deaths in the world. In the same period, Ethiopia reported 102K cases and 1.5K deaths. Effective public health preparedness and response to COVID-19 requires timely projections of the time and size of the peak of the outbreak. Currently, in the absence of vaccine or effective treatment, the implementation of NPIs (non-pharmaceutical interventions), like hand washing, wearing face coverings or social distancing, is recommended by WHO to bring the pandemic under control. This study proposes a modified Susceptible Exposed Infected and Recovered (SEIR) model to predict the number of COVID-19 cases at different stages of the disease under the implementation of NPIs with different adherence levels in both urban and rural settings of Ethiopia. To estimate the number of cases and their peak time, 30 different scenarios were simulated. The results reveal that the peak time of the pandemic is different in urban and rural populations of Ethiopia. In the urban population, under moderate implementation of three NPIs the pandemic will be expected to reach its peak in December, 2020 with 147,972 cases, of which 18,100 are symptomatic and 957 will require admission to an Intensive Care Unit (ICU). Among the implemented NPIs, increasing the coverage of wearing masks by 10% could reduce the number of new cases on average by one-fifth in urban-populations. Varying the coverage of wearing masks in rural populations minimally reduces the number of cases. In conclusion, the projection result reveals that the projected number of hospital cases is higher than the Ethiopian health system capacity during the peak time. To contain symptomatic and ICU cases within health system capacity, the government should give attention to the strict implementation of the existing NPIs or impose additional public health measures.


2020 ◽  
Author(s):  
Lukman Olagoke ◽  
Ahmet E. Topcu

BACKGROUND COVID-19 represents a serious threat to both national health and economic systems. To curb this pandemic, the World Health Organization (WHO) issued a series of COVID-19 public safety guidelines. Different countries around the world initiated different measures in line with the WHO guidelines to mitigate and investigate the spread of COVID-19 in their territories. OBJECTIVE The aim of this paper is to quantitatively evaluate the effectiveness of these control measures using a data-centric approach. METHODS We begin with a simple text analysis of coronavirus-related articles and show that reports on similar outbreaks in the past strongly proposed similar control measures. This reaffirms the fact that these control measures are in order. Subsequently, we propose a simple performance statistic that quantifies general performance and performance under the different measures that were initiated. A density based clustering of based on performance statistic was carried out to group countries based on performance. RESULTS The performance statistic helps evaluate quantitatively the impact of COVID-19 control measures. Countries tend show variability in performance under different control measures. The performance statistic has negative correlation with cases of death which is a useful characteristics for COVID-19 control measure performance analysis. A web-based time-line visualization that enables comparison of performances and cases across continents and subregions is presented. CONCLUSIONS The performance metric is relevant for the analysis of the impact of COVID-19 control measures. This can help caregivers and policymakers identify effective control measures and reduce cases of death due to COVID-19. The interactive web visualizer provides easily digested and quick feedback to augment decision-making processes in the COVID-19 response measures evaluation. CLINICALTRIAL Not Applicable


BMJ Leader ◽  
2021 ◽  
pp. leader-2020-000343
Author(s):  
Amit Jain ◽  
Tinglong Dai ◽  
Christopher G Myers ◽  
Punya Jain ◽  
Shruti Aggarwal

Elective surgical suspension during the COVID-19 pandemic resulted in a sizeable surgical case backlog throughout the world. As we ramp back up, how do we decide which cases take priority? Potential future waves (or a future pandemic) may lead to additional surgical shutdown and subsequent reopening. Deciding which cases to prioritise in the face of limited health system capacity has emerged as a new challenge for healthcare leaders. Here we present an ethically grounded and operationally efficient surgical prioritisation framework for healthcare leaders and practitioners, drawing insights from decision analysis and organisational sciences.


RSC Advances ◽  
2017 ◽  
Vol 7 (2) ◽  
pp. 1118-1126 ◽  
Author(s):  
Shereen M. Azab ◽  
Amany M. Fekry

Daclatasvir (DAC) is listed on the World Health Organization's list of essential medicines needed in a basic health system, therefore, electrochemical and impedance spectroscopic methods are necessary.


2021 ◽  
Vol 2 (1) ◽  
pp. 6-17
Author(s):  
Zahra Hassan AL Qamariat ◽  

Misuse of drugs is a serious health problem all around the world. Rational drug use can be characterized as follows: patients receive drugs that meet their clinical needs, at doses that meet their requirements, promptly and at the lowest cost to themselves and their region. Drug abuse, polypharmacy, and misuse are the most prominent drug use problems today. Misuse of drugs can occur for a variety of reasons at different levels, including recommended mistakes and over-the- counter medications. Inappropriate use of income can lead to real negative benefits and financial results. There are many irrational drug mixtures available. Appropriate rational use of medicines will increase personal satisfaction and lead to better local health services. A list of essential medicines recommended by the World Health Organization (WHO) can assist the countries around the globe in rationalizing the distribution and purchasing of medicines, thus decreasing the costs to healthcare systems. Irrational drug use has been a subject of concern for years as it affects the health system and patients badly. Irrational use of drugs can result from several factors such as patient, prescriber, dispenser, health system, supply system, or regulations. Thus, diverse strategies have been used to promote rational drug use and also to tackle irrational use. Thereby the concept of rational and irrational drug use and factors that lead to either result should be identified and monitored.


Sexual Health ◽  
2007 ◽  
Vol 4 (4) ◽  
pp. 301
Author(s):  
D. A. Lewis

The World Health Organization's Global strategy for the prevention and control of sexually transmitted infections (STIs): 2006-2015 highlighted the need for STI surveillance as a cornerstone for national programmes. Yet, in many countries of the world, little or no surveillance exists and, when it does, it is often clinical in nature. Much of the world's resource-poor areas use the syndromic management approach, which includes a recommendation for periodic surveillance of antimicrobial resistance in Neisseria gonorrhoeae. It is also important to perform aetiological surveillance, to assess the common causes of the main STI syndromes, such as genital ulceration (GUS), male urethritis syndrome (MUS) and the vaginal discharge syndrome (VDS). This allows observation of trends and ensures that the drugs used in the syndromic management flow chart as still valid. South Africa started to build a national microbiological and clinical surveillance programme in 2004. Prior to that, microbiological data came from surveillance among particular core groups, such as miners, that could not be extrapolated to the general population. 30 sentinel sites (primary healthcare facilities) were set up in each of the country's nine provinces for the purpose of enhanced clinical surveillance. Data were collected on all the main syndromes in terms of episodes per year. At the same time, microbiological surveillance was initiated in the following provinces: the Northern Cape, Mpumalanga, the Western Cape and Gauteng. Plans are to conduct further surveillance in the Free State and possibly the Eastern Cape later in 2007. Within each province, one primary health care facility was chosen on the criteria of a large STO caseload and proximity to the laboratory doing the initial culturing of N. gonorrhoeae. Consecutive patients were recruited using informed consent and anonymous specimens collected. Patients were treated syndromically in the normal manner according to national STI management guidelines. Gonococcal isolates, obtained from men with urethral discharge, were tested for ciprofloxacin and ceftriaxone resistance using E tests. In addition, swabs were collected from MUS patients and VDS patients for multiplex polymerase chain reaction (M-PCR) based testing for the following four pathogens: N. gonorrhoeae, Chlamydia trachomatis, Trichomonas vaginalis and Mycoplasma genitalium. Ulcer swabs were also tested by M-PCR for herpes simplex virus (HSV), Haemophilus ducreyi and Treponema pallidum. A separate PCR was used to test the extracted DNA for C. trachomatis L1-L3. Serum was taken from all participants and tested for syphilis (RPR plus TPPA), HSV-2 and HIV antibodies. Key findings have confirmed the decline of chancroid to below 1% of genital ulcers and the predominance of genital herpes as the major cause of genital ulceration in South Africa. Gonorrhoea continues to be the major cause of urethritis in men and prevalence far exceeds Chlamydial infection. Approximately 10% of men with MUS are also infected/colonized with T. vaginalis. Only about one third of VDS cases appear to be caused by sexually transmitted pathogens. HIV infection rates exceed those recorded in the annual antenatal surveys and are highest among genital ulcer patients (70%). RPR seropositivity in non-ulcer patients is around 5% and antibodies to HSV-2 occur in about 50!!60% of patients overall. The surveillance has also demonstrated alarming rises in the prevalence of ciprofloxacin resistant gonorrhoea since 2004.


2020 ◽  
Vol 7 (1) ◽  
pp. 85-88 ◽  
Author(s):  
Kiran Sapkota ◽  
Ganesh Dangal ◽  
Madhu Koirala ◽  
Kalyan Sapkota ◽  
Asmita Poudel ◽  
...  

Coronavirus disease (COVID-19) outbreak, caused by the most recently discovered coronavirus, is currently affecting a large population across the globe. World health organization (WHO) has already declared COVID-19, a pandemic, and the world is fighting to contain the COVID-19 outbreak. Nepal has taken several preventive measures to control the coronavirus outbreak. However, some additional steps are needed to prevent community transmission of the disease. This brief communication discusses the government of Nepal actions and provides recommendations for the prevention and control of COVID-19 infection in Nepal.


2020 ◽  
Vol 148 ◽  
Author(s):  
Rejane Maria Tommasini Grotto ◽  
Rodrigo Santos Lima ◽  
Gabriel Berg de Almeida ◽  
Claudia Pio Ferreira ◽  
Raul Borges Guimarães ◽  
...  

Abstract Different countries have adopted strategies for the early detection of SARS-CoV-2 since the declaration of community transmission by the World Health Organization (WHO) and timely diagnosis has been considered one of the major obstacles for surveillance and healthcare. Here, we report the increase of the number of laboratories to COVID-19 diagnosis in Brazil. Our results demonstrate an increase and decentralisation of certified laboratories, which does not match the much higher increase in the number of COVID-19 cases. Also, it becomes clear that laboratories are irregularly distributed over the country, with a concentration in the most developed state, São Paulo.


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