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The COVID-19 vaccines provide a high degree of protection against severe disease, hospitalisation, and death. However, no vaccine claimed 100% effectiveness and it is expected that a small proportion of vaccinated individuals may develop a breakthrough infection due to individual differences, virus variants and other factors. We conducted an epidemiological investigation and analysis of an imported case who had finished four doses of vaccination, and in order to provide a relevant reference for regular epidemic prevention and control in the post-pandemic era.
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Background: COVID-19's restrictive measures have significantly affected our health, work and social relationships. As yet, less attention has been given to the changes in sex life. Aim: This study investigates people's satisfaction with sex life in Kinshasa in the Democratic Republic of Congo (DRC). Methods: A cross-sectional survey of the general population (18 years and over) was conducted, from 1st to 18th July 2020, in 17 municipalities in Kinshasa and several measures were used: Quality of life MANSA, EQ-5D-3L, UCLA Loneliness;PHQ-9;GAD-7. Prior to conducting data analysis, diagnostic tests for our data were performed to assess distribution, variance and multicollinearity. Descriptive statistics, bivariate correlation and multiple regression analysis were used. Results: Sex life satisfaction increases from young adults aged 18- 35 to those aged 36-55 and then there is a decrease from ages 56-69. After controlling for socio-demographic factors, sex life satisfaction was positively associated with the number and quality of people's friendships (B=0.30, p=0.01) and people's relationships with their families (B=0.32, p=0.03). People who feel lonely have lower sex life satisfaction (B=-0.15, p=0.01). Conclusion: People's quality of their friendships and family relationships are important for their sexual well-being. Healthcare providers and policymakers should consider people's quality of friendships and family relationships when planning to improve the sexual well-being of people in DRC.
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Background: After two years of COVID in which activities were reduced due to the pandemic and each one's life was affected by restrictions and limitations, the Sickle Cell Disease (SCD) Association in Padova teamed up with the Sickle Cell Group at the Pediatric Hematology Oncology and Bone Marrow Transplant Unit to celebrate the Sickle Cell Disease world day by organizing an online meeting with children/youths and their families. Theme of the meeting was: "My Life with SCD: poems, pictures and writings express our view on disease and care". Aim(s): One of the goals of this meeting was to create an opportunity for individuals with SCD to meet and have a constructive discussion with each other about the disease and express their feelings after two years of pandemic. Method(s): One month before the meeting children, teenager and parents were asked to sharer with the organizing team any drawing, painting, poem, writing, that they felt could express their feelings or experience of the disease itself or how it affected their life, or their experience in the hospital. The materials received were organized in a power point presentation and At the meeting, families were able to see a PowerPoint presentation with the poems, drawings, writings. Each author had the choice to personally share their production or have it read out loud by a member of the team. Free time to comment or share experiences was given. Result(s): 20 children, teenagers and parents participated. Countries of origin (Nigeria, Ghana, Congo, Albania, Italy), religious background (catholic, muslim, no religion, other) were different as well as disease genotype (HbSS, HbSC, HbSBdegree), severity or treatment received (Hydroxyurea, transfusion, Hematopoietic stem cell transplantation -HSCT, none). Drawings and writings regarded experience with the disease (mechanism of action, admissions), feelings experienced (fear, hope, light at the end of the tunnel), aspirations (sports) and gratitude (to the social and medical team, to parents) (Figure 1). Surprisingly, families who had a child having undergone HSCT, reported on the need and importance to talk about this experience for years after the event and made a request of a support goup. Finally, all families underlined the need to meet again soon to discuss together issues related to personal experience with SCD, even via web. of discussion with each other and with the drepanocytosis group;and that throug the online telematics platform it is still possible to involve all families, listening and trying to comfort them on doubts and perplexities about the disease, In conclusion, it can be said that after two years of pandemic, in our setting, online meeting can help patients and families reconnect with each other and activities can be planned to aid experiences and feelings. Patients' associations and Health Care Teams can collaborate in this area.
