Crimean Congo Hemorrhagic Fever Virus and Alkhurma (Alkhumra) Virus in Ticks in Djibouti.

Crimean Congo hemorrhagic fever virus and Alkhumra virus, not previously reported in Djibouti, were detected among 141 (infection rate = 15.7 per 100, 95% CI: 13.4-18.1) tick pools from 81 (37%) cattle and 2 (infection rate = 0.2 per 100, 95% CI: 0.0-0.7) tick pools from 2 (1%) cattle, respectively, collected at an abattoir in 2010 and 2011

Preliminary Step towards COVID-19 Inactivated Vaccine Development in Egypt.

International audienceThe current worldwide COVID-19 pandemic is causing severe human health problems, with high mortality rates and huge economic burdens requiring the urgent development of a safe and effective vaccine. Here, preclinical evaluation of an inactivated SARS-CoV-2 vaccine candidate (EgySerVac-20) is reported. Oropharyngeal swabs and nasopharyngeal aspirates obtained from Egyptian patients with laboratory-confirmed SARS-CoV-2 infection were isolated using Vero cells and were then genetically characterized. Vaccine inactivation was performed using diluted formaldehyde, followed by safety testing for the inactivated vaccine. To determine the high humoral immune responses against SARSCOV-2 infection, the safety and capacity of the vaccine prepared with alum adjuvant were tested. The immunogenicity and efficacy of the vaccine candidate was tested in vitro by a neutralization assay and in vivo using mouse models. Our results revealed a cytopathic effect which was observed 48 hours post infection and the viral particles were identified by rRT-PCR as SARS-CoV-2. Propagation of the isolated virus in ten serial passages on the Vero cells yielded a virus titer 7.5 log10 TCID50/ml. Complete inactivation of SARS-CoV-2 was observed at 37°C in 24 hours post treatment by diluted formaldehyde. Inactivated SARS-CoV-2 infected fluid safety was determined by absence of cytopathic effect by repeated passage in Vero cell line, indicating loss of virus infectivity. Virus inactivated by diluted formaldehyde showed no deaths or clinical symptoms in mice groups post intraperitoneal inoculation (0.5ml/mouse). EgySerVac-20 inactivated vaccine has safely induced high levels of neutralizing antibodies titers in mice, where 0.1 ml immunization dose showed protective efficacy against SARS-CoV-2 challenge in mice. This finding will support the future preclinical and clinical trials evaluation for our SARS-CoV-2 vaccine candidate in primates and human, respectively

Global economic burden of unmet surgical need for appendicitis

Background There is a substantial gap in provision of adequate surgical care in many low- and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially

Global economic burden of unmet surgical need for appendicitis

Background There is a substantial gap in provision of adequate surgical care in many low- and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially