Challenges of contact tracing during COVID-19 pandemic response in a tertiary hospital in Northwestern Nigeria

Background: Contact tracing is a traditional pillar of infectious disease control, especially for illnesses involving direct transmission from person to person, such as COVID-19. Several challenges have arisen from COVID-19 contact tracing activities, particularly in low-resource settings. These include refusal of positive clients to disclose their close contacts, difficulties in conducting risk assessment for contacts traced, among others. Objectives: To explore the activities and identify challenges of contact tracing during COVID -19 pandemic response in a tertiary hospital in Northwestern Nigeria from May, 2020 to March, 2021. Methodology: Amixed method approach was done with quantitative secondary data analysis of COVID-19 contacts traced, and qualitative assessment through Key Informant Interviews (KII) of Ahmadu Bello University Teaching Hospital staff involved in COVID-19 outbreak response during the period. Results: Atotal of 2,249 clients were tested for COVID-19, of which 925 (41.1%) were healthcare workers. The identified challenges included problems with contact identification, delay in notification of results, refusal to disclose contacts by cases, contacts refusing to allow risk assessment, and health workers being overwhelmed by the task of contact tracing. Conclusion: Challenges identified include refusal of cases to disclose their contacts, overwhelming number of contacts, and delay in notification of results. There is need to institute contact tracing protocols to mandate cases to disclose their contacts, train more manpower to reduce the burden of contact tracing, and improve the notification of results.

Partner notification and associated factors among people living with human immunodeficiency Virus in Bushenge Hospital, Rwanda

Introduction Partner notification is among strategies adopted by WHO to identify people at risk of HIV infection among sexual partners with people living with HIV to achieve the 90-90-90 target. There is still a gap in Sub-Saharan Africa. Objective To assess the determinants of partner notification among people infected with HIV in Bushenge hospital. Methods An unmatched case control study was conducted, 141 people who successfully notified their sexual partners as controls and 141 who did not as cases were selected to identify the factors associated with partner notification. Data were analyzed with Stata V13. Results Most cases were female 81(58%); 91(64.5%) of cases and 97(68.8.5%) of controls were in couple, 40(28.8%)of cases and 67(48%) of controls had multiple partner. Thirty-five 35(25%) of cases and 51(36%) of controls were newly diagnosed; 73(74%) of cases and 78(86.6%) suppressed the viral load. Notification approach was associated with partner notification, aOR = 9, CI[2.8, 29]. Conclusion Partner notification as one of the strategies to reach the first 90 requires more efficient and effective efforts. Different initiatives are needed especially in partner notification approach.

Utility of early diagnosis, contact tracing and stakeholder engagement in outbreak response in three COVID-19 outbreak settings in Ghana

Objective: To describe how early case detection, testing and contact tracing measures were deployed by stakeholders in response to the COVID-19 outbreak in Ghana ­ using three outbreak scenarios. Design: A descriptive assessment of three case studies of COVID-19 outbreaks within three settings that occurred in Ghana from March 13 till the end of June 2020. Setting: A construction camp, a factory and a training institution in Ghana. Participants: Staff of a construction camp, a factory, workers and students of a training institution. Interventions: We described and compared the three COVID-19 outbreak scenarios in Ghana, highlighting identification and diagnosis of cases, testing, contact tracing and stakeholder engagement for each scenario. We also outlined the challenges and lessons learnt in the management of these scenarios. Main outcome measures: Approach used for diagnosis, testing, contact tracing and stakeholder engagement. Results: Index cases of the training institution and construction camp were screened the same day of reporting symptoms, whiles the factory index case required a second visit before the screening. All index cases were tested with RTPCR. The training institution followed and tested all contacts, and an enhanced contact tracing approach was conducted for staff of the other two sites. Multi-sectorial engagement and collaboration with stakeholders enabled effective handling of the outbreak response in all sites. Conclusion: Comparing all three settings, early diagnosis and prompt actions taken through multi-sectorial collaborations played a major role in controlling the outbreak. Engaging stakeholders in the COVID-19 response is an effective way to mitigate the challenges in responding to the pandemic.

Contact tracing during the COVID-19 pandemic: Protection of personal information in South Africa

Containing the COVID-19 pandemic necessitates the use of personal information without the consent of the person. The protection of personal information is fundamental to the rights that ensure an open and democratic society. When regulations that limit the right to privacy are issued outside of the democratic process, every effort must be made to protect personal information and privacy. The limitation of human rights must be treated as an exception to the norm, and any regulations should be drafted to ensure minimum limitation of rights, rather than to the minimum acceptable standard. The contact tracing regulations included in the COVID-19 disaster regulations include some basic principles to ensure privacy; however, other important principles are not addressed. These include principles of transparency and data security. The envisaged future use of human data for research purposes, albeit de-identified, needs to be addressed by the COVID-19 designated judge appointed under the regulations

South Africa's COVID-19 Tracing Database: Risks and rewards of which doctors should be aware

In response to the COVID-19 pandemic, South Africa (SA) has established a Tracing Database, collecting both aggregated and individualised mobility and locational data on COVID-19 cases and their contacts. There are compelling public health reasons for this development, since the database has the potential to assist with policy formulation and with contact tracing. While potentially demonstrating the rapid facilitation through technology of an important public service, the Tracing Database does, however, infringe immediately upon constitutional rights to privacy and heightens the implications of ethical choices facing medical professionals. The medical community should be aware of this surveillance innovation and the risks and rewards it raises. To deal with some of these risks, including the potential for temporary rights- infringing measures to become permanent, there are significant safeguards designed into the Tracing Database, including a strict duration requirement and reporting to a designated judge. African states including SA should monitor this form of contact tracing closely, and also encourage knowledge-sharing among cross-sectoral interventions such as the Tracing Database in responding to the COVID-19 pandemic

Psycho-social determinants for sexual partner referral in Uganda : quantitative Results

The purpose of this study was to investigate the factors influencing sexual partner referral using the attitude-social influence - self efficacy model as a guiding theoretical. The data was collected in an interview survey with 236 women and 190 men attending a sexually transmitted disease clinic in Kampala; Uganda. Intention; attitude; subjective norm; self-efficacy; and past behaviour predicted partner referral for women whereas intention; self efficacy; and previous behaviour predicted partner referral for men. For the women the strongest predictors for intention were self-efficacy followed by partner type and self efficacy. Social influence was a better predictor of intention for women than for men. An analysis of underlying cognitive beliefs discriminating those who referred and those who did not refer the sexual partner showed that attitudinal beliefs were the most important for men whereas self-efficacy beliefs were the most important for women. The targeting of the gender based descriminatory beleifs in intervention may improve compliance with sexual partner referral