Impact of hydroxychloroquin/azithromycin protocol on COVID-19 case-fatality rate reduction in Algeria. (Preprint)

2020 ◽  
Author(s):  
Ahmed Youssef Kada

BACKGROUND Covid-19 is an emerging infectious disease like viral zoonosis caused by new coronavirus SARS CoV 2. On December 31, 2019, Wuhan Municipal Health Commission in Hubei province (China) reported cases of pneumonia, the origin of which is a new coronavirus. Rapidly extendable around the world, the World Health Organization (WHO) declares it pandemic on March 11, 2020. This pandemic reaches Algeria on February 25, 2020, date on which the Algerian minister of health, announced the first case of Covid-19, a foreign citizen. From March 1, a cluster is formed in Blida and becomes the epicentre of the coronavirus epidemic in Algeria, its total quarantine is established on March 24, 2020, it will be smoothly alleviated on April 24. A therapeutic protocol based on hydroxychloroquine and azithromycin was put in place on March 23, for complicated cases, it was extended to all the cases confirmed on April 06. OBJECTIVE This study aimed to demonstrate the effectiveness of hydroxychloroquin/azithromycin protocol in Algeria, in particular after its extension to all patients diagnosed COVID-19 positive on RT-PCR test. We were able to illustrate this fact graphically, but not to prove it statistically because the design of our study, indeed in the 7 days which followed generalization of therapeutic protocol, case fatality rate decrease and doubling time increase, thus confirming the impact of wide and early prescription of hydroxychloroquin/azithromycin protocol. METHODS We have analyzed the data collected from press releases and follow-ups published daily by the Ministry of Health, we have studied the possible correlations of these data with certain events or decisions having a possible impact on their development, such as confinement at home and its reduction, the prescription of hydroxychloroquine/azithromycin combination for serious patients and its extension to all positive COVID subjects. Results are presented in graphics, the data collection was closed on 31/05/2020. RESULTS Covid-19 pandemic spreads from February 25, 2020, when a foreign citizen is tested positive, on March 1 a cluster is formed in the city of Blida where sixteen members of the same family are infected during a wedding party. Wilaya of Blida becomes the epicentre of coronavirus epidemic in Algeria and lockdown measures taken, while the number of national cases diagnosed begins to increases In any event, the association of early containment measures combined with a generalized initial treatment for all positive cases, whatever their degree of severity, will have contributed to a reduction in the fatality rate of COVID 19 and a slowing down of its doubling time. CONCLUSIONS In Algeria, the rapid combination of rigorous containment measure at home and early generalized treatment with hydroxychloroquin have demonstrated their effectiveness in terms of morbidity and mortality, the classic measures of social distancing and hygiene will make it possible to perpetuate these results by reducing viral transmission, the only unknown, the reopening procedure which can only be started after being surrounded by precautions aimed at ensuring the understanding of the population. CLINICALTRIAL Algeria, Covid-19, pandemic, hydroxychloroquin, azithromycin, case fatality rate

2021 ◽  
Vol 5 (1) ◽  
pp. 713
Author(s):  
Evi Diliana Rospia ◽  
Dwi Kartika Cahyaningtyas ◽  
Desi Rofita ◽  
Cahaya Indah Lestari ◽  
Ni Wayan Ari Adi Putri ◽  
...  

