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1.
African Journal of Health Professions Education ; 14(1), 2022.
Article in English | Africa Wide Information | ID: covidwho-2092767

ABSTRACT

AFRICAN DEVELOPMENT : Background. The COVID-19 pandemic necessitated drastic changes to undergraduate medical training at the University of Botswana (UB). To save the academic year when campus was locked down, the Department of Medical Education conducted a needs assessment to determine the readiness for emergency remote teaching (ERT) of the Faculty of Medicine, UB.Objectives. To report on the findings of needs assessment surveys to assess learner and teaching staff preparedness for fair and just ERT, as defined by philosopher John Rawls.Methods. Needs assessment surveys were conducted using Office 365 Forms distributed via WhatsApp, targeting medical students and teaching staff during the 5 undergraduate years. Data were analysed quantitatively and qualitatively.Results. Ninety-two percent (266/289) of students and 73.5% (62/84) of teaching staff responded. Surveys revealed a high penetration of smartphones among students, but poor internet accessibility and affordability in homes. Some teaching staff also reported internet and device insufficiencies. Only WhatsApp was accessible to students and teaching staff.Conclusions. For equitable access to ERT in the future, the surveys revealed infrastructural improvement needs, including wider, stronger, affordable WiFi coverage within Botswana and enhanced digital infrastructures in educational institutions, with increased support for students

3.
African Journal of Ecology ; 60(2):135-145, 2022.
Article in English | Africa Wide Information | ID: covidwho-2092265

ABSTRACT

NATCHA : The COVID-19 outbreak has had considerable negative impacts on the livelihoods and living conditions of communities around the world. Although the source of COVID-19 is still unknown, a widely spread hypothesis is that the virus could be of animal origin. Wild meat is used by rural communities as a source of income and food, and it has been hypothesised that the pandemic might alter their perceptions and use of wild meat. McNamara et al. (2020) developed a causal model hypothesising how the impacts of the pandemic could lead to a change in local incentives for wild meat hunting in sub-Saharan African countries. From February 27 to March 19, 2021, we carried out a survey around the Dja Faunal Reserve, Southeast Cameroon, to test McNamara et al.'s model in practice, using semi-structured questionnaires to investigate the impacts of the COVID-19 outbreak on wild meat hunting and consumption. Our results generally agree with the causal pathways suggested by McNamara et al. However, our study highlights additional impact pathways not identified in the model. We provide revisions to McNamara's model to incorporate these pathways and inform strategies to mitigate the impacts of the pandemic

4.
Tran, K. B.; Lang, J. J.; Compton, K.; Xu, R. X.; Acheson, A. R.; Henrikson, H. J.; Kocarnik, J. M.; Penberthy, L.; Aali, A.; Abbas, Q.; Abbasi, B.; Abbasi-Kangevari, M.; Abbasi-Kangevari, Z.; Abbastabar, H.; Abdelmasseh, M.; Abd-Elsalam, S.; Abdelwahab, A. A.; Abdoli, G.; Abdulkadir, H. A.; Abedi, A.; Abegaz, K. H.; Abidi, H.; Aboagye, R. G.; Abolhassani, H.; Absalan, A.; Abtew, Y. D.; Ali, H. A.; Abu-Gharbieh, E.; Achappa, B.; Acuna, J. M.; Addison, D.; Addo, I. Y.; Adegboye, O. A.; Adesina, M. A.; Adnan, M.; Adnani, Q. E. S.; Advani, S. M.; Afrin, S.; Afzal, M. S.; Aggarwal, M.; Ahinkorah, B. O.; Ahmad, A. R.; Ahmad, R.; Ahmad, S.; Ahmadi, S.; Ahmed, H.; Ahmed, L. A.; Ahmed, M. B.; Rashid, T. A.; Aiman, W.; Ajami, M.; Akalu, G. T.; Akbarzadeh-Khiavi, M.; Aklilu, A.; Akonde, M.; Akunna, C. J.; Al Hamad, H.; Alahdab, F.; Alanezi, F. M.; Alanzi, T. M.; Alessy, S. A.; Algammal, A. M.; Al-Hanawi, M. K.; Alhassan, R. K.; Ali, B. A.; Ali, L.; Ali, S. S.; Alimohamadi, Y.; Alipour, V.; Aljunid, S. M.; Alkhayyat, M.; Al-Maweri, S. A. A.; Almustanyir, S.; Alonso, N.; Alqalyoobi, S.; Al-Raddadi, R. M.; Al-Rifai, R. H. H.; Al-Sabah, S. K.; Al-Tammemi, A. B.; Altawalah, H.; Alvis-Guzman, N.; Amare, F.; Ameyaw, E. K.; Dehkordi, J. J. A.; Amirzade-Iranaq, M. H.; Amu, H.; Amusa, G. A.; Ancuceanu, R.; Anderson, J. A.; Animut, Y. A.; Anoushiravani, A.; Anoushirvani, A. A.; Ansari-Moghaddam, A.; Ansha, M. G.; Antony, B.; Antwi, M. H.; Anwar, S. L.; Anwer, R.; Anyasodor, A. E.; Arabloo, J.; Arab-Zozani, M.; Aremu, O.; Argaw, A. M.; Ariffin, H.; Aripov, T.; Arshad, M.; Al, Artaman, Arulappan, J.; Aruleba, R. T.; Aryannejad, A.; Asaad, M.; Asemahagn, M. A.; Asemi, Z.; Asghari-Jafarabadi, M.; Ashraf, T.; Assadi, R.; Athar, M.; Athari, S. S.; Null, Mmwa, Attia, S.; Aujayeb, A.; Ausloos, M.; Avila-Burgos, L.; Awedew, A. F.; Awoke, M. A.; Awoke, T.; Quintanilla, B. P. A.; Ayana, T. M.; Ayen, S. S.; Azadi, D.; Null, S. A.; Azami-Aghdash, S.; Azanaw, M. M.; Azangou-Khyavy, M.; Jafari, A. A.; Azizi, H.; Azzam, A. Y. Y.; Babajani, A.; Badar, M.; Badiye, A. D.; Baghcheghi, N.; Bagheri, N.; Bagherieh, S.; Bahadory, S.; Baig, A. A.; Baker, J. L.; Bakhtiari, A.; Bakshi, R. K.; Banach, M.; Banerjee, I.; Bardhan, M.; Barone-Adesi, F.; Barra, F.; Barrow, A.; Bashir, N. Z.; Bashiri, A.; Basu, S.; Batiha, A. M. M.; Begum, A.; Bekele, A. B.; Belay, A. S.; Belete, M. A.; Belgaumi, U. I.; Bell, A. W.; Belo, L.; Benzian, H.; Berhie, A. Y.; Bermudez, A. N. C.; Bernabe, E.; Bhagavathula, A. S.; Bhala, N.; Bhandari, B. B.; Bhardwaj, N.; Bhardwaj, P.; Bhattacharyya, K.; Bhojaraja, V. S.; Bhuyan, S. S.; Bibi, S.; Bilchut, A. H.; Bintoro, B. S.; Biondi, A.; Birega, M. G. B.; Birhan, H. E.; Bjorge, T.; Blyuss, O.; Bodicha, B. B. A.; Bolla, S. R.; Boloor, A.; Bosetti, C.; Braithwaite, D.; Brauer, M.; Brenner, H.; Briko, A. N.; Briko, N. I.; Buchanan, C. M.; Bulamu, N. B.; Bustamante-Teixeira, M. T.; Butt, M. H.; Butt, N. S.; Butt, Z. A.; dos Santos, F. L. C.; Camera, L. A.; Cao, C.; Cao, Y.; Carreras, G.; Carvalho, M.; Cembranel, F.; Cerin, E.; Chakraborty, P. A.; Charalampous, P.; Chattu, V. K.; Chimed-Ochir, O.; Chirinos-Caceres, J. L.; Cho, D. Y.; Cho, W. C. S.; Christopher, D. J.; Chu, D. T.; Chukwu, I. S.; Cohen, A. J.; Conde, J.; Cortas, S.; Costa, V. M.; Cruz-Martins, N.; Culbreth, G. T.; Dadras, O.; Dagnaw, F. T.; Dahlawi, S. M. A.; Dai, X. C.; Dandona, L.; Dandona, R.; Daneshpajouhnejad, P.; Danielewicz, A.; Dao, A. T. M.; Soltani, R. D. C.; Darwesh, A. M.; Das, S.; Davitoiu, D. V.; Esmaeili, E. D.; De la Hoz, F. P.; Debela, S. A.; Dehghan, A.; Demisse, B.; Demisse, F. W.; Denova-Gutierrez, E.; Derakhshani, A.; Molla, M. D.; Dereje, D.; Deribe, K. S.; Desai, R.; Desalegn, M. D.; Dessalegn, F. N.; Dessalegni, S. A. A.; Dessie, G.; Desta, A. A.; Dewan, S. M. R.; Dharmaratne, S. D.; Dhimal, M.; Dianatinasab, M.; Diao, N.; Diaz, D.; Digesa, L. E.; Dixit, S. G.; Doaei, S.; Doan, L. P.; Doku, P. N.; Dongarwar, D.; dos