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Iron and zinc are important minerals in humans in sub Saharan Africa, whose deficiency is known as "hidden hunger" due to the lack of recognised symptoms in the early stages. Although iron deficiency is the most prevalent, zinc is also involved in inhibition of replication of viruses, including the corona virus (COVID-19). In North Kivu and South Kivu provinces where more than 50% of common bean is produced and consumed in Democratic Republic of Congo, 36% and 47% of preschool children are anemic due to iron deficiency. This paradox is mainly due to insufficiency of iron-rich foods. The aim of this study is to characterise 59 iron and zinc biofortified varieties together with six local varieties of common bean for a potential selection programme in Butembo town in the Democratic Republic of Congo. We focused on 15 qualitative and five quantitative parameters. The qualitative parameters were helpful to distinguish the different morphotypes and for cluster analysis. In addition to the descriptive statistics, the quantitative data were used for Pearson correlation and for principal component analysis, PCA. Qualitative parameters enabled grouping of the study genotypes into 14 morphotypes according to the aspect and colour of the seed coat, the colour around the hilum and the size of seeds. Clustering grouped the 65 genotypes into 12 clusters with the most similar genotypes grouped in the same cluster. Quantitative parameters showed that the study genotypes were dissimilar (P=0.00). A positive correlation was obtained between the days to flowering and the days to maturity (P<0.05) and between the number of pods per plant and the days to flowering. A strong correlation was found between the number of pods per plant and seeds per pod (P<0.01). In contrast, a negative correlation was observed between the 100 seed weight and the number of seeds per pod. The PCA represented on two perpendicular axes showed 64.1% of the total variance of which the 42.3% is explained by the first axis and 21.8% by the second axis. Overall, the study genotypes are morphologically and quantitatively different and thus can be used in a selection programme.
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PurposeThe present article aims to determine the factors that explain the intention to adopt electronic commerce among women traders in a developing country like Democratic Republic of Congo (DRC) during a health crisis period.Design/methodology/approachThis study was conducted in the DRC, in Bukavu Town. A convenience sample of 282 respondents consisting of solely women entrepreneurs (importing traders) in Bukavu Town was selected and the structural equation model was used to test the research hypotheses resulted from Ajzen's theory of planned behaviour.FindingsThe finding results showed that only the factors attitude towards electronic commerce adoption and subjective norms which predict women traders' intention to adopt electronic commerce. The analysis shows that about 38.9% of the variation in the dependent variable is explained by the above variables.Originality/valueFew studies have presented technology and electronic commerce adoption as resilience of women entrepreneurs in a time of crisis, despite the abundance of the review literature on adoption. This study provides a new approach to assist women entrepreneurs as well as researchers in understanding the drivers of electronic commerce adoption factors in the DRC.
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Ebola virus disease (EVD) is a rare but highly contagious and lethal disease that occurs predominantly in African countries, with a case-fatality rate of 30–90%. The causative viral pathogens of EVD are within the genus Ebolavirus in the family Filoviridae. The primary route of human-to-human transmission is through direct contact with blood, bodily fluids and secretions from infected individuals. Direct contact with virally contaminated objects and sexual transmission have also been reported. Management of EVD is aggressive supportive care with possibly new therapeutic options. On 20 September 2022, an EVD outbreak was declared in Uganda, caused by Sudan ebolavirus. As of 7 November 2022, a total of 136 confirmed cases, 53 confirmed deaths have been reported, including 18 cases with seven deaths among healthcare workers. In the Democratic Republic of Congo (DRC), an EVD outbreak was also declared on 22 August 2022 (which ended on 27 September 2022);with only one case, a middle-aged woman. At the time when most countries in the world have been occupied with the coronavirus disease 2019 (COVID-19) pandemic and the recent human monkeypox outbreak, these two outbreaks of EVD have the potential to significantly add to the burden on global health. Authorities need to augment their multi-faceted response, including stringent contact tracing and border control, to avoid the catastrophe of the 2014–2016 EVD epidemic. © 2022, School of Medicine, Universitas Syiah Kuala. All rights reserved.
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COVID-19 is a zoonotic coronavirus disease caused by SARS-CoV-2. Its fast spreading by aerosol transmission has made it a highly contagious disease, causing the most recent 2020 pandemic. Although it mainly affects the respiratory system, atypical forms of the disease have been described, including developing an undifferentiated febrile illness without respiratory symptoms, that can represent a diagnostic challenge, mainly in tropical areas where several zoonotic febrile diseases are circulating. Thus, despite the broad clinical spectrum of COVID-19, in the tropics, other zoonotic etiologies should always be considered as differential diagnoses. According to our case reports review, eight different zoonotic febrile diseases misdiagnosed as COVID-19 have been reported in the available scientific literature of four databases. These were only suspected due to the epidemiological history. Thus, making a complete and detailed clinical history of a febrile patient in the tropics is essential to suspect the etiology and request the necessary confirmatory tests. Therefore, COVID-19 must be included as a differential diagnosis of undifferentiated febrile illness in the tropics, but other zoonotic infectious diseases must not be ruled out.
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Populations affected by humanitarian crises and emerging infectious disease outbreaks may have unique concerns and experiences that influence their perceptions toward vaccines. In March 2021, we conducted a survey to examine the perceptions toward COVID-19 vaccines and identify the factors associated with vaccine intention among 631 community members (CMs) and 438 healthcare workers (HCWs) affected by the 2018-2020 Ebola Virus Disease outbreak in North Kivu, Democratic Republic of the Congo. A multivariable logistic regression was used to identify correlates of vaccine intention. Most HCWs (81.7%) and 53.6% of CMs felt at risk of contracting COVID-19; however, vaccine intention was low (27.6% CMs; 39.7% HCWs). In both groups, the perceived risk of contracting COVID-19, general vaccine confidence, and male sex were associated with the intention to get vaccinated, with security concerns preventing vaccine access being negatively associated. Among CMs, getting the Ebola vaccine was associated with the intention to get vaccinated (RR 1.43, 95% CI 1.05-1.94). Among HCWs, concerns about new vaccines' safety and side effects (OR 0.72, 95% CI 0.57-0.91), religion's influence on health decisions (OR 0.45, 95% CI 0.34-0.61), security concerns (OR 0.52, 95% CI 0.37-0.74), and governmental distrust (OR 0.50, 95% CI 0.35-0.70) were negatively associated with vaccine perceptions. Enhanced community engagement and communication that address this population's concerns could help improve vaccine perceptions and vaccination decisions. These findings could facilitate the success of vaccine campaigns in North Kivu and similar settings.
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BACKGROUND: Since March 2020, the COVID-19 pandemic has shocked health systems worldwide. This analysis investigated the effects of the pandemic on basic health services utilization in the Democratic Republic of the Congo (DRC) and examined the variability of COVID effects in the capital city Kinshasa, in other urban areas, and in rural areas. METHODS: We estimated time trends models using national health information system data to replicate pre-COVID-19 (i.e., January 2017-February 2020) trajectories of health service utilization, and then used those models to estimate what the levels would have been in the absence of COVID-19 during the pandemic period, starting in March 2020 through March 2021. We classified the difference between the observed and predicted levels as the effect of COVID-19 on health services. We estimated 95% confidence intervals and p-values to examine if the effect of the pandemic, nationally and within specific geographies, was statistically significant. RESULTS: Our results indicate that COVID-19 negatively impacted health services and subsequent recovery varied by service type and by geographical area. COVID-19 had a lasting impact on overall service utilization as well as on malaria and pneumonia-related visits among young children in the DRC. We also found that the effects of COVID-19 were even more immediate and stronger in the capital city of Kinshasa compared with the national effect. Both nationally and in Kinshasa, most affected services had slow and incomplete recovery to expected levels. Therefore, our analysis indicates that COVID-19 continued to affect health services in the DRC throughout the first year of the pandemic. CONCLUSIONS: The methodology used in this article allows for examining the variability in magnitude, timing, and duration of the COVID effects within geographical areas of the DRC and nationally. This analytical procedure based on national health information system data could be applied to surveil health service disruptions and better inform rapid responses from health service managers and policymakers.
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COVID-19 , Health Information Systems , Child , Humans , Child, Preschool , Democratic Republic of the Congo/epidemiology , Facilities and Services Utilization , Pandemics , COVID-19/epidemiologyABSTRACT
Cholera, being a global health issue has remarkably affected the wellness of the people, especially in the Democratic Republic of Congo (DRC). This has worsened during the COVID-19 pandemic, and it could be more if no concrete Intervention is done to curtail the outbreak. The authors reviewed past and present literatures on cholera and COVID-19 from the year 2013-2023 in well renowned scientific journals such as PUBMED, ResearchGate, Google Scholar. Database servers of these journals were accessed based on their permissions. From this search the authors found that, cholera is at its peak amidst COVID in DRC. Between the 10 March 2020 to the 10 March 2022, DRC reported a total of 86 462 cases of COVID-19 in 314 health zones in all 26 provinces of the country, with 1335 deaths recorded. And since the beginning of 2022, 6692 suspected cholera cases including 107 deaths have been reported in 54 health zones in 11 provinces of DRC, compared with 3681 suspected cases and 91 deaths reported during the same period in 2021 in 67 health zones in 14 provinces in the country. The authors realized that despite all efforts to mitigate the spread of cholera in DRC by the Congolese government and the non-governmental organizations in the country, there are still some gaps required to be filled, such as; limited community mobilizations and awareness campaigns about the signs and symptoms of cholera and COVID-19, unavailability of free cholera and COVID-19 vaccines to all the Congolese populations as well as association of witchcraft to diseases. etc. Hence, to mitigate this menace, the authors urge the Congolese government to utilize research implementation strategies such as increase mass awareness campaigns on cholera and COVID among the Congolese populations as well as training workshops for the religious and traditional leaders as well as the healthcare providers in the country for a better diagnosis and treatment of these diseases.
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Introduction: IgM Multiple Myeloma (MM) is a rare subtype of MM consisting of <1% cases of MM. It is distinguished from Waldenstrom Macroglobinemia, which also produces IgM, by the absence of somatic mutation MYD88. We present a patient with a chief complaint of diarrhea which unknowingly led to his hematological diagnosis Case Description/Methods: A 64 year old male with RA-SLE overlap syndrome on steroids, and recent COVID19 pneumonia, had presented with 5 episodes of watery diarrhea every day and 40 Ib weight loss within 2 months. CT revealed small bowel enteritis and stool studies, including C. diff, cultures, ova and parasites were negative. Diarrhea persisted despite antibiotics, therefore an EGD and Colonoscopy were performed which showed duodenal lymphangiectasia and a normal colon. Duodenal biopsy revealed eosinophilic deposits in the villous lamina propria which stained for IgM and stained negative under congo red ruling out amyloidosis. SPEP and a bone marrow biopsy revealed monoclonal IgMspikes and plasma cells in the bone marrow suggesting MMalong with a co-existing population of CLL. Next-generation sequencing was negative forMYD88, supporting IgM MM instead of Waldenstrom. He developed a protein-losing enteropathy with dramatic hypoalbuminemia (albumin 0.9) and lower extremity edema and DVTs. He was started on chemotherapy and frequent albumin infusions. His diarrhea completely resolved, however not in time, as his other medical comorbidities lagged behind and he developed anasarca and continued to deteriorate. Discussion(s): Plasma cell dyscrasias such as IgM MM or more commonly Waldenstrom have rarely been reported to cause GI symptoms. GI involvement can include direct GI infiltration of plasma cells, IgM deposition, or the finding of a plasmacytoma. It has been speculated that IgM deposits can lead to interstitial viscosity and obstructive lymphangiectasia leading to diarrhea and a protein-losing enteropathy as in our patient. Protein loss has led him to have hypoalbuminemia and possibly loss of antithrombotic proteins that have caused DVTs. Few case reports have suggested that treating the underlying cause with chemotherapy stops diarrhea entirely. Although our patient's diarrhea ceased, we believe that it was not in time for him to entirely recover from the later complications of the disease. We hope that this case can help clinicians to attempt prompt treatment of patients when they find GI specimens showing IgM deposits and they suspect a plasma cell dyscrasia.
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The COVID-19 pandemic has severely affected public health system and surveillance of other communicable diseases across the globe. The lockdown, travel constraints and COVID phobia turned down the number of people with illness visiting to the clinics or hospitals. Besides this, the heavy workload of SARS-CoV-2 diagnosis has led to the reduction in differential diagnosis of other diseases. Consequently, it added to the underlying burden of many diseases which remained under-diagnosed. Amidst the pandemic, the rise of emerging and re-emerging infectious diseases was observed worldwide and reported to the World Health Organization i.e., Crimean Congo Hemorrhagic Fever (2022, Iraq;2021 India), Nipah virus (2021, India), Zika virus (2021, India), and H5N1 influenza (2021, India), Monkeypox (2022, multicountry outbreak), Ebola virus disease (2022, DRC, Uganda;2021, DRC, Guinea;2020, DRC), Marburg (2022, Ghana;2021, Guinea), Yellow fever (2022, Uganda, Kenya, West and Central Africa;2021, Ghana, Venezuela, Nigeria;2020, Senegal, Guinea, Nigeria, Gabon;2020, Ethiopia, Sudan, Uganda), Dengue (2022, Nepal, Pakistan, Sao Tome, Temor-Leste;2021, Pakistan), Middle east respiratory syndrome coronavirus (2022, Oman, Qatar;2021, Saudi Arabia, UAE;2020, Saudi Arabia, UAE), Rift valley fever (2021, Kenya;2020, Mauritania), wild poliovirus type 1 (2022, Mozambique), Lassa fever (2022, Guinea, Togo, Nigeria;2020, Nigeria), Avian Influenza (H3N8) (2022, China), Avian Influenza (H5N1) (2022, USA), H10N3 influenza (2021, China), Hepatitis E virus (2022, Sudan), Measles (2022, Malawi, Afghanistan;2020, Burundi, Mexico), Mayaro virus disease (2020, French Guiana), Oropouche virus disease (2020, French Guiana). All these diseases were associated with high morbidity and burdened the public health system during the COVID-19 pandemic. During this critical public health menace, majority of the laboratory workforce was mobilized to the SARS-CoV-2 diagnosis. This has limited the surveillance efforts that likely led to under diagnosis and under-detection of many infectious pathogens. Lockdowns and travel limitations also put a hold on human and animal surveillance studies to assess the prevalence of these zoonotic viruses. In addition, lack of supplies and laboratory personnel and an overburdened workforce negatively impacted differential diagnosis of the diseases. This is especially critical given the common symptoms between COVID-19 and other pathogens causing respiratory illnesses. Additionally, the vaccination programs against various vaccine preventable diseases were also hampered which might have added to the disease burden. Despite these challenges, the world is better prepared to detect and respond to emerging/re-emerging pathogens. India now has more than 3000 COVID-19 diagnostic laboratories and an enhanced hospital infrastructure. In addition, mobile BSL-3 facilities are being validated for onsite sampling and testing in remote areas during outbreak situations and surveillance activities. This will undoubtedly be valuable as the COVID-19 pandemic evolves as well as during future outbreaks and epidemics. In conclusion, an increase in the emergence and re-emergence of viruses demonstrates that other infectious diseases have been neglected during the COVID-19 pandemic. Lessons learned from the infrastructure strengthening, collaborations with multiple stakeholders, increased laboratory and manufacturing capacity, large-scale COVID-19 surveillance, extensive network for laboratory diagnosis, and intervention strategies can be implemented to provide quick, concerted responses against the future threats associated with other zoonotic pathogens.
