Evaluation of influenza surveillance systems in sub-Saharan Africa: a systematic review protocol

IntroductionInfluenza infrastructure systems are crucial for maintaining surveillance operations, and for mitigating and responding to the disease. The role of surveillance is to isolate and identify as rapidly as possible any new influenza strains and collate this information for the preparedness for, and response to, an impending influenza activity in humans. However, sources of surveillance information, particularly in Africa, are meagre. This systematic review will critically evaluate the existing influenza surveillance systems in sub-Saharan Africa.Method and analysisWe will build multiple electronic database search strategies for use in PubMed, Scopus, African Journal Online, Web of Science and Google scholar to identify as many studies as possible. The medical subject heading and keywords will include a wide range of synonyms, both in index terms and free-text words. Database search will be followed by hand searching of reference lists of all relevant studies. We will include eligible full-text studies published from 2002 in order to coincide with the establishment of the integrated disease surveillance and response system in Africa by WHO. We will examine the influenza surveillance performance systems using the US Centers for Disease Control and Prevention guidelines on evaluating public health surveillance systems. Our outcome measures will include surveillance system attributes such as timeliness, sensitivity, specificity, acceptability, representativeness, simplicity and usefulness. We will conduct a narrative synthesis of all studies.Ethics and disseminationThis study does not require ethics approval because it uses publicly available data. Our findings will be published in a peer review journal and disseminated to policy makers.PROSPERO registration numberCRD42018103042.

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PO 8581 ZOONOTIC VIRAL ANTIGENS SURVEILLANCE IN HEALTHY POPULATIONS LIVING IN LAMBARÉNÉ, GABON

BMJ Global Health ◽

10.1136/bmjgh-2019-edc.153 ◽

2019 ◽

Vol 4 (Suppl 3) ◽

pp. A58.2-A58

Author(s):

Emmanuel Bache ◽

Marguerite M Loembe ◽

Selidji T Agnandji

Keyword(s):

Disease Transmission ◽

Disease Surveillance ◽

Vaccine Trial ◽

Viral Rna ◽

Sub Saharan Africa ◽

Surveillance Systems ◽

Rt Pcr ◽

Zoonotic Infections ◽

Viral Antigens ◽

Sub Saharan

BackgroundWorldwide, viral zoonotic infections such as filoviruses, flaviviruses, nairoviruses and arenaviruses cause self-limiting to severe diseases. They are endemic in sub-Saharan Africa, causing sporadic outbreaks warranting the development of sustainable surveillance systems. In Gabon, Ebola outbreaks occurred from 1994 to 2002 causing 214 human cases and 150 deaths, while Dengue, Zika and Chikungunya virus outbreaks occurred between 2007 and 2010. Beyond these outbreaks, little is known about the epidemiology. Recently, in collaboration with the Japanese government, the Research and Health Ministries of Gabon supported the implementation of a biosecurity level-3 (BSL-3) laboratory at CERMEL in Lambaréné as a zoonotic disease surveillance unit. Start-off involved antigen detection and characterisation of circulating antibodies to targeted viral antigens in healthy populations. This study reports data from healthy participants (18–50 years) in a phase I rVSV-ZEBOV-GP Ebola vaccine trial.MethodsHundred-six (106) baseline samples were screened for Ebola, Dengue (serotypes) 1–4 and Chikungunya viral RNA by RT-PCR on serum. IgG ELISA on plasma was used to identify antibodies against: Zaire-Ebola-(EBOV-GP and EBOV-VP40), Marburg-(MARV-GP and MARV-VP40), Crimean Congo Haemorrhagic Fever-(CCHFV-GP), Lasa-(LASV-GPC and LASV-NP), Yellow Fever-(YFV-NS1), West-Nile-(WNV-NS1), Zika virus-(ZIKV-NS1), Chikungunya-(CHIKV-VLP) and Dengue-(DENV1-NS1,DENV2-NS1,DENV3-NS1,DENV4-NS1) virus antigens.ResultsNo viral RNA was isolated by RT-PCR in 106 samples. About 9% (10/106), 3% (3/106), 6% (6/106), 24% (25/106), 51% (54/106), 38% (40/106) and 36% (38/106) participants were seropositive for antibodies specific to EBOV-GP, MARV-GP, CCHFV-GP, YFV-NS1, WNV-NS1, ZIKV-NS1 and CHIKV-VLP, respectively. Twelve percent (12%; 13/106) of participants possessed antibodies specific to Zika, Chikungunya and Dengue 1–4 antigens. Six percent (6%; 6/106) of participants were seropositive for EBOV-GP and CCHFV-GP.ConclusionWe found antibodies to viral zoonotic infections among our healthy volunteers. Further assays, including neutralisation assays are being performed to ascertain the specificity of the antibodies. These findings, once confirmed, will provide insights into disease surveillance, vaccine trial designs, evaluation of post-vaccine immune responses, variability in adverse events and overall disease transmission patterns.

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COVID-19 Crisis in Africa: Revisiting the Contributing Factors

Annals of Public Health Issues ◽

10.2478/aphi-2021-0006 ◽

2021 ◽

Vol 1 (1) ◽

pp. 64-67

Author(s):

Ugochukwu A Eze ◽

Kingsley I Ndoh ◽

Kehinde K Kanmodi

Keyword(s):

Disease Surveillance ◽

Democratic Republic Of Congo ◽

The United States ◽

Sub Saharan Africa ◽

Surveillance Systems ◽

Contributing Factors ◽

African Countries ◽

The World ◽

Control And Prevention ◽

Sub Saharan

Abstract The COVID-19 pandemic has been a major threat to people and healthcare systems around the world. Each region of the world has had unique factors such as culture, demographics, socioeconomic and the political landscape that has either fueled or mitigated the severity of the pandemic. For example, the 2021 Indian Kumbh Mela festival fueled a devastating wave of the pandemic in India. Similarly, the pandemic in the United States has in part been fueled an epidemic of disinformation that led to a growing number of anti-vaxxers, and those who are opposed to COVID-19 prevention guidelines set by agencies like the Centers for Disease Control and Prevention. In Africa, burial practices in Liberia and the Democratic Republic of Congo once fueled the Ebola epidemic. Likewise, in the context of COVID-19, there are factors that are unique to Africa that may have either fueled or mitigated the severity of the pandemic. The anti-COVID-19 measures in many African countries significantly affected household income without commensurate deployment of palliative measures to cushion the effect. Fortunately, the pandemic has run a relatively milder course in sub-Saharan Africa—defying earlier devastating projections. Therefore, to be prepared for the next pandemic, African governments must involve critical stakeholders such as religious and traditional leaders, strengthen current disease surveillance systems and invest in systems that encourage private investments in local vaccine manufacturing.

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Nowcasting Influenza-like Illness Trends in Cameroon

10.1101/2020.07.02.20145250 ◽

2020 ◽

Cited By ~ 1

Author(s):

Elaine O. Nsoesie ◽

Olubusola Oladeji ◽

Aristide S. Abah Abah ◽

Martial L. Ndeffo-Mbah

Keyword(s):

Disease Surveillance ◽

Respiratory Infections ◽

Sub Saharan Africa ◽

Digital Data ◽

Surveillance Systems ◽

African Countries ◽

Influenza Like Illness ◽

Search Data ◽

Sub Saharan ◽

Google Search

ABSTRACTAlthough acute respiratory infections are a leading cause of mortality in sub-Saharan Africa, surveillance of diseases such as influenza is mostly neglected. Evaluating the usefulness of influenza-like illness (ILI) surveillance systems and developing approaches for forecasting future trends is important for pandemic preparedness. We applied statistical and machine learning models to forecast 2012 to 2018 trends in ILI cases reported by the Cameroon Ministry of Health (MOH), using Google searches for influenza symptoms, treatments, natural or traditional remedies as well as, infectious diseases with a high burden (i.e., AIDS, malaria, tuberculosis). The variance explained by the models based on Google search data were 87.7%, 79.1% and 52.0% for the whole country, the Littoral and Centre regions respectively. Our study demonstrates the need for developing contextualized approaches when using digital data for disease surveillance and demonstrates the potential usefulness of search data for monitoring ILI in sub-Saharan African countries.

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Integrating technology and data in public health disease surveillance in Africa: case study of the AVADAR program (Preprint)

10.2196/preprints.27150 ◽

2021 ◽

Author(s):

Chinedu Ejike Anarado ◽

Loveth Metiboba ◽

Faye Simmonds ◽

Tope Falodun

Keyword(s):

Public Health ◽

Disease Surveillance ◽

Data Gathering ◽

Sub Saharan Africa ◽

Surveillance Systems ◽

Wild Poliovirus ◽

Timely Response ◽

Sub Saharan ◽

Traditional Surveillance

BACKGROUND Sub-saharan Africa, Afghanistan and Pakistan are the last frontiers with the prevalence of wild poliovirus (WPV). Following joint efforts and partnerships some of which were instituted in the last 20 years, Africa was declared free of WPV in August 2020. While efforts now focus on eliminating circulating vaccine derived poliovirus (cVDPV), it is important to review some of the interventions that resulted in a polio-free certification for the continent. OBJECTIVE The Auto-visual AFP detection and response (AVADAR) program was one of such interventions. AVADAR helped with a more focused, technology and data driven campaign, to ensure that surveillance was broad, inclusive, and responsive. With the infusion of mobile health technology, the project became a success as it reported, investigated and confirmed more cases of AFP compared to the existing traditional surveillance systems. This study attempts a review of the AVADAR intervention with a view to understand the role played by technology and data. METHODS This study comparatively reviewed the data generated over a three year period, across nine countries where the AVADAR project was implemented. It sought to understand how AVADAR was an improvement over traditional surveillance systems. RESULTS The AVADAR program confirmed more reported AFP cases, when compared with the traditional (paper-based) system. It was found that more true AFP cases were found through the AVADAR system. AVADAR accounted for 76% of cases reported across eight countries. CONCLUSIONS Evidently, data and technology - in this case - the AVADAR tool, addressed most of the challenges of Public Health Surveillance in the target countries. The challenge of erratic surveillance data gathering, and feedback was reduced as the AVADAR program demonstrated coordinated data gathering, active case search, timely response to alerts, and ultimately, improved confirmation of true cases. It contributes lessons that could be useful in enhancing surveillance systems across the developing world particularly in Africa.

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Schistosomal appendicitis: Case series and systematic literature review

PLoS Neglected Tropical Diseases ◽

10.1371/journal.pntd.0009478 ◽

2021 ◽

Vol 15 (6) ◽

pp. e0009478

Author(s):

Mateus Zacarias ◽

Damiano Pizzol ◽

Helder de Miranda ◽

Anna Claudia Colangelo ◽

Nicola Veronese ◽

...

Keyword(s):

Systematic Review ◽

Literature Review ◽

Case Series ◽

Developed Countries ◽

Sub Saharan Africa ◽

Global Prevalence ◽

Wide Range ◽

The Mean ◽

Sub Saharan ◽

Possible Cause

Background Globally, schistosomiasis affects at least 240 million people each year with a high proportion of cases in sub-Saharan Africa. The infection presents a wide range of symptoms mainly at the gastrointestinal and urogenital level. Cases of schistosomiasis-related appendicitis are seldom reported. The aim of the present study is to identify the prevalence of schistosomiasis-related appendicitis in Beira, Mozambique and compare to global prevalence. Methods We retrospectively reviewed all cases of appendicitis recorded from January 2017 to March 2020 at a single pathology department located in Beira in order to assess the prevalence of schistosomiasis. Moreover, we performed a systematic review on the prevalence of schistosomiasis-related appendicitis in all countries. Findings A total of 145 appendicitis cases in Beira showed a 13.1% prevalence of schistosomal-related appendicitis. The mean age of patients was 29.1 years, and 14 (73.7%) were male. The systematic review identified 20 studies with 34,790 inpatients with schistosomiasis-related appendicitis with a global prevalence of 1.31% (95% confidence interval (CI): 0.72 to 2.06); a high heterogeneity (I2 = 96.0%) was observed. Studies carried out in Africa reported a significantly higher prevalence of schistosomiasis-related appendicitis (2.75%; 95% CI: 1.28 to 4.68) than those in Middle East (0.49%; 95% CI: 0.18 to 0.95) (p for interaction < 0.0001). Conclusions Schistosomiasis infection should be considered as possible cause of appendicitis not only in endemic areas but also in developed countries. Considering that prevention is the best way to control the infection, more efforts should be put in place in order to increase the prevention coverage and avoid the cascading implications for health. This is even more so important in this Coronavirus Disease 2019 (COVID-19) era where the majority of attention and funds are used to fight the pandemic.

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Crowdsourcing Covid-19 signals in sub-Saharan Africa: Leveraging digital contributor networks for participatory surveillance of Covid-19 symptoms and deaths (Preprint)

10.2196/preprints.26347 ◽

2020 ◽

Author(s):

Ngozi A Erondu ◽

Sagal A Ali ◽

Mohamed Ali ◽

Schadrac C Agbla

Keyword(s):

Public Health ◽

Sub Saharan Africa ◽

Specific Information ◽

Surveillance Systems ◽

Health Seeking ◽

African Countries ◽

Cross Sectional Survey ◽

Local Networks ◽

The World ◽

Sub Saharan

BACKGROUND In sub-Saharan Africa, underreporting of cases and deaths has been attributed to various factors including, weak disease surveillance, low health-seeking behaviour of flu like symptoms, and stigma of Covid-19. There is evidence that SARS-CoV-2 spread mimics transmission patterns of other countries across the world. Since the Covid-19 pandemic has changed the way research can be conducted and in light of restrictions on travel and risks to in-person data collection, innovative approaches to collecting data must be considered. Nearly 50% of Africa’s population is a unique mobile subscriber and it is one of the fastest growing smart-phone marketplaces in the world; hence, mobile phone platforms should be considered to monitor Covid-19 trends in the community. OBJECTIVE We demonstrate the use of digital contributor platforms to survey individuals about cases of flu-like symptoms and instances of unexplained deaths in Ethiopia, Kenya, Nigeria, Somalia, and Zimbabwe. METHODS Rapid cross-sectional survey of individuals with severe flu and pneumonia symptoms and unexplained deaths in Ethiopia, Kenya, Nigeria, Somalia and Zimbabwe RESULTS Using a non-health specific information platform, we found COVID-19 signals in five African countries, specifically: •Across countries, nearly half of the respondents (n=739) knew someone who had severe flu or pneumonia symptoms in recent months. •One in three respondents from Somalia and one in five from Zimbabwe respondents said they knew more than five people recently displaying flu and/or pneumonia symptoms. •In Somalia there were signals that a large number of people might be dying outside of health facilities, specifically in their homes or in IDP or refugee camps. CONCLUSIONS Existing digital contributor platforms with local networks are a non-traditional data source that can provide information from the community to supplement traditional government surveillance systems and academic surveys. We demonstrate that using these distributor networks to for community surveys can provide periodic information on rumours but could also be used to capture local sentiment to inform public health decision-making; for example, these insights could be useful to inform strategies to increase confidence in Covid19 vaccine. As Covid-19 continues to spread somewhat silently across sub-Saharan Africa, regional and national public health entities should consider expanding event-based surveillance sources to include these systems.

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Khat chewing and risky sexual behavior in Sub-Saharan Africa: a systematic review protocol

The JBI Database of Systematic Reviews and Implementation Reports ◽

10.11124/jbisrir-2013-877 ◽

2013 ◽

Vol 11 (12) ◽

pp. 59-67 ◽

Cited By ~ 4

Author(s):

Amanuel Tesfay Gebremedhin ◽

Hailay Abrha Gesesew ◽

Tariku Dejene Demissie ◽

Mirkuzie Woldie Kerie ◽

Morankar Sudhakar

Keyword(s):

Systematic Review ◽

Sexual Behavior ◽

Risky Sexual Behavior ◽

Sub Saharan Africa ◽

Systematic Review Protocol ◽

Khat Chewing ◽

Review Protocol ◽

Sub Saharan

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Gambling Patterns and Problem Gambling Among Youth in Sub-Saharan Africa: A Systematic Review

Journal of Gambling Studies ◽

10.1007/s10899-021-10001-w ◽

2021 ◽

Author(s):

Byron K. Y. Bitanihirwe ◽

Derrick Ssewanyana

Keyword(s):

Systematic Review ◽

Problem Gambling ◽

Sub Saharan Africa ◽

Sub Saharan ◽

Gambling Patterns

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Predictors of lost to follow up from antiretroviral therapy among adults in sub-Saharan Africa: a systematic review and meta-analysis

Infectious Diseases of Poverty ◽

10.1186/s40249-021-00822-7 ◽

2021 ◽

Vol 10 (1) ◽

Author(s):

Hafte Kahsay Kebede ◽

Lillian Mwanri ◽

Paul Ward ◽

Hailay Abrha Gesesew

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Meta Analysis ◽

Sub Saharan Africa ◽

Hiv Care ◽

Care Services ◽

Validity Assessment ◽

Sub Saharan ◽

Lost To Follow Up

Abstract Background It is known that ‘drop out’ from human immunodeficiency virus (HIV) treatment, the so called lost-to-follow-up (LTFU) occurs to persons enrolled in HIV care services. However, in sub-Saharan Africa (SSA), the risk factors for the LTFU are not well understood. Methods We performed a systematic review and meta-analysis of risk factors for LTFU among adults living with HIV in SSA. A systematic search of literature using identified keywords and index terms was conducted across five databases: MEDLINE, PubMed, CINAHL, Scopus, and Web of Science. We included quantitative studies published in English from 2002 to 2019. The Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) was used for methodological validity assessment and data extraction. Mantel Haenszel method using Revman-5 software was used for meta-analysis. We demonstrated the meta-analytic measure of association using pooled odds ratio (OR), 95% confidence interval (CI) and heterogeneity using I2 tests. Results Thirty studies met the search criteria and were included in the meta-analysis. Predictors of LTFU were: demographic factors including being: (i) a male (OR = 1.2, 95% CI 1.1–1.3, I2 = 59%), (ii) between 15 and 35 years old (OR = 1.3, 95% CI 1.1–1.3, I2 = 0%), (iii) unmarried (OR = 1.2, 95% CI 1.2–1.3, I2 = 21%), (iv) a rural dweller (OR = 2.01, 95% CI 1.5–2.7, I2 = 40%), (v) unemployed (OR = 1.2, 95% CI 1.04–1.4, I2 = 58%); (vi) diagnosed with behavioral factors including illegal drug use(OR = 13.5, 95% CI 7.2–25.5, I2 = 60%), alcohol drinking (OR = 2.9, 95% CI 1.9–4.4, I2 = 39%), and tobacco smoking (OR = 2.6, 95% CI 1.6–4.3, I2 = 74%); and clinical diagnosis of mental illness (OR = 3.4, 95% CI 2.2–5.2, I2 = 1%), bed ridden or ambulatory functional status (OR = 2.2, 95% CI 1.5–3.1, I2 = 74%), low CD4 count in the last visit (OR = 1.4, 95% CI 1.1–1.9, I2 = 75%), tuberculosis co-infection (OR = 1.2, 95% CI 1.02–1.4, I2 = 66%) and a history of opportunistic infections (OR = 2.5, 95% CI 1.7–2.8, I2 = 75%). Conclusions The current review identifies demographic, behavioral and clinical factors to be determinants of LTFU. We recommend strengthening of HIV care services in SSA targeting the aforementioned group of patients. Trial registration Protocol: the PROSPERO Registration Number is CRD42018114418

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