Determinants of time to viral clearance among SARS-CoV-2 infected individuals at Millennium COVID-19 care center in Ethiopia: A prospective observational study

Background: Understanding the COVID-19 disease course in terms of viral shedding is important to assist in providing a tailored isolation and treatment practice. Therefore, the current study aimed to estimate time to viral clearance and identify determinants among SARS-CoV-2 infected individuals admitted to Millennium COVID-19 Care Center in Ethiopia. Methods: A Prospective observational study was conducted among 360 randomly selected SARS-CoV-2 infected individuals who were on follow up from 2nd June to 5th July 2020. Kaplan Meier plots, median survival times, and Log-rank test were used to describe the data and compare survival distribution between groups. Association between time to viral clearance and determinants was assessed using the Cox proportional hazard survival model, where hazard ratio, P-value, and 95% CI for hazard ratio were used for testing significance Results: The Median time to viral clearance was 16 days. The log-rank test shows that having moderate and severe disease, one or more symptoms at presentation, and presenting with respiratory and constitutional symptoms seems to extend the time needed to achieve viral clearance. The Final Cox regression result shows that the rate of achieving viral clearance among symptomatic patients was 44% lower than patients who were asymptomatic (AHR=0.560, 95% CI=0.322-0.975, p-value=0.040). Conclusions: Presence of symptoms was found to be associated with delayed viral clearance implying that symptomatic patients are more likely to be infectious and therefore, attention should be paid to the practices regarding isolation and treatment of COVID-19 patients.

Perception and practice of social distancing among Egyptians in COVID-19 pandemic

Introduction: Social distancing is principally intended to reduce infectious disease transmission by decreasing interactions among people in a broader community. Keeping social distancing is an essential public health measure to resist the COVID-19 pandemic.Methodology: a cross sectional study was conducted among 1,036 Egyptians using an online questionnaire between 5 and 10 May 2020.Results: There was significant association between the practice of social distancing and some sociodemographic factors as sex, age, education, working status, and place of residence at p value < 0.001 and with community of residence at pvalue 0.021.Conclusions: Egyptians had good perception for social distancing to prevent transmission of COVID 19, but they were not strictly practicing it

COVID-19 Pandemic in Nigeria: A review

Background: An ongoing outbreak of pneumonia associated with a novel coronavirus was reported in Wuhan city, China. This new virus was named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by the Coronavirus Study Group (CSG) of the International Committee on Taxonomy of Viruses. That disease, caused by the SARS-CoV-2, has been named coronavirus disease 2019 (COVID-19) by the WHO. The outbreak has since spread across the globe, including countries in Africa. Main body: The dominant mode of transmission is from the respiratory tract, via droplets or indirectly via fomites, and to a lesser extent via aerosols. The rapidity with which the infection spread throughout the world was unexpected. The disease has now affected 212 countries, areas, or territories, with more than 2.1 million total confirmed cases and over 144 thousand fatalities as at the time of writing. It, therefore, behooves countries of the world to take firm public health measures for the pandemic is to be contained. Conclusion: Nigeria, with a population of at least 170 million people, is of global interest because a rapid rise in the number of infected people will have serious implications not only for the country but for the whole African continent

Emerging statistics on the epidemiology of COVID-19: Making prevention in pregnancy less grievous than the disease

Background:Pregnant women are a vulnerable group to the COVID-19 infection; although it is expected that adaptive changes of pregnancy put them at increased risk of adverse outcome from any respiratory tract infection, interventions for the COVID-19 may put them in more danger. Nigeria is one of the leading countries with very poor maternal mortality indices and many other sub-Saharan African nations are in the same boat. Contingency plans need to beput in place to prevent precipitous deterioration in mortality rates occasioned by the dreaded SARS-Cov-2 pandemic. This mini-review of literature and WHO global statistics is aimed to determine the trends in COVID-19 transmission and mortality rates to provide evidence-based information that may enable governments to tailor their interventions to the peculiar needs, of sub-Saharan African populations.Main body:Emerging epidemiological trends on transmission and mortality within Africa and the worst affected regions of the world suggests better outcomes of this infection in sub-Saharan Africa, than in other regions of the world. Also, present data allude to similar outcomes between pregnant and non-pregnant women. The present containment measures of isolation and quarantine, including city-wide lockdowns, may put pregnant women at higher risk of death from other causes rather than COVID-19. The danger posed, is the limitation of access to emergency obstetric care services when pregnant women develop non-COVID-19 complications of pregnancy.Conclusion:The COVID-19 pandemic has lower local transmission rates and fatality in Africa, the region where the virus arrived last. While special efforts should be geared at shielding the elderly and infirm from contracting the infection, preventive measures in pregnant women must allow for access to emergency obstetric care to forestall iatrogenic adverse maternal outcomes

The use of corticosteroids for COVID-19 infection

The SARS-CoV-2 pandemic is continuing relentlessly in many parts of the world and has resulted in the outpouring of literature on various aspects of the infection, including studies and recommendations regarding the optimal treatment of infected patients. Not surprisingly, the use of corticosteroids in the management of such patients has featured prominently in many of these publications. There is considerable debate in the literature as to the likely benefits, as well as the potential detrimental effects of corticosteroid therapy in general viral respiratory infections and, in particular, COVID-19 infections. While the definitive answer may need to await the results of ongoing randomised, controlled trials recent studies suggest that corticosteroid use in COVID-19 cases with hypoxaemia may benefit from low-dose corticosteroid therapy

Evaluating the response to the scourge of Coronavirus pandemic in poor resourced countries : the case of Zimbabwe

Towards the end of 2019 the world woke up to a novel virus which has come to be known as the Coronavirus (COVID-19). COVID-19 is threatening to reorder and reconfigure the world order in all spheres of life. Global infection rate has now surpassed two million. The World Health Organisation (WHO) has declared COVID-19 as a public health emergency of international concern. Worldwide there are measures and guidelines formulated to contain the pandemic. This paper evaluates the response of poor resourced countries to the scourge of COVID-19 and the measures or responses initiated to fight Coronavirus in poor resourced economies like Zimbabwe. The various measures taken by the Zimbabwean government to curb the spread of the virus in the country include onsite screening lockdown holding returning residents in isolation for a period of 21 days as well as public enlightenment and awareness about COVID-19. Notably these measures are laudable and commendable; however more is needed to ensure the spread of the disease is effectively managed and contained. Compulsory testing and enforcement of such best practices as social distancing and confinement to homes or self-isolation are desirable

The evolving role of family physicians during the coronavirus disease 2019 crisis: An appreciative reflection

Ten family physicians and family medicine registrars in a South African semi-rural training complex reflected on the coronavirus disease 2019 (COVID-19) crisis during their quarterly training complex meeting. The crisis has become the disruptor that is placing pressure on the traditional roles of the family physician. The importance of preventative and promotive care in a community-oriented approach, being a capacity builder and leading the health team as a consultant have assumed new meanings

The effects of coronavirus disease 2019 pandemic on the South African health system: A call to maintain essential health services

South Africa had its first coronavirus disease 2019 (COVID-19) case on 06 March 2020 in an individual who travelled overseas. Since then, cases have constantly increased and the pandemic has taken a toll on the health system. This requires extra mobilisation of resources to curb the disease and overcome financial loses whilst providing social protection to the poor. Assessing the effects of COVID-19 on South African health system is critical to identify challenges and act timely to strike a balance between managing the emergency and maintaining essential health services. We applied the World Health Organization (WHO) health systems framework to assess the effects of COVID-19 on South African health system, and proposed solutions to address the gaps, with a focus on human immunodeficiency virus (HIV) and expanded programme on immunisation (EPI) programmes. The emergence of COVID-19 pandemic has direct impact on the health system, negatively affecting its functionality, as depletion of resources to curb the emergency is eminent. Diversion of health workforce, suspension of services, reduced health-seeking behaviour, unavailability of supplies, deterioration in data monitoring and funding crunches are some of the noted challenges. In such emergencies, the ability to deliver essential services is dependent on baseline capacity of health system. Our approach advocates for close collaboration between essential services and COVID-19 teams to identify priorities, restructure essential services to accommodate physical distancing, promote task shifting at primary level, optimise the use of mobile/web-based technologies for service delivery/training/monitoring and involve private sector and non-health departments to increase management capacity. Strategic responses thus planned can assist in mitigating the adverse effects of the pandemic whilst preventing morbidity and mortality from preventable diseases in the population

Recommendations for a national Coronavirus disease 2019 response guideline for the care of older persons in Nigeria during and post-pandemic: A family physician's perspective

The older persons in our society are a special group of people in need of additional measures of care and protection. They have medical, financial, emotional and social needs. The novel Coronavirus disease 2019 (COVID-19) only exacerbates those needs. COVID-19 is a new disease, and there is limited information regarding the disease. Based on currently available information, older persons and people of any age who have serious underlying medical conditions may be at higher risk of severe illness from COVID-19. Family physicians provide care for individuals across their lifespan. Because geriatricians are internists or family physicians with post-residency training in geriatric medicine, they are major stakeholders in geriatric care. The authors are concerned about the absence of a COVID-19 response guideline/special advisory targeting the vulnerable population of older adults. The management and response to COVID-19 will be implemented in part based on the local context of available resources. Nigeria has been described as a resource-constrained nation. Infection prevention in older persons in Nigeria will far outweigh the possibilities of treatment given limited resources. The aim was to recommend actionable strategies to prevent COVID-19-related morbidity or mortality among older persons in Nigeria and to promote their overall well-being during and after the pandemic. These recommendations cut across the geriatric medicine domains of physical health, mental health, functioning ability and socio-environmental situation

Incidental finding of COVID-19 infection amongst staff at a primary care facility in Ghana

The COVID-19 pandemic has affected nearly every country worldwide and all African countries. The issue of healthcare workers (HCWs) contracting the disease is a growing concern in Ghana, because of the risk of spreading infections amongst themselves and to vulnerable patients in their care. This article illustrates how 14 staff at the Korle Bu Polyclinic/Family Medicine Department were incidentally found to be Covid-19 positive with most of them being asymptomatic. This observation led to a modification of the personal protective equipment (PPE) used by clinical staff when attending to patients. Furthermore, this finding suggests that a different criteria or guideline may be needed for testing of HCWs during a pandemic where a significant proportion of infected people are asymptomatic. We conclude that in the primary care setting HCWs must be ready to see all the following cases safely: routine patients, asymptomatic COVID-19 patients and suspected COVID-19 patients

Epidemiology of Coronavirus Disease (COVID-19) in Nigeria

In late December 2019, there was an outbreak of a new Coronavirus infection in Wuhan, Hubei Province, China, which caused acute respiratory syndrome of unknown aetiology. The World Health Organization (WHO) named the virus Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV2) or COVID-19 and declared the infection a pandemic on the 11th of March 2020. The first case of COVID-19 in Nigeria was reported on the 27th of February 2020 and since then the numbers of confirmed cases has been on the increase, at least in Nigeria. With no vaccine or cure in sight, only public health measures that include personal protective measures, physical distancing, environmental and travel-related measures have been recommended to mitigate and contain the spread of the disease. There is need to make testing for COVID-19 widely available so that the true burden of the infection will be described. This step should assist policy makers in making evidence-based decisions in the prevention and control of the disease

Manifestations cliniques de l'infection à Coronavirus SARS-Cov-2 (COVID-19)

La pandémie causée par le nouveau virus du coronavirus (SARS-CoV-2) à Wuhan, en Chine, en décembre 2019 est une maladie très contagieuse. L'Organisation mondiale de la Santé (OMS) a déclaré que l'épidémie en cours était une urgence mondiale de santé publique. Actuellement, les recherches sur ce nouveau coronavirus sont en cours et plusieurs publications sont disponibles. Les manifestations cliniques liées à l'infection au nouveau Corona-virus SARSCOV-2 semblent être très polymorphes et multi systémiques, dépassant largement le cadre nosologique typiquement respiratoire. Ces manifestations peuvent être cardiovasculaires, dermatologiques, ORL, hépatiques, rénales, ophtalmologiques et même neurologiques. Cette revue décrit les manifestations cliniques ainsi que de la pathogénie connues à ce jour du coronavirus 2019 (COVID19) ; le diagnostic et le traitement ne seront volontairement pas abordés

Pneumonie à l'infection à Coronavirus (COVID-19) : défis, opportunités et quelles solutions à envisager en Afrique subsaharienne ?

En décembre 2019, la ville de Wuhan en Chine a déclaré des cas de pneumonie virale à SARS-CoV-2, dénommée plus tard par l'Organisation mondiale de la Santé (OMS), COVID19. En quelques mois cette nouvelle entité est devenue une pandémie. Elle concerne à ce jour, 185 pays, atteignant plus de trois millions de personnes et a occasionné plus de 225 000 décès. Cette pandémie a perturbé et déséquilibré tous les systèmes de santé des pays concernés. Ces différents pays ont mis en œuvre des moyens conséquents pour y faire face.Les pays de l'Afrique sub-saharienne (ASS) en général et la République Démocratique du Congo (RDC) en particulier, doivent saisir cette opportunité pour s'organiser, former le personnel soignant, équiper les hôpitaux et améliorer l'accès aux soins des populations susceptibles de contracter cette maladie. La COVID-19 pouvant entraîner des complications graves chez certains patients, les unités des soins intensifs devraient être équipées pour apporter de l'oxygénothérapie de façon optimale, de l'assistance respiratoire par des moyens non invasifs ou invasifs et la suppléance d'autres organes afin d'améliorer le pronostic de ces patients graves. Voilà autant des défis à relever pour sécuriser la prise en charge des patients en ASS et en RDC

Vaccins et traitements de la pandémie à Coronavirus SARS-CoV-2 : évidences scientifiques, dangers et essais cliniques

Depuis décembre 2019, une maladie émergente à coronavirus SARS-CoV-2 (Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV) appelée coronavirus disease 2019 (COVID-19) s'est rapidement propagée dans le monde entier à partir de Wuhan en Chine, entrainant un nombre toujours plus élevé de cas confirmés et des décès. Malheureusement, à ce jour aucun médicament ou vaccin n'a encore été approuvé ou recommandé universellement, les thérapeutiques actuelles sont essentiellement de soutien ou compassionnelles. Plusieurs options sont envisagées ou en étude comprenant les vaccins, les antibiotiques (azithromycine), les agents antiviraux (lopinavir, ritonavir, Ribavirin, Arbidol), antiparasitaires (chloroquine, hydroxychloroquine, ivermectine), les immunomodulateurs et autres molécules du système immunitaire (Tocilizumab, interférons), les plantes de la médecine traditionnelle

Tests diagnostiques de l'infection à Coronavirus (COVID-19) : des atouts et des limites

Le monde entier fait face à une crise sanitaire sans précédent due à la pandémie de maladie à virus SARS-COV-2 alias COVID-19. Malgré les connaissances très incomplètes sur la COVID-19, on a constaté une contagiosité interhumaine élevée au début de la pandémie actuelle, et on estime que chaque nouveau cas de COVID-19 infecte en moyenne deux à trois personnes. En conséquence, la stratégie de lutte contre la pandémie à COVID-19 qui ébranle nos sociétés passe nécessairement par une intensification des tests de détection de l'infection. Ces tests diagnostiques de la COVID-19 sont un outil essentiel pour suivre la propagation de la pandémie. Ainsi, l'objectif de la présente revue de la littérature est d'aborder le diagnostic de l'infection à Coronavirus (COVID-19) en s'attardant sur les tests de diagnostic, leurs atouts et leurs limites. Il y a deux catégories de test : ceux qui recherchent la présence directe du virus ou de ses fragments, et ceux qui recherchent les anticorps résultant de l'infection par le virus du COVID-19. Le test real time ­Reverse Transcriptase ­Polymerase chain reaction (rt-RT-PCR) reste le gold standard pour le diagnostic de la COVID-19. Sa sensibilité sur les écouvillons nasopharyngés semble élevée, mais des faux négatifs peuvent se produire, avec une fréquence incertaine (environ 30% des cas). Les tests sérologiques détectent les anticorps spécifiques du SARSCoV-2. Ils permettent l'identification des individus qui ont été infectés par le virus, se sont rétablis, et ont développé, en théorie, une réponse immunitaire efficace contre le virus. Ils constituent des tests d'orientation diagnostique de la COVID19. A ce jour, aucun de ces tests n'est fiable à 100 %, mais, utilisés par un personnel médical qualifié et en combinaison, ils permettent l'identification de la majorité des individus infectés et immunisés

Impact économique de la pandémie à COVID-19 dans les pays à ressources limitées : le cas des pays de l'Afrique subsaharienne

La propagation de la COVID-19 dans les pays à ressources faibles de l'Afrique subsaharienne ainsi que les mesures prises pour y faire face influent considérablement sur leurs économies. On observe un ralentissement d'activités dans tous les secteurs économiques occasionnant des pertes de rentabilité au niveau d'entreprises, de revenus pour les ménages, de recettes fiscales au niveau des Etats et d'emploi pour les travailleurs. Il en résulte une baisse drastique de la production et un risque de récession pour l'ensemble de la région. Il faut donc des mesures de ripostes multisectorielles et une politique macroéconomique permettant de renouer avec la croissance de la production

Recommandations de la Société Congolaise de Néphrologie (SOCONEPH) pour la prise en charge des patients en dialyse dans le contexte de pandémie à COVID-19

Les patients en hémodialyse présente un risqué élevé d'infection à SARS-Cov-2. Les stratégies préventives doivent donc être mises en place pour réduire le risque de transmission de la maladie en hémodialyse parmi lesquelles, l'éducation du staff médical ainsi que des patients, le screening de la maladie à COVID-19 ainsi que la séparation des patients infectés ou symptomatiques des non infectés