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Background: As part of an international multi-country study on COVID-19 vaccine immunogenicity (InVITE, NCT05096091), we sought to characterize baseline anti-Nucleocapsid (N) and anti-Spike (S) seropositivity by country and by self-report of prior positive SARS-CoV-2 test result. Method(s): 3063 vaccine-naive individuals from the InVITE study cohort, who received a COVID-19 vaccine as part of their country's national immunization programs at participating sites in Democratic Republic of Congo (DRC), Guinea, Liberia and Mali, were enrolled between August 2021 and February 2022. Demographic and baseline characteristics were collected at study enrollment. Blood was collected at baseline prior to initiation of the vaccine regimen. SARS-CoV-2 anti-S antibody and anti-N antibody levels were measured using Quanterix anti-S IgG semi-quantitative antibody and BioRad Platelia SARSCoV- 2 anti-N Total Ab assays, respectively. Demographic characteristics were assessed for association with positive anti-S and anti-N serology. Result(s): Baseline demographics and serology results by country and overall are shown in the table. Conclusion(s): Despite low numbers of prior self-reported positive SARS-CoV-2 test, the serology results in this cohort indicate prior infection in a significant proportion of the InVITE study participants prior to receipt of a first dose of COVID-19 vaccination. These results suggest widespread previous SARS-CoV-2 infections that were unrecognized possibly due to mild-no symptoms, poor access to/availability of testing and/or limited monitoring through surveillance. Baseline Demographics and Serology Results.
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Four broad themes run through this year's N'Galy-Mann lecture: clinical medicine, HIV, health security, and global health. Three patterns of disease characterized medicine in East Africa at the time that AIDS was first described in the United States: diseases of poverty, mainly infectious;non-communicable diseases with differing international epidemiology;and classic tropical diseases restricted in distribution by ecologic needs of parasites and vectors. Limited resources did not prevent the practice of good medicine under adverse circumstances, nor application of basic principles of research. The recognition of a second AIDS virus (HIV-2) in West Africa in the mid-late 1980s required applied research to assess implications and potential global impact of this novel infection. CDC established a second collaborative research site in sub-Saharan Africa, Projet RETRO-CI, in Abidjan, Cote d'Ivoire (the first was Projet SIDA in the Democratic Republic of Congo, where N'Galy and Mann made seminal contributions). Controversy around HIV-2 diagnosis, transmission, and pathogenicity was slowly resolved through West African research showing HIV-2 was an AIDS-causing pathogen, slower than HIV-1 in its progression, and less transmissible until late in the course of infection. Mother-to-child transmission was exceptionally rare. Claims that HIV-2 protected against HIV-1 were not substantiated. Projet RETRO-CI clarified the spectrum of HIVassociated disease and the dominant role of tuberculosis. Placebo-controlled trials demonstrated efficacy of short-course zidovudine for prevention of perinatal transmission of HIV-1, and of cotrimoxazole prophylaxis in reducing hospitalization and mortality in persons with HIV. Global health today is dominated by discourse around health security. The West African and Congolese Ebola epidemics since 2014 aroused strong declarations, yet the world was poorly prepared to address the pandemic of COVID-19. Health in the world has changed substantially since AIDS emerged. As 2030, the year for delivery on the Sustainable Development Goals, approaches, development assistance for health remains essential to address traditional, unfinished commitments yet does not match today's global burden of disease. CROI attendees are encouraged to remember colleagues lost to COVID-19 and other challenges;to assess priorities in today's global health, including relating to HIV;and to reflect on what issues? N'Galy and Mann would focus on today.
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Introduction: Crimean-Congo Hemorrhagic Fever (CCHF) is a zoonotic disease that progresses with fever and bleeding and is endemic in our region. In this study, we aimed to determine the symptoms, transmission routes and risk factors in CCHF patients who have similar clinical features with COVID-19, and to investigate the relationship between CCHF cases and COVID-19 restrictions in our region where CCHF is endemic. Materials and Methods: One hundred fifty-nine patients diagnosed with CCHF in the infectious diseases and clinical microbiology clinic between April 2021 and September 2021 were included in the study. A questionnaire consisting of a set of questions was filled in for patients diagnosed with CCHF, in which demographic data, admission complaints, risk factors and habits during the COVID-19 pandemic were evaluated. Results: The mean age of the 159 CCHF patients included in the study was 50.9 +/- 18.5 years and 59.7% were male. The most frequently reported complaints by the patients were fatigue (94.5%), muscle-joint pain (79.9%) and fever (74.2%). During the disease period, COVID-19 was suspected in 62.3% of them, PCR test was applied to all of them, and the result was positive in only one patient. There was no change of residence of the patients during the illness period. There was no significant increase in the population of the residence area or the frequency of visits due to the pandemic. The number of patients who reported an increase in the number of ticks in their environment was 44 (27.8%). It was determined that there was no significant increase in the number of activities such as visiting rural areas or having a picnic due to the COVID-19 pandemic. Only 32.2% of patients engaged in animal husbandry or field work reported an increase in the frequency of these jobs compared to the pre-pandemic period. Conclusion: The reason for the increase in the number of CCHF cases in our center was not associated with the increase in the frequency of visits to rural areas or the change of residence during the COVID-19 pandemic period.
