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1. Sustainable strategies for Ebola virus disease outbreak preparedness in Africa: a case study on lessons learnt in countries neighbouring the Democratic Republic of the Congo

Author

Caroline S. Ryan, Marie-Roseline D. Belizaire, Miriam Nanyunja, Olushayo Oluseun Olu, Yahaya Ali Ahmed, Anderson Latt, Matthew Tut Kol, Bertrand Bamuleke, Jayne Tusiime, Nadia Nsabimbona, Ishata Conteh, Shamiso Nyashanu, Patrick Otim Ramadan, Solomon Fisseha Woldetsadik, Jean-Pierre Mulunda Nkata, Jim T. Ntwari, Senya D. Nzeyimana, Leopold Ouedraogo, Georges Batona, Vedaste Ndahindwa, Elizabeth A. Mgamb, Magdalene Armah, Joseph Francis Wamala, Argata Guracha Guyo, Alex Yao Sokemawu Freeman, Alexander Chimbaru, Innocent Komakech, Muhau Kuku, Walter M. Firmino, Grace E. Saguti, Faraja Msemwa, Shikanga O-Tipo, Precious C. Kalubula, Ngoy Nsenga, and Ambrose Otau Talisuna

Subjects
Ebola virus disease, Emergency preparedness and response, Lessons learned, Case study, International Health Regulations, Democratic Republic of the Congo, Infectious and parasitic diseases, RC109-216, Public aspects of medicine, RA1-1270
Abstract

Abstract Background From May 2018 to September 2022, the Democratic Republic of Congo (DRC) experienced seven Ebola virus disease (EVD) outbreaks within its borders. During the 10th EVD outbreak (2018–2020), the largest experienced in the DRC and the second largest and most prolonged EVD outbreak recorded globally, a WHO risk assessment identified nine countries bordering the DRC as moderate to high risk from cross border importation. These countries implemented varying levels of Ebola virus disease preparedness interventions. This case study highlights the gains and shortfalls with the Ebola virus disease preparedness interventions within the various contexts of these countries against the background of a renewed and growing commitment for global epidemic preparedness highlighted during recent World Health Assembly events. Main text Several positive impacts from preparedness support to countries bordering the affected provinces in the DRC were identified, including development of sustained capacities which were leveraged upon to respond to the subsequent coronavirus disease 2019 (COVID-19) pandemic. Shortfalls such as lost opportunities for operationalizing cross-border regional preparedness collaboration and better integration of multidisciplinary perspectives, vertical approaches to response pillars such as surveillance, over dependence on external support and duplication of efforts especially in areas of capacity building were also identified. A recurrent theme that emerged from this case study is the propensity towards implementing short-term interventions during active Ebola virus disease outbreaks for preparedness rather than sustainable investment into strengthening systems for improved health security in alignment with IHR obligations, the Sustainable Development Goals and advocating global policy for addressing the larger structural determinants underscoring these outbreaks. Conclusions Despite several international frameworks established at the global level for emergency preparedness, a shortfall exists between global policy and practice in countries at high risk of cross border transmission from persistent Ebola virus disease outbreaks in the Democratic Republic of Congo. With renewed global health commitment for country emergency preparedness resulting from the COVID-19 pandemic and cumulating in a resolution for a pandemic preparedness treaty, the time to review and address these gaps and provide recommendations for more sustainable and integrative approaches to emergency preparedness towards achieving global health security is now.

Published
2022
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2. What should the African health workforce know about disasters? Proposed competencies for strengthening public health disaster risk management education in Africa

Author

Olushayo Olu, Abdulmumini Usman, Kalula Kalambay, Stella Anyangwe, Kuku Voyi, Christopher Garimoi Orach, Aklilu Azazh, Mala Ali Mapatano, Ngoy Nsenga, Lucien Manga, Solomon Woldetsadik, Francois Nguessan, and Angela Benson

Subjects
Public health, Disaster risk management, Education, Core competencies, Training curricula, Health workforce, Special aspects of education, LC8-6691, Medicine
Abstract

Abstract Background As part of efforts to implement the human resources capacity building component of the African Regional Strategy on Disaster Risk Management (DRM) for the health sector, the African Regional Office of the World Health Organization, in collaboration with selected African public health training institutions, followed a multistage process to develop core competencies and curricula for training the African health workforce in public health DRM. In this article, we describe the methods used to develop the competencies, present the identified competencies and training curricula, and propose recommendations for their integration into the public health education curricula of African member states. Methods We conducted a pilot research using mixed methods approaches to develop and test the applicability and feasibility of a public health disaster risk management curriculum for training the African health workforce. Results We identified 14 core competencies and 45 sub-competencies/training units grouped into six thematic areas: 1) introduction to DRM; 2) operational effectiveness; 3) effective leadership; 4) preparedness and risk reduction; 5) emergency response and 6) post-disaster health system recovery. These were defined as the skills and knowledge that African health care workers should possess to effectively participate in health DRM activities. To suit the needs of various categories of African health care workers, three levels of training courses are proposed: basic, intermediate, and advanced. The pilot test of the basic course among a cohort of public health practitioners in South Africa demonstrated their relevance. Conclusions These competencies compare favourably to the findings of other studies that have assessed public health DRM competencies. They could provide a framework for scaling up the capacity development of African healthcare workers in the area of public health DRM; however further validation of the competencies is required through additional pilot courses and follow up of the trainees to demonstrate outcome and impact of the competencies and curriculum.

Published
2018
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3. Strengthening health disaster risk management in Africa: multi-sectoral and people-centred approaches are required in the post-Hyogo Framework of Action era

Author

Olushayo Olu, Abdulmumini Usman, Lucien Manga, Stella Anyangwe, Kalula Kalambay, Ngoy Nsenga, Solomon Woldetsadik, Craig Hampton, Francois Nguessan, and Angela Benson

Subjects
Health, Disaster risk management, Africa, Health system, Hyogo Framework for Action, Disaster risk reduction, Public aspects of medicine, RA1-1270
Abstract

Abstract Background In November 2012, the 62nd session of the Regional Committee for Africa adopted a comprehensive 10-year regional strategy for health disaster risk management (DRM). This was intended to operationalize the World Health Organization’s core commitments to health DRM and the Hyogo Framework for Action 2005–2015 in the health sectors of the 47 African member states. This study reported the formative evaluation of the strategy, including evaluation of the progress in achieving nine targets (expected to be achieved incrementally by 2014, 2017, and 2022). We proposed recommendations for accelerating the strategy’s implementation within the Sendai Framework for Disaster Risk Reduction. Methods This study used a mixed methods design. A cross-sectional quantitative survey was conducted along with a review of available reports and information on the implementation of the strategy. A review meeting to discuss and finalize the study findings was also conducted. Results In total, 58 % of the countries assessed had established DRM coordination units within their Ministry of Health (MOH). Most had dedicated MOH DRM staff (88 %) and national-level DRM committees (71 %). Only 14 (58 %) of the countries had health DRM subcommittees using a multi-sectoral disaster risk reduction platform. Less than 40 % had conducted surveys such as disaster risk analysis, hospital safety index, and mapping of health resources availability. Key challenges in implementing the strategy were inadequate political will and commitment resulting in poor funding for health DRM, weak health systems, and a dearth of scientific evidence on mainstreaming DRM and disaster risk reduction in longer-term health system development programs. Conclusions Implementation of the strategy was behind anticipated targets despite some positive outcomes, such as an increase in the number of countries with health DRM incorporated in their national health legislation, MOH DRM units, and functional health sub-committees within national DRM committees. Health system-based, multi-sectoral, and people-centred approaches are proposed to accelerate implementation of the strategy in the post-Hyogo Framework of Action era.

