Recent Submissions

  • Beyond knowledge: Evaluating the practices and precautionary measures towards COVID-19 amongst medical doctors in Jordan.

    Ramadan, M; Hasan, Z; Saleh, T; Jaradat, M; Al-Hazaimeh, M; Bani Hani, O; Al-Tammemi, AB; Shorman, E; Al-Mistarehi, AH; Kheirallah, K (Wiley, 2021-03-17)
    Background Health Care Workers (HCWs), including medical doctors, played a pivotal role as a first-line defence against the COVID-19 pandemic. Because of high exposure, HCWs are at an increased risk of contracting the disease. Aims This study aims to assess the level of precautionary measures, both at home and the workplace, amongst medical doctors who were on duty during the national lockdown in Jordan. Methods A cross-sectional study was conducted between March 23 and May 1, 2020, utilising a self-administered web-based questionnaire to examine a sample of medical doctors (n = 270) working at different healthcare institutions in Jordan. Likert scale was used to code the data and generate means and percentages. Results The most practiced on-duty precautionary measures were cleaning hands with water and disinfectant for more than 20 seconds (47.4%), followed by proper hygiene before and during meals (38.9%). The most practiced off-duty measures were taking off clothes before entering the residential place (65.9%) and prohibiting visitors (58.1%). Overall, the mean work protection percentage score was 73.8% (range: 28%-100%), while the mean home safety percentage score was 71.3% (range: 25%-100%). Work protection score was positively correlated with the home safety score. Female doctors were found to be more precautious at home than males. Doctors with chronic illness(es) were found to be less precautious than their healthier counterparts. Participants who isolated themselves expressed the highest level of home safety practice. Doctors who reported to smoke were found more precautious at home and doctors who preferred to work during lockdowns were more precautious at the workplace. Conclusion The level of precautionary behaviour of medical doctors in Jordan was not optimal. More attention and efforts are needed to enhance the adherence of doctors to precautionary guidance. Strengthening the role of infectious disease and infection control units within healthcare settings remains a necessity.
  • Coding-Complete Genome Sequence and Phylogenetic Relatedness of a SARS-CoV-2 Strain Detected in March 2020 in Cameroon.

    Njouom, R; Sadueh-Mba, SA; Tchatchueng, J; Diagne, MM; Dia, N; Tagnouokam, PAN; Boum, Y; Hamadou, A; Esso, L; Faye, O; et al. (American Society for Microbiology, 2021-03-11)
    We describe the coding-complete genome sequence of a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) strain obtained in Cameroon from a 58-year-old French patient who arrived from France on 24 February 2020. Phylogenetic analysis showed that this virus, named hCoV-19/Cameroon/1958-CMR-YAO/2020, belongs to lineage B.1.5 and is closely related to an isolate from France.
  • Correcting COVID-19 vaccine misinformation: Lancet Commission on COVID-19 Vaccines and Therapeutics Task Force Members.

    Hotez, P; Batista, C; Ergonul, O; Figueroa, JP; Gilbert, S; Gursel, M; Hassanain, M; Kang, G; Kim, JH; Lall, B; et al. (Elsevier, 2021-03-06)
  • Measles: the long walk to elimination drawn out by COVID-19.

    Gignoux, E; Esso, L; Boum, Y (Elsevier, 2021-03-01)
  • A positive COVID-19 test is associated with high mortality in RR-TB-HIV patients

    Mohr-Holland, E; Daniels, J; Douglas-Jones, B; Mema, N; Scott, V; Trivino Duran, L; Pfaff, C; Furin, J; Isaakidis, P (International Union Against Tuberculosis and Lung Disease, 2021-03)
  • Clinical profile and factors associated with COVID-19 in Cameroon: a prospective cohort study

