An Exploration of COVID-19 Management Policies across Nine African Countries

Background: The Coronavirus disease 2019 (COVID-19) has registered more than 16 million cases and has been declared a global pandemic. Social distancing measures have been recommended as part of health policies aimed at reducing the transmission of the disease. These have resulted in adverse social and economic implications; many countries are therefore discussing exit strategies for the relaxation of COVID-19 restrictions.Aim: To explore the COVID-19 management policies and their outcomes among 9 African countries in order to guide the upcoming and ongoing relaxation of containment and mitigation measures.Methods: Daily COVID-19 statistics were obtained from the World Health Organization between12th March 2020 and 17th July 2020). Data on government policies was obtained from the Human Data Exchange Program between 20th January 2020 and 24th July 2020, a service operated by the United Nations Office for the Coordination of Humanitarian Affairs (OCHA). Data analysis was conducted using the Python (version 3) programming language modules: Pandas, NumPy, Matplotlib, Seaborn and SciPy.Results: The most common containment and mitigation measures were under the categories of; health systems strengthening, enhanced detection measures, implementation of quarantine measures, movement restrictions and social distancing. Countries with low cases and low deaths prioritised social distancing and movement restriction policies, while countries with high cases and high deaths focused on quarantines, closures of public places and borders and public communication. High cases with low death areas implemented health systems strengthening, social distancing, detection and logistics/ security improvement. Low cases with high death countries focused on public communication and improved detection measures.Conclusion: The current study found that social distancing measures remain an effective method of controlling COVID-19. However, coordination between government and organisations to develop social distancing protocols within businesses and specialist organisations such as the military, prisons, educational facilities and the transport industry was observed in countries with better control of the diseas

Socio economic scenarios : key socio economic considerations

This brief presentation outlines socio-economic factors linked to climate change and climate change mitigation: the nature of economic growth; global population and rate of population growth; technological considerations; homogenization of the world through capacity building

Climate change impacts on urban development in Africa

This brief presentation outlines climate impacts on urban areas. More than 50 % of the population are concentrated in fertile coastal lowlands. Sea level rise associated with climate change will lead to out-migration. Wetlands and river valleys are popular sites for informal settlements, and are subject to damage during climate extremes, especially during floods linked to climate change

A multi-methods study of the factors influencing the adoption of proprotein convertase subtilisin/kexin-type 9 (PCSK9) inhibitors

Introduction A new class of lipid lowering agent Proprotein Convertase Subtilisin/Kexin Type 9 inhibitors (PCSK9) was launched in 2015 for the treatment of heterozygous familial hypercholesterolemia (HeFH) in combination with statin therapy. There appeared to be a relatively slow uptake of PCSK9 inhibitors. The first aim of the study was to examine clinical attributes associated with reduction in low-density lipoproteins cholesterol (LDLC) among HeFH patients, while the second aim was to explore the factors influencing the use of PCSK9 inhibitors in clinical practice. Methods The quantitative phase of the study used logistic regression to investigate HeFH clinical attributes from the Clinical Practice Research Datalink (CPRD) database (n=5134) in relation to a final LDLC level of 5 mmol/l; which is the threshold for PCSK9 inhibitor eligibility for HeFH. The qualitative phase of the project involved 17 in-depth semi structured interviews to explore stakeholder perceptions of the factors influencing the use of PCSK9 inhibitors. Results LDLC levels featured prominently in the results of both phases of the study. Quantitative analysis showed that 18% of HeFH patients did not meet the 5mmol/l threshold for PCSK9 inhibitor eligibility even though they did not achieve the guideline recommended treatment target of 50% LDLC reduction with statin therapy. Lipid consultants perceived the eligibility threshold as an inhibitor of prescription in these cases. There was also an issue with LDLC levels not being recorded; 48% of HeFH patients in the CPRD dataset did not have a record of LDLC. In the clinical setting, this had the effect of delaying PCSK9 inhibitor prescription when evidence of multiple LDLC readings meeting the prescription threshold was required. In primary care, GPs suggested that nurses could increase the recording of LDLC records because they had first contact with patients while performing health checks. Overall, low awareness of HeFH was associated with low rates of referral to secondary care for PCSK9 inhibitor consideration. Facilitators of PCSK9 inhibitor use included support from pharmaceutical companies who provided educational material for PCSK9 inhibitor use. Patients were also perceived to engage with treatment when they understood that HeFH could cause cardiac events. Conclusions This study found that LDLC records were critical to the prescription of PCSK9 inhibitors. In the quantitative analysis the clinical attributes of maximum LDLC on record, age and lipid medication use were statistically associated to LDLC achievement. It was however not possible to predict PCSK9 inhibitor eligibility; further work would involve the addition of clinical attributes such as lipoprotein (a) to the model analysis. PCSK9 inhibitor prescription was perceived to be hindered by inadequate recording of LDLC records. Consultants also reported that the LDLC thresholds for eligibility were restrictive in some cases. LDLC is an important determiner of PCSK9 inhibitor use; improved LDLC recording and evaluation of LDLC thresholds may be necessary in efforts to optimise PCSK9 inhibitor use

Mitigation briefs : ICRA Workshop

According to the Intergovernmental Panel on Climate Change (IPCC) there is economic potential for the mitigation of global greenhouse gas (GHG) emissions that could offset the projected growth of global emissions. This brief presentation focuses on dryland ‘bio-carbon’ opportunities towards climate change adaptation and mitigation strategies, such as reforestation, agro-forestry, and bio-fuels production. Mitigation technologies such as solar panels are also reviewed

Do floods affect food security? A before-and-after comparative study of flood-affected households’ food security status in South-Eastern Nigeria

A comparative study of pre- and post-flood households’ food security statuses in South-Eastern Nigeria was performed to answer the question “Do floods affect food security?” Data were generated via a survey of 400 households in eight communities using stratified and random sampling methods. Households’ food security statuses were assessed using the Household Food Security Survey Module (HFSSM) and computed using a Rasch analysis, where households were divided into four categories, namely: food secure, food insecure without hunger, moderately food insecure with hunger and severely food insecure with hunger. The results show that flooding affects food security negatively by increasing the number of food insecure households to 92.8%, and the regression coefficient of ˗0.798 indicates a very strong negative effect of flooding on household food security. An odds ratio of 2.221 implies that households that have experienced flooding are 2.221 times more probable to be food insecure than households that have not. The implication of the findings is that flooding is capable of turning communities into food insecurity hotspots that would need long-term assistance to cope, and flooding is capable of hampering the achievement of Goal 2 of the SDGs

Is it feasible to integrate alcohol-related risk reduction counseling into VCT services? Findings from Kenya

In Kenya, an estimated 30 percent of men report to be alcohol users which may be fueling the HIV pandemic, due to its association with high-risk sexual behavior and reduced inhibitions. The Population Council’s Horizons program collaborated on a study to improve screening of clients for alcohol use, provision of feedback of screening results, and referrals to care and support during voluntary testing and counseling (VCT) for HIV. Overall, the results indicate that it is feasible to integrate alcohol risk reduction counseling into VCT, and that it is generally accepted by providers and clients alike. This study therefore supports the formal integration of alcohol risk reduction counseling into VCT services in Kenya

The feasibility of integrating alcohol risk-reduction counseling into existing VCT services in Kenya

This pretest-posttest separate-sample study with intervention and comparison groups documented the abilities and willingness of trained voluntary counseling and testing (VCT) service providers to integrate alcohol screening and risk reduction counseling into their routine service delivery. Pre-test (n=1073) and post-test data (n=1058) were collected from different clients exiting from 25 VCT centers. A 12-month intervention that required all VCT providers from the intervention groups to screen all VCT clients for their alcohol use and offer them brief risk reduction alcoholrelated counseling was implemented. At post-test, the intervention group clients (n=456) had better study outcomes than the comparison group clients (n=602). Intervention clients were more likely to report that their VCT service provider had: asked them about their alcohol use (83% vs. 41%: