Evaluation of the effect of border closure on COVID-19 incidence rates across nine African countries: an interrupted time series study

Background: Border closure is one of the policy changes implemented to mitigate against coronavirus disease 2019 (COVID-19). We evaluated the effect of border closure on the incidence rate of COVID-19 across nine African countries. Methods: An interrupted time series analysis was used to assess COVID-19 incidence rates in Egypt, Tunisia, Democratic Republic of the Congo (DRC), Ethiopia, Kenya, Ghana, Nigeria, Senegal and South Africa (SA). Data were collected between 14 February and 19 July 2020 from online data repositories. The linear trend and magnitude of change were evaluated using the itsa function with ordinary least-squares regression in Stata with a 7-d deferred interruption point, which allows a period of diffusion post-border closure. Results: Overall, the countries recorded an increase in the incidence rate of COVID-19 after border closure. However, when compared with matched control groups, SA, Nigeria, Ghana, Egypt and Kenya showed a higher incidence rate trend. In contrast, Ethiopia, DRC and Tunisia showed a lower trend compared with their controls. Conclusions: The implementation of border closures within African countries had minimal effect on the incidence of COVID-19. The inclusion of other control measures such as enhanced testing capacity and improved surveillance activities will reveal the effectiveness of border closure measures

Knowledge of spacer device, peak flow meter and inhaler technique (MDIs) among health care providers: an evaluation of doctors and nurses.

Background: Metered dose inhalers are cornerstone in effective management of bronchial asthma when correctly used. Most studies hitherto have focused on assessing patient’s knowledge of inhaler technique. We sought to assess the knowledge of inhaler technique, spacer device and peak flow meter among doctors and nurses in a tertiary healthcare institution in Nigeria.Method: A cross sectional survey of nurses and doctors from emergency department, family and internal medicine; who were attending a continuous professional development lecture, was carried out. From a total of 100 questionnaires administered, we retrieved 87 of which 75 were completed, giving a response rate of 75%. It was a selfadministered questionnaire. Data was analysed with SPSS version 21.0. Descriptive statistics were done. Associationwas examined using chi-square test.Result: Mean age of respondent was 35.8 years ± 8.7, 47(62.7%) were < 40 years, 33(44%) were male, nurses were 30(40.0%). Only 28(37.3%) had ever used a peak flow meter. Only 4(14.3%) used peak flow meter frequently, while 12(26.7%) checked patient’s inhaler technique often. Only 9 out of the 75 (12%) participants all of who are doctors knew at least 3 essential steps of the techniques in using the metered dose inhaler correctly. None of the participants got all the steps for the use of pMDI totally correct.Conclusion: Knowledge regarding the use of the metered dose inhaler and spacer device was poor. Health practitioners should have constant reminders in the form of continuous medical education to update their knowledge regarding correct inhaler technique.Funding: self-fundedKeywords: asthma, inhalers, knowledge, doctors, nurse

Impact of air pollution on global burden of disease in 2019

Air pollution consisting of ambient air pollution and household air pollution (HAP) threatens health globally. Air pollution aggravates the health of vulnerable people such as infants, children, women, and the elderly as well as people with chronic diseases such as cardiorespiratory illnesses, little social support, and poor access to medical services. This study is aimed to estimate the impact of air pollution on global burden of disease (GBD). We extracted data about mortality and disability adjusted life years (DALYs) attributable to air pollution from 1990 to 2019. The extracted data were then organized and edited into a usable format using STATA version 15. Furthermore, we also estimated the impacts for three categories based on their socio-demographic index (SDI) as calculated by GBD study. The impacts of air pollution on overall burden of disease by SDI, gender, type of pollution, and type of disease is estimated and their trends over the period of 1990 to 2019 are presented. The attributable burden of ambient air pollution is increasing over the years while attributable burden of HAP is declining over the years, globally. The findings of this study will be useful for evidence-based planning for prevention and control of air pollution and reduction of burden of disease from air pollution at global, regional, and national levels

Health Problems and Health Seeking Behaviour of Hospital Cleaners in a Tertiary Health Facility in South West Nigeria