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Crimean-Congo hemorrhagic fever (CCHF) is an acute viral disease with fever and bleeding caused by a tick-borne virus belonging to the Bunyaviridae family. Coronavirus disease-2019 (COVID-19) is a novel disease caused by Severe Acute Respiratory Syndrome Coronavirus Type 2, which can lead to acute respiratory distress syndrome (ARDS). Here, we present a case with CCHF and COVID-19 co-infection to draw attention to the increased mortality in co-infection cases. A 77-year-old female patient with known hypertension was admitted to the emergency department with complaints of fever, nausea, vomiting, diarrhea, and myalgia for two days. There was no history of tick bite or contact with a patient with COVID-19. Current anamnesis and clinical and laboratory findings pre-diagnose the patient with CCHF, hemolytic uremic syndrome, and thrombotic thrombocytopenic purpura, leading to a ward admission. Crimean-Congo hemorrhagic fever was diagnosed after receiving a positive CCHF immunoglobulin M (indirect fluorescent antibody) result. A nasopharyngeal swab sample for COVID-19 real-time polymerase time reaction was sent due to a continuous fever and the development of shortness of breath on day three of hospitalization, which revealed positive results;thus, the patient was started on favipiravir treatment. The patient was transferred to the intensive care unit on day four due to increased oxygen demand and ARDS diagnosis. The patient died due to respiratory failure on the seventh day of hospitalization. COVID-19-related ARDS that overlapped on top of CCHF caused her to develop a cytokine storm and died despite her clinical parameter improvement due to CCHF. Crimean-Congo hemorrhagic fever and COVID-19 symptoms or findings can be confused because of their similarities, but the possibility of being seen together should not be overlooked. Concurrently, some similarities in the pathogenesis of these two diseases suggest that co-infection may worsen the clinical course;hence, new studies are needed on this subject.
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In this study, the purpose was to investigate the demographic, laboratory, and clinical characteristics of the Crimean-Congo Hemorrhagic Fever (CCHF) cases that were treated in our hospital during the Coronavirus disease-2019 (COVID-19) pandemic. It was also investigated whether the patients hospitalized with a provisional diagnosis of CCHF who tested negative for CCHF PCR were infected with COVID-19. In our study, data (epidemiological, clinical, laboratory, prognosis) from 38 patients diagnosed with CCHF through reverse-transcriptase polymerase chain reaction (PCR) and viral-RNA and/or Immunoglobulin M antibodies using ELISA between May 2020 and November 2022 were investigated retrospectively. Of all the patients, 23 were CCHF PCR (+) and 15 were CCHF PCR (-).15 (65.2%) of PCR (+) patients and 9 (60%) of PCR (-) patients were engaged in farming. 65.2% of PCR (+) and 26.7% of PCR (-) patients presented with a history of tick bites. 21 (91.3%) of PCR (+) and 12 (80%) of PCR (-) patients had a history of rural living. Among the PCR (+) patients, 65.2%, 17.4%, and 17.4% received treatment for CCHF in 2022, 2021, and 2020 respectively. 87% of PCR (+) and 60% of PCR (-) patients were discharged after full recovery. The most common symptoms were fever, diffuse body ache, weakness, and headache. Significant differences were found between PCR (+) and PCR (-) patients in terms of leukocytes, LDH, INR, NEU, PLT, fibrinogen, and NLR values. 3 patients hospitalized with a provisional diagnosis of CCHF tested negative for CCHF PCR and positive for COVID-19 PCR. Thoracic CT, clinical, and laboratory findings of these patients showed no differences from the other patients. The possibility of misdiagnosis should be considered in CCHF and COVID-19 infections due to their similar symptoms and indications. Extensive multicentric studies need to be conducted to investigate the causes of the increased number of CCHF cases during the pandemic. © 2023 Ondokuz Mayis Universitesi. All rights reserved.