Published
2016
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4. Incident Management Systems are essential for Effective Coordination of Large Disease Outbreaks: Perspectives from the Coordination of the Ebola Outbreak Response in Sierra Leone

Author

Olushayo Oluseun Olu, Margaret Lamunu, Alexander Chimbaru, Ayotunde Adegboyega, Ishata Conteh, Ngoy Nsenga, Noah Sempiira, Kande-Bure Kamara, and Foday Mohamed Dafae

Subjects
Sierra Leone, coordination, outbreak response, Incident Management System, Ebola virus disease, Public aspects of medicine, RA1-1270
Abstract

Background: Response to the 2014–2015 Ebola Virus Disease (EVD) outbreak in Sierra Leone overwhelmed the national capacity to contain it and necessitated a massive international response and strong coordination platform. Consequently, the Sierra Leone Government, with support of the international humanitarian community, established and implemented various models for national coordination of the outbreak. In this article we review the strengths and limitations of the EVD outbreak response coordination systems in Sierra Leone and propose recommendations for improving coordination of similar outbreaks in the future. Conclusions: There were two main frameworks used for the coordination of the outbreak; the Emergency Operation Center (EOC) and the National Ebola Response Center (NERC). We observed an improvement in outbreak coordination as the management mechanism evolved from the EOC to the NERC. Both coordination systems had their advantages and disadvantages; however the NERC coordination mechanism appeared to be more robust. We identified challenges, such as competition and duplication of efforts between the numerous coordination groups, slow resource mobilization, inadequate capacity of NERC/EOC staff for health coordination and an overtly centralized coordination and decision making system as the main coordination challenges during the outbreak. Recommendations: We recommend the establishment of emergency operation centers with simple incident management system-based coordination prior to outbreaks, strong government leadership, decentralization of coordination systems and functions to the epicenter of outbreaks, with clear demarcation of roles and responsibilities between different levels, regular training of key coordination leaders and better community participation as methods to improve coordination of future disease outbreaks.

Published
2016
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5. Coordination and management of COVID-19 in Africa through health operations and technical expertise pillar: A case study from who AFRO one year into response

Author

Ngoy, Nsenga, Conteh, Ishata Nannie, Oyugi, Boniface, Abok, Patrick, Kobie, Aminata, Phori, Peter, Hamba, Cephas, Ejiofor, Nonso Ephraim, Fitzwanga, Kaizer, Appiah, John, Edwin, Ama, Fawole, Temidayo, Kamara, Rashidatu, Cihambanya, Landry Kabego, Mzozo, Tasiana, Ryan, Caroline, Braka, Fiona, Yoti, Zabulon, Kasolo, Francis, Okeibunor, Joseph C, and Gueye, Abdou Salam

Published
2022

6. A rapid increase in coverage of COVID-19 vaccination, Central African Republic/Hausse rapide de la couverture vaccinale contre la COVID-19 en Republique centrafricaine/Aumento rapido de la cobertura de la vacunacion contra la COVID-19 en la Republica Centroafricana

Author

Amani, Adidja, Atuhebwe, Phionah, Mboussou, Franck Fortune, Ngoy, Nsenga, M'boufoungou, Nicaise Eloi, Osei-Sarpong, Fred, Traore, Celestin, Mihigo, Richard, and Chaiban, Ted

Subjects
Coronaviruses, Vaccination, COVID-19, Community health aides
Abstract

Introduction In 2021, as countries worldwide were rapidly rolling out their coronavirus disease 2019 (COVID-19) vaccination programmes, Central African Republic faced major challenges in vaccinating its population against COVID-19. (1) [...], Problem In 2021, Central African Republic was facing multiple challenges in vaccinating its population against coronavirus disease 2019 (COVID-19), including inadequate infrastructure and funding, a shortage of health workers and vaccine hesitancy among the population. Approach To increase COVID-19 vaccination coverage, the health ministry used three main approaches: (i) task shifting to train and equip existing community health workers (CHWs) to deliver COVID-19 vaccination; (ii) evidence gathering to understand people's reluctance to be vaccinated; and (iii) bundling of COVID-19 vaccination with the polio vaccination programme. Local setting Central African Republic is a fragile country with almost two thirds of its population in need of humanitarian assistance. Despite conducting two major COVID-19 vaccination campaigns, by January 2022 only 9% (503 000 people) of the 5 570 659 general population were fully vaccinated. Relevant changes In the 6 months from February to July 2022, Central African Republic tripled its coverage of COVID-19 vaccination to 29% (1 615 492 out of 5 570 659 people) by August 2022. The integrated polio-COVID-19 campaign enabled an additional 136 040 and 218 978 people to be vaccinated in the first and second rounds respectively, at no extra cost. Evidence obtained through surveys and focus group discussions enabled the health ministry to develop communication strategies to dispel vaccine hesitancy and misconceptions. Lessons learnt Task shifting COVID-19 vaccination to CHWs can be an efficient solution for rapid scaling-up of vaccination campaigns. Building trust with the community is also important for addressing complex health issues such as vaccine hesitancy. Collaborative efforts are necessary to provide access to COVID-19 vaccines for high- risk and vulnerable populations. Probleme En 2021, la Republique centrafricaine s'est retrouvee confrontee a de nombreuses difficultes au moment de vacciner sa population contre la maladie a coronavirus 2019 (COVID-19): infrastructures inadaptees, manque de financement, penurie de soignants, reticence des citoyens face a la vaccination... Approche Afin d'ameliorer la couverture vaccinale contre la COVID-19, le Ministere de la Sante a adopte trois grandes approches: (i) delegation des taches en vue de former et d'equiper les agents de sante communautaires (ASC) existants pour qu'ils puissent prendre en charge la vaccination contre la COVID-19; (ii) collecte des preuves permettant de comprendre pourquoi les gens hesitent a se faire vacciner; et enfin, (iii) combinaison de la vaccination contre la COVID-19 avec le programme de vaccination contre la poliomyelite. Environnement local La Republique centrafricaine est un pays fragile et pres des deux tiers de ses habitants ont besoin d'une aide humanitaire. Malgre deux vastes campagnes de vaccination contre la COVID-19, a peine 9% (503 000 personnes) de la population generale (5 570 659 personnes) avait recu un schema vaccinal complet en janvier 2022. Changements significatifs Au cours des six mois compris entre fevrier 2022 et juillet 2022, la Republique centrafricaine a triple sa couverture vaccinale contre la COVID-19, qui est passee a 29% de la population (1 615 492 personnes sur un total de 5 570 659) en aout 2022. La campagne integree poliomyelite-COVID-19 a permis de vacciner 136 040 personnes de plus lors de la premiere phase et 218 978 autres lors de la seconde, sans frais supplementaires. Grace aux preuves recoltees par le biais d'enquetes et de discussions dans des groupes de reflexion, le Ministere de la Sante a pu developper des strategies de communication visant a desamorcer les idees fausses et dissiper les doutes relatifs a la vaccination. Lecons tirees Solliciter les ASC pour la vaccination contre la COVID-19 peut representer un moyen efficace de renforcer les campagnes deployees. En outre, etablir une relation de confiance avec la communaute est essentiel pour repondre a des defis sanitaires complexes tels que la reticence face a la vaccination. Des efforts sont necessaires en matiere de collaboration afin de garantir l'acces aux vaccins contre la COVID-19 aux populations vulnerables et a haut risque. Situacion En 2021, la Republica Centroafricana se enfrentaba a multiples dificultades para vacunar a su poblacion contra la enfermedad por coronavirus de 2019 (COVID-19), como infraestructuras y financiacion inadecuadas, escasez de personal sanitario y reticencia de la poblacion a vacunarse. Enfoque Para aumentar la cobertura de la vacunacion contra la COVID-19, el Ministerio de Sanidad utilizo tres enfoques principales: (i) cambio de tareas para formar y equipar a los agentes de salud comunitarios existentes para vacunar contra la COVID-19; (ii) recopilacion de pruebas para comprender la reticencia de la poblacion a vacunarse; y (iii) agrupacion de la vacunacion contra la COVID-19 con el programa de vacunacion contra la polio. Marco regional La Republica Centroafricana es un pais fragil con casi dos tercios de su poblacion necesitada de ayuda humanitaria. A pesar de haber llevado a cabo dos grandes campanas de vacunacion contra la COVID-19, en enero de 2022 solo el 9% (503 000 personas) de los 5 570 659 habitantes estaban totalmente vacunados. Cambios importantes En los 6 meses que van de febrero a julio de 2022, la Republica Centroafricana triplico su cobertura de vacunacion contra la COVID-19 hasta alcanzar el 29% (1 615 492 de 5 570 659 personas) en agosto de 2022. La campana integrada de polio-COVID-19 permitio vacunar a 136 040 y 218 978 personas mas en la primera y segunda rondas, respectivamente, sin coste adicional. Los datos obtenidos mediante encuestas y grupos de discusion permitieron al Ministerio de Sanidad desarrollar estrategias de comunicacion para disipar las dudas y las ideas erroneas sobre la vacuna. Lecciones aprendidas La asignacion de la vacunacion contra la COVID-19 a los ASC puede ser una solucion eficaz para ampliar rapidamente las campanas de vacunacion. Asimismo, es importante generar confianza en la comunidad para abordar asuntos sanitarios complejos, como la reticencia a vacunarse. Los esfuerzos de colaboracion son necesarios para que las poblaciones vulnerables y de alto riesgo puedan acceder a las vacunas contra la COVID-19.

Published
2023
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8. The toll of COVID-19 on African children: A descriptive analysis on COVID-19-related morbidity and mortality among the pediatric population in Sub-Saharan Africa

Author

Rodriguez Velásquez, Sabina, Jacques, Léa, Dalal, Jyoti, Sestito, Paolo, Habibi, Zahra, Venkatasubramanian, Akarsh, Nguimbis, Benedict, Mesa, Sara Botero, Chimbetete, Cleophas, Keiser, Olivia, Impouma, Benido, Mboussou, Franck, William, George Sie, Ngoy, Nsenga, Talisuna, Ambrose, Gueye, Abdou Salam, Hofer, Cristina Barroso, and Cabore, Joseph Waogodo

Published
2021
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9. Lessons Learned From a Large Cross-Border Field Simulation Exercise to Strengthen Emergency Preparedness in East Africa, 2019

Author

Freddy Banza Mutoka, Ali Ahmed Yahaya, Fahari Marwa, Jackline Mosinya Nyaberi, Lyndah Makayotto, Florian Mutabazi, Vida Mmbaga, Edward Areuse Komba, Charles Mwaipopo, Simon Wathigo Kiarie, Frederik A Copper, Stella Chungong, Mary Archson Makata, Cindy Chiu de Vázquez, George Kauki, Florian Gehre, Denis Charles, Pauline Nandako Nafula Kituyi, David Balikowa, Michael Katende, Damascent Kabanda, James Nyongesa Wakhungu, Thomas Daido Dulu, Patrick Marabu Nyakundi, Hilary Njenge, Folorunso Oludayo Fasina, Caroline Wambua, Willy Were, Lucia Mullen, Ambrose Talisuna, Benezeth Lutege Malinda, Zheng Jie Marc Ho, Enock Kasyombe Mwakyusa, Geoffrey Gitau Mukora, Landry Ndriko Mayigane, Mary Stephen, Emanuel Senyaeli Swai, Vones Uiso, Julius Wekesa, Grace Elizabeth Bai Saguti, James Kivuva, Nirmal Kandel, Toba Nguvila, Charles Msangi, Stephen Komora, Abbas Omaar, Stephane de la Rocque, David Knaggs, Ngoy Nsenga, Athman Mwatondo, Mpairwe Allan, Justino Mutisya Muinde, Solomon Fisseha Woldetsadik, Kenneth Byoona, Nollascus Ganda, Allan Bell, Geoffrey Misati Kebaki, Miriam Nanyunja, Timothy Wesonga, John Gachohi, Rajesh Sreedharan, Muna Affara, Mary Njoroge, and Harrison Chinyuka

Subjects
medicine.medical_specialty, Health (social science), Health, Toxicology and Mutagenesis, Disaster Planning, Management, Monitoring, Policy and Law, World Health Organization, Disease Outbreaks, Political science, medicine, Humans, biology, Emergency management, Scope (project management), business.industry, Public health, Public Health, Environmental and Occupational Health, Civil Defense, Africa, Eastern, Public relations, biology.organism_classification, Test (assessment), Tanzania, One Health, Preparedness, Scale (social sciences), Emergency Medicine, Public Health, business, Safety Research
Abstract

Field simulation exercises (FSXs) require substantial time, resources, and organizational experience to plan and implement and are less commonly undertaken than drills or tabletop exercises. Despite this, FSXs provide an opportunity to test the full scope of operational capacities, including coordination across sectors. From June 11 to 14, 2019, the East African Community Secretariat conducted a cross-border FSX at the Namanga One Stop Border Post between the Republic of Kenya and the United Republic of Tanzania. The World Health Organization Department of Health Security Preparedness was the technical lead responsible for developing and coordinating the exercise. The purpose of the FSX was to assess and further enhance multisectoral outbreak preparedness and response in the East Africa Region, using a One Health approach. Participants included staff from the transport, police and customs, public health, animal health, and food inspection sectors. This was the first FSX of this scale, magnitude, and complexity to be conducted in East Africa for the purpose of strengthening emergency preparedness capacities. The FSX provided an opportunity for individual learning and national capacity strengthening in emergency management and response coordination. In this article, we describe lessons learned and propose recommendations relevant to FSX design, management, and organization to inform future field exercises.

Published
2021
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10. A shift from reactionary towards more proactive and sustainable approaches is required for effective Ebola virus disease preparedness in Africa: A case study of key lessons learned from the Democratic Republic of Congo

Author

Caroline S. Ryan, Marie-Roseline D. Belizaire, Miriam Nanyunja, Olushayo Oluseun Olu, Yahaya Ali Ahmed, Anderson Latt, Matthew Tut Kol Yiek, Bertrand Bamuleke, Jayne Tusiime, Nadia Nsabimbona, Ishata Conteh, Shamiso Nyashanu, Patrick Otim Ramadan, Solomon Fisseha Woldetsadik, Jean-Pierre Mulunda Nkata, Jim T. Ntwari, Senya D. Nzeyimana, Leopold Ouedraogo, Georges Batona, Vedaste Ndahindwa, Elizabeth A. Mgamb, Magdalene Armah, Joseph Francis Wamala, Argata Guracha Guyo, Alex Yao Sokemawu Freeman, Alexander Chimbaru, Innocent Komakech, Muhau Kuku, Walter M. Firmino, Grace E. Saguti, Faraja Msemwa, Shikanga O-Tipo, Precious C. Kalubula, Ngoy Nsenga, and Ambrose Talisuna Otau

Abstract

Background From May 2018 to the end of June 2022, the Democratic Republic of Congo (DRC) experienced six Ebola virus disease outbreaks within its borders. During the 10th EVD outbreak, the largest experienced in the DRC and the second largest and most prolonged EVD outbreak recorded globally, a WHO risk assessment identified nine countries bordering the DRC as moderate to high risk from cross border importation. Burundi, Rwanda, South Sudan and Uganda were classified as priority one countries while Angola, Central African Republic, Congo, Tanzania and Zambia as priority two. These countries implemented varying levels of Ebola virus disease preparedness interventions. This case study highlights the gains and shortfalls with the Ebola virus disease preparedness interventions against the background of a renewed and growing commitment for global epidemic preparedness highlighted during recent World Health Assembly events. Main text Several positive impacts from preparedness support to countries bordering the affected provinces in the DRC were identified, including development of sustained capacities which were leveraged upon to respond to the subsequent COVID-19 pandemic. Shortfalls such as lost opportunities in vertical approaches to response pillars such as surveillance, over dependence on external support and duplication of efforts especially in the areas of capacity building were also identified. A recurrent theme that emerged from this case study is the propensity towards implementing short-term interventions during Ebola virus disease outbreak preparedness and response rather than sustainable investment into strengthening systems for improved health security in alignment with IHR obligations and the Sustainable Development Goals. Conclusions Despite several international frameworks established at the global level for emergency preparedness, a shortfall exists between global policy and practice in countries at high risk of cross border transmission from persistent Ebola virus disease outbreaks in the Democratic Republic of Congo. With renewed global health commitment for country emergency preparedness resulting from the COVID-19 pandemic and cumulating in a resolution for a pandemic preparedness treaty, the time to review and address these gaps and provide recommendations for more sustainable approaches to emergency preparedness towards achieving global health security is now.

