Data from the cervical cancer program in the Covid-19 pandemic / Dados do programa do câncer do colo do útero na pandemia Covid-19 / Datos del programa de cáncer cervical sobre la pandemia Covid-19

O câncer do colo do útero é considerado um dos cânceres mais comuns entre mulheres, representando um grande problema de saúde global, sendo a quarta causa mais frequente de morte por câncer na população feminina. Mediante a um estudo quantitativo e retrospectivo de dados pré- analíticos e analíticos das requisições do exame citopatológico do colo do útero, objetivou-se avaliar os resultados de exames citopatológicos de mulheres usuárias do SUS de um município do oeste do Paraná, realizados no período antes da pandemia COVID-19, de março de 2019 a fevereiro de 2020 e durante a pandemia COVID-19, de março de 2020 a fevereiro de 2021, dos exames citopatológicos alterados. Foram utilizadas as requisições de exames citopatológicos do Programa Nacional de Controle do CCU e o sistema eletrônico SISCAN como ferramentas de busca. Dentre os resultados, totalizaram-se 20.425 amostras processadas no período antes da pandemia, sendo 19.908 consideradas satisfatórias para análise oncótica, onde 1.148 (5,76%) amostras apresentaram alteração citológica. No período da pandemia, totalizaram-se 11.315 amostras processadas, sendo 11.149 amostras satisfatórias para análise oncótica, das quais 721 (6,47%) apresentaram alteração citológica. No período da pandemia, o estudo demostra que metade da população de mulheres usuárias do SUS em um município do oeste do Paraná encontra-se na faixa etária da população-alvo preconizada pelo MS, sendo que a maioria delas realizou seu exame citopatológico por motivo de rastreamento. Contudo, mesmo com a interrupção dos atendimentos eletivos, as mulheres continuaram realizando seus exames citopatológicos, sendo elucidado um discreto aumento de 0,71% das alterações citológicas no período da pandemia, quando comparado ao período anterior, demonstrando o cenário deste programa na pandemia COVID-19.

Cervical cancer is considered one of the most common cancers among women, representing a major global health problem, being the fourth most frequent cause of cancer death in the female population. Through a quantitative and retrospective study of pre-analytical and analytical data of requests for cervical cytopathological examination, the objective was to evaluate the results of cytopathological examinations of women using the SUS in a city in western Paraná, carried out in the period before during the COVID-19 pandemic, from March 2019 to February 2020, and during the COVID-19 pandemic, from March 2020 to February 2021, from the altered cytopathological exams. Requests for cytopathological exams from the National Control Program of the CCU and the SISCAN electronic system were used as search tools. Among the results, a total of 20.425 samples were processed in the period before the pandemic, 19.908 of which were considered satisfactory for oncotic analysis, where 1.148 (5,76%) samples showed cytological alterations. During the pandemic period, a total of 11.315 samples were processed, of which 11.149 were satisfactory for oncotic analysis, of which 721 (6,47%) showed cytological alterations. During the pandemic period, the study shows that half of the population of women using the SUS in a municipality in western Paraná is in the target population age group recommended by the MS, and most of them underwent their cytopathological examination due to tracking. However, even with the interruption of elective care, women continued to perform their cytopathological exams, with a slight increase of 0,71% in cytological changes during the pandemic period, when compared to the previous period, demonstrating the scenario of this program in the COVID-19 pandemic.

El cáncer de cuello uterino se considera uno de los cánceres más comunes entre las mujeres, representando un importante problema de salud mundial, siendo la cuarta causa más frecuente de muerte por cáncer en la población femenina. Mediante el estudio cuantitativo y retrospectivo de los datos preanalíticos y analíticos de los requisitos del examen citopatológico del útero, se evaluaron los resultados de los exámenes citopatológicos de las usuarias del SUS de un municipio del oeste de Paraná, realizados en el período anterior a la pandemia COVID-19, de marzo de 2019 a febrero de 2020, y durante la pandemia COVID-19, de marzo de 2020 a febrero de 2021, de los exámenes citopatológicos alterados. Se utilizaron como herramientas de búsqueda las requisiciones de exámenes citopatológicos del Programa Nacional de Control de UCC y el sistema electrónico SISCAN. Entre los resultados, un total de 20.425 muestras fueron procesadas en el período anterior a la pandemia, de las cuales 19.908 fueron consideradas satisfactorias para el análisis oncológico, donde 1.148 (5,76%) muestras presentaron alteración citológica. En el periodo de la pandemia, se procesaron un total de 11.315 muestras, de las cuales 11.149 fueron satisfactorias para el análisis oncológico, y 721 (6,47%) presentaron alteraciones citológicas. En el período de la pandemia, el estudio demuestra que la mitad de la población de mujeres usuarias del SUS en una ciudad del oeste de Paraná está en la franja de edad de la población objetivo recomendada por el MS, y la mayoría de ellas se sometió a un examen citopatológico con fines de cribado. Sin embargo, aún con la interrupción de la atención electiva, las mujeres continuaron realizando sus exámenes citopatológicos, siendo dilucidado un leve aumento de 0,71% de alteraciones citológicas en el período pandémico, cuando comparado con el período anterior, demostrando el escenario de este programa en la pandemia COVID-19.

