Global polio eradication; can we replicate the smallpox success story?

Although the Global Polio Eradication Initiative has been largely successful in elimination of polio from various parts of the world, sporadic local outbreaks in non-endemic areas continue to pose a threat to global polio eradication efforts. In the two endemic countries, Pakistan and Afghanistan, a staggering 176 cases of wild poliovirus 1 (WPV1) were reported in 2019. In 2020 alone, 959 cases of Circulating Vaccine Derived Poliovirus 2 were reported globally from 27 countries. After staying polio-free for years, cases of WPV were detected in Malawi and Mozambique in 2022. The roots of the reported strains matched with the WPV strain from Pakistan. The emergence of WPV cases in Malawi and Mozambique underscores the fact that WPV still has the chance to spread beyond the Afghanistan-Pakistan region and sustained efforts are required for its complete eradication. In the case of smallpox, surveillance-containment was the key to eradication as many countries had already eradicated smallpox and the bigger concern was to track and contain any new cases emerging. Smallpox eradication followed a comprehensive plan which included elements like quality control and standardisation of vaccination protocols. Governments all over the world should prioritise immunisation drives, surveillance, and awareness campaigns to achieve the dream of a polio-free world.

MASCULINIDAD HEGEMÓNICA, ROLES DE GÉNERO Y VIOLENCIA INTRAFAMILIAR EN PUEBLA-TLAXCALA, MÉXICO

El objetivo del artículo es analizar, desde la perspectiva de género, la incidencia de la masculinidad hegemónica y los roles de género estereotipados en la armonía familiar en la Zona Metropolitana de Puebla-Tlaxcala (ZMTP), donde se reporta un incremento de violencia durante el confinamiento por Covid-19 como resultado del reparto desigual en los quehaceres domésticos y el machismo en México. Es una investigación cualitativa donde se empleó el método de encuesta telefónica y descriptivo-exploratorio. Al final del trabajo, se evidencia que las tradiciones culturales y la normalización de la dominación masculina impiden la erradicación de los abusos en el hogar.Alternate :The objective of the article is to analyze, from the gender perspective, the incidence of hegemonic masculinity and stereotyped gender roles in family harmony where it refers to an increase in violence during confinement by Covid-19 in the Metropolitan Area Puebla-Tlaxcala (ZMTP) as a result of the unequal distribution of domestic chores and sexism in Mexico. It is a qualitative investigation where the method of telephone and descriptive-exploratory survey was used. At the end of the work, it shows that cultural traditions and the normalization of male domination prevent the eradication of abuse in the home.

Pandémie de rougeole, 1988-1992. Virus, vaccinations de masse et vulnérabilités contemporaines

At the turn of the 1990s, measles swept the world. Vaccine-preventable since 1963, the "first disease" is nevertheless one of the great absentees of a pandemic century that is slow to come to an end, if not to make it the incarnation of a rampant anti-vaccinationism. Through a chronicle of the "crisis" of 1988‑1992, we will return to the process of coproduction between the infection and the technologies that protect against it. In particular, we will address the social dimension of the viral infection in order to understand why mass vaccination, at the heart of a strong eradication effort, is not enough to revent measles and even contributes to increasing health inequalities that influence its epidemiology in return. The COVID‑19 experience urges us to conduct this kind of retrospective work and to mobilize history as a discipline of public health to better understand the place of vaccination in the viral and contagious past and present. WHO documentation, scientific literature and ethnographic fieldwork will together force an "equal" approach to the spaces and actors involved, bringing together very local experiences and international policies to reveal the pitfalls of an ultratechnologized and very vertical global (public) health.Alternate :A principios de los años 1990, el sarampión asoló al mundo. Evitable con la vacuna desde 1963, la «primera enfermedad» es sin embargo una de las grandes ausentes de un siglo pandémico que tarda en acabarse, si no es para encarnarse en una anti-vacunación galopante. A través de una crónica de la «crisis» de 1988-1992, retornaremos el proceso de coproducción entre la infección y las tecnologías de protección. Abordaremos en particular la dimensión social de la infección viral para comprender por qué la vacunación masiva, en el centro de una campaña de erradicación apoyada, no basta para evitar el sarampión e incluso contribuye al aumento de ciertas desigualdades en salud que influyen sobre su epidemiología. La experiencia de la COVID‑19 nos exhorta a realizar este tipo de trabajo retrospectivo y a movilizar la historia de la salud pública para comprender mejor el lugar de la vacunación en el pasado y el presenta viral y contagioso. Documentos de la Organización Mundial de la Salud (OMS), literatura científica y trabajo de campo etnográfico contribuirán conjuntamente a una perspectiva «a partes iguales» de los espacios y los actores para mostrar los obstáculos de una salud (pública) global ultra-tecnologizada y muy vertical.Alternate :Au tournant des années 1990, la rougeole a balayé le monde. Évitable par la vaccination depuis 1963, la « première maladie » est pourtant une des grandes absentes d'un siècle pandémique qui tarde à s'achever, si ce n'est pour en faire l'incarnation d'un antivaccinationisme rampant. Au travers d'une chronique de la « crise » de 1988-1992, nous reviendrons sur le processus de coproduction entre l'infection et les technologies qui en protègent. Nous aborderons plus particulièrement la dimension sociale de l'infection virale pour comprendre pourquoi la vaccination de masse, au coeur d'une entreprise d'éradication appuyée, ne suffit pas à éviter la rougeole et participe même à accroître certaines inégalités en santé qui influent sur son épidémiologie. L'expérience de la COVID‑19 nous exhorte à mener ce genre de travail rétrospectif et à mobiliser l'Histoire en discipline de santé publique pour mieux saisir la place de la vaccination dans le passé et le présent viraux et contagieux. Documentation de l'OMS, littérature scientifique et terrain ethnographique forceront ensemble une approche « à parts égales » des espaces et des acteurs concernés, faisant dialoguer les expériences très locales et les politiques internationales pour révéler les écueils d'une santé (publique) globale ultra-technologisée et très verticale.

Implementation of National Leprosy Eradication Programme during COVID-19 era: A qualitative research.

Introduction The COVID-19 pandemic imposed new challenge to the implementation of the National Leprosy Eradication Programme. According to national data, after lockdown due to COVID-19, there was a 29% reduction in total leprosy cases reported in the first quarter (April-June) of 2020 in comparison to 2019. Objectives To explore the difficulties faced by different stakeholders of the National Leprosy Eradication Programme like policy makers, doctors, grass root level health workers as well as leprosy patients during COVID-19 pandemic with respect to programme implementation and access to leprosy care. Materials and Methods Qualitative research was undertaken including two focus-group-discussions held among six leprosy patients diagnosed after lockdown and nine ASHA workers as well as six in-depth interviews of doctors, leprologists, and programme managers. Ethics committee approval was sought and informed consent was obtained from all participants. All focus-group-discussions were electronically recorded and the in-depth interviews telephonically recorded, transcribed and translated from Bengali-to-English. Transcripts were separately coded by researchers and thematically analysed with the help of Visual-Anthropac software version 1.0. Results Solitary focus on COVID-19 control, capacity building and information, education and communication, leprosy case search & surveillance, co-infection among health workers, transportation issues were the themes explored from focus-group-discussions of health workers and ASHA workers. Similarly, the present study identified six themes from in-depth interviews of programme manager, leprologists, programme manager as diagnostic difficulty, operational issues, rehabilitation issues, capacity building & information education and communication activities and way forward. Limitations The research reveals the perceptions of rural population of Eastern India with high leprosy prevalence, which might not be applicable for urban areas or low prevalent districts Conclusion The solitary focus of the administration towards COVID and shifting the infrastructure and human resource only towards the management of COVID can lead to resurgence of the leprosy. Having an organised framework of operations, catering to the need of the front-line workers in rendering services, utilizing the digital platform and social media, and focusing on rehabilitation would be needed to overcome the crisis.