Published
2022
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11. SARS-CoV-2 infection in Africa: a systematic review and meta-analysis of standardised seroprevalence studies, from January 2020 to December 2021

Author

Lewis, Hannah C, primary, Ware, Harriet, additional, Whelan, Mairead, additional, Subissi, Lorenzo, additional, Li, Zihan, additional, Ma, Xiaomeng, additional, Nardone, Anthony, additional, Valenciano, Marta, additional, Cheng, Brianna, additional, Noel, Kim, additional, Cao, Christian, additional, Yanes-Lane, Mercedes, additional, Herring, Belinda L, additional, Talisuna, Ambrose, additional, Ngoy, Nsenga, additional, Balde, Thierno, additional, Clifton, David, additional, Van Kerkhove, Maria D, additional, Buckeridge, David, additional, Bobrovitz, Niklas, additional, Okeibunor, Joseph, additional, Arora, Rahul K, additional, and Bergeri, Isabel, additional

Published
2022
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12. Case Report: COVID-19 and Lassa Fever Coinfection in an Ebola Suspected Patient in Guinea

Author

Mory Keita, Mahamoud Sama Cherif, Billy Sivahera, Samuel T. Boland, Freddy Banza-Mutoka, Mamadou Kourouma, Alseny Modet Camara, Youssouf Sidibe, Jean Paul Kimenyi, Lamine Diassy, Angelo Loua, Ibrahima Sory Fofana, Youba Kandako, Dobo Onivogui, Enogo Koivogui, Tamba Jacques Millimono, Fode Diakite, Mamadou Balde, Bienvenu Houndjo, Ngoy Nsenga, Ambrose Talisuna, Alexandre Delamou, Olivia Keiser, Georges Alfred Ki-Zerbo, and Abdou Salam Gueye

Subjects
Infectious Diseases, viruses, Virology, Parasitology
Abstract

In this case report, we describe a clinical presentation and therapeutic history of a unique case diagnosed with Lassa fever and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in a 23-year-old man from Yomou prefecture in southeast Guinea identified with suspected Ebola Virus Disease (EVD) in the midst of an ongoing outbreak of that disease in the same region. On May 3, 2021, he was admitted to the Nzérékoré Epidemic disease treatment center where his clinical condition deteriorated significantly. Laboratory testing performed on the same day reveals a negative EVD polymerase chain reaction (PCR). Three days later, the patient was tested positive for SARS-CoV-2 and Lassa fever by reverse transcriptase PCR (RT-PCR) assays. Laboratory examination also indicated severe hematological and biochemical deteriorations in the patient. This case substantiates the need for systematic differential diagnosis during epidemic-prone disease outbreaks to better manage severely unwell patients.

Published
2022

13. Assessment of COVID-19 pandemic responses in African countries: thematic synthesis of WHO intra-action review reports

Author

Talisuna, Ambrose, primary, Iwu, Chinwe, additional, Okeibunor, J, additional, Stephen, Mary, additional, Musa, Emmanuel Onuche, additional, Herring, Belinda Louise, additional, Ramadan, Otim Patrick Cossy, additional, Yota, Daniel, additional, Nanyunja, Miriam, additional, Mpairwe, Allan, additional, Banza, Freddy Mutoka, additional, Diallo, Amadou Bailo, additional, Wango, Roland Kimbi, additional, Massidi, Christian, additional, Njenge, Hilary Kagume, additional, Traore, Martin, additional, Oke, Antonio, additional, Bonkoungou, Boukare, additional, Mayigane, Landry Ndriko, additional, Conteh, Ishata Nannie, additional, Senait, Fekadu, additional, Chungong, Stella, additional, Impouma, Benido, additional, Ngoy, Nsenga, additional, Wiysonge, Charles Shey, additional, Yoti, Zabulon, additional, and Gueye, Abdou Salam, additional

Published
2022
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17. Estimating the SARS-CoV2 infections detection rate and cumulative incidence in the World Health Organization African Region 10 months into the pandemic

Author

Caitlin M. Wolfe, Antoine Flahault, Francis Kasolo, Cláudia Torres Codeço, Roland Ngom, George Sie Williams, Franck Mboussou, Bridget Farham, Ngoy Nsenga, Olivia Keiser, Humphrey Karamagi, Benido Impouma, Zabulon Yoti, and Cyrus Shahpar

Subjects
2019-20 coronavirus outbreak, Original Paper, detection rate, Time Factors, Coronavirus disease 2019 (COVID-19), Epidemiology, SARS-CoV-2, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Incidence, COVID-19, Middle Aged, World Health Organization, World health, Infectious Diseases, Geography, Environmental health, Pandemic, Africa, Humans, Cumulative incidence, Detection rate, cumulative incidence, Aged, Retrospective Studies
Abstract

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.

