Better understanding extrapulmonary tuberculosis: A scoping review of public health impact in Pakistan, Afghanistan, India, and Bangladesh.

Background and Aims: South Asian countries, including Pakistan, Afghanistan, India, and Bangladesh, have a high prevalence of pulmonary and extra-pulmonary tuberculosis (EPTB). This prevalence is influenced by various risk factors such as ethnicity, nutrition, socioeconomic disparities, high out-of-pocket healthcare expenses, and specific Mycobacterium Tuberculosis (TB) lineages. The COVID-19 pandemic has likely hindered access to healthcare and led to under-reporting of EPTB cases nationally and internationally. This rapid review aimed to summarize the literature on the prevalence and disease outcomes of EPTB in the mentioned countries, compare the situations across countries, and provide recommendations for future action. Methods: The review utilized PubMed and Google Scholar databases to search for literature on EPTB in South Asian countries. The search string included keywords related to different forms of EPTB and the countries of interest while excluding pulmonary tuberculosis. Results: The results showed that both TB, including drug-resistant TB, and EPTB are prevalent and burdensome in South Asia. In Pakistan, pleural TB was the most commonly reported form of EPTB, followed by lymph node TB, abdominal TB, osteoarticular TB, Central Nervous System TB, and miliary TB. In India, lymph node TB(LNTB) was more common among EPTB cases. Bangladesh reported a high prevalence of EPTB involving lymph node, pleura, and abdomen, while Afghanistan had a higher prevalence of forms such as LNTB and tuberculous meningitis. Conclusion: In conclusion, the prevalence of EPTB in Pakistan, Afghanistan, India, and Bangladesh is alarmingly high and negatively impacts population health. Effective measures are needed for treatment and management of this condition, along with addressing current and future challenges. Strengthening the evidence base through surveillance and research is crucial to understand the patterns and significant factors related to EPTB, requiring investment in these areas.

Third wave of COVID-19 pandemic in Africa: Challenges and recommendations.

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has evolved in different waves and is currently in its third wave for the majority of countries around the world. Each wave emanated with its own set of challenges. Lower- and middle-income countries such as most African countries have faced additional challenges compared to high-income countries. This paper highlights the challenges faced by Africa during the third wave of COVID-19 and proposes recommendations and strategies to contain the spread. We conducted a mini-review for the newly released articles and researches about the challenges faced by Africa during COVID-19. Fragmented healthcare sectors, limited healthcare resources and emergence of co-infections in COVID-19 patients, inadequate vaccination rollout and political conflicts are the major challenges faced by the African countries. Our recommendations to defeat this outbreak and subsequent pandemics is to raise the public's awareness about vaccines through campaigns and social media in order to lessen vaccine hesitancy. Governments as well should focus on under-served and vulnerable populations, patients with comorbidities, and communities living in endemic-striking settings as these people are more prone to the severe form of the disease. Moreover, by adopting socio-ecological perspectives, one can implement multi-level integrated interventions to help control COVID-19 more effectively.

Teleradiology in India during the COVID-19 pandemic: merits, pitfalls and future perspectives.

The field of teleradiology has been of interest for almost 55 years and its potential prospects for healthcare have been constantly assessed and investigated. In view of the global preventive measures, such as social distancing and hand hygiene, the ongoing COVID-19 pandemic has further accentuated the necessity for telemedicine and teleradiology. In a country as densely populated as India wherein radiology services are often fragmented, teleradiology can prove to be a lifesaving technology and aid dampen the repercussions stemming from the highly skewed doctor to patient ratio. Although innovative, the effective adoption of teleradiology faces several obstacles in India, such as inadequate technological infrastructure, a lack of knowledge among most medical practitioners, urban-rural disparities and a lack of financing. Similar challenges continue to also be faced by several other developing countries across the globe. This article therefore aims to elaborate on the most important facets of implementation of teleradiology observed in the Indian context to help provide salient pointers for the readership of relevant jurisdictions who may be embracing comparable teleradiology challenges. Despite the hurdles, the future of teleradiology seems promising. The respective governments, policymakers and all relevant stakeholders must continue to take decisive action to ensure that this potential is fully exploited by allocation of necessary funds, strengthening of information technology and its related fields, involvement of human resources with adequate technical and administrative expertise as well as taking continued action to improve existing telemedicine and teleradiology services.

Effects of SARS-CoV-2 vaccination on blood donation and blood banks in India.

India, the second most populous country in the world, started its mass vaccination campaign on January 16th, 2021. With the aim to vaccinate 1.3 billion people, this vaccination programme was dubbed as the world's largest vaccination drive. However, with depleted blood stores due to the COVID-19 pandemic and lockdown leading to reduced blood camps, the superposed regulations on blood donation deferral poses an impending risk of depletion of blood and its products. This will lead to the inability in meeting unpredictable patterns of demand in blood requirement post-pandemic. Hence to prevent avoidable risks of blood shortage in surgeries and lifesaving procedures, a secure storage system should be ensured.

Redressing COVID-19 vaccine inequity amidst booster doses: charting a bold path for global health solidarity, together.

BACKGROUND: With large swathes of the world's population-majority clustered in low- and middle-income countries-still yet to receive the minimum of two doses of the COVID-19 vaccine; The need to address the failures of international solidarity to equitably distribute COVID-19 vaccines is now more urgent than ever to help curb the pandemic and prevent future variants. However, many high-income countries have adopted a "me first" approach, proceeding to offer COVID-19 booster doses to their entire populations, including those at least risk of severe illness, whilst the rest of the world is left unvaccinated or partially vaccinated with one dose for even their most vulnerable communities. MAIN BODY: COVID-19 vaccine inequity places the health of the global population at risk and exacerbates socio-economic repercussions, especially in low- and middle-income countries. Initiatives launched to combat vaccine inequity such as the Fair Allocation Framework for the COVID-19 Vaccines (COVAX) have been unsuccessful as several governments, primarily from high-income countries, have scaled down their contributions to the initiative. Furthermore, COVAX has not seriously engaged with the Access to COVID-19 Tools (ACT) Health Systems Connector, as was originally intended, leading to crucial health systems components critical to vaccine delivery to be overlooked. Several strategies can be employed to help achieve the desired global immunization goals, such as Intellectual Property waivers, increased donations, and activation of new COVID-19 vaccine manufacturing hubs. In addition, continued advocacy for vaccine equity by all involved and affected stakeholders, as well as critical amendments to existing or upcoming legislation and funding mechanisms will help address the shortcomings of current inequitable vaccine distribution. CONCLUSIONS: Global solidarity and collective action through pandemic governance mechanisms are urgently needed to ensure vaccine equity. These interventions are vital to rapidly mitigate ongoing health and humanitarian crises and ultimately curb the pandemic, sooner rather than later.

Meningitis during COVID -19 pandemic in the Democratic Republic of Congo: A call for concern.

Meningitis is a severe infection and a major public health challenge. The meningitis outbreak which had resurfaced amid the coronavirus disease 2019 (COVID-19) pandemic in the Democratic Republic of Congo (DRC) has been further stressing the health care systems that are already overburdened with detecting, preventing, and treating the current coronavirus disease. The recent meningitis outbreak in the DRC has resulted in a high case fatality ratio of 50% - an extremely worrying concern. Robust strategies are hence needed to curb the spread of the disease amid the COVID-19 pandemic, to prevent further adverse health outcomes and to mitigate the compounding burden on the country's healthcare systems. Several measures such as vaccination campaigns, adherence to sanitation and hygiene, improved surveillance and diagnostic capabilities could help prevent future epidemics in the country.

COVID-19 associated pulmonary aspergillosis (CAPA): An added potential burden on India's pre-existing fungal superinfection.

The ongoing pandemic that initiated in Wuhan, China, has been an international public health emergency since January 2020. India has been battling a brutal COVID-19's second wave since April 2021. The healthcare system was struggling with a substantial increase in COVID-19 cases when the lack of necessary resources further aroused a major setback. Opportunistic fungal infections, specifically mucormycosis and candidiasis have become a pressing matter of concern. Recent cases of aspergillosis have also heightened public alarm. Hence, call for an immediate response to this public health crisis is the need of the hour by establishing countrywide surveillance, diagnostic, and management system, as well as public awareness to alleviate the burden of COVID-19 and fungal infections in India.

COVID-19, measles, and yellow fever: The need to reinforce vaccination in the Democratic Republic of Congo.

The immunization programs have been jeopardized all over the world due to the stay-at-home constraints imposed, to mitigate the ongoing COVID-19 pandemic. This has directly or indirectly placed the global health care system in peril, resulting in an overlapping public health crisis. With this commentary, we aim to accentuate the need to reinforce vaccination in the Democratic Republic of Congo, in lieu of the intersecting COVID-19, measles, and yellow fever outbreak, besides, providing recommendations so as to help alleviate the situation.

COVID-19 vaccination strategies and policies in India: The need for further re-evaluation is a pressing priority.

India is one of the worst-hit nations by the COVID-19 pandemic and witnessed a devastating impact across cities in the country. Although behavioral measures like wearing a face mask, maintaining social distance, and hand hygiene helped to control the spread of the disease initially, but a long-term action by vaccinating the population is a promising solution. On 16 January 2021, India undertook the challenge to vaccinate 300 million people by August 2021 against COVID-19, the largest vaccination campaign globally. India has been lauded by several prominent organizations around the world for its efforts. But catering to India's massive population is not without its own set of complex challenges. As of 29 July 2021, a mere 9.82 million (approximately 7.03 percent of the total Indian population) people have been fully vaccinated against COVID-19 with the first and second dose, and only 352.5 million (roughly 25.28 percent of the total Indian population) have been partly vaccinated with the first dose. This shows, India's current COVID-19 vaccination policies and plans are still inadequate and not undisputedly equitable even after several amendments in the guidelines. However, even with the second wave abating slowly and steadily in India, there is a need to further re-strategize the current vaccination policy and plans in India against COVID-19 to help achieve long-term positive outcomes in the shortest feasible time frame hoping to evade a third wave.

From black to white: A roadmap to containing the rise of candidiasis amidst COVID-19 and mucormycosis in India.

With numbers of active COVID-19 cases in India falling in recent weeks and the healthcare system finally showing signs of coping with the mucormycosis epidemic, several new reports of COVID-19 cases linked to "white fungus" have emerged. This has led to rising concern with the potential to stretch the capacity of an already burdened healthcare system. Moreover, the implications of this disease in the COVID-19 population and its consequences on the health and socio-economic structure of the country have not been vastly studied. This commentary explores the need for government efforts in the context of containing candidiasis during the pandemic and provides key recommendations on combating this imminent public health challenge.