Santos, W. M.; Driscoll, T. R.; Dsouza, H. L.; Durojaiye, O. C.; Edalati, S.; Eghbalian, F.; Ehsani-Chimeh, E.; Eini, E.; Ekholuenetale, M.; Ekundayo, T. C.; Ekwueme, D. U.; El Tantawi, M.; Elbahnasawy, M. A.; Elbarazi, I.; Elghazaly, H.; Elhadi, M.; El-Huneidi, W.; Emamian, M. H.; Bain, L. E.; Enyew, D. B.; Erkhembayar, R.; Eshetu, T.; Eshrati, B.; Eskandarieh, S.; Espinosa-Montero, J.; Etaee, F.; Etemadimanesh, A.; Eyayu, T.; Ezeonwumelu, I. J.; Ezzikouri, S.; Fagbamigbe, A. F.; Fahimi, S.; Fakhradiyev, I. R.; Faraon, E. J. A.; Fares, J.; Farmany, A.; Farooque, U.; Farrokhpour, H.; Fasanmi, A. O.; Fatehizadeh, A.; Fatima, W.; Fattahi, H.; Fekadu, G.; Feleke, B. E.; Ferrari, A. A.; Ferrero, S.; Desideri, L. F.; Filip, I.; Fischer, F.; Foroumadi, R.; Foroutan, M.; Fukumoto, T.; Gaal, P. A.; Gad, M. M.; Gadanya, M. A.; Gaipov, A.; Galehdar, N.; Gallus, S.; Garg, T.; Fonseca, M. G.; Gebremariam, Y. H.; Gebremeskel, T. G.; Gebremichael, M. A.; Geda, Y. F.; Gela, Y. Y.; Gemeda, B. N. B.; Getachew, M.; Getachew, M. E.; Ghaffari, K.; Ghafourifard, M.; Ghamari, S. H.; Nour, M. G.; Ghassemi, F.; Ghimire, A.; Ghith, N.; Gholamalizadeh, M.; Navashenaq, J. G.; Ghozy, S.; Gilani, S. A.; Gill, P. S.; Ginindza, T. G.; Gizaw, A. T. T.; Glasbey, J. C.; Godos, J.; Goel, A.; Golechha, M.; Goleij, P.; Golinelli, D.; Golitaleb, M.; Gorini, G.; Goulart, B. N. G.; Grosso, G.; Guadie, H. A.; Gubari, M. I. M.; Gudayu, T. W.; Guerra, M. R.; Gunawardane, D. A.; Gupta, B.; Gupta, S.; Gupta, V.; Gupta, V. K.; Gurara, M. K.; Guta, A.; Habibzadeh, P.; Avval, A. H.; Hafezi-Nejad, N.; Ali, A. H.; Haj-Mirzaian, A.; Halboub, E. S.; Halimi, A.; Halwani, R.; Hamadeh, R. R.; Hameed, S.; Hamidi, S.; Hanif, A.; Hariri, S.; Harlianto, N. I.; Haro, J. M.; Hartono, R. K.; Hasaballah, A. I.; Hasan, S. M. M.; Hasani, H.; Hashemi, S. M.; Hassan, A. M.; Hassanipour, S.; Hayat, K.; Heidari, G.; Heidari, M.; Heidarymeybodi, Z.; Herrera-Serna, B. Y.; Herteliu, C.; Hezam, K.; Hiraike, Y.; Hlongwa, M. M.; Holla, R.; Holm, M.; Horita, N.; Hoseini, M.; Hossain, M. M.; Hossain, M. B. H.; Hosseini, M. S.; Hosseinzadeh, A.; Hosseinzadeh, M.; Hostiuc, M.; Hostiuc, S.; Househ, M.; Huang, J. J.; Hugo, F. N.; Humayun, A.; Hussain, S.; Hussein, N. R.; Hwang, B. F.; Ibitoye, S. E.; Iftikhar, P. M.; Ikuta, K. S.; Ilesanmi, O. S.; Ilic, I. M.; Ilic, M. D.; Immurana, M.; Innos, K.; Iranpour, P.; Irham, L. M.; Islam, M. S.; Islam, R. M.; Islami, F.; Ismail, N. E.; Isola, G.; Iwagami, M.; Merin, J. L.; Jaiswal, A.; Jakovljevic, M.; Jalili, M.; Jalilian, S.; Jamshidi, E.; Jang, S. I.; Jani, C. T.; Javaheri, T.; Jayarajah, U. U.; Jayaram, S.; Jazayeri, S. B.; Jebai, R.; Jemal, B.; Jeong, W.; Jha, R. P.; Jindal, H. A.; John-Akinola, Y. O.; Jonas, J. B.; Joo, T.; Joseph, N.; Joukar, F.; Jozwiak, J. J.; Jarisson, M.; Kabir, A.; Kacimi, S. E. O.; Kadashetti, V.; Kahe, F.; Kakodkar, P. V.; Kalankesh, L. R.; Kalhor, R.; Kamal, V. K.; Kamangar, F.; Kamath, A.; Kanchan, T.; Kandaswamy, E.; Kandel, H.; Kang, H.; Kanno, G. G.; Kapoor, N.; Kar, S. S.; Karanth, S. D.; Karaye, I. M.; Karch, A.; Karimi, A.; Kassa, B. G.; Katoto, Pdmc, Kauppila, J. H.; Kaur, H.; Kebede, A. G.; Keikavoosi-Arani, L.; Kejela, G. G.; Bohan, P. M. K.; Keramati, M.; Keykhaei, M.; Khajuria, H.; Khan, A.; Khan, A. A. K.; Khan, E. A.; Khan, G.; Khan, M. N.; Ab Khan, M.; Khanali, J.; Khatab, K.; Khatatbeh, M. M.; Khatib, M. N.; Khayamzadeh, M.; Kashani, H. R. K.; Tabari, M. A. K.; et al..
Lancet ; 400(10352):563-591, 2022.
Article in English | Web of Science | ID: covidwho-2068419

ABSTRACT

Background Understanding the magnitude of cancer burden attributable to potentially modifiable risk factors is crucial for development of effective prevention and mitigation strategies. We analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 to inform cancer control planning efforts globally. Methods The GBD 2019 comparative risk assessment framework was used to estimate cancer burden attributable to behavioural, environmental and occupational, and metabolic risk factors. A total of 82 risk-outcome pairs were included on the basis of the World Cancer Research Fund criteria. Estimated cancer deaths and disability-adjusted life-years (DALYs) in 2019 and change in these measures between 2010 and 2019 are presented. Findings Globally, in 2019, the risk factors included in this analysis accounted for 4.45 million (95% uncertainty interval 4.01-4.94) deaths and 105 million (95.0-116) DALYs for both sexes combined, representing 44.4% (41.3-48.4) of all cancer deaths and 42.0% (39.1-45.6) of all DALYs. There were 2.88 million (2.60-3.18) risk-attributable cancer deaths in males (50.6% [47.8-54.1] of all male cancer deaths) and 1.58 million (1.36-1.84) risk-attributable cancer deaths in females (36.3% [32.5-41.3] of all female cancer deaths). The leading risk factors at the most detailed level globally for risk-attributable cancer deaths and DALYs in 2019 for both sexes combined were smoking, followed by alcohol use and high BMI. Risk-attributable cancer burden varied by world region and Socio-demographic Index (SDI), with smoking, unsafe sex, and alcohol use being the three leading risk factors for risk-attributable cancer DALYs in low SDI locations in 2019, whereas DALYs in high SDI locations mirrored the top three global risk factor rankings. From 2010 to 2019, global risk-attributable cancer deaths increased by 20.4% (12.6-28.4) and DALYs by 16.8% (8.8-25.0), with the greatest percentage increase in metabolic risks (34.7% [27.9-42.8] and 33.3% [25.8-42.0]). Interpretation The leading risk factors contributing to global cancer burden in 2019 were behavioural, whereas metabolic risk factors saw the largest increases between 2010 and 2019. Reducing exposure to these modifiable risk factors would decrease cancer mortality and DALY rates worldwide, and policies should be tailored appropriately to local cancer risk factor burden. Copyright (C) 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.

5.
Berkeley Planning Journal ; 32(1), 2022.
Article in English | ProQuest Central | ID: covidwho-2011196

ABSTRACT

This paper charts my path from observer to action researcher – and my ex post realisation that a transition had happened in my work. This transition happened on the fly, in the field, without me critically reflecting on it at the time, while I was studying evictions in Port Vila, Vanuatu, South Pacific. My ethics came into direct conflict with my research approach, and I chose to change my approach. I theorise my transformation in the modernity/coloniality literature and close by offering strategies to students and other researchers who are looking for ways to engage more deeply with, and give something back to, the communities they study.

6.
Berkeley Planning Journal ; 32(1), 2022.
Article in English | ProQuest Central | ID: covidwho-1990210

ABSTRACT

Chinatowns in North America have been especially hit hard by COVID-19, a reality of anti-Asian racist and xenophobic sentiment exacerbated by the global pandemic. The factors contributing to increased business closures, commercial vacancy, and gentrification in Chinatowns have existed before the pandemic and have only been exacerbated. In order to preserve Chinatowns, municipalities have enacted historic preservation and small business support measures, such as historic designations, technical assistance for businesses, increased permit scrutiny, and legacy business programs. This study investigates the difference in retail changes across three Chinatowns in Vancouver, San Francisco and Los Angeles both prior and during the COVID-19 pandemic. Concurrently, this study also examines the impact of retaining a legacy business program and other preservation measures on the retail landscape. Interviews with city officials, organizers, community institutions, and members of the business community were conducted along with an analysis of existing local programs, policies and reports. This study finds that measures taken through historic preservation, small business support, and pandemic relief have not significantly addressed core needs within Chinatown communities. The most effective forms of relief and preservation was affordable housing, community-ownership of commercial businesses, and direct assistance for commercial rent. This study also acknowledges that some Chinatowns are faring better than others due to the ability of the Chinese community to fight against to historic discriminatory planning practices such as urban renewal, slum clearance, and highway building. The impact of these histories is deeply intertwined with the survivability of ethnic retail within each distinct Chinatown, and depending on the strength of existing community ties that remain will inform how preservation policies should be enacted.

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Berkeley Planning Journal ; 32(1), 2022.
Article in English | ProQuest Central | ID: covidwho-1989827

ABSTRACT

During the COVID-19 pandemic, the City of San Francisco sanctioned the use of public space on sidewalks and parking spaces for commercial use as part of their Shared Spaces initiative. Combined with streamlined permitting processes and an iterative rollout of design guidelines and inspections, the program facilitated a rapid and large-scale shift in the city’s streetscape. Using the Valencia Street commercial corridor in San Francisco’s Mission District as a case study area, we define and observe the “outdoor commercial spaces” (OCS) to present a preliminary typology based on degree of enclosure as a potential signifier of different patterns in use and perception of public space. We interview residents and other stakeholders to explore emerging themes in the perception of OCS, complemented by pedestrian path tracing along different sections of Valencia Street. Our findings indicate that differences in the degree of enclosure in OCS on Valencia Street partially reflect their diversity in use and business type. The limited interview data also suggests that individuals across all stakeholder groups generally believe OCS represent an improvement to public space even when more enclosed OCS imply the privatization of public space. Additionally, pedestrian behavior while the street is closed to vehicular traffic implies that the street closure is an important complement to OCS that maximizes the potential benefits of an activated streetscape while mitigating the negative effects and perceptions of privatization. However, these changes may amplify existing patterns of inclusion and exclusion in public spaces on Valencia Street. Especially as many OCS may become permanent fixtures of San Francisco’s streets, their design and purpose have important implications for street-level accessibility and city-wide equity for small businesses. These dynamics –and the OCS themselves –are likely to continue evolving during the transition to long-term guidelines and implementation.

8.
Transboundary and Emerging Diseases ; 69(2):632-644, 2022.
Article in English | Africa Wide Information | ID: covidwho-1971026

ABSTRACT

BIRDS : The variety and widespread of coronavirus in natural reservoir animals is likely to cause epidemics via interspecific transmission, which has attracted much attention due to frequent coronavirus epidemics in recent decades. Birds are natural reservoir of various viruses, but the existence of coronaviruses in wild birds in central China has been barely studied. Some bird coronaviruses belong to the genus of Deltacoronavirus. To explore the diversity of bird deltacoronaviruses in central China, we tested faecal samples from 415 wild birds in Hunan Province, China. By RT-PCR detection, we identified eight samples positive for deltacoronaviruses which were all from common magpies, and in four of them, we successfully amplified complete deltacoronavirus genomes distinct from currently known deltacoronavirus, indicating four novel deltacoronavirus stains (HNU1-1, HNU1-2, HNU2 and HNU3). Comparative analysis on the four genomic sequences showed that these novel magpie deltacoronaviruses shared three different S genes among which the S genes of HNU1-1 and HNU1-2 showed 93.8% amino acid (aa) identity to that of thrush coronavirus HKU12, HNU2 S showed 71.9% aa identity to that of White-eye coronavirus HKU16, and HNU3 S showed 72.4% aa identity to that of sparrow coronavirus HKU17. Recombination analysis showed that frequent recombination events of the S genes occurred among these deltacoronavirus strains. Two novel putative cleavage sites separating the non-structural proteins in the HNU coronaviruses were found. Bayesian phylogeographic analysis showed that the south coast of China might be a potential origin of bird deltacoronaviruses existing in inland China. In summary, these results suggest that common magpie in China carries diverse deltacoronaviruses with novel genomic features, indicating an important source of environmental coronaviruses closed to human communities, which may provide key information for prevention and control of future coronavirus epidemics