This study aimed to determine the prevalent health problems and also investigate the health seeking behavior among hospital cleaners of Federal Medical Center, Owo, Ondo State. Nigeria. A cross-sectional study of 249 hospital cleaning staff was conducted. Semi-structured interviewer administered questionnaires were used to obtain information. Descriptive statistics were done and associations were explored with the chi square test at 5% level of significance. The mean age of respondent was 34 ±7 years, 142(57.0%) attended secondary school. The workplace health problems of the cleaning staff in the month preceding the study included low back pains 63.1%, muscular and joint pains 38.6% and skin rashes 14.9%, 15.7% had eye problems. The chronic health problems reported among the cleaners were hypertension 5.6%, asthma (0.8%) and epilepsy (0.4%). Some ( 3.2%) of the respondents did not seek healthcare at FMC, Owo because they felt they were not being cared for while 3.6% believed they were healthy and others 4.4% believed the services were too expensive. Like other health workers, hospital cleaners as shown in this study, also have health needs which must be met. Services of the hospital can be made available to the cleaners at subsidized costs. DOI: 10.5901/ajis.2014.v3n6p18

Pulmonary involvement in Lassa fever: a scoping review

INTRODUCTION: Lassa fever (LF) affects all body systems, however, inadequate knowledge exists on the involvement of the pulmonary system in LF infections. This scoping review, therefore, aimed to describe the pulmonary involvement of LF. MATERIAL AND METHODS: We conducted an extensive search of the literature on two databases, namely PubMed and Google Scholar. Overall, 5,217 articles were retrieved from a database search, out of which 107 duplicates were removed. Overall, 12 articles were included: four review articles, three case reports, three experimental inoculation studies, one retrospective study, and a prospective case-control study. RESULTS: Symptoms experienced included fever, pharyngitis, retrosternal pain, respiratory distress, and proteinuria. Complications included unique pulmonary arteritis, pulmonary embolization, mucosal bleeding, pleural or pericardial effusion, pulmonary edema, and interstitial pneumonitis. Consequences of the effect of Lassa virus infection were impairment of the immune system alongside continual replication of Lassa virus infection in affected tissues and death of affected individuals. LF has varied but serious effects on the pulmonary system. CONCLUSIONS: These symptoms, particularly in areas where LF is known to be endemic, should prompt clinicians to request LF polymerase chain reaction for confirmatory diagnosis. These features should promote the provision of respiratory support for patients in need of such

Prevalence, risk factors and prevention of burnout syndrome among healthcare workers: An umbrella review of systematic reviews and meta-analyses

Introduction: Burnout syndrome (BOS) is a psychological syndrome characterized by emotional exhaustion, depersonalization, and low personal accomplishment. This umbrella review aimed to investigate BOS among healthcare workers (HCWs). Methods: An umbrella review of systematic reviews and meta-analyses concerning the prevalence of BOS among physicians, nurses, medical students and other HCWs, and its associated factors was conducted across PubMed Central/Medline, Cochrane Library, PROSPERO and Epistemonikos databases. Only systematic reviews and meta-analyses from inception to 15 January 2020 and restricted to English language documents were included. Results: A total of 43 studies met the full inclusion criteria and were included. Among them, there were 3 meta-analyses, 26 systematic reviews, and 14 systematic reviews with meta-analysis. The prevalence of BOS was highest among nurses, younger persons, and trainees. The most frequent risk factors associated with BOS included stress, lack of family support, and organizational risk factors such as prolonged night shifts, length of experience, and exposure to traumatic events. Individual coping strategies such as exercise and communication with peers, and organizational strategies such as periodic review of shift schedule should be undertaken. Discussion: BOS has profound effects on the mental health states of HCWs. Individuals and the hospital authority need to pay specific attention to work-related stress risk factors to improve the psychological well-being of HCWs

a-Amylase inhibition, anti-glycation property and characterization of the binding interaction of citric acid with a-amylase using multiple spectroscopic, kinetics and molecular docking approaches

The quest to suppress complications associated with diabetes mellitus is ever increasing, while food additives and preservatives are currently being considered to play additional roles besides their uses in food enhancement and preservation. In the present study, the protective prowess of a common food preservative (citric acid, CA) against advanced glycation end-products (AGEs) formation and its binding interaction mechanism with a-amylase (AMY), an enzyme linked with hyperglycemia management, were examined. Enzyme inhibition kinetics, intrinsic fluorescence, synchronous and 3D fluorescence spectroscopies, ultraviolet–visible (UV–Vis) absorption spectroscopy, Fourier transform-infrared (FT-IR) spectroscopy, thermodynamics, and molecular docking analyses were employed. Results obtained showed that citric acid decreased a-amylase activity via mixed inhibition (IC50 = 5.01 ± 0.87 mM, Kic = 2.42 mM, Kiu = 160.34 mM) and suppressed AGEs formation (IC50 = 0.795 ± 0.001 mM). The intrinsic fluorescence of free a-amylase was quenched via static mechanism with high bimolecular quenching constant (Kq) and binding constant (Ka) values. Analysis of thermodynamic properties revealed that AMY-CA complex was spontaneously formed (DG DH), with involvement of electrostatic forces. UV–Vis, FT-IR and 3D fluorescence spectroscopies affirmed alterations in aamylase native conformation due to CA binding interaction. CA interacted with His-101, Asp-197, His- 299, and Glu-233 within AMY active site. Our findings indicated that CA could impair formation of AGEs and interact with a-amylase to slow down starch hydrolysis; vital properties in management of type 2 diabetes complications

Global, Regional, and National Cancer Incidence, Mortality, Years of Life Lost, Years Lived With Disability, and Disability-Adjusted Life-Years for 29 Cancer Groups, 1990 to 2016: A Systematic Analysis for the Global Burden of Disease Study

Importance: The increasing burden due to cancer and other noncommunicable diseases poses a threat to human development, which has resulted in global political commitments reflected in the Sustainable Development Goals as well as the World Health Organization (WHO) Global Action Plan on Non-Communicable Diseases. To determine if these commitments have resulted in improved cancer control, quantitative assessments of the cancer burden are required. Objective: To assess the burden for 29 cancer groups over time to provide a framework for policy discussion, resource allocation, and research focus. Evidence Review: Cancer incidence, mortality, years lived with disability, years of life lost, and disability-adjusted life-years (DALYs) were evaluated for 195 countries and territories by age and sex using the Global Burden of Disease study estimation methods. Levels and trends were analyzed over time, as well as by the Sociodemographic Index (SDI). Changes in incident cases were categorized by changes due to epidemiological vs demographic transition. Findings: In 2016, there were 17.2 million cancer cases worldwide and 8.9 million deaths. Cancer cases increased by 28% between 2006 and 2016. The smallest increase was seen in high SDI countries. Globally, population aging contributed 17%; population growth, 12%; and changes in age-specific rates, -1% to this change. The most common incident cancer globally for men was prostate cancer (1.4 million cases). The leading cause of cancer deaths and DALYs was tracheal, bronchus, and lung cancer (1.2 million deaths and 25.4 million DALYs). For women, the most common incident cancer and the leading cause of cancer deaths and DALYs was breast cancer (1.7 million incident cases, 535¿000 deaths, and 14.9 million DALYs). In 2016, cancer caused 213.2 million DALYs globally for both sexes combined. Between 2006 and 2016, the average annual age-standardized incidence rates for all cancers combined increased in 130 of 195 countries or territor. CONCLUSIONS AND RELEVANCE Large disparities exist between countries in cancer incidence,deaths, and associated disability. Scaling up cancer prevention and ensuring universal access to cancer care are required for health equity and to fulfill the global commitments fornoncommunicable disease and cancer control.The Institute for Health Metricsand Evaluation received funding from the Bill &Melinda Gates Foundation

Global burden of peripheral artery disease and its risk factors, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

Background: Peripheral artery disease is a growing public health problem. We aimed to estimate the global disease burden of peripheral artery disease, its risk factors, and temporospatial trends to inform policy and public measures. Methods: Data on peripheral artery disease were modelled using the Global Burden of Disease, Injuries, and Risk Factors Study (GBD) 2019 database. Prevalence, disability-adjusted life years (DALYs), and mortality estimates of peripheral artery disease were extracted from GBD 2019. Total DALYs and age-standardised DALY rate of peripheral artery disease attributed to modifiable risk factors were also assessed. Findings: In 2019, the number of people aged 40 years and older with peripheral artery disease was 113 million (95% uncertainty interval [UI] 99·2–128·4), with a global prevalence of 1·52% (95% UI 1·33–1·72), of which 42·6% was in countries with low to middle Socio-demographic Index (SDI). The global prevalence of peripheral artery disease was higher in older people, (14·91% [12·41–17·87] in those aged 80–84 years), and was generally higher in females than in males. Globally, the total number of DALYs attributable to modifiable risk factors in 2019 accounted for 69·4% (64·2–74·3) of total peripheral artery disease DALYs. The prevalence of peripheral artery disease was highest in countries with high SDI and lowest in countries with low SDI, whereas DALY and mortality rates showed U-shaped curves, with the highest burden in the high and low SDI quintiles. Interpretation: The total number of people with peripheral artery disease has increased globally from 1990 to 2019. Despite the lower prevalence of peripheral artery disease in males and low-income countries, these groups showed similar DALY rates to females and higher-income countries, highlighting disproportionate burden in these groups. Modifiable risk factors were responsible for around 70% of the global peripheral artery disease burden. Public measures could mitigate the burden of peripheral artery disease by modifying risk factors. Funding: Bill & Melinda Gates Foundation