Democracy in the Indonesian Digital Public Sphere: Social Network Analysis of Twitter Users' Responses to the Issue of Nationalism Knowledge Test at the Corruption Eradication Commission (TWK-KPK)

The mobility restriction during the COVID-19 pandemic did not stop the public from expressing their opinions. Since they could not go on demonstrations, they moved democracy to the digital sphere, such as on Twitter. Previous research has shown that Twitter users in Indonesia use the platform to express political views and opinions on governmental issues. The issue of the Nationalism Knowledge Test (TWK) at the Corruption Eradication Commission (KPK) was a trending topic on Twitter for a while. The issue spurred discussions on Twitter when 75 employees did not pass the KPK-TWK on May 2021. The discussion then stopped for a moment before picking up again during the official dismissal of the employees on 30 September 2021. This article focuses on the social network analysis of the public's responses to this issue on Twitter. Social network data were collected using Drone Emprit from May to October 2021 and analyzed using Gephi to generate graphical representations of the social networks. The results reveal the structure of the movement was centralized and dynamic. Regarding the dissemination of information, the most central was news media and anti-corruption activists' accounts. These accounts mobilized the community on Twitter to make a critical social movement. This means that the digital sphere can be an evolution of democracy form and activism, especially in the anti-corruption movement. © 2022 Rev. Archai. All rights reserved.

Impact of elexacaftor/tezacaftor/ivacaftor on Pseudomonas aeruginosa acquisition and chronic infection at a single pediatric cystic fibrosis center

Background: As cystic fibrosis (CF) lung disease progresses, the airways become colonized with opportunistic pathogens such as Pseudomonas aeruginosa secondary to airway surface liquid depletion. Acquisition of P. aeruginosa is associated with decline in lung function and increase in treatment burden and mortality. In October 2019, the Food and Drug Administration approved elexacaftor/tezacaftor/ivacaftor (ELX/TEZ/IVA), a highly effective modulator therapy (HEMT) for individuals aged 12 and older with one copy of the F508del CFTR mutation. ELX/TEZ/IVA increases the amount of and function of CF transmembrane conductance regulator (CFTR) in the respiratory epithelium, increasing mucociliary clearance (MCC) and reducing static airway mucous, a major trigger for chronic infection and inflammation. Method(s): A retrospective analysis of inhaled tobramycin (iTOB) prescriptions prescribed between January 1, 2016, and December 31, 2021, was performed. This captured data before and after ELX/TEZ/IVA approval at Children's Mercy Kansas City (CMKC). The number of individuals with new P. aeruginosa acquisition was determined by identifying electronic prescriptions for iTOB eradication courses. An eradication course was defined as a first lifetime prescription for iTOB or a new prescription for iTOB submitted at least 1 year after a previous prescription. The number of individuals considered chronically infected with P. aeruginosa was determined by identifying individuals receiving chronic iTOB prescriptions and confirmed by respiratory cultures indicating chronic infection based on the Leeds criteria (P. aeruginosa recovered in >=50% of airway cultures in the previous 12 months). Result(s): Eradication courseswere prescribed to 34 individuals in 2016 (15% of people receiving care at CMKC). The number of eradication prescriptions declined in 2020 and 2021, with only 15 (7%) individuals prescribed eradication therapy in 2020 and 12 (5%) in 2021. A similar pattern was observed for prescriptions for chronic infection. In 2016, 57 individuals (25% of our patient population) were receiving iTOB for chronic P. aeruginosa infection. Reductions were seen in 2020 and 2021, with 28 (13%) and 20 (9%) individuals prescribed chronic therapy, respectively. The number of individuals prescribed iTOB for P. aeruginosa eradication and chronic infection per year is represented in Figure 1.(Figure Presented)Conclusions: CMKC experienced a decrease in the number of courses of iTOB prescribed over the last 6 years. HEMT use is associated with greater MCC and anti-inflammatory effects affecting the airway microbiome. The decrease in respiratory cultures growing P. aeruginosa likely reflects these phenomena. A confounding factor is the SARS-CoV-2 pandemic and widespread use of HEMT. Clinic closures and implementation of telemedicine limited in-person patient visits during 2020 and 2021. Despite limited in-person visits, the average number of respiratory cultures per individual at CMKC in 2020 was 3.5, which is consistent with previous years.Wewere able to obtain frequent surveillance cultures through implementation of a drive-through respiratory specimen collection process. Hence, the decrease in number of iTOB courses cannot be attributed to a decrease in frequency of respiratory cultures, although we cannot assess the impact of school closures and a decrease in social gatherings on new P. aeruginosa acquisition or chronic infection. Looking at all these variables, the widespread use of HEMT likely played a significant role in reducing new P. aeruginosa acquisition and chronic P. aeruginosa infection.Copyright © 2022, European Cystic Fibrosis Society. All rights reserved

Jahrestagung der Gesellschaft fur Padiatrische Pneumologie.

The proceedings contain 54 papers. The topics discussed include: cytokines in severe childhood asthma;transcriptional gene regulation of interleukin-6 in epithelial cells in viral-induced asthma exacerbation;assessment of the long-term safety and efficacy of dupilumab in children with asthma: LIBERTY ASTHMA EXCURSION;impulse oscillometry bronchodilator response in preschool children;pulmonary function in non-hospitalized adults and children after mild Covid-19;exhaled aerosols in PCR-confirmed SARS-CoV-2-infected children;early respiratory infectious diseases have an influence on the gut microbiome;comparison of three eradication treatment protocols for pseudomonas aeruginosa in children and adolescents with cystic fibrosis;neutrophilic airway inflammation in children with repaired esophageal atresia-tracheoesophageal fistula (EA/TEF);and multiplex immunofluorescence and multispectral imaging as a tool to evaluate host directed therapy.

Detection of SARS-CoV-2 RNA in wastewater and comparison to COVID-19 cases in two sewersheds, North Carolina, USA

Wastewater surveillance of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may be useful for monitoring population-wide coronavirus disease 2019 (COVID-19) infections, especially given asymptomatic infections and limitations in diagnostic testing. We aimed to detect SARS-CoV-2 RNA in wastewater and compare viral concentrations to COVID-19 case numbers in the respective counties and sewersheds. Influent 24-hour composite wastewater samples were collected from July to December 2020 from two municipal wastewater treatment plants serving different population sizes in Orange and Chatham Counties in North Carolina. After a concentration step via HA filtration, SARS-CoV-2 RNA was detected and quantified by reverse transcription droplet digital polymerise chain reaction (RT-ddPCR) and quantitative PCR (RT-qPCR), targeting the N1 and N2 nucleocapsid genes. SARS-CoV-2 RNA was detected by RT-ddPCR in 100 % (24/24) and 79 % (19/24) of influent wastewater samples from the larger and smaller plants, respectively. In comparison, viral RNA was detected by RT-qPCR in 41.7 % (10/24) and 8.3 % (2/24) of samples from the larger and smaller plants, respectively. Positivity rates and method agreement further increased for the RT-qPCR assay when samples with positive signals below the limit of detection were counted as positive. The wastewater data from the larger plant generally correlated (square similar to 0.5, p < 0.05) with, and even anticipated, the trends in reported COVID-19 cases, with a notable spike in measured viral RNA preceding a spike in cases when students returned to a college campus in the Orange County sewershed. Correlations were generally higher when using estimates of sewershed-level case data rather than county-level data. This work supports use of wastewater surveillance for tracking COVID-19 disease trends, especially in identifying spikes in cases. Wastewater-based epidemiology can be a valuable resource for tracking disease trends, allocating resources, and evaluating policy in the fight against current and future pandemics.

Viral Mitigation: Weak Theoretical Underpinnings

Mitigation measures included primarily lockdowns and masks and, later in the pandemic, mass vaccination. All of them were supposed to eradicate the disease or at least to "flatten the curve.” To stress the need for disease eradication and/or the need for reduced transmission rates, three postulates were put forward by the proponents of the pandemic policy responses. First, it was claimed that the virus poses a high death risk to all age-groups, and so we need policies that will be able to offer protection to all people. This is the first postulate, which I would like to call the "equal vulnerability thesis.” Second, the claim that there is no pre-existing immunity and hence all people are equally susceptible to the virus, which is the "equal susceptibility thesis.” The third postulate is that the coronavirus can be transmitted not only by symptomatic but also by asymptomatic people. This is the "equal infectivity thesis.” These three premises were mistaken, and the pandemic policies, i.e., lockdowns, masks, and mass vaccination, failed to achieve their declared goals, i.e., they did not eradicate the disease and they did not impact on transmission rates. © 2023, The Author(s), under exclusive license to Springer Nature Switzerland AG.

Modeling undetected live type 1 wild poliovirus circulation after apparent interruption of transmission: Pakistan and Afghanistan.

Since 2013, wild poliovirus (WPV) transmission occurred only for type 1 (WPV1). Following several years of increasing reported incidence (2017-2019) and programmatic disruptions caused by COVID-19 (early 2020), Pakistan and Afghanistan performed a large number of supplementary immunization activities (late 2020-2021). This increased intensity of immunization, following widespread transmission, substantially decreased WPV1 cases and positive environmental samples during 2021. Modeling the potential for undetected circulation of WPV1 after apparent interruption can support regional and global decisions about certification of the eradication of indigenous WPV1 transmission. We apply a stochastic model to estimate the confidence about no circulation (CNC) of WPV1 in Pakistan and Afghanistan as a function of time since the last reported case and/or positive environmental sample. Exploration of different assumptions about surveillance quality suggests a range for CNC for WPV1 as a function of time since the last positive surveillance signal, and supports the potential use of a time with no evidence of transmission of less than 3 years as sufficient to assume die out in the context of good acute flaccid paralysis (AFP) surveillance. We show high expected CNC based on AFP surveillance data alone, even with imperfect surveillance and some use of inactivated poliovirus vaccine masking the ability of AFP surveillance to detect transmission. Ensuring high quality AFP and environmental surveillance may substantially shorten the time required to reach high CNC. The time required for high CNC depends on whether immunization activities maintain high population immunity and the quality of surveillance data.

Viktor Mikhailovich Zhdanov and the eradication of smallpox

Considering current epidemiological and social phenomena such as CoVid-19 pandemic, re-occurrence of monkeypox and vaccine hesitancy, the authors chose to delineate an historical, human, and scientific profile of Dr. Viktor Mikhailovich Zhdanov, as a key figure related not only to smallpox eradication, but also to the building up of worldwide vaccination strategies. The authors present some of Zhdanov main life and scientific experiences and awards in virology, epidemiology, and public health. The authors highlight the need for international commitment to cooperate in the fields of vaccine research and vaccine hesitancy. © Mattioli 1885

Strategies of Epidemic Control and Histories of Disease

In this short essay, I place the diversity of international responses to Covid-19 into the longer history of epidemic control strategies. Following a brief discussion of such strategies prior to the twentieth century, I focus on the trajectory of the idea of eradication throughout the twentieth and into the twenty-first century. I examine why elimination and eradication were seen as achievable epidemic control objectives in the mid- to late 20th century, and why that, by and large, has ceased to be the case in recent decades. © 2021 Authors. All rights reserved.

Serotype 2 oral poliovirus vaccine (OPV2) choices and the consequences of delaying outbreak response.

The Global Polio Eradication Initiative (GPEI) faces substantial challenges with managing outbreaks of serotype 2 circulating vaccine-derived polioviruses (cVDPV2s) in 2021. A full five years after the globally coordinated removal of serotype 2 oral poliovirus vaccine (OPV2) from trivalent oral poliovirus vaccine (tOPV) for use in national immunization programs, cVDPV2s did not die out. Since OPV2 cessation, responses to outbreaks caused by cVDPV2s mainly used serotype 2 monovalent OPV (mOPV2) from a stockpile. A novel vaccine developed from a genetically stabilized OPV2 strain (nOPV2) promises to potentially facilitate outbreak response with lower prospective risks, although its availability and properties in the field remain uncertain. Using an established global poliovirus transmission model and building on a related analysis that characterized the impacts of disruptions in GPEI activities caused by the COVID-19 pandemic, we explore the implications of trade-offs associated with delaying outbreak response to avoid using mOPV2 by waiting for nOPV2 availability (or equivalently, delayed responses waiting for national validation of meeting the criteria for nOPV2 initial use). Consistent with prior modeling, responding as quickly as possible with available mOPV2 promises to reduce the expected burden of disease in the outbreak population and to reduce the chances for the outbreak virus to spread to other areas. Delaying cVDPV2 outbreak response (e.g., modeled as no response January-June 2021) to wait for nOPV2 can considerably increase the total expected cases (e.g., by as many as 1,300 cVDPV2 cases in the African region during 2021-2023) and increases the likelihood of triggering the need to restart widescale preventive use of an OPV2-containing vaccine in national immunization programs that use OPV. Countries should respond to any cVDPV2 outbreaks quickly with rounds that achieve high coverage using any available OPV2, and plan to use nOPV2, if needed, once it becomes widely available based on evidence that it is as effective but safer in populations than mOPV2.

Successful Eradication of Porcine Epidemic Diarrhea in an Enzootically Infected Farm: A Two-Year Follow-Up Study.

Porcine epidemic diarrhea virus (PEDV) has negatively affected the welfare of animals and their productivity in South Korea for three decades. A shortage of effective control measures has led to the virus becoming endemic in domestic pig populations. This study aimed to describe how our intervention measures were implemented for PEDV elimination in an enzootically infected farm. We operated a risk assessment model of PEDV recurrence to obtain information about the virus itself, herd immunity, virus circulation, and biosecurity at the farm. Next, we conducted a four-pillar-based two-track strategy to heighten sow immunity and eradicate the virus, with longitudinal monitoring of immunity and virus circulation, involving strict biosecurity, prime-boost pre-farrow L/K/K immunization, all-in-all-out and disinfection practices in farrowing houses, and disinfection and gilt management in wean-to-finish barns. In particular, we observed a high prevalence and long-term survival of PEDV in slurries, posing a critical challenge to PED eradication and highlighting the necessity for consecutive testing of barn slurry samples and for the management of infected manure to control PEDV. Genetic analysis of PEDVs in this farm indicated that genetic drift continued in the spike gene, with a substitution rate of 1.683 × 10-4 substitutions/site/year. Our study underlines the need for active monitoring and surveillance of PEDV in herds and their environments, along with the coordinated means, to eliminate the virus and maintain a negative herd. The tools described in this study will serve as a framework for regional and national PED eradication programs.

The immediate impact of the COVID-19 pandemic on polio immunization and surveillance activities.

In addition to affecting individual health the COVID-19 pandemic has disrupted efforts to deliver essential health services around the world. In this article we present an overview of the immediate programmatic and epidemiologic impact of the pandemic on polio eradication as well as the adaptive strategic and operational measures taken by the Global Polio Eradication Initiative (GPEI) from March through September 2020. Shortly after the World Health Organization (WHO) declared a global pandemic on 11 March 2020, the GPEI initially redirected the programme's assets to tackle COVID-19 and suspended house-to-house supplementary immunization activities (SIAs) while also striving to continue essential poliovirus surveillance functions. From March to May 2020, 28 countries suspended a total of 62 polio vaccine SIAs. In spite of efforts to continue poliovirus surveillance, global acute flaccid paralysis (AFP) cases reported from January-July 2020 declined by 34% compared with the same period in 2019 along with decreases in the mean number of environment samples collected per active site in the critical areas of the African and Eastern Mediterranean regions. The GPEI recommended countries should resume planning and implementation of SIAs starting in July 2020 and released guidelines to ensure these could be done safely for front line workers and communities. By the end of September 2020, a total of 14 countries had implemented circulating vaccine-derived poliovirus type 2 (cVDPV2) outbreak response vaccination campaigns and Afghanistan and Pakistan restarted SIAs to stop ongoing wild poliovirus type 1 (WPV1) transmission. The longer-term impacts of disruptions to eradication efforts remain to be determined, especially in terms of the effect on poliovirus epidemiology. Adapting to the pandemic situation has imposed new considerations on program implementation and demonstrated not only GPEI's contribution to global health security, but also identified potential opportunities for coordinated approaches across immunization and health services.

Viral hepatitis elimination challenges in low- and middle-income countries-Uzbekistan Hepatitis Elimination Program (UHEP).

BACKGROUND & AIMS: Chronic infection with hepatitis B and C viruses (HBV & HCV) is a major contributor to liver disease and liver-related mortality in Uzbekistan. There is a need to demonstrate the feasibility of large-scale simplified testing and treatment to implement a national viral hepatitis elimination program. METHODS: Thirteen polyclinics were utilized to screen, conduct follow-up biochemical measures and treat chronic HBV and HCV infection in the general adult population. Task shifting and motivational interviewing training allowed nurses to provide rapid screening and general practitioners (GPs) to treat individuals on-site. An electronic medical system tracked individuals through the cascade of care. RESULTS: The use of rapid tests allowed for screening of 60 769 people for HCV and HBV over 6 months and permitted outdoor testing during the COVID-19 pandemic along with COVID testing. 13%-14% of individuals were lost to follow-up after the rapid test, and another 62%-66% failed to come in for their consultation. One stop testing and treatment did not result in a statistically increase in retention and lack of patient awareness of viral hepatitis was identified as a key factor. Despite training, there were large differences between GPs and patients initiating treatment. CONCLUSIONS: The current study demonstrated the feasibility of large-scale general population screening and task shifting in low- and middle-income countries. However, such programs need to be proceeded by awareness campaign to minimize loss to follow up. In addition, multiple trainings are needed for GPs to bolster their skills to talk to patients about treatment.

Post-Covid Mucormycosis: A Case Series

Introduction: COVID-19, a new coronavirus illness, swiftly spread throughout all continents. However, evidence on all of COVID-19's indications and symptoms is lacking. Patients who have COVID-19 may be more susceptible to fungal infections. Mucormycosis is an uncommon and frequently fatal fungal illness caused by hyphae invading the bloodstream and causing thrombosis and necrosis. Material(s) and Method(s): Patients diagnosed with mucormycosis following a recent COVID-19 infection were included in the case series analysis. Surgical therapy was limited to individuals who tested negative for COVID-19 on PCR. To remove the infection, endoscopic, open, and combination techniques were used. For the first month after surgery, survivors were followed up on on a regular basis. Result(s): About 30 people with a history of Covid-19 were given dexamethasone and remdesivir in this study. Following therapy, these individuals developed mucormycosis, which was treated by Functional Endoscopic Sinus Surgery (FESS). As a consequence, 16 patients (53.34 %) had numerous operations. The most prevalent related condition was diabetes mellitus (60 %). The majority of the patients were men (60 %). Our patients had an average age of 55.53+/-8.093. 43.34 % of the people died. Conclusion(s): In conclusion, mucormycosis is a rare but critical problem complicating the later part of the clinical course of COVID-1, possibly due to improper drug usage during Covid treatment. Copyright © 2023 Authors. All rights reserved.

Agenda 2030 in the Context of the COVID-19 Pandemic in South Africa and Zimbabwe

This article explored the global development targets of the Sustainable Development Goals (SDGs) in the context of a global pandemic, using South Africa and Zimbabwe as case studies. The coronavirus disease of 2019, abbreviated as COVID-19, has arguably triggered a renewed focus on the SDGs as the pandemic has impacted the Agenda 2030 trajectory. The eradication of hunger is an overarching theme in this global discourse of development. The COVID-19 pandemic has exposed Africa's progress or lack of it in achieving SDGs. The continent remains burdened by poverty and hunger and these twin challenges have retarded development in Africa. Using Zimbabwe and South Africa as case studies, the study analysed literature on the extent of hunger and how this influenced the management of the COVID-19 pandemic. The results showed that while South Africa and Zimbabwe prioritised the fight against COVID-19, the pandemic exposed their shortfall in meeting the SDG agenda. The pandemic disrupted the production and distribution of food and aggravated the challenge of hunger in Zimbabwe and South Africa. The study concluded that South Africa and Zimbabwe are far from achieving the SDGs, only eight years from the target year of 2030.