Published
2021

18. A year of genomic surveillance reveals how the SARS-CoV-2 pandemic unfolded in Africa

Author

Aida Elargoubi, John M. Morobe, Jiro Yasuda, Madisa Mine, Faustinos T. Takawira, Jean-Jacques Muyembe Tamfum, Amal Souissi, Hela Karray, Dominique Goedhals, Michael Owusu, Mitoha O. Ayekaba, Pascale Ondoa, Bryan Fulbert Nkengfack Tegomoh, Daniel G. Amoako, Mathabo Mareka, Sameh Trabelsi, Dorcas Maruapula, Magalutcheemee Ramuth, Danny S. Park, Bamidele Soji Oderinde, Maitshwarelo I. Matsheka, Robert A. Kingsley, Philippe Dussart, Matthew Cotten, Hesham A. Elgahzaly, Oyewale Tomori, Arash Iranzadeh, Nicksy Gumede, Marta Giovanetti, Folarin Onikepe, Omoruyi E. Chukwuma, Nnaemeka Ndodo, Mba Nwando, Oladiji Femi, Sylvie L. Budiaki, Gemma L. Kay, Johnson C. Okolie, Saber Masmoudi, Okokhere Peter, Hlanai Gumbo, Sara H.A. Agwa, Mooko Sekhele, Imed Gaaloul, Sheila M. Mandanda, Enatha Mukantwari, Ngonda Saasa, Sanaâ Lemriss, Hellen Nansumba, Akano Kazeem, Upasana Ramphal, Carolyn Williamson, Belinda Louise Herring, Vagner Fonseca, Edidah M. Ong'era, Joana Q. Mends, Ahmed E Ogwell Ouma, Anika Vinze, Ahmad Sayed, Richard Phillips, Adewunmi M. Olubusuyi, Bourema Kouriba, Vivianne Gorova, John O. Gyapong, Tulio de Oliveira, Arnold W. Lambisia, Najla Kharrat, Wolfgang Preiser, Ojide Chiedozie Kingsley, Yenew K. Tebeje, Sherihane Aryeetey, Yaw Bediako, David A. Rasmussen, Wael H. Roshdy, Norosoa Harline Razanajatovo, Siham Elhamoumi, Sylvie van der Werf, Moussa Moïse Diagne, Claudia Daubenberger, Oshomah Cyril, Andrew J. Page, Uwanibe Jessica, Matoke-Muhia Damaris, Daniel J. Bridges, Sumir Panji, Mahjoub Aouni, Adnene Hammami, Simani Gaseitsiwe, Daniel Lule Bugembe, Gugu Maphalala, Kim Hae-Young, Mohamed K. Khalifa, Safietou Sankhe, Fabian H. Leendertz, Richard Njouom, Ousmane Faye, Kwabena O. Duedu, Jeffrey G. Shaffer, Tobias Schindler, Bankole Bolajoko, Cathrine Scheepers, Francisca M. Muyembe, Ajogbasile F. Victoria, Mirabeau T. Youtchou, Ayoade Femi, Amel Chtourou, Kefentse A. Tumedi, Adrienne A. Amuri, Joyce M. Ngoi, Etile Anoh, Richmond Gorman, Mohamed Abouelhoda, Ali Ahmed Yahaya, Paulo Arnaldo, Alexander J. Trotter, Lahcen Belyamani, Isaac Ssewanyana, Susan Nabadda, Arshad Ismail, Julia C. Andeko, James Emmanuel San, Susan Engelbrecht, Sikhulile Moyo, Jinal N. Bhiman, Jean-Michel Heraud, Julius J. Lutwama, Samar Metha, Amadou Diallo, Soa-Fy Andriamandimby, Rosina A. A. Carr, Edgar Simulundu, Steve A. Mundeke, Nelson B. Silochi, Shymaa S. Ahmed, Nadia Touil, Ihekweazu Chikwe, Deogratius Ssemwanga, Ilhem Boutiba-Ben Boubaker, Houriiyah Tegally, Okogbenin Sylvanus, Abdoul K. Sangare, Mulenga Mwenda, Fausta Shakiwa Mosha, Amadou A. Sall, Derek Tshiabuila, D. James Nokes, Yvan Butera, Maximillian Mpina, Adedotun-Sulaiman Kemi, Onwe E. Ogah, Jean B. Lekana-Douk, Stephen F. Schaffner, Vincent Enouf, Chantal Akoua-Koffi, Diarra Bassirou, Edwin Shumba, Deelan Doolabh, Saba Gargouri, Kayode T. Adeyemi, Wonderful T. Choga, Nicola Mulder, Inbal Gazy, Mushal Allam, Saâd El Kabbaj, Christian T. Happi, Frank Tanser, Sobajo Tope, Michael R. Wiley, Katherine J. Siddle, Charles N. Agoti, John Kayiwa, George Githinji, Diego F. Cuadros, Abdoul-Salam Ouédraogo, Fowotade Adeola, Sonia Lekana-Douki, Edith N. Ngabana, William Ampofo, U George, Elmostafa El Fahime, Jean-Claude C Makangara, Nalia Ismael, Ebenezer Foster-Nyarko, Samar K. Kassim, Nedio Mabunda, Hafaliana Christian Ranaivoson, Tapfumanei Mashe, Sylvie Behillil, Etienne Simon-Loriere, Donwilliams O. Omuoyo, Darren P. Martin, Azeddine Ibrahimi, Paul E. Oluniyi, Richard J Lessells, My V. T. Phan, Feriel Bouzid, Salako B. Lawal, Gert U. van Zyl, Fares Wasfi, Christophe Peyrefitte, Joyce Namulondo, Ugochukwu J. Anyaneji, Mariétou Faye Paye, Augustina Sylverken, Sébastien Calvignac-Spencer, Malebogo Kebabonye, Sophie J Prosolek, Mahmoud el Hefnawi, Adeyemi O. O. Oluwapelumi, Fakayode O. Enoch, Eddy Kinganda Lusamaki, Gaetan Thilliez, Beatrice Dhaala, Gabriel K. Mbunsu, Lavanya Singh, Nnennaya A. Ajayi, Justin O'Grady, Olawoye Idowu, Ngoy Nsenga, Baba Marycelin, Ndongo Dia, Abdul Karim Sesay, Ikponmwosa Odia, Chika K. Onwuamah, Pardis C. Sabeti, Collins M. Morang’a, Hajar Lemriss, Dominic S. Y. Amuzu, Jones Gyamfi, Sofonias K. Tessema, Iyaloo Konstantinus, Pontiano Kaleebu, Patrick Semanda, Fawzi Derrar, Alpha Kabinet Keita, Joweria Nakaseegu, Ibtihel Smeti, Jocelyn Kiconco, Audu Rosemary, K Said, Bronwyn Kleinhans, Fatma Abdelmoula, Sureshnee Pillay, Abechi Priscilla, Manel Turki, Fred A. Dratibi, Berthe-Marie Njanpop-Lafourcade, Zaydah R. de Laurent, David Baker, Nadine Rujeni, Oguzie Judith, Peter K. Quashie, Phillip Armand Bester, Emmanuel Lokilo, Catherine Pratt, Nabil Abid, Mamadou Diop, Placide Mbala, Eduan Wilkinson, Johnathan A. Edwards, Ahmed Rebai, Haruka Abe, Ana Victoria Gutierrez, Thanh Le-Viet, Essia Belarbi, Steven Rudder, Jouali Farah, Maha Mastouri, Nei-yuan Hsiao, Happi Anise, Cara E. Brook, Lamia Fki-Berrajah, Gordon A. Awandare, Ugwu Chinedu, Abdel-Rahman N. Zekri, Sami Kammoun, Leonardo de Oliveira Martins, Martin M. Nyaga, Lynn Tyers, Jingjing Li, Ikhlas Ben Ayed, Mouna Ouadghiri, Amadou Koné, Reuben Ayivor-Djanie, Innocent Mudau, Thabo Mohale, Olumade Testimony, Eromon Philomena, Yeshnee Naidoo, Patrice Combe, Seydou Doumbia, Anne von Gottberg, Akpede George, Nosamiefan Iguosadolo, Mohamed G. Seadawy, Bronwyn McInnis, Faida Ajili, Grit Schubert, Tarik Aanniz, Maureen W. Mburu, Soumeya Ouangraoua, John N. Nkengasong, Jennifer Giandhari, University of KwaZulu-Natal [Durban, Afrique du Sud] (UKZN), Stellenbosch University, Laboratório de Biologia Molecular de Flavivírus [Rio de Janeiro], Instituto Oswaldo Cruz / Oswaldo Cruz Institute [Rio de Janeiro] (IOC), Fundação Oswaldo Cruz / Oswaldo Cruz Foundation (FIOCRUZ), Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)-Fundação Oswaldo Cruz / Oswaldo Cruz Foundation (FIOCRUZ), Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP), Universidade Federal de Minas Gerais = Federal University of Minas Gerais [Belo Horizonte, Brazil] (UFMG), University of Cincinnati (UC), University of Cape Town, North Carolina State University [Raleigh] (NC State), University of North Carolina System (UNC), Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques et émergentes (TransVIHMI), Institut de Recherche pour le Développement (IRD)-Université de Yaoundé I-Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Institut Pasteur de Dakar, Réseau International des Instituts Pasteur (RIIP), University of Chicago, Institut Pasteur de Madagascar, Génomique évolutive des virus à ARN - Evolutionary genomics of RNA viruses, Institut Pasteur [Paris] (IP), Centre Hospitalier de Mayotte, Centre Pasteur du Cameroun, Génétique Moléculaire des Virus à ARN - Molecular Genetics of RNA Viruses (GMV-ARN (UMR_3569 / U-Pasteur_2)), Institut Pasteur [Paris] (IP)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Cité (UPCité), Centre National de Référence des virus des infections respiratoires (dont la grippe) - National Reference Center Virus Influenzae [Paris] (CNR - laboratoire coordonnateur), Institut Pasteur [Paris] (IP)-Université Paris Cité (UPCité), Université de Sfax - University of Sfax, National Institute for Communicable Diseases [Johannesburg] (NICD), University of the Witwatersrand [Johannesburg] (WITS), Centre Hospitalier Universitaire Souro Sanou [Bobo-Dioulasso] (CHUSS), Centre for the AIDS Programme of Research [Durban, South Africa] (CAPRISA), University of Washington [Seattle], The University of Ghana (WACCBIP) team was funded by a Wellcome/African Academy of Sciences Developing Excellence in Leadership Training and Science (DELTAS) grant (DEL-15-007 and 107755/Z/15/Z: Awandare), National Institute of Health Research (NIHR) (17.63.91) grants using UK aid from the UK government for a global health research group for genomic surveillance of malaria in West Africa (Wellcome Sanger Institute, UK) and the global research unit for Tackling Infections to Benefit Africa (TIBA partnership, University of Edinburgh), and a World Bank African Centres of Excellent grant (WACCBIP-NCDs: Awandare). Project ADAGE PRFCOV19-GP2 (2020-2022) includes 40 researchers from the Center of Biotechnology of Sfax, the University of Sfax, the University of Monastir, the University Hospital Hédi Chaker of Sfax, the Military Hospital of Tunis, and Dacima Consulting. Ministry of Higher Education and Scientific Research and Ministry of Health of the Republic of Tunisia. The Uganda contributions were funded by the UK Medical Research Council (MRC/UKRI) and the UK Department for International Development (DFID) under the MRC/DFID concordat agreement (grant agreement number NC_PC_19060) and by the Wellcome, DFID–Wellcome Epidemic Preparedness–Coronavirus (grant agreement number 220977/Z/20/Z) awarded to M.C. Work from Quadram Institute Bioscience was funded by The Biotechnology and Biological Sciences Research Council Institute Strategic Programme Microbes in the Food Chain BB/R012504/1 and its constituent projects BBS/E/F/000PR10348, BBS/E/F/000PR10349, BBS/E/F/000PR10351, and BBS/E/F/000PR10352 and by the Quadram Institute Bioscience BBSRC–funded Core Capability Grant (project number BB/CCG1860/1). The Africa Pathogen Genomics Initiative (Africa PGI) at the Africa CDC is supported by the Bill & Melinda Gates Foundation (INV018978 and INV018278), Illumina Inc, the US Centers for Disease Control and Prevention (CDC), and Oxford Nanopore Technologies. Sequences generated in Zambia through PATH were funded by the Bill & Melinda Gates Foundation. The findings and conclusions contained within are those of the authors and do not necessarily reflect positions or policies of the Bill & Melinda Gates Foundation. Funding for sequencing in Côte d’Ivoire, Burkina Faso, and part of the sequencing in the DRC was granted by the German Federal Ministry of Education and Research (BMBF). Sequencing efforts from Morocco have been supported by Academie Hassan II of Science and Technology, Morocco. Funding for surveillance, sampling, and testing in Madagasar was provided by the WHO, the CDC (grant U5/IP000812-05), the US Agency for International Development (USAID, cooperation agreement 72068719CA00001), and the Office of the Assistant Secretary for Preparedness and Response in the US Department of Health and Human Services (DHHS, grant number IDSEP190051-01-0200). Funding for sequencing was provided by the Bill & Melinda Gates Foundation (GCE/ID OPP1211841), Chan Zuckerberg Biohub, and the Innovative Genomics Institute at UC Berkeley. The Botswana Harvard AIDS Institute was supported by the following funding: H3ABioNet through funding from the National Institutes of Health Common Fund (U41HG006941)—H3ABioNet is an initiative of the Human Health and Heredity in Africa Consortium (H3Africa) program of the African Academy of Science (AAS), DHHS–NIH–National Institute of Allergy and Infectious Diseases (NIAID) (5K24AI131928-04 and 5K24AI131924-04), Sub-Saharan African Network for TB/HIV Research Excellence (SANTHE), a DELTAS Africa Initiative (grant DEL-15-0060—the DELTAS Africa Initiative is an independent funding scheme of the AAS’s Alliance for Accelerating Excellence in Science in Africa (AESA) and supported by the New Partnership for Africa’s Development Planning and Coordinating Agency (NEPAD Agency) with funding from the Wellcome Trust [grant 107752/Z/15/Z] and the UK government, and the South African Medical Research Council (SAMRC) and the Department of Technology and Innovation as part of the Network for Genomic Surveillance in South Africa (NGS-SA) and the Stellenbosch University Faculty of Medicine & Health Sciences, Strategic Equipment Fund. D.P.M. is funded by the Wellcome Trust (Wellcome Trust grant 222574/Z/21/Z). Sequencing activities at the NICD were supported by a conditional grant from the South African National Department of Health as part of the emergency COVID-19 response, a cooperative agreement between the National Institute for Communicable Diseases of the National Health Laboratory Service and the U.S. Centers for Disease Control and Prevention (grant number 5 U01IP001048-05-00), the African Society of Laboratory Medicine (ASLM) and Africa Centers for Disease Control and Prevention through a sub-award from the Bill and Melinda Gates Foundation grant number INV-018978, the UK Foreign, Commonwealth and Development Office and Wellcome (Grant no 221003/Z/20/Z), the South African Medical Research Council (Reference number SHIPNCD 76756), the UK Department of Health and Social Care, managed by the Fleming Fund and performed under the auspices of the SEQAFRICA project. Furthermore, pandemic surveillance in South Africa and Senegal was supported in part through NIH grant U01 AI151698 for the United World Antiviral Research Network (UWARN). Support for pandemic surveillance from the Tulio de Oliveira group to other African countries is funded by the Rockefeller Foundation. Sequencing efforts in the DRC were funded by the Bill & Melinda Gates Foundation under grant INV-018030 awarded to C.B.P. and further supported by funding from the Africa CDC through the ASLM (African Society of Laboratory Medicine) for Accelerating SARS-CoV-2 Genomic Surveillance in Africa. Sequencing efforts in Rwanda were commissioned by the NIHR Global Health Research program (16/136/33) using UK aid from the UK government (funding to E.M. and N.R. through TIBA partnership) and additional funds from the government of Rwanda through RBC/National Reference Laboratory in collaboration with the Belgian Development Agency (ENABEL) for additional genomic sequencing at GIGA Research Institute–Liege/Belgium. The sequencing effort in Equatorial Guinea was supported by a public-private partnership, the Bioko Island Malaria Elimination Project, composed of the government of Equatorial Guinea Ministries of Mines and Hydrocarbons, and Health and Social Welfare, Marathon EG Production Limited, Noble Energy, Atlantic Methanol Production Company, and EG LNG. Sample collection and typing in Mali were supported by Fondation Merieux–France, and sequence efforts have been supported by the Enable and Enhance Initiative of the German Federal Government’s Security Cooperation against Biological Threats in the G5 Sahel Region. The Nigeria work was made possible by support from Flu Lab and a cohort of generous donors through TED’s Audacious Project, including the ELMA Foundation, MacKenzie Scott, the Skoll Foundation, and Open Philanthropy. Further Nigeria funding came from grants from the NIAID (www.niaid.nih.gov), NIH-H3Africa (https://h3africa.org) (U01HG007480 and U54HG007480), and the World Bank grant (worldbank.org) (ACE IMPACT project) to C.H. Analysis for the Gabon strains was supported by the Science and Technology Research Partnership for Sustainable Development (SATREPS), Japan International Cooperation Agency (JICA), and Japan Agency for Medical Research and Development (AMED) (grant number JP20jm0110013) and a grant from AMED (grant number JP20wm0225003). Sequencing at KEMRI-Wellcome Trust Research Programme site in Kenya was supported by the National Institute for Health Research (NIHR) (project references 17/63/82 and 16/136/33), using UK aid from the UK Government to support global health research, and the UK Foreign, Commonwealth and Development Office and Wellcome Trust (grant# 102975, 220985)., and We acknowledge the authors from the originating laboratories and the submitting laboratories, who generated and shared, via GISAID, the genetic sequence data on which this research is based (table S4). We also acknowledge the contribution of K. Maria from the NGS-SA platform for their contribution toward the sequencing effort in Cape Town, South Africa. Similarly, we thank A. M. Elsaame, S. M. Elsayed, and R. M. Darwish from the Faculty of Medicine Ain Shams Research Institute (MASRI) for their efforts toward sequencing in Egypt. We thank S. Bane, M. Sanogo, D. Diallo, A. Combo Georges Togo, and A. Coulibaly from the University Clinical Research Centre (UCRC) at the University of Sciences, Techniques, and Technologies of Bamako for the contribution they have made toward sequencing efforts in Mali. We acknowledge the contribution of M. Moeti and A. Salam Gueye from the WHO for their contribution toward combating SARS-CoV-2 on the African continent. We further wish to extend acknowledgment to S. Lutucuta and J. Morais from the Angolan Ministry of Health for their continued hard work with regards to SARS-CoV-2 sampling, sequencing, and pandemic response in Angola. From Malawi we wish to acknowledge the work of B. Chilima, B. Mvula, and M. Chitenje from the Malawian Ministry of Health for their work on the COVID-19 response within the country.

Subjects
2019-20 coronavirus outbreak, [SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases, Multidisciplinary, Early introduction, Coronavirus disease 2019 (COVID-19), Transmission (medicine), SARS-CoV-2, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), COVID-19, Genetic Variation, [SDV.BBM.BM]Life Sciences [q-bio]/Biochemistry, Molecular Biology/Molecular biology, Genomics, Left behind, Geography, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Development economics, Pandemic, Africa, Epidemiological Monitoring, [SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology, Humans, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, QH426, RA, Pandemics
Abstract

The progression of the SARS-CoV-2 pandemic in Africa has so far been heterogeneous and the full impact is not yet well understood. Here, we describe the genomic epidemiology using a dataset of 8746 genomes from 33 African countries and two overseas territories. We show that the epidemics in most countries were initiated by importations, predominantly from Europe, which diminished following the early introduction of international travel restrictions. As the pandemic progressed, ongoing transmission in many countries and increasing mobility led to the emergence and spread within the continent of many variants of concern and interest, such as B.1.351, B.1.525, A.23.1 and C.1.1. Although distorted by low sampling numbers and blind-spots, the findings highlight that Africa must not be left behind in the global pandemic response, otherwise it could become a breeding ground for new variants.

Published
2021
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19. Predictors of COVID-19 epidemics in countries of the World Health Organization African Region

Author

Zabulon Yoti, Miranda Ferguson, Giles Calder-Gerver, Francisca Mutapi, Feifei Zhang, Humphrey Karamagi, Gordon A. Awandare, Miles McGibbon, Joseph Cabore, Alistair Morrison, Ngoy Nsenga, Miriam Karinja, Alexandra Huber, Samuel Haynes, Chuan-Guo Guo, Miriam Nanyunja, Margo Chase-Topping, Seth Amanfo, Matshidiso Moeti, Mark E. J. Woolhouse, and Tara Wagner-Gamble

Subjects
Adult, Male, Epidemiology, Population, Disease, World Health Organization, General Biochemistry, Genetics and Molecular Biology, Article, Pregnancy, Pandemic, Per capita, Humans, education, Child, Epidemics, Pandemics, education.field_of_study, Government, SARS-CoV-2, Mortality rate, Infant, Newborn, COVID-19, General Medicine, Health policy, Geography, Socioeconomic Factors, Risk factors, Preparedness, Africa, Observational study, Female, Demography
Abstract

Countries of the World Health Organization (WHO) African Region have experienced a wide range of coronavirus disease 2019 (COVID-19) epidemics. This study aimed to identify predictors of the timing of the first COVID-19 case and the per capita mortality in WHO African Region countries during the first and second pandemic waves and to test for associations with the preparedness of health systems and government pandemic responses. Using a region-wide, country-based observational study, we found that the first case was detected earlier in countries with more urban populations, higher international connectivity and greater COVID-19 test capacity but later in island nations. Predictors of a high first wave per capita mortality rate included a more urban population, higher pre-pandemic international connectivity and a higher prevalence of HIV. Countries rated as better prepared and having more resilient health systems were worst affected by the disease, the imposition of restrictions or both, making any benefit of more stringent countermeasures difficult to detect. Predictors for the second wave were similar to the first. Second wave per capita mortality could be predicted from that of the first wave. The COVID-19 pandemic highlights unanticipated vulnerabilities to infectious disease in Africa that should be taken into account in future pandemic preparedness planning., A new study from the WHO African Region identifies features of countries that predict timing of the first case and the per capita mortality rate for the first and second waves of the COVID-19 epidemics.

Published
2021
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20. Predictors of COVID-19 Epidemics in Countries of the World Health Organisation African Region

Author

Samuel Haynes, Humphrey Karamagi, Zabulon Yoti, Francisca Mutapi, Margo Chase-Topping, Mark E. J. Woolhouse, Feifei Zhang, Matshidiso Moeti, Miranda Ferguson, Giles Calder-Gerver, Joseph Cabore, Miriam Karinja, Tara Wagner-Gamble, Ngoy Nsenga, Seth Amanfo, Chuan-Guo Guo, Miles McGibbon, Alexandra Huber, Miriam Nanyunja, Gordon A. Awandare, and Alistair Morrison

Subjects
Government, education.field_of_study, media_common.quotation_subject, Mortality rate, Population, Geography, Pandemic, Per capita, Observational study, Psychological resilience, education, Demography, Multinomial logistic regression, media_common
Abstract

Background: WHO African Region countries have experienced very different COVID-19 epidemics. This study aimed to identify predictors for the timing of the first COVID-19 case and the per capita mortality rate during the first and second pandemic wave in the region, and to test for any impact of countermeasures. Methods: We performed a region-wide, country-based observational study. Data on COVID-19 cases and deaths for all 47 countries in the WHO African Region were obtained from the WHO COVID-19 Dashboard. A set of predictors classified to nine categories were collected and used as explanatory variables. We applied Cox proportional hazards regression models, generalized linear mixed models and multinomial logistic regression models as appropriate. Findings: Predictors for an earlier first case were a more urban population, high volume of international air travel and more land borders, and better COVID-19 test capacity. Predictors for a high per capita mortality rate during the first wave were a more urban population, more pre-pandemic international air travel and higher prevalence of HIV. The stringency and timing of government restrictions on behaviour were not associated with a lower per capita mortality rate in the first wave. A more urban population and a higher infectious disease resilience score were associated with more stringent restrictions and/or a higher per capita mortality rate in the first wave. The predictor set for the second wave was similar, and first wave per capita mortality predicted that in the second wave. These results were not altered when measures of national testing effort were included in the models. Interpretation: COVID-19 in Africa arrived earlier and caused greater mortality in countries with more international travel and a more urban population. Mortality was exacerbated by high HIV prevalence; it is not clear whether this is a direct or indirect effect. Countries that were better prepared and judged to have more resilient health systems were worst affected, both by the disease and by the imposition of restrictions. The COVID-19 pandemic highlights unanticipated vulnerabilities to infectious disease in Africa. Funding Statement: National Institute for Health Research, Darwin Trust of Edinburgh Declaration of Interests: The authors disclose no conflicts of interest.

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

Author

Ngoy Nsenga, Joseph Cabore, Benido Impouma, Abdou Salam Gueye, Richard Mihigo, Krys Johnson, Caitlin M. Wolfe, Zabulon Yoti, Ambrose Talisuna, Franck Mboussou, Catherine Clary, Antoine Flahault, Olivia Keiser, Matshidiso Moeti, and Bridget Farham

Subjects
2019-20 coronavirus outbreak, Time Factors, Coronavirus disease 2019 (COVID-19), SARS-CoV-2, Epidemiology, business.industry, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), COVID-19, Comorbidity, World Health Organization, African region, Pandemic response, Virology, Public health and social measures, pandemic response, Infectious Diseases, Risk Factors, Africa, Pandemic, Humans, Short Paper, Medicine, public health and social measures, business, ddc:613
Abstract

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.

Published
2021
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22. The toll of COVID-19 on African children: A descriptive analysis on the COVID-19-related morbidity and mortality among the pediatric population in Sub-Saharan Africa

Author

Velásquez, Sabina Rodriguez, primary, Jacques, Léa, additional, Dalal, Jyoti, additional, Sestito, Paolo, additional, Habibi, Zahra, additional, Venkatasubramanian, Akarsh, additional, Nguimbis, Benedict, additional, Mesa, Sara Botero, additional, Chimbetete, Cleophas, additional, Keiser, Olivia, additional, Impouma, Benido, additional, Mboussou, Franck, additional, William, George Sie, additional, Ngoy, Nsenga, additional, Talisuna, Ambrose, additional, Gueye, Abdou Salam, additional, Hofer, Cristina Barroso, additional, and Cabore, Joseph Waogodo, additional

Published
2021
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23. Intra Action Review of the COVID-19 Pandemic Response in Africa: Best Practices, Challenges, and Perspectives for the Future

Author

Talisuna, Ambrose Otau, primary, Iwu-Jaja, Chinwe Juliana, additional, Okeibunor, Joseph, additional, Stephen, Mary, additional, Onuche, Emmanuel Musa, additional, Herring, Belinda Louise, additional, Otim, Patrick Ramadan, additional, Yota, Daniel, additional, Nanyunja, Miriam, additional, Mpairwe, Allan, additional, Banza-Mutoka, Freddy, additional, Diallo, Bailo Amadu, additional, Wango, Roland, additional, Massidi, Christian, additional, Njenge, Hilary Kagume, additional, Traore, Martin, additional, Antonio, Oke, additional, Bonkoungou, Boukare, additional, Mayigane, Landry Ndriko, additional, Conteh, Ishata Nannie, additional, Senait, Fekadu, additional, Chungong, Stella, additional, Mpouma, Benido, additional, Ngoy, Nsenga, additional, Wiysonge, Charles Shey, additional, Yoti, Zabulon, additional, and Gueye, Abdou Salam, additional

Published
2021
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24. Using evidence to inform response to the 2017 plague outbreak in Madagascar: a view from the WHO African Regional Office

Author

Ibrahima Socé Fall, Benido Impouma, Boubacar Diallo, Ngoy Nsenga, Charles Okot Lukoya, K Heitzinger, Mamoudou Harouna Djingarey, Esther L Hamblion, L A Rakotonjanabelo, Bridget Farham, C Machingaidze, Michel Yao, and C F Ndiaye

Subjects
0301 basic medicine, Economic growth, medicine.medical_specialty, Epidemiology, Public health, 030106 microbiology, Psychological intervention, Outbreak, Qualitative property, Plague (disease), Article, 03 medical and health sciences, 0302 clinical medicine, Infectious Diseases, Geography, medicine, Christian ministry, 030212 general & internal medicine
Abstract

The 2017 plague outbreak in Madagascar was unprecedented in the African region, resulting in 2417 cases (498 confirmed, 793 probable and 1126 suspected) and 209 deaths by the end of the acute urban pneumonic phase of the outbreak. The Health Emergencies Programme of the WHO Regional Office for Africa together with the WHO Country Office and WHO Headquarters assisted the Ministry of Public Health of Madagascar in the rapid implementation of plague prevention and control measures while collecting and analysing quantitative and qualitative data to inform immediate interventions. We document the key findings of the evidence available to date and actions taken as a result. Based on the four goals of operational research – effective dissemination of results, peer-reviewed publication, changes to policy and practice and improvements in programme performance and health – we evaluate the use of evidence to inform response to the outbreak and describe lessons learned for future outbreak responses in the WHO African region. This article may not be reprinted or reused in any way in order to promote any commercial products or services.

Published
2018

25. Additional file 1: of What should the African health workforce know about disasters? Proposed competencies for strengthening public health disaster risk management education in Africa

Author

Olushayo Olu, Abdulmumini Usman, Kalula Kalambay, Anyangwe, Stella, Kuku Voyi, Orach, Christopher, Aklilu Azazh, Mapatano, Mala, Ngoy Nsenga, Manga, Lucien, Woldetsadik, Solomon, Francois Nguessan, and Benson, Angela

Subjects
ComputingMilieux_GENERAL, ComputingMilieux_LEGALASPECTSOFCOMPUTING
Abstract

Health DRM core competencies, sub-competencies and learning objectives. (DOCX 39 kb)

Published
2018
Full Text
View/download PDF

26. Additional file 3: of What should the African health workforce know about disasters? Proposed competencies for strengthening public health disaster risk management education in Africa

Author

Olushayo Olu, Abdulmumini Usman, Kalula Kalambay, Anyangwe, Stella, Kuku Voyi, Orach, Christopher, Aklilu Azazh, Mapatano, Mala, Ngoy Nsenga, Manga, Lucien, Woldetsadik, Solomon, Francois Nguessan, and Benson, Angela

Abstract

Proposed public health DRM training modules. (DOCX 23 kb)

Published
2018
Full Text
View/download PDF

27. Additional file 2: of What should the African health workforce know about disasters? Proposed competencies for strengthening public health disaster risk management education in Africa

Author

Olushayo Olu, Abdulmumini Usman, Kalula Kalambay, Anyangwe, Stella, Kuku Voyi, Orach, Christopher, Aklilu Azazh, Mapatano, Mala, Ngoy Nsenga, Manga, Lucien, Woldetsadik, Solomon, Francois Nguessan, and Benson, Angela

Subjects
ComputingMilieux_GENERAL, ComputingMilieux_COMPUTERSANDEDUCATION, ComputingMilieux_LEGALASPECTSOFCOMPUTING
Abstract

Curriculum for basic, intermediate and advanced training in health DRM. (DOCX 38 kb)

Published
2018
Full Text
View/download PDF

28. What Should an African Health Workforce Know About Disasters? Proposed Competencies for Strengthening Public Health Disaster Risk Management Education in the African Region

Author

Angela Benson, Francois Nguessan, Aklilu Azazh, Olushayo Olu, Lucien Manga, Kalula Kalambay, Mala Ali Mapatano, Abdulmumini Usman, Kuku Voyi, Christopher Garimoi Orach, Solomon Fisseha Woldetsadik, Ngoy Nsenga, and Stella Anyangwe

Subjects
medicine.medical_specialty, Economic growth, business.industry, Environmental health, Public health, Workforce, Emergency Medicine, medicine, Business, Emergency Nursing, Risk management
Published
2017
Full Text
View/download PDF

29. Review of preparedness and readiness for Ebola virus disease in South Sudan by joint monitoring missions: progress, successes, challenges and the way forward.

Author

Huda, Qudsia, Olu, Olushayo, Chungong, Stella, Yahaya, Ali Ahmed, Ngoy, Nsenga, Conteh, Ishata, Yeneabat, Ayana, Udenweze, Ifeanyi, Choupe, Luc Tsachoua, and Warren, Taylor

Subjects
*EBOLA virus disease, *EPIDEMICS, *EXERCISE, *HEALTH planning, *PUBLIC health surveillance, *RISK assessment, *DISEASE management, *DISEASE risk factors, TREATMENT of Ebola virus diseases
Abstract

The article reports on the progress, successes, and challenges on preparedness and readiness for Ebola virus disease (EVD) in South Sudan by joint monitoring missions. Highlights include Ebola virus disease checklist in South Sudan from November 2018 to March 2019, challenges to EVD readiness, and South Sudan's plan to build on the strengths of the national and sub-national health system within the framework of the International Health Regulations.

Published
2019

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