COVID-19 risk factors among health workers: A rapid review

Coronavirus disease 2019 (Covid-19) poses an important occupational health risk to health workers (HWs) that has attracted global scrutiny. To date, several thousand HWs globally have been reported as infected with the severe acute respiratory syndrome coronavirus 2 virus that causes the disease. It is therefore a public health priority for policymakers to understand risk factors for this vulnerable group to avert occupational transmission. A rapid review was carried out on 20 April 2020 on Covid-19 risk factors among HWs in PubMed, Google Scholar, and EBSCOHost Web (Academic Search Complete, CINAHL Complete, MEDLINE with Full Text, CINAHL with Full Text, APA PsycInfo, Health Source—Consumer Edition, Health Source: Nursing/Academic Edition) and WHO Global Database. We also searched for preprints on the medRxiv database. We searched for reports, reviews, and primary observational studies (case control, case cross-over, cross-sectional, and cohort). The review included studies conducted among HWs with Covid-19 that reported risk factors irrespective of their sample size. Eleven studies met the inclusion criteria. Lack of personal protective equipment, exposure to infected patients, work overload, poor infection control, and preexisting medical conditions were identified as risk factors for Covid-19 among HWs. In the context of Covid-19, HWs face an unprecedented occupational risk of morbidity and mortality. There is need for rapid development of sustainable measures that protect HWs from the pandemi

Towards virtual doctor consultations: A call for the scale-up of telemedicine in sub-Saharan Africa during COVID-19 lockdowns and beyond

The outbreak of COVID-19 has resulted in adoption and implementation of mitigatory policies, including movement restrictions (lockdowns) to curb its spread. These lockdowns have brought unintended consequences such as increasing the inequalities in health delivery. In the context of these restrictions, telemedicine provides an opportunity for continuation of essential health care provision. This review aimed to map available literature on the current status of telemedicine in sub-Saharan Africa to proffer recommendations for scale up during COVID-19 and beyond. Our review highlighted the lack of meaningful investment in the area. The literature identified resistance to telemedicine, infrastructural barriers, and the lack of policy and budgetary support as main deterrents to current implementation. We recommend the region to leverage on the rapid expansion of internet and telecommunication in addition to adopting a mix of strategies to set up an infrastructure for providing scale up of telemedicine and overcome barriers to implementation. There is an urgent need for policy formulation and the provision of budgetary support through sustainable business models

Digital technologies and COVID-19 : reconsidering lockdown exit strategies for Africa

Widespread vaccination provides a means for countries to lift strict COVID-19 restrictions previously imposed to contain the spread of the disease. However, to date, Africa has secured enough COVID-19 vaccine doses for less than 5% of its population. With widespread vaccination not on the horizon for Africa, there is a strong emphasis on non-pharmaceutical interventions which include movement restrictions (lockdowns). This general COVID-19 pandemic response of imposing lockdowns, however, neglects to factor in non-fatal consequences leading to disruption socio-economic wellbeing of the society at large. The economy in most African countries can no longer sustain lockdown restrictions. Some studies have indicated that a hard lockdown statistical value of the extra lives saved would be dwarfed by its long-term cost. At the same time not responding to the threat of the pandemic will cost lives and disrupts the social fabric. This paper proffers ways to mitigate the both and advocate for better policymaking that addresses specific challenges in defined communities thus yield higher population welfare.https://www.panafrican-med-journal.compm2021School of Health Systems and Public Health (SHSPH

Stigma and public health responses : lessons learnt from the COVID-19 pandemic to inform the recent monkeypox outbreak

Monkeypox is a zoonotic disease caused by the monkeypox virus, and first reported in the Democratic Republic of the Congo in 1970. An outbreak of the monkeypox is currently ongoing, the first case was reported to the World Health Organization (WHO) on 7 May 2022. Most of the cases have been identified in young men, self-identifying as men who have sex with men (MSM). Since most reported monkeypox cases in humans in the developed world have been reported in MSM, this may result in the perception in some quarters that it’s a disease associated with this key population group. This may result in increased stigma being directed to MSM. Similar perceptions existed at the advent of HIV, which were later proven incorrect as HIV is readily transmissible between heterosexuals. Some recent public and media coverage has generated homophobic and racist stereotypes that have brought attention to MSM fueling stigma and discrimination towards an already marginalized group. Disease outbreaks often breed fear and distress among populations and have historically been accompanied by stigma, discrimination, and homophobia.https://www.sciencedirect.com/journal/public-health-in-practiceam2023School of Health Systems and Public Health (SHSPH

Implementation of public health genomics in Africa : lessons from the COVID-19 pandemic, challenges, and recommendations

DATA AVAILABILITY STATEMENT : Data sharing not applicable to this article as no data sets were generated or analysed during the current study.Public Health Genomics (PHG) is a relatively new field. The wide application of genomic technologies played a pivotal role in elucidating the full genomic sequence of the SARS-CoV-2 virus. This breakthrough proved to be the starting point in the manufacture of diagnostic kits and the subsequent making of vaccines. Beyond the COVID-19 pandemic, many African countries can take advantage of the various investments in genomic technologies to introduce and intensify the use of genomics for public health gain. Public Health Genomics effectively monitors, prevents, and manages non-communicable and infectious diseases. However, there are several challenges to implementing PHG in Africa. In this perspective article, we discuss the utilization of PHG during the COVID-19 pandemic, the lessons learned from using PHG to manage and contain the COVID-19 pandemic, as well as potential challenges Africa may face when putting PHG into practice compared to challenges of other regions. We also discuss our recommendations for overcoming these challenges.https://wileyonlinelibrary.com/journal/jmv2023-11-11hj2023School of Health Systems and Public Health (SHSPH

Implementing HPV-DNA screening as primary cervical cancer screening modality in Zimbabwe : challenges and recommendations

The World Health Organisation’s 90–70–90 cancer strategy is premised upon the implementation of human papillomavirus deoxyribonucleic acid (HPV-DNA) testing as the primary cervical cancer screening modality. The ultimate aim is to reduce the age-standardized incidence of cervical cancer to less than 4 per 100 000 by the end of the 21st century and eliminate the disease as a significant global health concern. Zimbabwe, like other countries in sub-Saharan Africa, has a high burden of cervical cancer, with data from the Zimbabwe National Cancer Registry showing that cervical cancer is the leading cause of cancer deaths among women. This is despite visual inspection of the cervix with acetic acid (VIA) and cytology being available as screening modalities. These programs have suffered several implementation challenges, and the success of implementing HPV-DNA screening programs will depend partly on addressing the challenges that have been faced by these pre-existing programs. Additionally, other challenges unique to HPVDNA testing must be anticipated with adequate measures put in place to avert these potential challenges. This calls for a close collaboration between academia, clinicians, public health stakeholders, policymakers, and implementing partners to ensure the success of the program and avert cervical cancer deaths.https://www.elsevier.com/locate/sciafam2024School of Health Systems and Public Health (SHSPH)SDG-03:Good heatlh and well-bein

Burnout among healthcare workers during public health emergencies in sub-Saharan Africa : contributing factors, effects, and prevention measures

Countries in sub-Saharan Africa (SSA) are expected to experience more public health emergencies (PHEs) in the near future. The fragile health systems emanating from poor health governance, inadequate health infrastructure, shortage of healthcare workers (HCWs), inadequate essential medicines and technology, and limited funding will make responses to these outbreaks slow and ineffective as seen with the COVID-19 pandemic. The workload for HCWs will grow due to these PHEs, which will increase the likelihood that they may experience burnout. This narrative review loosely followed the guidelines provided in the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA-P) statement. Google Scholar, PubMed, and ScienceDirect databases were used to retrieve relevant articles. Two reviewers assessed the titles and abstracts of all identified articles and extracted the data independently and compared their results thereafter. The causes of burnout among HCWs, its impact on patients, HCWs, and healthcare institutions, as well as preventive steps that should be taken to safeguard HCWs from burnout, are all covered in this article.http://www.elsevier.com/locate/hfham2024School of Health Systems and Public Health (SHSPH)SDG-03:Good heatlh and well-bein

Limited syphilis testing for key populations in Zimbabwe : a silent public health threat

In this article, the authors discuss the problem of high prevalences of active syphilis amongst key populations (KPs) in Zimbabwe, in combination with low testing rates, partly because of a difficult legal and social environment for these populations. The article highlights the need to develop strategies to address the high prevalence of syphilis amongst KPs. The authors discuss requirements for addressing deficits in existing clinical services, predominantly primary care settings, in providing primary healthcare, including sexually transmitted infection (STI) management, to Zimbabwe’s KP communities and utility of point-of-care testing and self-testing and other innovations to improve testing uptake.https://sajid.co.za/index.php/sajiddm2022School of Health Systems and Public Health (SHSPH

Mapping evidence on the acceptability of human papillomavirus self-sampling for cervical cancer screening among women in sub-Saharan Africa : a scoping review

DATA AVAILABILITY STATEMENT : All data relevant to the study are included in the article or uploaded as online supplemental information. Data sharing not applicable as no data sets were generated and/or analysed for this study. All data underlying the results are available as part of the article and no additional source data are required.OBJECTIVES : The objective of this scoping review was to map evidence on the acceptability of self-sampling for human papillomavirus testing (HPVSS) for cervical cancer screening among women in the sub-Saharan Africa region. DESIGN : Scoping review. METHODS : Using Arksey and O’Malley’s framework, we searched Scopus, PubMed, Medline Ovid, Cochrane and Web of Science databases for evidence on the acceptability of HPVSS among women aged 25 years and older published between January 2011 and July 2021. We included studies that reported evidence on the acceptability of HPVSS for cervical cancer screening. Review articles and protocols were excluded. We also searched for evidence from grey literature sources such as dissertations/theses, conference proceedings, websites of international organisations such as WHO and relevant government reports. Two reviewers independently performed the extraction using a pre-designed Excel spreadsheet and emerging themes were narratively summarised. RESULTS : The initial search retrieved 1018 articles. Of these, 19 articles were eligible and included in the review. The following themes emerged from the included articles: acceptability of HPVSS; lack of self-efficacy to perform HPVSS, complications when performing HPVSS, preferences for provider sampling or assistance; setting of HPVSS; HPVSS by vulnerable populations. CONCLUSION : Evidence shows that HPVSS is highly acceptable for cervical cancer screening in sub-Saharan Africa. Further research exploring the acceptability of HPVSS among women residing in rural areas is required, as well as studies to determine women’s preferences for HPVSS intervention including the preferred type of sampling devices. Knowledge on the acceptability and preferences for HPVSS is important in designing women-centred interventions that have the potential to increase screening coverage and participation in cervical cancer screening programmes.http://bmjopen.bmj.comam2024School of Health Systems and Public Health (SHSPH)SDG-03:Good heatlh and well-bein

Co-creation of human papillomavirus self-sampling delivery strategies for cervical cancer screening in rural Zimbabwe: nominal group technique

DATA AVAILABILITY STATEMENT : The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation.BACKGROUND : Human papillomavirus (HPV) self-sampling is recommended for cervical cancer screening, particularly among women who do not participate in or have access to current screening methods offered in Zimbabwe. Key stakeholder involvement is critical in co-creating acceptable delivery strategies for implementing HPV self-sampling to ensure demand and facilitate uptake by the target population. Themain objective of this study was to engage key stakeholders in co-creating acceptable HPV self-sampling delivery strategies for cervical cancer screening in rural Zimbabwe. METHODS : We invited key stakeholders and employed a nominal group technique (NGT) for data collection. We employed the NGT to (1) identify barriers to access and utilisation of available cervical cancer screening services and (2) co-create delivery strategies for HPV self-sampling. The workshop included 8 participants (women n = 4, health workers n = 2 and policymakers n = 2). Quantitative data was gathered by ranking ideas and qualitative data were collected fromparticipant group discussions and analysed thematically. The results of the ranking exercise were fed back to the participants for comments. RESULTS : The most significant barriers to accessing and utilising current cervical cancer screening services by women were: Inadequate information and education on cervical cancer, lack of resources and funding for cervical cancer programmes, long distances to nearest health facilities, and low perceived personal risk of cervical cancer. Key stakeholders recommended enhanced education and awareness, results notification, linkage to care, community-based self-sampling, and the choice of sampling devices as potential HPV self-sampling delivery strategies. CONCLUSION : Our study demonstrated the utility of the NGT for reaching a consensus. Using the NGT, we established priority delivery strategies for HPV self-sampling cervical cancer screening. Adequate education and awareness, early results notification, choice of sampling device and community-based self-sampling were crucial to HPV self-sampling screening in rural Zimbabwe. The proposed delivery strategies can guide the development of guidelines for designing and implementing an HPV self-sampling intervention.We recommend a study to determine women’s most preferred HPV self-sampling delivery strategies before implementing the intervention.https://www.frontiersin.org/journals/public-health#am2024School of Health Systems and Public Health (SHSPH)Non