COVID-19 and its impacts: The situation in Niger republic.

COVID-19 being a public health emergency of international concern has emerged in most African countries including Niger. Niger, a landlocked country, is tasked with controlling the pandemic. However, of the big challenges the country faced is the fragility of healthcare system which posed limitations to the fight against the virus. The virus overwhelmed the fragile healthcare system which led to inaccessibility of quality healthcare to the citizens coupled with issues of flooding and economic recession that happened during the pandemic. The healthcare sectored has further been crippled by exposure and infection of the already insufficient healthcare workers. In addition to this, there was the burden of NTDs and other communicable and non-communicable diseases that subverted the country in the depths of difficulties. As per the predictions of World Bank, the poverty curve is likely to escalate due to the outrageous impacts of COVID-19. Adding on to this, the occurrence of natural disasters such as flooding has further stretched the country. It's no coincidence that the country would confront plethora of challenges amidst the second wave. Therefore, timely decision and necessary interventions are needed to strengthen the country's fight against the pandemic. However, this is only feasible when Nigerien government, international allies and other wealthy nations work closely to ensure that the challenges faced by the healthcare system are tackled.

The Pandemic Treaty, the Pandemic Fund, and the Global Commons: our scepticism.

The call to strengthen global health governance against future outbreaks through a binding treaty on pandemics has attracted global attention and opinion. Yet, few of these perspectives have reflected the voices from early career global health professionals in Africa. We share our perspectives on the Pandemic Treaty, and specifically our scepticism on the limitations of the current top-down approach of the treaty, and the need for the treaty to centre equity, transparency and fairness to ensure equitable and effective cooperation in response to global health emergencies. We also highlight the challenges intergovernmental organisations for health faced in coordinating nation states during the COVID-19 crisis and how a Pandemic Treaty would address these challenges. We argue that lessons from the COVID-19 pandemic provide a critical opportunity to strengthen regional institutions in Africa-particularly in a multipolar world with huge disparities in power and resources. However, addressing these challenges and achieving this transformation may not be easy. Fiscal space in many countries remains constrained now more than ever. New tools such as the Pandemic Fund should be designed in ways that consider the specific needs and capacities of countries. Therefore, strengthening countries' capacities overall requires an increase in domestic investment. This paper calls for wider structural reforms such as debt restructuring among other tools to strengthen countries' capacities.

The COVID-19 pandemic and health workforce brain drain in Nigeria.

Over the years, the Nigerian healthcare workforce, including doctors, nurses, and pharmacists have always been known to emigrate to developed countries to practice. However, the recent dramatic increase in this trend is worrisome. There has been a mass emigration of Nigerian healthcare workers to developed countries during the COVID-19 pandemic. While the push factors have been found to include the inadequate provision of personal protective equipment, low monthly hazard allowance, and inconsistent payment of COVID-19 inducement allowance on top of worsening insecurity, the pull factors are higher salaries as well as a safe and healthy working environment. We also discuss how healthcare workers can be retained in Nigeria through increment in remunerations and prompt payment of allowances, and how the brain drain can be turned into a brain gain via the use of electronic data collection tools for Nigerian health workers abroad, implementation of the Bhagwati's tax system, and establishment of a global skill partnership with developed countries.

Bibliometric analysis of contributions to COVID-19 research in Malaysia.

Introduction: The advent of COVID-19 has led to an exponential rise in related publications to provide a knowledge driven approach to tame the tide of infection and impact in all spheres. This study gives an insight into COVID-19 research publication pattern in Malaysia using bibliometric analysis. Method: COVID-19 publications on Scopus database between January 1, 2020, and August 26, 2022, were extracted using predetermined search strings. Inclusion and exclusion criteria were set, and data was extracted from the database. Descriptive statistics was used to summarize our findings. Results: A total of 3,553 COVID-19 related papers were retrieved out of global count of 392,613 and 16,466 for Southeast Asia (SEA). This implies that 0.9% and 21.6% is contributed globally and SEA respectively. Indonesia, Malaysia and Singapore are the three top countries with highest research outputs in the region. This may be correlated to high GDP per capita, research and development, and research and development expenditure. Most of the publications are article/original research (n = 2832, 67%). Ministry of Higher education is the top funding sponsor and Universiti Malaya is the highest contributor and the most cited (n = 466, 4920 citations). The majority of publications are from physical sciences (30.3%), but medicine subcategory produced the highest number of papers (1,586). The top journal was International Journal of Environmental and Public Health (n = 96 publications). Most active collaborating country was the United Kingdom and most active author was from Monash University. Conclusion: Malaysian institutions have made profound contributions to COVID-19 research globally and in SEA. However, there is a need for continuous efforts to improve research outputs on the topic.

Navigating the COVID-19 outbreak in Zambia.

COVID-19 is a global public health crisis wreaking havoc in nearly every corner of the globe and Zambia is not an exception. Amid an already existing disease burden of HIV/AIDS, malaria, malnutrition, and cholera, the resilience of the health care system is yet to be tested especially since it lacks about 40% of its estimated workforce. Meanwhile, the government has already established measures to contain the spread of COVID-19. This includes; reorientation and training for health workers, indefinite closure of all learning institutions, and banning non-essential traveling. With the COVID-19 vaccine roll-out on the ground, the milestones achieved thus far in fighting the pandemic are expected to intensify.

Nigeria's scientific contributions to COVID-19: A bibliometric analysis.

Introduction: The COVID-19 pandemic has prompted a historic global research effort to create a knowledge base that can guide mitigation strategies. This study uses the Scopus database to examine the literature published by Nigerian institutions since the outbreak of COVID-19, with a focus on bibliometric items, global collaboration, Scopus subject area classification, document types, active authors and institutions, journals, highly cited papers, and funding agencies. Method: We searched for articles indexed in the Scopus database between January 1st, 2020 and July 20th, 2022 using predetermined search terms. All article types and study designs were included. Results: During the period under consideration, researchers affiliated with Nigerian institutions published a total of 2,217 COVID-19 papers out of a total of 281,589 global outputs, implying that Nigerian institutions contributed 0.8% of total global COVID-19 scientific output. The majority of the documents published were articles/original research (n = 1,455, 68.4%). The National Institute of Health was the top funder, and the University of Ibadan was the most active institution. The vast majority of publications (38.3%) were in the field of health sciences, with 1197 papers in the medicine sub-category. The top journal was Pan African Medical Journal, which published 114 COVID-19 papers with at least one Nigerian institution affiliation. The most active collaborator with Nigerian institutions was the United States. With 745 citations, the most cited paper with at least one Nigerian institution affiliation was from the Nigeria Center for Disease Control. Conclusion: Nigerian institutions have contributed to the scientific output of COVID-19. There is, however, a need to improve research capacity across all subject areas.

Addressing the social issues around vaccination could be the pivotal strategy to achieve the 2022 COVID-19 vaccination coverage target.

The COVID-19 pandemic is a public health emergency on a global scale, and vaccination has been shown to be effective in containing the pandemic. Social issues surrounding COVID-19 vaccination contribute to the level of skepticism and opposition expressed by a sizable proportion of the global population. The need to address socio-cultural and religious standpoints on COVID-19 immunization and related discussions is becoming more pressing as the pandemic's socioeconomic implications become more concerning. Without a doubt, failing to address social issues jeopardizes countries' ability to achieve the WHO-recommended 70 percent coverage target for all countries, which would halt the pandemic by creating a global herd immunity. In this article, we discussed some of these social issues as well as emerging strategies for addressing these challenges and driving a rapid increase in COVID-19 vaccine uptake.

Decisive or impulsive? Re-examining Africa's lockdown response to COVID-19.

Due to the high transmission rate and mortality index of the current coronavirus pandemic, many settings in Africa instituted lockdowns to reduce its rate of spread and avert exponential growth rate. At the early stage, this measure seemed to heighten awareness of the virus and subsequently minimized exponential growth of cases. However, these lockdowns have had great consequences on the weak health systems and frail economy in place in many African countries. In this paper, we examine the impact of lockdown measures in these countries and provides key recommendations in dealing with present and future pandemics.

Why many African countries may not achieve the 2022 COVID-19 vaccination coverage target.

COVID-19 continues to strain, stress, and stretch health systems globally. With the development of the COVID-19 vaccines, there are many issues still lurking behind the widespread coverage; one of which is COVID-19 vaccine nationalism and African countries are not exempted from these issues. This is evident in that many countries in the African region missed the earlier targets set by World Health Organization (WHO) for COVID-19 vaccination coverage. The WHO further set a target of 70% coverage of the COVID-19 vaccines for all countries by June 2022. In this article, we discuss the possible reasons why many African countries are struggling and may not achieve the COVID-19 vaccination target in 2022. With the fundamental issues facing COVID-19 vaccination ranging from nationalism to hesitancy, it is important that stakeholders continue to work harder to ensure that the continent is not left behind in the race to keep the world free and safe from the sting of the COVID-19 pandemic.

COVID-19 surveillance systems in African countries.

Background: Surveillance forms the basis for response to disease outbreaks, including COVID-19. Herein, we identified the COVID-19 surveillance systems and the associated challenges in 13 African countries. Methods: We conducted a comprehensive narrative review of peer-reviewed literature published between January 2020 and April 2021 in PubMed, Medline, PubMed Central, and Google Scholar using predetermined search terms. Relevant studies from the search and other data sources on COVID-19 surveillance strategies and associated challenges in 13 African countries (Mauritius, Algeria, Nigeria, Angola, Cote d'Ivoire, the Democratic Republic of the Congo, Ghana, Ethiopia, South Africa, Kenya, Zambia, Tanzania, and Uganda) were identified and reviewed. Results: Our findings revealed that the selected African countries have ramped up COVID-19 surveillance ranging from immediate case notification, virological surveillance, hospital-based surveillance to mortality surveillance among others. Despite this, there exist variations in the level of implementation of the surveillance systems across countries. Integrated Disease Surveillance and Response (IDSR) strategy is also being leveraged in some African countries, but the implementation across countries remains uneven. Our study also revealed various challenges facing surveillance which included shortage of skilled human resources resulting in poor data management, weak health systems, complexities of ethical considerations, diagnostic insufficiency, the burden of co-epidemic surveillance, and geographical barriers, among others. Conclusion: With the variations in the level of implementation of COVID-19 surveillance strategies seen across countries, it is pertinent to ensure proper coordination of the surveillance activities in the African countries and address all the challenges facing COVID-19 surveillance using tailored strategies.

The status of neglected tropical diseases amidst COVID-19 in Africa: Current evidence and recommendations.

Health care services and programs directed towards combating the neglected tropical diseases (NTDs) have been disrupted because of the impact of the coronavirus disease 2019 (COVID-19). The African continent because of its staggering health care system and poor economy disproportionately bears the burden of these diseases. While successes have been recorded in controlling and eliminating the NTDs, policymakers in Africa should consider the potential of the COVID-19 to dwindle these successes an issue of high priority. This commentary seeks to discuss the current status of NTDs in Africa and proffer recommendations to help combat these diseases at this period. It is worthy to say that similar dedication directed towards fighting the COVID-19 should also be deployed into eliminating other diseases like the NTDs which often, are neglected.

Can Africa achieve herd immunity?

The World Health Organization described herd immunity, also known as population immunity, as the indirect fortification from an infectious disease that happens when a population is immune either through vaccination or immunity developed through previous exposure to infection. The emergence of COVID-19 vaccine is a step towards the achievement of herd immunity. Over one billion people across the globe have been vaccinated and Africa recorded only 2%. The objective of this article was to develop a forecast of the number of people to be vaccinated to achieve herd immunity in the 13 WHO-identified priority African countries for COVID-19. Herd immunity is achieved when one infected person in a population causes less than one secondary case on average, corresponding to the effective basic reproduction number (R0). Vaccine delivery and distribution infrastructure including the cold chain remains weak. Vaccine hesitancy is also one of the limiting factors that may hinder herd immunity in Africa. In order to achieve herd immunity globally, African countries should not be excluded in fair and equal distribution of vaccines. Relevant stakeholders should foster commitment as well as community sensitization on COVID-19 vaccines and integration of COVID-19 vaccines in existing healthcare services.

COVID-19 and Antimicrobial Resistance: A Review.

As the world continues to respond to the coronavirus pandemic (COVID-19), there is a larger hidden threat of antimicrobial resistance (AMR) lurking behind. AMR remains worrisome in that the pathogens causing resistant infections to thrive in hospitals and medical facilities, putting all patients at risk, irrespective of the severity of their medical conditions, further compounding the management of COVID-19. This study aims to provide overview of early findings on COVID-19 and AMR as well as to provide recommendations and lesson learned toward improving antimicrobial stewardship. We conducted a rapid narrative review of published articles by searching PubMed and Google Scholar on COVID-19 and Antimicrobial Resistance with predetermined keywords. Secondary bacterial infections play crucial roles in mortality and morbidity associated with COVID-19. Research has shown that a minority of COVID-19 patients need antibiotics to treat secondary bacterial infections. Current evidence reiterates the need not to give antibiotic therapy or prophylaxis to patients with mild COVID-19 or to patients with suspected or confirmed moderate COVID-19 illness unless it is indicated. The pandemic has also brought to the fore the deficiencies in health systems around the world. This comes with a lot of lessons, one of which is that despite the advances in medicine; we remain incredibly vulnerable to infections with limited or no standard therapies. This is worth thinking in the context of AMR, as the resistant pathogens are evolving and leading us to the era of untreatable infections. There is a necessity for continuous research into understanding and controlling infectious agents, as well as the development of newer functional antimicrobials and the need to strengthen the antimicrobial stewardship programs.

COVID-19 calls for health systems strengthening in Africa: A case of Nigeria.

The COVID-19 pandemic has proven the need for countries worldwide to implement strategies that promote health systems strengthening and ensure epidemic preparedness. Many African countries are burdened by fragile healthcare systems, hence, this paper emphasises the need for African policymakers to improve healthcare quality in their countries. Through a brief review of various online literatures concerning health systems strengthening in Africa, this paper focuses on the nature of healthcare in Nigeria amidst the COVID-19 pandemic. The major stress areas include COVID-19 testing capacity, health workforce, infection prevention and control, health information and surveillance systems, health insurance, public-private partnerships, and governance. The COVID-19 pandemic has amplified several challenges ravaging Africa's already fragile healthcare systems, leaving the health sectors of most African countries ill-prepared to deal with the pandemic. If Nigeria and many other African countries had invested sufficiently in strengthening their healthcare systems prior to COVID-19, their pandemic response efforts would have been more effective. Health systems strengthening is necessary to ensure steady progress toward universal health coverage and global health security. Through health systems strengthening, Nigeria and other African countries can greatly improve their infection prevention and control measures.

The use of antibiotics in COVID-19 management: a rapid review of national treatment guidelines in 10 African countries.

Antimicrobial resistance is a hidden threat lurking behind the COVID-19 pandemic which has claimed thousands of lives prior to the emergence of the global outbreak. With a pandemic on the scale of COVID-19, antimicrobial resistance has the potential to become a double-edged sword with the overuse of antibiotics having the potential of taking us back to the pre-antibiotic era. Antimicrobial resistance is majorly attributed to widespread and unnecessary use of antibiotics, among other causes, which has facilitated the emergence and spread of resistant pathogens. Our study aimed to conduct a rapid review of national treatment guidelines for COVID-19 in 10 African countries (Ghana, Kenya, Uganda, Nigeria, South Africa, Zimbabwe, Botswana, Liberia, Ethiopia, and Rwanda) and examined its implication for antimicrobial resistance response on the continent. Our findings revealed that various antibiotics, such as azithromycin, doxycycline, clarithromycin, ceftriaxone, erythromycin, amoxicillin, amoxicillin-clavulanic acid, ampicillin, gentamicin, benzylpenicillin, piperacillin/tazobactam, ciprofloxacin, ceftazidime, cefepime, vancomycin, meropenem, and cefuroxime among others, were recommended for use in the management of COVID-19. This is worrisome in that COVID-19 is a viral disease and only a few COVID-19 patients would have bacterial co-infection. Our study highlighted the need to emphasize prudent and judicious use of antibiotics in the management of COVID-19 in Africa.

COVID-19 and progress towards achieving universal health coverage in Africa: A case of Nigeria.

Universal Health Coverage (UHC) 2030 is a global health target, and countries are making efforts to convert plans into tangible results. Nigeria, the most populated country in Africa, has made commitments towards UHC2030 target but is underperforming across many building blocks of health and progress has been slow. The arrival of COVID-19 poses additional pressure on the already feeble health system causing the government to direct focus towards containing the pandemic. However, existing gaps in health workforce density, weak primary health care infrastructure and inadequate budgetary allocation have resulted in inequitable access to basic healthcare services. This situation weighs most heavily on the poor who are mostly part of the informal economy thereby pushing people further into poverty. On the other hand, COVID-19 has provided valuable insights into Nigeria's current health system status which hopefully can be helpful in strengthening efforts towards building resilient health system and preparing the country towards future pandemic. The pandemic has highlighted the importance of essential health services and the need to strengthen primary healthcare system. It is, therefore, important that stakeholders in Nigeria and other African countries carry out situation analysis of the current health systems towards achieving UHC2030.

Risk communication and community engagement strategies for COVID-19 in 13 African countries.

Background: Coronavirus disease 2019 (COVID-19) outbreak is a major threat facing health systems globally and African countries are not an exception. Stakeholders, governments, and national authorities have mounted responses to contain the pandemic. This study aimed to catalogue the risk communication and community engagement (RCCE) strategies as well as the challenges facing RCCE in 13 African countries. Methods: We conducted a narrative review of evidence to answer the aim of the study. The search was conducted in March 2021 and evidence published between December 2019 and February 2021 were included. Data reported in this article were obtained from reports, literature in peer-reviewed journals, grey literature and other data sources in 13 African countries. The 13 countries include Ethiopia, Ghana, Kenya, Algeria, Angola, Cote d'Ivoire, the Democratic Republic of the Congo, Mauritius, Nigeria, South Africa, Tanzania, Uganda, and Zambia. The authors also snowball further data to gather information for this review. Results: Most of the priority African countries have RCCE strategies to contain the transmission and spread of the coronavirus. Our findings revealed RCCE strategies in the 13 African countries focused on training and capacity building, risk communication systems, internal and partners' coordination, community engagement, public communication, contending uncertainty, addressing misperceptions and managing misinformation. However, the RCCE response activities were not without challenges, which included distrust in government, cultural, social, and religious resistance, and inertia among others. Conclusion: With the similar RCCE approaches and interventions seen across the countries, it is clear that countries are learning from each other and from global health organizations to develop COVID-19 RCCE programs. It is important for African countries to address the challenges facing RCCE in order to effectively contain the pandemic and to prepare for future public health emergencies.

Community distribution of oxygen: a unique COVID-19 intervention.

The rapid spread of COVID-19 around the world has exposed some long-standing deficiencies in health systems, particularly in environments with low financial and medical resources. Most patients ill with COVID-19 require oxygen and supportive therapy for survival as there remains no conclusively established curative therapy. Following a number of critical research work and drawing from a millennia-long evolution of medical practice, respiratory support has been identified as a paramount intervention to ensure lives are saved when supportive care is required, and oxygen is an essential commodity to achieve this. This letter focuses on the numerous means for oxygen delivery to health facilities and in turn the end users and expands on the importance of innovation to improve oxygen supply. We describe a community distribution system with a telemedicine structure that can be leveraged for oxygen delivery.