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1.
Front Public Health ; 9: 654299, 2021.
Article in English | MEDLINE | ID: covidwho-1348570

ABSTRACT

There are many outstanding questions about how to control the global COVID-19 pandemic. The information void has been especially stark in the World Health Organization Africa Region, which has low per capita reported cases, low testing rates, low access to therapeutic drugs, and has the longest wait for vaccines. As with all disease, the central challenge in responding to COVID-19 is that it requires integrating complex health systems that incorporate prevention, testing, front line health care, and reliable data to inform policies and their implementation within a relevant timeframe. It requires that the population can rely on the health system, and decision-makers can rely on the data. To understand the process and challenges of such an integrated response in an under-resourced rural African setting, we present the COVID-19 strategy in Ifanadiana District, where a partnership between Malagasy Ministry of Public Health (MoPH) and non-governmental organizations integrates prevention, diagnosis, surveillance, and treatment, in the context of a model health system. These efforts touch every level of the health system in the district-community, primary care centers, hospital-including the establishment of the only RT-PCR lab for SARS-CoV-2 testing outside of the capital. Starting in March of 2021, a second wave of COVID-19 occurred in Madagascar, but there remain fewer cases in Ifanadiana than for many other diseases (e.g., malaria). At the Ifanadiana District Hospital, there have been two deaths that are officially attributed to COVID-19. Here, we describe the main components and challenges of this integrated response, the broad epidemiological contours of the epidemic, and how complex data sources can be developed to address many questions of COVID-19 science. Because of data limitations, it still remains unclear how this epidemic will affect rural areas of Madagascar and other developing countries where health system utilization is relatively low and there is limited capacity to diagnose and treat COVID-19 patients. Widespread population based seroprevalence studies are being implemented in Ifanadiana to inform the COVID-19 response strategy as health systems must simultaneously manage perennial and endemic disease threats.


Subject(s)
COVID-19 , COVID-19 Testing , Humans , Madagascar/epidemiology , Pandemics , SARS-CoV-2 , Seroepidemiologic Studies
2.
PLoS One ; 16(4): e0240872, 2021.
Article in English | MEDLINE | ID: covidwho-1197367

ABSTRACT

Social grooming in the animal kingdom is common and serves several functions, from removing ectoparasites to maintaining social bonds between conspecifics. We examined whether time spent grooming with others in a highly social mammal species was associated with infection status for gastrointestinal parasites. Of six parasites detected, one (Trichuris sp.) was associated with social grooming behaviors, but more specifically with direct physical contact with others. Individuals infected with Trichuris sp. spent significantly less time grooming conspecifics than those not infected, and time in direct contact with others was the major predictor of infection status. One model correctly predicted infection status for Trichuris sp. with a reliability of 95.17% overall when the variables used were time spent in direct contact and time spent grooming others. This decrease in time spent grooming and interacting with others is likely a sickness behavior displayed by individuals with less energy or motivation for non-essential behaviors. This study emphasizes the possible links between host behavior and parasitic infections and highlights the need for an understanding of a study population's parasitic infections when attempting to interpret animal behavior.


Subject(s)
Behavior, Animal/physiology , Chlorocebus aethiops/physiology , Chlorocebus aethiops/parasitology , Trichuris/pathogenicity , Animals , Child , Child, Preschool , Female , Grooming/physiology , Humans , Infant , Intestinal Diseases, Parasitic/parasitology , Intestinal Diseases, Parasitic/physiopathology , Male , Reproducibility of Results , Social Behavior , Trichuriasis/physiopathology
3.
Innovation (N Y) ; 1(3): 100065, 2020 Nov 25.
Article in English | MEDLINE | ID: covidwho-1057502

ABSTRACT

Coronavirus disease 2019 (COVID-19) and other epidemics (such as severe acute respiratory syndrome [SARS], Ebola, and H1N1) are stark reminders that knowledge of animal behavior and ecosystem health are key to controlling the spread of zoonotic diseases early in their onset. However, we have very limited information about the set of behavioral and ecological factors that promote viral spillover and the effects that has on ecosystem health and disease transmission. Thus, expanding our current knowledge of reservoir hosts and pandemics represents an urgent and critical tool in ecological epidemiology. We also propose to create an integrative database that ranks animal species in terms of their likelihood as hosts for specific infectious diseases. We call for a global and cooperative effort of field and laboratory scientists to create, maintain, and update this information in order to reduce the severity of future pandemics.

4.
Glob Chang Biol ; 27(7): 1319-1321, 2021 04.
Article in English | MEDLINE | ID: covidwho-1052282

ABSTRACT

Spillover of novel pathogens from wildlife to people, such as the virus responsible for the COVID-19 pandemic, is increasing and this trend is most strongly associated with tropical deforestation driven by agricultural expansion. This same process is eroding natural capital, reducing forest-associated health co-benefits, and accelerating climate change. Protecting and promoting tropical forests is one of the most immediate steps we can take to simultaneously mitigate climate change while reducing the risk of future pandemics; however, success in this undertaking will require greater connectivity of policy initiatives from local to global, as well as unification of health and environmental policy.


Subject(s)
COVID-19 , Environmental Policy , Conservation of Natural Resources , Forests , Humans , Pandemics , SARS-CoV-2 , Tropical Climate
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