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1.
International Journal of Environmental Research and Public Health ; 19(8):4582, 2022.
Article in English | ProQuest Central | ID: covidwho-1809858

ABSTRACT

The key message was that investing in people and in building research capacity ahead of public health emergencies is essential to equip the health system with “the right people in the right place at the right time”. In January 2019, the Government of the United Kingdom of Great Britain and Northern Ireland, represented by its Department of Health and Social Care, through the National Institute of Health Research (NIHR), provided funding for a Structured Operational Research and Training Initiative (SORT IT) for strengthening health systems for tackling AMR (AMR SORT IT). Achievements of the SORT IT Project on Antimicrobial Resistance (2019–2022) The achievements of the SORT IT project can be categorized into: (1) innovating in digital technology—a SORT IT online platform for implementing research during COVID-19;(2) implementing high-quality policy/practice relevant research and building research capacity;(3) strengthening health systems resilience;and (4) building global engagement for AMR through networks and LMIC equitable research partnerships. Going forward, the main strategic pillars that will guide all project activities include focusing on national priorities;strengthening health systems and research capacity;building a critical mass of trained institutions;and fostering global and community engagement (Box 1).

2.
Int J Infect Dis ; 2022 Mar 25.
Article in English | MEDLINE | ID: covidwho-1757409

ABSTRACT

BACKGROUND: The unprecedented and ongoing COVID-19 pandemic has exposed weaknesses in African countries' health systems. The impact of shifted focus on COVID-19 for the past 2 years on routine health services, especially those for the epidemics of Tuberculosis, HIV/AIDS and Malaria, have been dramatic in both quantity and quality. METHODS: In this article, we reflect on the COVID-19 related disruptions on the Tuberculosis, HIV/AIDS and Malaria routine health services across Africa. RESULTS: The COVID-19 pandemic resulted in disruptions of routine health services and diversion of already limited available resources in sub-Saharan Africa. As a result, disease programs like TB, malaria and HIV have recorded gaps in prevention and treatment with the prospects of reversing gains made towards meeting global targets. The extent of the disruption is yet to be fully quantified at country level as most data available is from modelling estimates before and during the pandemic. CONCLUSIONS: Accurate country-level data is required to convince donors and governments to invest more into revamping these health services and help prepare for managing future pandemics without disruption of routine services. Increasing government expenditure on health is a critical part of Africa's economic policy. Strengthening health systems at various levels to overcome the negative impacts of COVID-19, and preparing for future epidemics will require strong visionary political leadership. Innovations in service delivery and technological adaptations are required as countries aim to limit disruptions to routine services.

6.
Int J Infect Dis ; 113 Suppl 1: S78-S81, 2021 Dec.
Article in English | MEDLINE | ID: covidwho-1575136

ABSTRACT

After a century of controversies on its usefulness in protection against TB, underlying mechanisms of action, and benefits in various groups and geographical areas, the BCG vaccine is yet again a focus of global attention- this time due to the global COVID-19 pandemic caused by the novel severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Recent studies have shown that human CD4+ and CD8+ T-cells primed with a BCG-derived peptide developed high reactivity to its corresponding SARS-CoV-2-derived peptide. Furthermore, BCG vaccine has been shown to substantially increase interferon-gamma (IFN-g) production and its effects on CD4+ T-cells and these non-specific immune responses through adjuvant effect could be harnessed as cross protection against severe forms of COVID-19.The completion of ongoing BGG trials is important as they may shed light on the mechanisms underlying BCG-mediated immunity and could lead to improved efficacy, increased tolerance of treatment, and identification of other ways of combining BCG with other immunotherapies.


Subject(s)
BCG Vaccine , COVID-19 , Cross Protection , Humans , Pandemics , SARS-CoV-2
7.
Int J Infect Dis ; 113 Suppl 1: S68-S72, 2021 Dec.
Article in English | MEDLINE | ID: covidwho-1574772

ABSTRACT

Despite slow reductions in the annual burden of active human tuberculosis (TB) cases, zoonotic TB (zTB) remains a poorly monitored and an important unaddressed global problem. There is a higher incidence in some regions and countries, especially where close association exists between growing numbers of cattle (the major source of Mycobacterium bovis) and people, many suffering from poverty, and where dairy products are consumed unpasteurised. More attention needs to be focused on possible increased zTB incidence resulting from growth in dairy production globally and increased demand in low income countries in particular. Evidence of new zoonotic mycobacterial strains in South Asia and Africa (e.g. M. orygis), warrants urgent assessment of prevalence, potential drivers and risk in order to develop appropriate interventions. Control of M. bovis infection in cattle through detect and cull policies remain the mainstay of reducing zTB risk, whilst in certain circumstances animal vaccination is proving beneficial. New point of care diagnostics will help to detect animal infections and human cases. Given the high burden of human tuberculosis (caused by M. tuberculosis) in endemic areas, animals are affected by reverse zoonosis, including multi-drug resistant strains. This, may create drug resistant reservoirs of infection in animals. Like COVID-19, zTB is evolving in an ever-changing global landscape.


Subject(s)
COVID-19 , Tuberculosis , Africa , Animals , Cattle , Humans , Policy , SARS-CoV-2 , Tuberculosis/diagnosis , Tuberculosis/epidemiology , Tuberculosis/prevention & control
8.
Int J Infect Dis ; 113 Suppl 1: S7-S12, 2021 Dec.
Article in English | MEDLINE | ID: covidwho-1573985

ABSTRACT

The October 2020 Global TB report reviews TB control strategies and United Nations (UN) targets set in the political declaration at the September 2018 UN General Assembly high-level meeting on TB held in New York. Progress in TB care and prevention has been very slow. In 2019, TB remained the most common cause of death from a single infectious pathogen. Globally, an estimated 10.0 million people developed TB disease in 2019, and there were an estimated 1.2 million TB deaths among HIV-negative people and an additional 208, 000 deaths among people living with HIV. Adults accounted for 88% and children for 12% of people with TB. The WHO regions of South-East Asia (44%), Africa (25%), and the Western Pacific (18%) had the most people with TB. Eight countries accounted for two thirds of the global total: India (26%), Indonesia (8.5%), China (8.4%), the Philippines (6.0%), Pakistan (5.7%), Nigeria (4.4%), Bangladesh (3.6%) and South Africa (3.6%). Only 30% of the 3.5 million five-year target for children treated for TB was met. Major advances have been development of new all oral regimens for MDRTB and new regimens for preventive therapy. In 2020, the COVID-19 pandemic dislodged TB from the top infectious disease cause of mortality globally. Notably, global TB control efforts were not on track even before the advent of the COVID-19 pandemic. Many challenges remain to improve sub-optimal TB treatment and prevention services. Tuberculosis screening and diagnostic test services need to be ramped up. The major drivers of TB remain undernutrition, poverty, diabetes, tobacco smoking, and household air pollution and these need be addressed to achieve the WHO 2035 TB care and prevention targets. National programs need to include interventions for post-tuberculosis holistic wellbeing. From first detection of COVID-19 global coordination and political will with huge financial investments have led to the development of effective vaccines against SARS-CoV2 infection. The world now needs to similarly focus on development of new vaccines for TB utilizing new technological methods.


Subject(s)
COVID-19 , Tuberculosis, Miliary , Adult , Child , Humans , Nigeria , Pandemics , RNA, Viral , SARS-CoV-2
10.
Antibiotics (Basel) ; 10(11)2021 Nov 05.
Article in English | MEDLINE | ID: covidwho-1518590

ABSTRACT

Tuberculosis (TB) does not respect borders, and migration confounds global TB control and elimination. Systematic screening of immigrants from TB high burden settings and-to a lesser degree TB infection (TBI)-is recommended in most countries with a low incidence of TB. The aim of the study was to evaluate the views of a diverse group of international health professionals on TB management among migrants. Participants expressed their level of agreement using a six-point Likert scale with different statements in an online survey available in English, French, Mandarin, Spanish, Portuguese and Russian. The survey consisted of eight sections, covering TB and TBI screening and treatment in migrants. A total of 1055 respondents from 80 countries and territories participated between November 2019 and April 2020. The largest professional groups were pulmonologists (16.8%), other clinicians (30.4%), and nurses (11.8%). Participants generally supported infection control and TB surveillance established practices (administrative interventions, personal protection, etc.), while they disagreed on how to diagnose and manage both TB and TBI, particularly on which TBI regimens to use and when patients should be hospitalised. The results of this first knowledge, attitude and practice study on TB screening and treatment in migrants will inform public health policy and educational resources.

11.
Infect Genet Evol ; 96: 105101, 2021 12.
Article in English | MEDLINE | ID: covidwho-1506832

ABSTRACT

COVID-19 stalled the world in 2020 and continues to be the greatest health crisis of this generation. While the apparent case fatality rates across fluctuates around ~2% globally, associated mortality/death rate (deaths per million population) varies distinctly across regions from the global average of ~600 per million population. Heterogeneous factors have been linked with COVID-19 associated mortalities and these include age, share of geriatric population, comorbidities, trained immunity and climatic conditions. Apart from direct or indirect role of endemic diseases, dietary factors and host immunity in regulating COVID-19 severity, human behaviour will inevitably control outcome of this pandemic. Comprehensive understanding of these factors will have a bearing on management of future health crises.


Subject(s)
COVID-19/etiology , COVID-19/mortality , Angiotensin-Converting Enzyme 2/genetics , COVID-19/immunology , COVID-19/psychology , Comorbidity , Diabetes Mellitus/epidemiology , Diet , Humans , Immunity, Innate , Polymorphism, Genetic , Vaccines/immunology
12.
13.
Trop Med Infect Dis ; 6(2)2021 Jun 08.
Article in English | MEDLINE | ID: covidwho-1295928

ABSTRACT

Real-time operational research can be defined as research on strategies or interventions to assess if they are feasible, working as planned, scalable and effective. The research involves primary data collection, periodic analysis during the conduct of the study and dissemination of the findings to policy makers for timely action. This paper aims to illustrate the use of real-time operational research and discuss how to make it happen. Four case studies are presented from the field of tuberculosis. These include (i) mis-registration of recurrent tuberculosis in Malawi; (ii) HIV testing and adjunctive cotrimoxazole to reduce mortality in TB patients in Malawi; (iii) screening TB patients for diabetes mellitus in India; and (iv) mitigating the impact of COVID-19 on TB case detection in capital cities in Kenya, Malawi and Zimbabwe. The important ingredients of real-time operational research are sound ethics; relevant research; adherence to international standards of conducting and reporting on research; consideration of comparison groups; timely data collection; dissemination to key stakeholders; capacity building; and funding. Operational research can improve the delivery of established health interventions and ensure the deployment of new interventions as they become available, irrespective of diseases. This is particularly important when public health emergencies, including pandemics, threaten health services.

14.
Trop Med Infect Dis ; 6(2)2021 May 10.
Article in English | MEDLINE | ID: covidwho-1224247

ABSTRACT

There was concern that the COVID-19 pandemic would adversely affect TB and HIV programme services in Kenya. We set up real-time monthly surveillance of TB and HIV activities in 18 health facilities in Nairobi so that interventions could be implemented to counteract anticipated declining trends. Aggregate data were collected and reported monthly to programme heads during the COVID-19 period (March 2020-February 2021) using EpiCollect5 and compared with monthly data collected during the pre-COVID period (March 2019-February 2020). During the COVID-19 period, there was an overall decrease in people with presumptive pulmonary TB (31.2%), diagnosed and registered with TB (28.0%) and in those tested for HIV (50.5%). Interventions to improve TB case detection and HIV testing were implemented from August 2020 and were associated with improvements in all parameters during the second six months of the COVID-19 period. During the COVID-19 period, there were small increases in TB treatment success (65.0% to 67.0%) and referral of HIV-positive persons to antiretroviral therapy (91.2% to 92.9%): this was more apparent in the second six months after interventions were implemented. Programmatic interventions were associated with improved case detection and treatment outcomes during the COVID-19 period, suggesting that monthly real-time surveillance is useful during unprecedented events.

16.
Trans R Soc Trop Med Hyg ; 115(1): 117-119, 2021 01 07.
Article in English | MEDLINE | ID: covidwho-1066407

ABSTRACT

With lockdown restrictions over coronavirus disease 2019 being relaxed, airlines are returning to the skies. Published evidence of severe acute respiratory syndrome (SARS) coronavirus 2 transmission on aircraft is limited, but in-flight transmission of respiratory infections such as tuberculosis, influenza and SARS has been well described. Risk factors include proximity to index patients and sitting in aisle seats. Personal protection on aircraft could be enhanced by always wearing a well-fitting face mask and face shield or sunglasses, wiping surfaces and hands with alcohol-based sanitizers, not touching the face, not queuing for washrooms, changing seats if nearby passengers are coughing and choosing a window rather than an aisle seat.


Subject(s)
Air Travel , Aircraft , COVID-19/prevention & control , Communicable Disease Control/methods , Pandemics , SARS-CoV-2 , COVID-19/epidemiology , COVID-19/transmission , COVID-19/virology , Cough , Disinfection , Eyeglasses , Hand Sanitizers , Humans , Masks , Physical Distancing , Risk Factors , Touch
17.
Emerg Infect Dis ; 26(11): 2709-2712, 2020 11.
Article in English | MEDLINE | ID: covidwho-762400

ABSTRACT

Coronavirus disease has disrupted tuberculosis services globally. Data from 33 centers in 16 countries on 5 continents showed that attendance at tuberculosis centers was lower during the first 4 months of the pandemic in 2020 than for the same period in 2019. Resources are needed to ensure tuberculosis care continuity during the pandemic.


Subject(s)
Continuity of Patient Care/trends , Coronavirus Infections/epidemiology , Facilities and Services Utilization/trends , Global Health/trends , Pneumonia, Viral/epidemiology , Tuberculosis/therapy , Betacoronavirus , COVID-19 , Humans , Pandemics , SARS-CoV-2 , Tuberculosis/epidemiology
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