Implementing epidemic intelligence in the WHO African region for early detection and response to acute public health events.

Epidemic intelligence activities are undertaken by the WHO Regional Office for Africa to support member states in early detection and response to outbreaks to prevent the international spread of diseases. We reviewed epidemic intelligence activities conducted by the organisation from 2017 to 2020, processes used, key results and how lessons learned can be used to strengthen preparedness, early detection and rapid response to outbreaks that may constitute a public health event of international concern. A total of 415 outbreaks were detected and notified to WHO, using both indicator-based and event-based surveillance. Media monitoring contributed to the initial detection of a quarter of all events reported. The most frequent outbreaks detected were vaccine-preventable diseases, followed by food-and-water-borne diseases, vector-borne diseases and viral haemorrhagic fevers. Rapid risk assessments generated evidence and provided the basis for WHO to trigger operational processes to provide rapid support to member states to respond to outbreaks with a potential for international spread. This is crucial in assisting member states in their obligations under the International Health Regulations (IHR) (2005). Member states in the region require scaled-up support, particularly in preventing recurrent outbreaks of infectious diseases and enhancing their event-based surveillance capacities with automated tools and processes.

Estimating the SARS-CoV2 infections detection rate and cumulative incidence in the World Health Organization African Region 10 months into the pandemic.

As of 03 January 2021, the WHO African region is the least affected by the coronavirus disease-2019 (COVID-19) pandemic, accounting for only 2.4% of cases and deaths reported globally. However, concerns abound about whether the number of cases and deaths reported from the region reflect the true burden of the disease and how the monitoring of the pandemic trajectory can inform response measures.We retrospectively estimated four key epidemiological parameters (the total number of cases, the number of missed cases, the detection rate and the cumulative incidence) using the COVID-19 prevalence calculator tool developed by Resolve to Save Lives. We used cumulative cases and deaths reported during the period 25 February to 31 December 2020 for each WHO Member State in the region as well as population data to estimate the four parameters of interest. The estimated number of confirmed cases in 42 countries out of 47 of the WHO African region included in this study was 13 947 631 [95% confidence interval (CI): 13 334 620-14 635 502] against 1 889 512 cases reported, representing 13.5% of overall detection rate (range: 4.2% in Chad, 43.9% in Guinea). The cumulative incidence of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) was estimated at 1.38% (95% CI: 1.31%-1.44%), with South Africa the highest [14.5% (95% CI: 13.9%-15.2%)] and Mauritius [0.1% (95% CI: 0.099%-0.11%)] the lowest. The low detection rate found in most countries of the WHO African region suggests the need to strengthen SARS-CoV-2 testing capacities and adjusting testing strategies.

The COVID-19 pandemic in the WHO African region: the first year (February 2020 to February 2021).

The World Health Organization African region recorded its first laboratory-confirmed coronavirus disease-2019 (COVID-19) cases on 25 February 2020. Two months later, all the 47 countries of the region were affected. The first anniversary of the pandemic occurred in a changed context with the emergence of new variants of concern (VOC) and growing COVID-19 fatigue. This study describes the epidemiological trajectory of COVID-19 in the region, summarises public health and social measures (PHSM) implemented and discusses their impact on the pandemic trajectory. As of 24 February 2021, the African region accounted for 2.5% of cases and 2.9% of deaths reported globally. Of the 13 countries that submitted detailed line listing of cases, the proportion of cases with at least one co-morbid condition was estimated at 3.3% of all cases. Hypertension, diabetes and human immunodeficiency virus (HIV) infection were the most common comorbid conditions, accounting for 11.1%, 7.1% and 5.0% of cases with comorbidities, respectively. Overall, the case fatality ratio (CFR) in patients with comorbid conditions was higher than in patients without comorbid conditions: 5.5% vs. 1.0% (P < 0.0001). Countries started to implement lockdown measures in early March 2020. This contributed to slow the spread of the pandemic at the early stage while the gradual ease of lockdowns from 20 April 2020 resulted in an upsurge. The second wave of the pandemic, which started in November 2020, coincided with the emergence of the new variants of concern. Only 0.08% of the population from six countries received at least one dose of the COVID-19 vaccine. It is critical to not only learn from the past 12 months to improve the effectiveness of the current response but also to start preparing the health systems for subsequent waves of the current pandemic and future pandemics.

Information management practices in the WHO African Region to support response to the COVID-19 pandemic.

The rapid transmissibility of the severe acute respiratory syndrome-coronavirus-2 causing coronavirus disease-2019, requires timely dissemination of information and public health responses, with all 47 countries of the WHO African Region simultaneously facing significant risk, in contrast to the usual highly localised infectious disease outbreaks. This demanded a different approach to information management and an adaptive information strategy was implemented, focusing on data collection and management, reporting and analysis at the national and regional levels. This approach used frugal innovation, building on tools and technologies that are commonly used, and well understood; as well as developing simple, practical, highly functional and agile solutions that could be rapidly and remotely implemented, and flexible enough to be recalibrated and adapted as required. While the approach was successful in its aim of allowing the WHO Regional Office for Africa (WHO AFRO) to gather surveillance and epidemiological data, several challenges were encountered that affected timeliness and quality of data captured and reported by the member states, showing that strengthening data systems and digital capacity, and encouraging openness and data sharing are an important component of health system strengthening.

Effect of Pfizer/BioNTech and Oxford/AstraZeneca vaccines against COVID-19 morbidity and mortality in real-world settings at countrywide vaccination campaign in Saudi Arabia.

OBJECTIVE: Vaccinations are highly essential to control infectious diseases and epidemics. Presently, the entire world faces a challenging crisis of "Severe Acute Respiratory Diseases Coronavirus 2 (SARS-CoV-2), also known as the COVID-19 pandemic". The impact of vaccines at national levels to reduce the SARS-CoV-2 cases and deaths are unclear, and people have concerns about the effectiveness of vaccines in real-world settings. This study's objective was to examine the effect of the "Pfizer/BioNTech and Oxford/AstraZeneca" vaccines to prevent SARS-CoV-2 cases and deaths in Saudi Arabia. MATERIALS AND METHODS: In this retrospective cohort study, we collected data on SARS-CoV-2 cases and deaths from the date of the first case of SARS-CoV-2 in Saudi Arabia March 2, 2020, to the date of launching the vaccination campaign on December 14, 2020; and from December 15, 2020, to September 8, 2021. We recorded the World Health Organization data and Ministry of Health of Saudi Arabia to evaluate the impact of the "Pfizer/BioNTech, (BNT162b2 mRNA) and Oxford/AstraZeneca (AZD1222)" vaccine against SARS-CoV-2 cases and deaths before and after the vaccination campaign in Saudi Arabia. RESULTS: Saudi Arabia launched the "Pfizer/BioNTech and Oxford/AstraZeneca" vaccination campaign against SARS-CoV-2 on December 14, 2020. In Saudi Arabia, before the vaccination campaign from March 2, 2020, to December 14, 2020, the mean daily SARS-CoV-2 cases were 1235.60, daily deaths were 22.70, that significantly reduced (p=0.0001) compared to the period after the vaccination campaign from December 15, 2020, to September 8, 2021, in which the daily cases fell to 692.08, and daily deaths fell to 9.48 (p=0.0001). CONCLUSIONS: In Saudi Arabia, Pfizer/BioNTech and Oxford/AstraZeneca vaccinations significantly reduced the number of SARS-CoV-2 cases and deaths after the vaccination compared to the period before the vaccination campaign at country levels. The study findings demonstrate that vaccination and adherence to nonpharmaceutical intervention can better control the COVID-19 pandemic.

WHO Report: COVID-19 Was a Preventable Disaster.

Failures in preparation and response led to a worsened crisis.