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In January 2023, a total of 64 infectious diseases were reported globally, affecting 235 countries and regions. Except for influenza, the top five infectious diseases affecting greatest number of countries and regions were COVID-19 (235), monkeypox (110), dengue fever (31), measles (27) and cholera (15). The top five infectious diseases with highest case fatality rates were Nipah virus disease (62.5%), Ebola virus disease (47.0%), Crimean-Congo haemorrhagic fever (37.5%), Lassa fever (15.1%) and West Nile fever (7.6%). The top five infectious diseases with greatest number of deaths were COVID-19, malaria, cholera, measles and dengue fever. The prevalent infectious diseases in Asia were COVID-19, cholera and dengue fever, the prevalent infectious diseases in Africa were COVID-19, cholera, yellow fever, Lassa fever, malaria and monkeypox, the prevalent infectious diseases in America were COVID-19, cholera, monkeypox, dengue fever and chikungunya fever, the prevalent infectious disease in Europe were COVID-19, monkeypox and invasive group A streptococcus infection.
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Following the emergence of SARS-CoV-2, cases of pets infected with variants circulating among humans were reported. In order to evaluate the occurrence of SARS-CoV-2 circulation among pets in the Republic of the Congo, we conducted a ten-month study of dogs and cats living in COVID-19-positive households in Brazzaville and neighboring localities. Real-time PCR and the Luminex platform were used to detect SARS-CoV-2 RNA and antibodies to SARS-CoV-2 RBD and S proteins, respectively. Our results show for the first time the simultaneous circulation of several variants of SARS-CoV-2, including viruses from clades 20A and 20H and a putative recombinant variant between viruses from clades 20B and 20H. We found a high seroprevalence of 38.6%, with 14% of tested pets positive for SARS-CoV-2 RNA. Thirty-four percent of infected pets developed mild clinical signs, including respiratory and digestive signs, and shed the virus for about one day to two weeks. These results highlight the potential risk of SARS-CoV-2 interspecies transmission and the benefits of a "One Health" approach that includes SARS-CoV-2 diagnosis and surveillance of viral diversity in pets. This approach aims to prevent transmission to surrounding wildlife as well as spillback to humans.
Subject(s)
COVID-19 , Cat Diseases , Dog Diseases , Animals , Cats , Dogs , Humans , SARS-CoV-2/genetics , Congo/epidemiology , COVID-19/epidemiology , COVID-19/veterinary , COVID-19 Testing , Dog Diseases/diagnosis , Dog Diseases/epidemiology , RNA, Viral/genetics , Seroepidemiologic Studies , Recombination, GeneticABSTRACT
The COVID-19 pandemic has led communities, including Kinshasa peri-urban schools, to reinforce WASH-related practices as a key com-ponent in preventing the spread of COVID-19. This study aimed to determine the institutional and behavioural changes in adolescent girl students' handwashing practices before and during the COVID-19 pandemic. A cross-sectional study was performed, observing the hand hygiene of adolescent girl students, and assessing WASH facilities at schools, chosen from a sample previously selected in the study area. The results indicate significant increases in the prevalence of water points in schools from 10.9 to 22.5%, of handwashing facilities from 43 to 60.1% of schools with an average number of handwashing facilities from one to two, and the prevalence of school WASH brigades from 4.8 to 11.8% of schools. There was also a significant increase in schools receiving funds, and other support for WASH, respectively, from 24.9 to 70.3%, and from 17 to 45.9%, while the proportion of adolescent girl students washing their hands after using the toilet and before eating significantly increased from 6 to 28.4%. However, to improve the current WASH picture, and succeed in curtailing the spread of COVID-19 and related impacts, additional efforts to enhance handwashing practice and WASH items' coverage are expected. © 2023 The Authors.