Community-Based Assessment of People with Chronic Diseases and Conditions Worsening the Severity of COVID-19 in Addis Ababa City Administration

AbstractBackground: the COVID-19 pandemic stayed in a sporadic form for a long time after introducing the coronavirus in the country, later appearing in clusters within communities. During such sporadic and clustered spread of the disease, the government of Ethiopia started identifying suspects through active surveillance for COVID-19. This study aimed to describe people who have chronic illnesses that could be underlying conditions for increased severity of COVID-19.Methods: A survey was conducted in May 2020 using active community-based case surveillance in 30 randomlyselected woredas in Addis Ababa City. Data were collected from each household member by assessing for general conditions and diseases expected to increase their risk of suffering higher severity from COVID-19. Data were stored in M.S. Excel and analyzed using SPSS-version 26 for windows. Descriptive analysis was conducted to know the proportion of persons with chronic diseases, and thus the population with a higher risk of suffering more severity from COVID-19 by place, person, and time. The results are presented using tables and graphs as appropriate.Results: The point prevalence of flu-like syndrome was 51.9 per 100,000 persons, and the prevalence was higher among older people. The study showed that 11,600 per 100,000 households have at least a member with chronic diseases that worsen the severity of COVID-19 morbidity. The survey also found 6,939 and 5,140 households per 100,000 households have diabetes mellitus and hypertension, respectively, and about 1950 per 100,000 households were with bronchial asthma. Nearly a quarter of the households have people with two or more chronic diseases that worsen their risk of facing a more severe course of COVID-19 than it would be for people without those underlying conditions.Discussion: High proportion of households have people with chronic diseases that worsen their risk of suffering a more severe course of COVID-19 than it would be for people without those underlying conditions. The Ministry of Health should devise and implement mechanisms to safeguard people with chronic diseases from contracting the diseases. [Ethiop. J. Health Dev. 2021; 35(2):133-140]Keywords: COVID-19, chronic diseases, severe course of COVID-19, Addis Abab

Active case detection and treatment of malaria in pregnancy using LAMP technology (LAMPREG): a pragmatic randomised diagnostic outcomes trial—study protocol

Introduction Malaria is one of the major public health problems in sub-Saharan Africa. It contributes significantly to maternal and fetal morbidity and mortality in affected countries. This study aims to evaluate the impact of enhanced case detection using molecular testing called loop-mediated isothermal amplification (LAMP) on birth outcomes in a prospective study design.Methods and analysis A pragmatic randomised diagnostic outcomes trial will be conducted in several health institutes in different Ethiopian regions. Women (n=2583) in their first and second trimesters of pregnancy will be included in the study and individually randomised to the standard of care or enhanced case detection arms, and followed until delivery. Enrolment will encompass the malaria peak transmission seasons. In the standard of care arm, a venous blood sample will be collected for malaria diagnosis only in symptomatic patients. In contrast, in the intervention arm, mothers will be tested by a commercially available Conformité Européene (CE)-approved LAMP malaria test, microscopy and rapid diagnostic test for malaria regardless of their symptoms at each antenatal care visit. The primary outcome of the study is to measure birth weight.Ethics and dissemination The study was approved by the following ethical research boards: Armauer Hansen Research Institute/ALERT Ethics Review Committee (FORM AF-10-015.1, Protocol number PO/05/20), the Ethiopia Ministry of Science and Higher Education National Research Ethics Review Committee (approval SRA/11.7/7115/20), the Ethiopia Food and Drug Administration (approval 02/25/33/I), UCalgary Conjoint Health Research Ethics Board (REB21-0234). The study results will be shared with the institutions and stakeholders such as the Ethiopia Ministry of Health, the Foundation for Innovative Diagnostics, WHO’s Multilateral initiative on Malaria - Tropical Diseases Research (TDR-MIM), Roll Back Malaria and the Malaria in Pregnancy Consortium. The study results will also be published in peer-reviewed journals and presented at international conferences.Trial registration number NCT03754322

Scripture and reform

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