9.
Agricultural Economics ; 53(1):72-89, 2022.
Article in English | Africa Wide Information | ID: covidwho-1970443

ABSTRACT

AFRICAN DEVELOPMENT : Swift response models are vital tools for emergency assistance agencies. The COVID-19 pandemic revealed the lack of economic models for short-run policy relevant research to anticipate local impacts and design effective policy responses. The most direct effects of the pandemic and lockdown tended to be concentrated in urban areas;however, markets quickly transmitted impacts to rural areas as well as among poor and non-poor households. General equilibrium modeling is a tool of choice to capture indirect, spillover effects of exogenous shocks. This article describes an unusual micro general-equilibrium (GE) modeling approach that we developed to quickly simulate impacts of the pandemic and lockdowns on poor and non-poor rural and urban households across sub-Saharan Africa. Monte Carlo bootstrapping was used to construct four stylized regional GE models from 34 existing local economy-wide impact evaluation (LEWIE) models. Simulations revealed that the pandemic and policy responses to curtail its spread were likely to affect rural households at least as severely as urban households. Simulated income losses are greater in poor households in both urban and rural settings. These findings are relatively consistent across models spanning sub-Saharan Africa. Because COVID-19 impacts are so far-reaching, all types of economies experience downturns. Our research underlines the importance of modeling assumptions. We find total annualized impacts of around a 6-percent loss of GDP, smaller than estimates from single-country models that ignore price effects, such as SAM-multiplier models, but in line with The World Bank's baseline forecast of a 5.2% contraction in global GDP in 2020. The largest negative impacts are on poor rural households

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Journal of Health Care for the Poor & Underserved ; 33(1):1-12, 2022.
Article in English | CINAHL | ID: covidwho-1688392

ABSTRACT

A state-academic-community partnership formed in response to the mental health needs fueled by the COVID-19 pandemic and the disproportionate effects on marginalized communities. Taking a community-partnered approach and using a health equity lens, the partnership developed a website to guide users through digital mental health resources, prioritizing accessibility, engagement, and community needs.

13.
African Journal of Health Professions Education ; 13(3):208-209, 2021.
Article in English | Africa Wide Information | ID: covidwho-1661256

ABSTRACT

AFRICAN DEVELOPMENT : Acquiring psychomotor and clinical skills are an essential part of dental students training. This particular aspect posed a unique challenge for an undergraduate Prosthetic final year module in a South African dental school during the Corona virus disease-19 (COVID-19) pandemic. Teaching of clinical skills was completely interrupted during the country's initial response to the pandemic. With the easing of country lockdown restrictions, the final year dental students were allowed to return to campus to continue with clinical practice training. This therefore called for innovative and novel strategies to determine and address inadequacies in their learning and clinical practices

14.
African Journal of Health Professions Education ; 13(3):203-204, 2021.
Article in English | Africa Wide Information | ID: covidwho-1661018

ABSTRACT

AFRICAN DEVELOPMENT : Background. The COVID-19 pandemic resulted in innovative and creative changes to educational practices in order to produce pharmacy graduates amidst a global crisis. Experiential learning was unable to take place during the highest levels of lockdown in South Africa with access to health care facilities restricted to essential staff only

15.
African Journal of Health Professions Education ; 13(3):163-166, 2021.
Article in English | Africa Wide Information | ID: covidwho-1660930

ABSTRACT

AFRICAN DEVELOPMENT : The sudden transition to Emergency Remote Teaching (ERT) during the COVID-19 crisis hindered small group student learning, including Supported Problem-based Learning (SPBL), in the undergraduate medical curriculum at the University of Cape Town. Consequently, a socially just and equitable online Remote SPBL model was needed to promote learning, social cohesion, track student progress, and render emotional containment to students experiencing crisis-related anxiety and social isolation.Remote SPBL was conducted asynchronously using the "Forums" tool within the Learning Management System, namely VULA, to accommodate students with limited internet access. Some SPBL steps were excluded to accommodate the decreased available learning time which may have compromised the SPBL process.SPBL facilitators trained in online facilitation, served as a bridge between students and course convenors ensuring the early detection of academic and non-academic barriers to learning, and enabling timely support. Thus, Remote SPBL offered students' academic and social support at a time of great change, while maintaining the core elements of the curriculum and enabling the integration of disciplinary knowledge. However, the asynchronous approach and non-academic obstacles to accessing online learning limited effective group interaction and collaborative learning. Based on the experiences of the model, course convenors will consider integrating SPBL into a blended model in future and will include all the SPBL steps to enhance student learning using both synchronous and asynchronous approaches.This model, that draws on simple web-based learning platforms, could easily be adopted, and effectively utilized in low-resourced educational and healthcare settings due to its easy and cost-effective approach

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American Journal of Tropical Medicine and Hygiene ; 104(3 Suppl):87-98, 2021.
Article in English | Africa Wide Information | ID: covidwho-1490071

ABSTRACT

WATERLIT Abstract: Current recommendations for the management of patients with COVID-19 and acute kidney injury (AKI) are largely based on evidence from resource-rich settings, mostly located in high-income countries. It is often unpractical to apply these recommendations to resource-restricted settings. We report on a set of pragmatic recommendations for the prevention, diagnosis, and management of patients with COVID-19 and AKI in low- and middle-income countries (LMICs). For the prevention of AKI among patients with COVID-19 in LMICs, we recommend using isotonic crystalloid solutions for expansion of intravascular volume, avoiding nephrotoxic medications, and using a conservative fluid management strategy in patients with respiratory failure. For the diagnosis of AKI, we suggest that any patient with COVID-19 presenting with an elevated serum creatinine level without available historical values be considered as having AKI. If serum creatinine testing is not available, we suggest that patients with proteinuria should be considered to have possible AKI. We suggest expansion of the use of point-of-care serum creatinine and salivary urea nitrogen testing in community health settings, as funding and availability allow. For the management of patients with AKI and COVID-19 in LMICS, we recommend judicious use of intravenous fluid resuscitation. For patients requiring dialysis who do not have acute respiratory distress syndrome (ARDS), we suggest using peritoneal dialysis (PD) as first choice, where available and feasible. For patients requiring dialysis who do have ARDS, we suggest using hemodialysis, where available and feasible, to optimize fluid removal. We suggest using locally produced PD solutions when commercially produced solutions are unavailable or unaffordable

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American Journal of Tropical Medicine and Hygiene ; 104(3 Suppl):25-33, 2021.
Article in English | Africa Wide Information | ID: covidwho-1489471

ABSTRACT

WATERLIT Abstract: Infection prevention and control (IPC) strategies are key in preventing nosocomial transmission of COVID-19. Several commonly used IPC practices are resource-intensive and may be challenging to implement in resource-constrained settings. An international group of healthcare professionals from or with experience in low- and middle-income countries (LMICs) searched the literature for relevant evidence. We report on a set of pragmatic recommendations for hospital-based IPC practices in resource-constrained settings of LMICs. For cases of confirmed or suspected COVID-19, we suggest that patients be placed in a single isolation room, whenever possible. When single isolation rooms are unavailable or limited, we recommend cohorting patients with COVID-19 on dedicated wards or in dedicated hospitals. We also recommend that cases of suspected COVID-19 be cohorted separately from those with confirmed disease, whenever possible, to minimize the risk of patient-to-patient transmission in settings where confirmatory testing may be limited. We suggest that healthcare workers be designated to care exclusively for patients with COVID-19, whenever possible, as another approach to minimize nosocomial spread. This approach may also be beneficial in conserving limited supplies of reusable personal protective equipment (PPE). We recommend that visitors be restricted for patients with COVID-19. In settings where family members or visitors are necessary for caregiving, we recommend that the appropriate PPE be used by visitors. We also recommend that education regarding hand hygiene and donning/doffing procedures for PPE be provided. Last, we suggest that all visitors be screened for symptoms before visitation and that visitor logs be maintained

18.
American Journal of Tropical Medicine and Hygiene ; 104(2):461-465, 2021.
Article in English | Africa Wide Information | ID: covidwho-1320717

ABSTRACT

WATERLIT Abstract: In the African context, there is a paucity of data on SARS-CoV-2 infection and associated COVID-19 in pregnancy. Given the endemicity of infections such as malaria, HIV, and tuberculosis (TB) in sub-Saharan Africa (SSA), it is important to evaluate coinfections with SARS-CoV-2 and their impact on maternal/infant outcomes. Robust research is critically needed to evaluate the effects of the added burden of COVID-19 in pregnancy, to help develop evidence-based policies toward improving maternal and infant outcomes. In this perspective, we briefly review current knowledge on the clinical features of COVID-19 in pregnancy;the risks of preterm birth and cesarean delivery secondary to comorbid severity;the effects of maternal SARS-CoV-2 infection on the fetus/neonate;and in utero mother-to-child SARS-CoV-2 transmission. We further highlight the need to conduct multicountry surveillance as well as retrospective and prospective cohort studies across SSA. This will enable assessments of SARS-CoV-2 burden among pregnant African women and improve the understanding of the spectrum of COVID-19 manifestations in this population, which may be living with or without HIV, TB, and/or other coinfections/comorbidities. In addition, multicountry studies will allow a better understanding of risk factors and outcomes to be compared across countries and subregions. Such an approach will encourage and strengthen much-needed intra-African, south-to-south multidisciplinary and interprofessional research collaborations. The African Forum for Research and Education in Health's COVID-19 Research Working Group has embarked upon such a collaboration across Western, Central, Eastern and Southern Africa

19.
American Journal of Tropical Medicine and Hygiene ; 104(3 Suppl):34-47, 2021.
Article in English | Africa Wide Information | ID: covidwho-1320715

ABSTRACT

WATERLIT Abstract: Management of patients with severe or critical COVID-19 is mainly modeled after care of patients with severe pneumonia or acute respiratory distress syndrome from other causes. These models are based on evidence that primarily originates from investigations in high-income countries, but it may be impractical to apply these recommendations to resource-restricted settings in low- and middle-income countries (LMICs). We report on a set of pragmatic recommendations for microbiology and laboratory testing, imaging, and the use of diagnostic and prognostic models in patients with severe COVID-19 in LMICs. For diagnostic testing, where reverse transcription–PCR (RT-PCR) testing is available and affordable, we recommend using RT-PCR of the upper or lower respiratory specimens and suggest using lower respiratory samples for patients suspected of having COVID-19 but have negative RT-PCR results for upper respiratory tract samples. We recommend that a positive RT-PCR from any anatomical source be considered confirmatory for SARS-CoV-2 infection, but, because false-negative testing can occur, recommend that a negative RT-PCR does not definitively rule out active infection if the patient has high suspicion for COVID-19. We suggest against using serologic assays for the detection of active or past SARS-CoV-2 infection, until there is better evidence for its usefulness. Where available, we recommend the use of point-of-care antigen-detecting rapid diagnostic testing for SARS-CoV-2 infection as an alternative to RT-PCR, only if strict quality control measures are guaranteed. For laboratory testing, we recommend a baseline white blood cell differential platelet count and hemoglobin, creatinine, and liver function tests and suggest a baseline C-reactive protein, lactate dehydrogenase, troponin, prothrombin time (or other coagulation test), and D-dimer, where such testing capabilities are available. For imaging, where availability of standard thoracic imaging is limited, we suggest using lung ultrasound to identify patients with possible COVID-19, but recommend against its use to exclude COVID-19. We suggest using lung ultrasound in combination with clinical parameters to monitor progress of the disease and responses to therapy in COVID-19 patients. We currently suggest against using diagnostic and prognostic models as these models require extensive laboratory testing and imaging, which often are limited in LMICs

20.
American Journal of Tropical Medicine and Hygiene ; 104(3 Suppl):99-109, 2021.
Article in English | Africa Wide Information | ID: covidwho-1320714

ABSTRACT

WATERLIT Abstract: New studies of COVID–19 are constantly updating best practices in clinical care. Often, it is impractical to apply recommendations based on high-income country investigations to resource limited settings in low- and middle-income countries (LMICs). We present a set of pragmatic recommendations for the management of anticoagulation and thrombotic disease for hospitalized patients with COVID-19 in LMICs. In the absence of contraindications, we recommend prophylactic anticoagulation with either low molecular weight heparin (LMWH) or unfractionated heparin (UFH) for all hospitalized COVID-19 patients in LMICs. If available, we recommend LMWH over UFH for venous thromboembolism (VTE) prophylaxis to minimize risk to healthcare workers. We recommend against the use of aspirin for VTE prophylaxis in hospitalized COVID-19 and non–COVID-19 patients in LMICs. Because of limited evidence, we suggest against the use of “enhanced” or “intermediate” prophylaxis in COVID-19 patients in LMICs. Based on current available evidence, we recommend against the initiation of empiric therapeutic anticoagulation without clinical suspicion for VTE. If contraindications exist to chemical prophylaxis, we recommend mechanical prophylaxis with intermittent pneumatic compression (IPC) devices or graduated compression stockings (GCS) for hospitalized COVID-19 patients in LMICs. In LMICs, we recommend initiating therapeutic anticoagulation for hospitalized COVID-19 patients, in accordance with local clinical practice guidelines, if there is high clinical suspicion for VTE, even in the absence of testing. If available, we recommend LMWH over UFH or Direct oral anticoagulants for treatment of VTE in LMICs to minimize risk to healthcare workers. In LMIC settings where continuous intravenous UFH or LMWH are unavailable or not feasible to use, we recommend fixed dose heparin, adjusted to body weight, in hospitalized COVID-19 patients with high clinical suspicion of VTE. We suggest D-dimer measurement, if available and affordable, at the time of admission for risk stratification, or when clinical suspicion for VTE is high. For hospitalized COVID-19 patients in LMICs, based on current available evidence, we make no recommendation on the use of serial D-dimer monitoring for the initiation of therapeutic anticoagulation. For hospitalized COVID-19 patients in LMICs receiving intravenous therapeutic UFH, we recommend serial monitoring of partial thromboplastin time or anti-factor Xa level, based on local laboratory capabilities. For hospitalized COVID-19 patients in LMICs receiving LMWH, we suggest against serial monitoring of anti-factor Xa level. We suggest serial monitoring of platelet counts in patients receiving therapeutic anticoagulation for VTE, to assess risk of bleeding or development of heparin induced thrombocytopenia

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