A Surge in Malaria Cases in the Eastern Health Region of Saudi Arabia During the COVID-19 Pandemic.

Background Malaria transmission was stopped on most of the vast area of the Kingdom of Saudi Arabia. However, the pandemic of coronavirus disease (COVID-19) has negatively affected the efforts to control malaria. For instance, COVID-19 was reported to induce a relapse of malaria that is caused by Plasmodium vivax. Furthermore, physicians' attention toward COVID-19 can only result in neglect and delayed diagnosis of complicated malaria cases. These factors, among others, might have contributed to an increase of malaria cases in Dammam, Saudi Arabia. Thus, this study was conducted to examine the effects of COVID-19 on malarial cases. Methods The medical records of all patients who were treated at Dammam Medical Complex for malaria between July 1, 2018, and June 30, 2022, were reviewed. Malaria cases were compared between the pre-COVID-19 period (between July 1, 2018, and June 30, 2020) and the COVID-19 period (between July 1, 2020, and June 30, 2022). Results A total of 92 malaria cases occurred in the total study period. There were 60 cases of malaria in the COVID-19 period as opposed to only 32 cases in the pre-COVID-19 period. All the cases were imported from the endemic Saudi southern areas or from outside the country. Eighty-two patients (89.1%) were males. Most of them were Sundaneses (39 patients, 42.4%), Saudis (21 patients, 22.8%), and tribal peoples (14 patients, 15.2%). Fifty-four patients (58.7%) were infected with Plasmodium falciparum. Seventeen patients (18.5%) were infected with Plasmodium vivax. Another 17 patients (18.5%) had a mixed infection with both Plasmodium falciparum and Plasmodium vivax. A trend toward more infected stateless tribal patients was observed in the COVID-19 period compared to the pre-COVID-19 period (21.7% vs 3.1%). A similar trend was noticed for mixed malarial infections with both Plasmodium falciparum and Plasmodium vivax (29.8% vs 0%) with a P value of less than 0.01. Conclusion Malaria cases were almost doubled during the COVID-19 pandemic as compared to the pre-pandemic era signifying the negative effects of the pandemic on malaria epidemiology. The cases increased for a variety of causes that include alternation of health-seeking behaviors, changes in healthcare structures and regulations, and the interruption of malaria preventive services. Future research is needed to study the long-term effects of the changes imposed by the COVID-19 pandemic and to mitigate the effects of any future pandemic on malaria control. As two patients from our cohort were diagnosed with malaria based on blood smears, although they had negative rapid detection tests (RDTs), we recommend testing all the patients who are suspected to have malaria with both RDTs and peripheral blood smears.

From more testing to smart testing: data-guided SARS-CoV-2 testing choices, the Netherlands, May to September 2020.

BackgroundSARS-CoV-2 RT-PCR assays are more sensitive than rapid antigen detection assays (RDT) and can detect viral RNA even after an individual is no longer infectious. RDT can reduce the time to test and the results might better correlate with infectiousness.AimWe assessed the ability of five RDT to identify infectious COVID-19 cases and systematically recorded the turnaround time of RT-PCR testing.MethodsSensitivity of RDT was determined using a serially diluted SARS-CoV-2 stock with known viral RNA concentration. The probability of detecting infectious virus at a given viral load was calculated using logistic regression of viral RNA concentration and matched culture results of 78 specimens from randomly selected non-hospitalised cases. The probability of each RDT to detect infectious cases was calculated as the sum of the projected probabilities for viral isolation success for every viral RNA load found at the time of diagnosis in 1,739 confirmed non-hospitalised COVID-19 cases.ResultsThe distribution of quantification cycle values and estimated RNA loads for patients reporting to drive-through testing was skewed to high RNA loads. With the most sensitive RDT (Abbott and SD Biosensor), 97.30% (range: 88.65-99.77) of infectious individuals would be detected. This decreased to 92.73% (range: 60.30-99.77) for Coris BioConcept and GenBody, and 75.53% (range: 17.55-99.77) for RapiGEN. Only 32.9% of RT-PCR results were available on the same day as specimen collection.ConclusionThe most sensitive RDT detected infectious COVID-19 cases with high sensitivity and may considerably improve containment through more rapid isolation and contact tracing.

Innovative intra-operative rapid detection test for visualisation of mucor.

In this manuscript, we report a rapid intra-operative detection test for visualisation of mucor, with the use of the Smartphone-based intraocular lens microscope (IOLSCOPE). IOLSCOPE helps not only in detecting tissue affected by mucor, but also makes sure that the surgeon does not leave any fungus behind; similar to the principles employed by a 'Frozen section' in conventional general surgery. In the technique proposed by us, we have used an undigested tissue sample, to quickly diagnose mucor, intra-operatively. Thus, in view of tackling the COVID-19 and mucor duplet, IOLSCOPE can be considered by ophthalmologists and otorhinolaryngologists for its rapid screening property, convenience of ease, good quality images and cost effectiveness.