ABSTRAKNovel coronavirus 2019 atau virus corona sindrom pernafasan akut parah yang disebut COVID-19. Gejala klinis utama yang muncul yaitu demam, batuk dan kesulitan bernapas. World Health Organization (WHO) melaporkan 11.84.226 kasus konfirmasi dengan 545.481 kematian di seluruh dunia (Case Fatality Rate/CFR 4,6%). Di Indonesia kasus meningkat dan menyebar dengan cepat, kasus pertama pada tanggal 2 Maret 2020, pada tanggal 9 Juli 2020 Kementerian Kesehatan melaporkan 70.736 kasus konfirmasi COVID-19 dengan 3.417 kasus meninggal (CFR 4,8%). Kegiatan vaksinasi masal ini bertujuan terbentuknya herd immunity (kekebalan kelompok) dan berkurangnya angka kematian akibat COVID-19 pada masyarakat. Kegiatan vaksinasi masal dilaksanakan di Universitas Muhammadiyah Mataram Kota Mataram Nusa Tenggara Barat, dan jenis vaksin yang digunakan pada kegiatan vaksinasi masal ini adalah Sinovac. Jumlah responden yang mengikuti kegiatan ini sebanyak 1.000 orang. Hasil pengabdian didapatkan jumlah yang melakukan vaksinasi sebanyak 1000 orang yang terdiri dari masyarakat umum dan karyawan Universitas Muhammadiyah Mataram. Kata kunci: vaksinasi; covid-19; komunitas; indonesia. ABSTRACTNovel coronavirus 2019 or severe acute respiratory syndrome coronavirus called COVID-19. The main symptoms that appear are fever, cough and difficulty breathing. The World Health Organization (WHO) reports 11,84,226 confirmed cases with 545,481 deaths worldwide (Case Fatality Rate/CFR 4.6%) In Indonesia cases are increasing and spreading rapidly, the first case on March 2, 2020, on July 9 2020 The Ministry of Health reported 70,736 confirmed cases of COVID-19 with 3,417 deaths (CFR 4.8%). This mass vaccination activity aims to form herd immunity and reduce the death rate due to COVID-19 in the community. The mass vaccination activity was carried out at the Muhammadiyah University of Mataram, and the type of vaccine used in this mass vaccination activity was Sinovac. The number of respondents who participated in this activity was 1,000 people. The results of the service found that the number of people who vaccinated was 1000 people consisting of the general public and employees of the Muhammadiyah University of Mataram. Keywords: vaccination; covid-19; community; indonesia. 


Author(s):  
Daniel Martin Simadibrata ◽  
Cleopas Martin Rumende ◽  
Rahmad Mulyadi ◽  
Marcellus Simadibrata

Coronavirus disease 2019 (COVID-19) is an emerging infectious disease officially declared as a pandemic on 11 March 2020 by the World Health Organization (WHO). Indonesia’s COVID-19 case fatality rate remain consistently high, approximately twice the global case fatality rate available. Patients typically present with fever, dry cough and dyspnea. However, there were reports of atypical COVID-19 symptoms such as myalgia, fatigue, diarrhea, nausea, and vomiting. These atypical presentations were suggested to indicate a more severe COVID-19. Here, we present a case of COVID-19 patient presenting with gastrointestinal-specific symptoms in Indonesia.


2021 ◽  
Author(s):  
Suaad Ameen Moghalles ◽  
Basher Ahmed Aboasba ◽  
Mohammed Abdullah Alamad ◽  
Yousef Saleh Khader

BACKGROUND As a consequence of war and the collapse of the health system in Yemen, which prevented many people from accessing health facilities to obtain primary health care, vaccination coverage was affected, leading to a deadly diphtheria epidemic at the end of 2017. OBJECTIVE This study aimed to describe the epidemiology of diphtheria in Yemen and determine its incidence and case fatality rate. METHODS Data were obtained from the diphtheria surveillance program 2017-2018, using case definitions of the World Health Organization. A probable case was defined as a case involving a person having laryngitis, pharyngitis, or tonsillitis and an adherent membrane of the tonsils, pharynx, and/or nose. A confirmed case was defined as a probable case that was laboratory confirmed or linked epidemiologically to a laboratory-confirmed case. Data from the Central Statistical Organization was used to calculate the incidence per 100,000 population. A <i>P</i> value &lt;.05 was considered significant. RESULTS A total of 2243 cases were reported during the period between July 2017 and August 2018. About 49% (1090/2243, 48.6%) of the cases were males. About 44% (978/2243, 43.6%) of the cases involved children aged 5 to 15 years. Respiratory tract infection was the predominant symptom (2044/2243, 91.1%), followed by pseudomembrane (1822/2243, 81.2%). Based on the vaccination status, the percentages of partially vaccinated, vaccinated, unvaccinated, and unknown status patients were 6.6% (148/2243), 30.8% (690/2243), 48.6% (10902243), and 14.0% (315/2243), respectively. The overall incidence of diphtheria was 8 per 100,000 population. The highest incidence was among the age group &lt;15 years (11 per 100,000 population), and the lowest incidence was among the age group ≥15 years (5 per 100,000 population). The overall case fatality rate among all age groups was 5%, and it was higher (10%) in the age group &lt;5 years. Five governorates that were difficult to access (Raymah, Abyan, Sa'ada, Lahj, and Al Jawf) had a very high case fatality rate (22%). CONCLUSIONS Diphtheria affected a large number of people in Yemen in 2017-2018. The majority of patients were partially or not vaccinated. Children aged ≤15 years were more affected, with higher fatality among children aged &lt;5 years. Five governorates that were difficult to access had a case fatality rate twice that of the World Health Organization estimate (5%-10%). To control the diphtheria epidemic in Yemen, it is recommended to increase routine vaccination coverage and booster immunizations, increase public health awareness toward diphtheria, and strengthen the surveillance system for early detection and immediate response.


Author(s):  
Anamaria Ioana PAȘTIU ◽  
Vlad COCOSTÎRC ◽  
Carmen TURCU ◽  
Felix LUCACI ◽  
Dana Liana PUSTA

December 2019 was marked by the emergence of a novel human coronavirus (SARS-CoV-2) in Wuhan, China, which causes a variety of symptoms, commonly known as COVID-19. The high contagiousness, rapid worldwide spread and case fatality rate have led to a sharp increase in number of infected persons and related deaths, which subsequently resulted in the recognition of the COVID-19 outbreak as a pandemic by the World Health Organization. SARS-CoV-2 is an ongoing challenge not only for the healthcare professional but also for the general population. The aim of this literature review is to summarize the currently available data on COVID-19 regarding the origins, pathogenesis and epidemiology.


2021 ◽  
Vol 2 (4) ◽  
pp. 01-08
Author(s):  
Gouri Sakre ◽  
Gulappa Devagappanavar

Background: According to CDC, Coronavirus disease 2019 (COVID-19) is caused by a new coronavirus which was first identified in Wuhan, China, in December 2019. Although most people who have COVID-19 have mild symptoms, it can also cause severe illness and even death. Some groups, including older adults and people who have certain underlying medical conditions, are at increased risk of severe illness. On February 11, 2020, the World Health Organization announced an official name for the disease that is causing the 2019 novel coronavirus outbreak. The new name of this disease is coronavirus disease 2019, abbreviated as COVID-19. Objectives: Analysis of COVID 19 data in the Davanagere district from April 2020 to August 2020. Methods: In this current study the secondary data is obtained from the Official Website of Government of Karnataka, Covid-19 Informational Portal – Media Bulletin. By using different indicators Davanagere district covid data is further used to calculate Attack rate, Case fatality rate and complete case fatality rate. Results: In this study it is found that, in the month of April there were no covid positive cases reported till fourth week of month, by fourth week, total two positive cases were reported the first case being encountered on 28th April 2020, with discharge of those patient in the end of the month. The attack rate has steeped up from 8.018 to 355.74 per one lakh population i.e. about 44 times more than initial months of pandemic. The strict preventive measures were followed by public and government too. So the prevalence rate is less in May, June and went on increasing once the unlocking is done. In summer the total positive cases steeping up from 2 cases to 154 total positive cases for the month April to May, and there is steady in rise of total positive cases for the month June with total positive cases of 153. In the beginning of summer there were fewer cases as pandemic was just begun and chances of transmission were very less. As monsoon appeared in June last week there is surge in total positive cases. With added burden of Unlock 1.0 phase, as public started moving out from home without any freak of infection. Conclusion: In this study it is found that due to strict nationwide lockdown and social distancing, hygiene practices among the Davanagere people has made it possible to restrict the spread of covid among the people, although the international immigration of Davanagere residents lead to transmission of infection. Further removal of lockdown after three months has lead to three fold spread of disease. Also there is rise in death rate, attack rate and case fatality in Davanagere district.


2020 ◽  
Vol 90 (3) ◽  
Author(s):  
Shahir Asfahan ◽  
Aneesa Shahul ◽  
Gopal Chawla ◽  
Naveen Dutt ◽  
Ram Niwas ◽  
...  

Coronavirus disease 2019, i.e. COVID-19, started as an outbreak in a district of China and has engulfed the world in a matter of 3 months. It is posing a serious health and economic challenge worldwide. However, case fatality rates (CFRs) have varied amongst various countries ranging from 0 to 8.91%. We have evaluated the effect of selected socio-economic and health indicators to explain this variation in CFR. Countries reporting a minimum of 50 cases as on 14th March 2020, were selected for this analysis. Data about the socio-economic indicators of each country was accessed from the World bank database and data about the health indicators were accessed from the World Health Organisation (WHO) database. Various socioeconomic indicators and health indicators were selected for this analysis. After selecting from univariate analysis, the indicators with the maximum correlation were used to build a model using multiple variable linear regression with a forward selection of variables and using adjusted R-squared score as the metric. We found univariate regression results were significant for GDP (Gross Domestic Product) per capita, POD 30/70 (Probability Of Dying Between Age 30 And Exact Age 70 From Any of Cardiovascular Disease, Cancer, Diabetes or Chronic Respiratory Disease), HCI (Human Capital Index), GNI(Gross National Income) per capita, life expectancy, medical doctors per 10000 population, as these parameters negatively corelated with CFR (rho = -0.48 to -0.38 , p<0.05). Case fatality rate was regressed using ordinary least squares (OLS) against the socio-economic and health indicators. The indicators in the final model were GDP per capita, POD 30/70, HCI, life expectancy, medical doctors per 10,000, median age, current health expenditure per capita, number of confirmed cases and population in millions. The adjusted R-squared score was 0.306. Developing countries with a poor economy are especially vulnerable in terms of COVID-19 mortality and underscore the need to have a global policy to deal with this on-going pandemic. These trends largely confirm that the toll from COVID-19 will be worse in countries ill-equipped to deal with it. These analyses of epidemiological data are need of time as apart from increasing situational awareness, it guides us in taking informed interventions and helps policy-making to tackle this pandemic.


2021 ◽  
Vol 15 (1) ◽  
pp. 53-63
Author(s):  
Anna Sączewska-Piotrowska ◽  
Damian Piotrowski

The aim of this study was to assess the case fatality rate (CFR) of COVID-19 by performing a meta-analysis according to the air temperature and to determine if the temperature modifies the pandemic duration to the peak day for CFR of the COVID-19. A novel coronavirus spread began in December 2019 in Wuhan, China, and half a year after, more than 9 million total cases were confirmed worldwide. Therefore, knowing the conditions favorable for the spread of the virus (including weather conditions) is crucial from the perspective of the entire population. Using information from the World Health Organization, subgroup meta-analysis by temperature was performed. Survival analysis using the Kaplan-Meier estimates and the Cox proportional hazards models was conducted. Based on the conducted analysis we can conclude that in countries with temperature equal or lower than 14.8°C the pooled CFR of COVID-19 is higher than in countries with tempera ture greater than 14.8°C. Besides, in countries with lower temperature the peak of the CFR appears after a longer time from the first case of the novel coronavirus than in countries with higher temperature.


2020 ◽  
Author(s):  
Manisha Mandal ◽  
Shyamapada Mandal

Abstract There is a huge loss of lives worldwide in relation to COVID-19 pandemic, the primary epicentre of which is China, where the causative agent of the disease called SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) was first emerged in December 2019. In view of this the severity, in terms of case fatality rate (CFR), is essential to explore for COVID-19. Data of ongoing COVID-19 global pandemic have been retrieved from publicly accessible website of the WHO (World Health Organization), and were processed for the estimation of global (both including and excluding China) CFRs of COVID-19. The CFRs were explored following the naive estimates, 14-day delay estimates, and linear regression model analysis, for the period between January 25, 2020 and April 25, 2020, on weekly basis. To explore the current situation, in terms of global CFR, data for the next 6 weeks (May 2, 2020 through June 6, 2020), were processed by naive and linear regression model analysis. Mean CFRs, in the naive estimates, were 4.59% (95% CI: 3.59 – 5.59) for the world including China, and 3.62% (95% CI: 2.01 – 5.23) for the world excluding China. The 14-day delay estimates of CFRs were 15.6% (95% CI: 7.18 – 24.02) globally, and 21.65% (95% CI: 11.15 – 32.15) in countries outside China. Following statistical model analysis, the global (both including and excluding China) CFRs were 6.81%, by naive estimates, and ~13%, by 14-day delay estimates. The global CFR of COVID-19 during May 2, 2020 to June 6, 2020, ranged 5.9 – 7.04% (mean: 6.58%; 95% CI: 6.11 – 7.03), by naive estimates, and by statistical regression analysis the CFR was 4.78%. The CFR as explored in the current study might help estimate the need of up-to-date hospital supplies and other mitigation measures for COVID-19 ongoing pandemic.


2021 ◽  
Vol 4 (3) ◽  
Author(s):  
Gulappa Devagappanavar

Background: According to CDC, Coronavirus disease 2019 (COVID-19) is caused by a new coronavirus which was first identified in Wuhan, China, in December 2019. Although most people who have COVID-19 have mild symptoms, it can also cause severe illness and even death. Some groups, including older adults and people who have certain underlying medical conditions, are at increased risk of severe illness. On February 11, 2020, the World Health Organization announced an official name for the disease that is causing the 2019 novel coronavirus outbreak. The new name of this disease is coronavirus disease 2019, abbreviated as COVID-19. Objectives: Analysis of COVID 19 data in the Davanagere district from April 2020 to August 2020. Methods: In this current study the secondary data is obtained from the Official Website of Government of Karnataka, Covid-19 Informational Portal – Media Bulletin. By using different indicators Davanagere district COVID data is further used to calculate Attack rate, Case fatality rate and complete case fatality rate. Results: In this study it is found that, in the month of April there were no COVID positive cases reported till fourth week of month, by fourth week, total two positive cases were reported the first case being encountered on 28th April 2020, with discharge of those patient in the end of the month. The attack rate has steeped up from 8.018 to 355.74 per one lakh population i.e. about 44 times more than initial months of pandemic. The strict preventive measures were followed by public and government too. So the prevalence rate is less in May, June and went on increasing once the unlocking is done. In summer the total positive cases steeping up from 2 cases to 154 total positive cases for the month April to May, and there is steady in rise of total positive cases for the month June with total positive cases of 153. In the beginning of summer there were fewer cases as pandemic was just begun and chances of transmission were very less. As monsoon appeared in June last week there is surge in total positive cases. With added burden of Unlock 1.0 phase, as public started moving out from home without any freak of infection. Conclusion: In this study it is found that due to strict nationwide lockdown and social distancing, hygiene practices among the Davanagere people has made it possible to restrict the spread of covid among the people, although the international immigration of Davanagere residents lead to transmission of infection. Further removal of lockdown after three months has lead to three fold spread of disease. Also there is rise in death rate, attack rate and case fatality in Davanagere district


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Firas J. Raheman ◽  
Djamila M. Rojoa ◽  
Jvalant Nayan Parekh ◽  
Reshid Berber ◽  
Robert Ashford

AbstractIncidence of hip fractures has remained unchanged during the pandemic with overlapping vulnerabilities observed in patients with hip fractures and those infected with COVID-19. We aimed to investigate the independent impact of COVID-19 infection on the mortality of these patients. Healthcare databases were systematically searched over 2-weeks from 1st–14th November 2020 to identify eligible studies assessing the impact of COVID-19 on hip fracture patients. Meta-analysis of proportion was performed to obtain pooled values of prevalence, incidence and case fatality rate of hip fracture patients with COVID-19 infection. 30-day mortality, excess mortality and all-cause mortality were analysed using a mixed-effects model. 22 studies reporting 4015 patients were identified out of which 2651 (66%) were assessed during the pandemic. An excess mortality of 10% was seen for hip fractures treated during the pandemic (OR 2.00, p = 0.007), in comparison to the pre-pandemic controls (5%). Estimated mortality of COVID-19 positive hip fracture patients was four-fold (RR 4.59, p < 0.0001) and 30-day mortality was 38.0% (HR 4.73, p < 0.0001). The case fatality rate for COVID-19 positive patients was 34.74%. Between-study heterogeneity for the pooled analysis was minimal (I2 = 0.00) whereas, random effects metaregression identified subgroup heterogeneity for male gender (p < 0.001), diabetes (p = 0.002), dementia (p = 0.001) and extracapsular fractures (p = 0.01) increased risk of mortality in COVID-19 positive patients.


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