    Mbarga, NF; Emilienne, E; Mbarga, M; Ouamba, P; Nanda, H; Kengni, A; Joseph, G; Eyong, J; Tossoukpe, S; Sosso, NS; et al. (medRxiv, 2021-02-23)
    Objectives This study explores the clinical profiles and factors associated with COVID-19 in Cameroon. Research design and methods In this prospective cohort study, we followed patients admitted for suspicion of COVID-19 at Djoungolo Hospital between 01st April and 31st July 2020. Patients were categorised by age groups and disease severity: mild (symptomatic without clinical signs of pneumonia pneumonia), moderate (with clinical signs of pneumonia without respiratory distress) and severe cases (clinical signs of pneumonia and respiratory distress not requiring invasive ventilation). Demographic information and clinical features were summarised. Multivariable analysis was performed to predict risk. Results A total of 323 patients were admitted during the study period; 262 were confirmed cases of COVID-19 by Polymerase Chain Reaction (PCR). Among the confirmed cases, the male group aged 40 to 49 years (13.9%) was predominant. Disease severity ranged from mild (77%; N=204) to moderate (15%; N=40) to severe (7%; N=18); the case fatality rate was 1% (N=4). Dysgusia (46%; N=111) and hyposmia/anosmia (39%; N=89) were common features of COVID-19. Nearly one-third of patients had comorbidities (29%; N=53), of which hypertension was the most common (20%; N=48). Participation in a mass gathering (OR=5.47; P=0.03) was a risk factor for COVID-19. Age groups 60 to 69 (OR=7.41; P=0.0001), 50 to 59 (OR=4.09; P=0.03), 40 to 49 (OR=4.54; P=0.01), male gender (OR=2.53; P=0.04), diabetes (OR= 4.05; P= 0.01), HIV infection (OR=5.57; P=0.03), lung disease (OR= 6.29; P=0.01), dyspnoea (OR=3.70; P=0.008) and fatigue (OR=3.35; P=0.02) significantly predicted COVID-19 severity. Conclusion Unlike many high-income settings, most COVID-19 cases in this study were benign with low fatality. Such findings may guide public health decision-making.
  • Comparison of Lung Ultrasound versus Chest X-ray for Detection of Pulmonary Infiltrates in COVID-19.

    Mateos Gonzalez, M; Garcia de Casasola Sanchez, G; Munoz, FJT; Proud, K; Lourdo, D; Sander, JV; Oritz Jaimes, GE; Mader, M; Lebrato, JC; Restrepo, MI; et al. (MDPI, 2021-02-22)
    Point-of-care lung ultrasound (LUS) is an attractive alternative to chest X-ray (CXR), but its diagnostic accuracy compared to CXR has not been well studied in coronavirus disease 2019 (COVID-19) patients. We conducted a prospective observational study to assess the correlation between LUS and CXR findings in COVID-19 patients. Ninety-six patients with a clinical diagnosis of COVID-19 underwent an LUS exam and CXR upon presentation. Physicians blinded to the CXR findings performed all LUS exams. Detection of pulmonary infiltrates by CXR versus LUS was compared between patients categorized as suspected or confirmed COVID-19 based on reverse transcriptase-polymerase chain reaction. Sensitivities and correlation by Kappa statistic were calculated between LUS and CXR. LUS detected pulmonary infiltrates more often than CXR in both suspected and confirmed COVID-19 subjects. The most common LUS abnormalities were discrete B-lines, confluent B-lines, and small subpleural consolidations. Most important, LUS detected unilateral or bilateral pulmonary infiltrates in 55% of subjects with a normal CXR. Substantial agreement was demonstrated between LUS and CXR for normal, unilateral or bilateral findings (Κ = 0.48 (95% CI 0.34 to 0.63)). In patients with suspected or confirmed COVID-19, LUS detected pulmonary infiltrates more often than CXR, including more than half of the patients with a normal CXR.
  • Some lessons that Peru did not learn before the second wave of COVID-19.

    Herrera-Anazco, P; Uyen-Cateriano, A; Mezones-Holguin, E; Taype-Rondan, A; Mayta-Tristan, P; Malaga, G; Hernandez, AV (Wiley, 2021-02-17)
  • How to ensure a needs-driven and community-centred vaccination strategy for COVID-19 in Africa.

    Boum, Y; Ouattara, A; Torreele, E; Okonta, C (BMJ Publishing Group, 2021-02-15)
  • Copan eNAT Transport System to Address Challenges in COVID-19 Diagnostics in Regions with Limited Testing Access.

    Richard-Greenblatt, M; Comar, CE; Flevaud, L; Berti, M; Harris, RM; Weiss, SR; Glaser, L (American Society for Microbiology, 2021-02-12)
    Community-based healthcare clinics and hospital outreach services have the potential to expand coronavirus disease 2019 (COVID-19) diagnostics to rural areas. However, reduced specimen stability during extended transport, the absence of cold chain to centralized laboratories, and biosafety concerns surrounding specimen handling has limited this expansion. In the following study, we evaluated eNAT (Copan Italia, Brescia, Italy) as an alternative transport system to address the biosafety and stability challenges associated with expanding COVID-19 diagnostics to rural and remote regions. In this study, we demonstrated that high titer severe acute respiratory virus syndrome coronavirus 2 (SARS-CoV-2) lysate placed into eNAT medium cannot be propagated in cell culture, supporting viral inactivation. To account for off-site testing in these settings, we assessed the stability of contrived nasopharyngeal (NP) specimens stored for up to 14 days in various transport medium (eNAT, eSwab, viral transport media [VTM], saline and phosphate-buffered saline [PBS]) at 4°C, 22-25°C, and 35°C. Molecular detection of SARS-CoV-2 was unaffected by sample storage temperature over the 2 weeks when stored in eNAT or PBS (change in cycle threshold [ΔCT ] ≤ 1). In contrast, variable stability was observed across test conditions for other transport media. As eNAT can inactivate SARS-CoV-2, it may support COVID-19 diagnostics at the point-of-care (POC). Evaluation of compatibility of eNAT with Cepheid Xpert Xpress SARS-CoV-2 assay demonstrated equivalent diagnostic accuracy and sensitivity compared to VTM. Taken together, these findings suggest that the implementation of eNAT as a collection device has the potential to expand COVID-19 testing to areas with limited healthcare access.
  • Seroprevalence and risk factors of exposure to COVID-19 in homeless people in Paris, France: a cross-sectional study.

    Roederer, T; Mollo, B; Vincent, C; Nikolay, B; Llosa, AE; Nesbitt, R; Vanhomwegen, J; Rose, T; Goyard, S; Anna, F; et al. (2021-02-06)
    Between June 23 and July 2, 2020, 426 (52%) of 818 individuals recruited tested positive in 14 sites. Seroprevalence varied significantly by type of recruitment site (χ2 p<0·0001), being highest among those living in workers' residences (88·7%, 95% CI 81·8-93·2), followed by emergency shelters (50·5%, 46·3-54·7), and food distribution sites (27·8%, 20·8-35·7). More than two thirds of COVID-19 seropositive individuals (68%, 95% CI 64·2-72·2; 291 of 426) did not report any symptoms during the recall period. COVID-19 seropositivity was strongly associated with overcrowding (medium density: adjusted odds ratio [aOR] 2·7, 95% CI 1·5-5·1, p=0·0020; high density: aOR 3·4, 1·7-6·9, p<0·0001).
  • Long Duration and Resurgence of SARS-CoV-2 in Cameroonian Population

    Buri, D; Njuwa, FKG; Matchim, L; Akendji, B; Eteki, L; Fouda, NM; Bebbel, L; Ndifon, M; Hamadou, A; Tchiasso, D; et al. (BMC, 2021-02-02)
    Background Infection with SARS-CoV-2 can lead to a detectable serological immune response even though extent of its protection is still not yet well known. We report long duration and resurgence of SARS-CoV-2 in patients with COVID-19. Methods We included a cohort of 99 participants from our non-blinded non-randomized evaluation of COVID-19 tests in Cameroon. Demographic and clinical information was collected from participants including self-reported age, race, ethnicity, and gender. Qualitative data was described as proportions while quantitative data was described with means and accompanying ranges. Results Duration of PCR for SARS-CoV-2 positivity was found to range from 4 – 81 days, with mean duration of 32.8 days in patients with PCR-positive. We also identified 4 participants who also had SARS-CoV-2 resurgence within a three-month period. Conclusion These observations raise questions on clinical decision to release COVID-19 cases from isolation after 14 days.
  • South Sudan: a young country's fight against COVID-19.

    Aluk Dinyo, DG; Ahmadi, A; Okereke, M; Yasir Essar, M; Lucero-Prisno, DE (Pan African Medical Journal, 2020-12-17)
    COVID-19 is a highly infectious disease that has started to creep into African countries including South Sudan. Following confirmation of the first few cases, the government enacted preventive measures to curb community transmission. However, daunting challenges deter these precautionary measures. Just after two years the country took its independence from Sudan, civil conflicts sparked and continue to overburden and undermine the fragile healthcare system. The conflicts have caused disruption of health services, destruction of health facilities, death and migration of health workers, displacements of a huge number of people. This scenario continues while the country is grappling with the pandemic. Other concerning issues include: insufficient COVID-19 testing capacity, limited medical and personal protective equipment and an inadequate number of health workers which leave the country ill-equipped in the battle against the pandemic. Non-compliance of COVID-19 prevention protocols by the general public due to high rate of poverty and social stigma contribute to the spread of the virus. The current situation in South Sudan make evident that there is a need for an immediate ceasefire by the warring sides so the available health services including COVID-19 efforts, are not disrupted to ensure the safety of all. The government needs to further build the capacity of its health sector with the cooperation of its international health allies to be able to provide its citizens with the health services they need.
  • Considerations for planning COVID-19 treatment services in humanitarian responses

    Garry, S; Abdelmagid, N; Baxter, L; Roberts, N; de Waroux, OL; Ismail, S; Ratnayake, R; Favas, C; Lewis, E; Checchi, F (BMC, 2020-12-01)
    The COVID-19 pandemic has the potential to cause high morbidity and mortality in crisis-affected populations. Delivering COVID-19 treatment services in crisis settings will likely entail complex trade-offs between offering services of clinical benefit and minimising risks of nosocomial infection, while allocating resources appropriately and safeguarding other essential services. This paper outlines considerations for humanitarian actors planning COVID-19 treatment services where vaccination is not yet widely available. We suggest key decision-making considerations: allocation of resources to COVID-19 treatment services and the design of clinical services should be based on community preferences, likely opportunity costs, and a clearly articulated package of care across different health system levels. Moreover, appropriate service planning requires information on the expected COVID-19 burden and the resilience of the health system. We explore COVID-19 treatment service options at the patient level (diagnosis, management, location and level of treatment) and measures to reduce nosocomial transmission (cohorting patients, protecting healthcare workers). Lastly, we propose key indicators for monitoring COVID-19 health services.
  • Evaluating Ten Commercially-Available SARS-CoV-2 Rapid Serological Tests Using the STARD (Standards for Reporting of Diagnostic Accuracy Studies) Method.

    Dortet, L; Ronat, JB; Vauloup-Fellous, C; Langendorf, C; Mendels, DA; Emeraud, C; Oueslati, S; Girlich, D; Chauvin, A; Afdjei, A; et al. (American Society for Microbiology, 2020-11-25)
    Numerous SARS-CoV-2 rapid serological tests have been developed, but their accuracy has usually been assessed using very few samples, and rigorous comparisons between these tests are scarce. In this study, we evaluated and compared 10 commercially-available SARS-CoV-2 rapid serological tests using the STARD methodology (Standards for Reporting of Diagnostic Accuracy Studies). 250 sera from 159 PCR-confirmed SARS-CoV-2 patients (collected from 0 to 32 days after onset of symptoms) were tested with rapid serological tests. Control sera (N = 254) were retrieved from pre-COVID periods from patients with other coronavirus infections (N = 11), positive rheumatoid factors (N = 3), IgG/IgM hyperglobulinemia (N = 9), malaria (n = 5), or no documented viral infection (N = 226). All samples were tested using rapid lateral flow immunoassays (LFIA) from 10 manufacturers. Only four tests achieved ≥98% specificity, with other tests ranging from 75.7%-99.2%. Sensitivities varied by the day of sample collection, from 31.7%-55.4% (Days 0-9), 65.9%-92.9% (Days 10-14), and 81.0%-95.2% (>14 days) after the onset of symptoms, respectively. Only three tests evaluated met French Health Authorities’ thresholds for SARS-CoV-2 serological tests (≥90% sensitivity + ≥98% specificity). Overall, the performances between tests varied greatly, with only a third meeting acceptable specificity and sensitivity thresholds. Knowing the analytical performance of these tests will allow clinicians and most importantly laboratorians to use them with more confidence, could help determine the general population’s immunological status, and may help to diagnose some patients with false-negative RT-PCR results.
  • Extended use or reuse of single-use surgical masks and filtering face-piece respirators during the coronavirus disease 2019 (COVID-19) pandemic: A rapid systematic review.

    Toomey, E; Conway, Y; Burton, C; Smith, S; Smalle, M; Chan, X; Adisesh, A; Tanveer, S; Ross, L; Thomson, I; et al. (Cambridge University Press, 2020-10-08)
    Background: Shortages of personal protective equipment during the coronavirus disease 2019 (COVID-19) pandemic have led to the extended use or reuse of single-use respirators and surgical masks by frontline healthcare workers. The evidence base underpinning such practices warrants examination. Objectives: To synthesize current guidance and systematic review evidence on extended use, reuse, or reprocessing of single-use surgical masks or filtering face-piece respirators. Data sources: We used the World Health Organization, the European Centre for Disease Prevention and Control, the US Centers for Disease Control and Prevention, and Public Health England websites to identify guidance. We used Medline, PubMed, Epistemonikos, Cochrane Database, and preprint servers for systematic reviews. Methods: Two reviewers conducted screening and data extraction. The quality of included systematic reviews was appraised using AMSTAR-2. Findings were narratively synthesized. Results: In total, 6 guidance documents were identified. