18 research outputs found
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
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
COVID‑19 Lockdowns: Impact on facility‑based HIV testing and the case for the scaling up of home‑based testing services in Sub‑Saharan Africa
In December 2019, China reported the emergence of a pneumonia of unknown cause in Wuhan [1]. By 7 January 2020, the etiology of the pneumonia was attributed to a virus of the coronavirus family, and later on the disease was named coronavirus disease (COVID-19) on 11 February 2020 by the WHO [2, 3]. The symptoms of COVID-19 appear after an average incubation period of 5.2 days [1]
Covid-19 prevalence among healthcare workers. A systematic review and meta-analysis
Understanding the burden of SARS-CoV-2 infections among healthcare workers is a critical
component to inform occupational health policy and strategy. We conducted a systematic review and
meta-analysis to map and analayse the available global evidence on the prevalence of SARS-CoV-2
infections among healthcare workers. The random-effects adjusted pooled prevalence of COVID-19
among those studies that conducted the test using the antibody (Ab) method was 7% [95% CI: 3
to 17%]. The random-effects adjusted pooled prevalence of COVID-19 among those studies that
conducted the test using the PCR method was 11% [95% CI: 7 to 16%]. We found the burden of
COVID-19 among healthcare workers to be quite significant and therefore a cause for global health
concern. Furthermore, COVID-19 infections among healthcare workers affect service delivery through
workers’ sick leave, the isolation of confirmed cases and quarantine of contacts, all of which place
significant strain on an already shrunken health workforc
Estimating the budget impact of adopting tenofovir/emtricitabine for pre-exposure prophylaxis of HIV in the public health sector in Namibia (2021 – 2023)
Namibia started implementing pre-exposure prophylaxis (PrEP) of Human
Immunodeficiency Virus (HIV) in 2016, no study to determine its budget impact has been conducted. This
study, therefore, aimed to estimate the budget impact of adopting tenofovir/emtricitabine for PrEP of HIV
for all eligible people in the public health sector in Namibia from 2021 to 2023.
Methods: A country-specific model was developed for this budget impact analysis (BIA). PrEP has targeted
all eligible people in Namibia who receive health services from the public sector. It was assumed that the
adherence rate was 75% and PrEP effectiveness 60% in this study. Costs used in this study were taken from a
study that included Namibian costs
Risk factors for Covid-19 infection among healthcare workers. A first report from a living systematic review and meta-analysis
Health care workers (HCWs) are more than ten times more likely to be infected with coronavirus in-
fectious disease 2019 (COVID-19) than the general population, thus demonstrating the burden of COVID-
19 among HCWs. Factors that expose HCWs to a differentially high-risk of COVID-19 acquisition are
important to elucidate, enable appropriate public health interventions to mitigate against high risk and
reduce adverse outcomes from the infection. We conducted a systematic review and meta-analysis to
summarize and critically analyze the existing evidence on SARS-CoV-2 risk factors among HCWs. With
no geographical limitation, we included studies, in any country, that reported (i) the PCR laboratory
diagnosis of COVID-19 as an independent variable (ii) one or more COVID-19 risk factors among HCWs
with risk estimates (relative risk, odds ratio, or hazard ratio) (iii) original, quantitative study design, and
published in English or Mandarian
Utility of telemedicine in sub-Saharan Africa during the COVID-19 pandemic. A rapid review
Telemedicine is the use of technology to achieve remote care. This review looks at
the utility of telemedicine during the pandemic, period March 2020 to February
2021. Eleven articles met inclusion criteria. There was moderate use of telemedicine
in sub-Sahara Africa during the pandemic, however, there were also some limitations.
Benefits of telemedicine include continuing medical service provision, connecting relatives with loved ones in quarantine, education, and awareness of mental health
issues, and toxicovigilance and infection control. Challenges to the implementation of
telemedicine on the continent were lack of supporting telemedicine framework and
policies, digital barriers, and patient and healthcare personnel biases. To address
these challenges, this article proposes the development of policy frameworks that
fosters telemedicine use by all stakeholders, including medical insurance organizations, the introduction of telemedicine training of medical workers, educational
awareness programs for the public, and improvement of digital platforms access and
affordability
COVID-19 rapid response in a limited resource setting (notes from the field): Chinhoyi Provincial Hospital, Mashonaland West Province, Zimbabwe
COVID-19 has impacted health systems globally with varying impacts across regions. In Zimbabwe, a country with perennial problems of shortage of healthcare workers and resources, the pandemic has caused substantial strain on the public health system. The ability to share experiences on what has worked and what has not can be valuable as scientists, policymakers, and others determine steps forward and reflect backward to determine lessons learned in the pandemic response. We describe the setup and function of a COVID-19 rapid response team in the context of a limited resource setting. The response had to be tailored to make maximal use of the resources available and manage the outbreak. In this article, we share notes from the field and discuss the process of setting up a rapid response protocol in a limited resource provincial hospital, the challenges encountered, improvised interventions and recommendations for managing a COVID-19 resurgence and future similar pandemics
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
Risk factors for COVID-19 among healthcare workers. A protocol for a systematic review and meta-analysis
Evidence on the spectrum of risk factors for infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) among front-line healthcare workers (HCWs) has not been well-described. While several studies evaluating the risk factors associated with SARS-CoV-2 infection among patient-facing and non-patient-facing front-line HCWs have been reported since the outbreak of the coronavirus disease in 2019 (COVID-19), and several more are still underway. There is, therefore, an immediate need for an ongoing, rigorous systematic review that continuously assesses the risk factors of SARS-CoV-2 infection among front-line HCWs.Here, we outline a protocol to serve as a guideline for conducting a living systematic review
and meta-analysis to examine the burden of COVID-19 on front-line HCWs and identify risk
factors for SARS-CoV-2 infection in patient-facing and non-patient-facing front-line HCWs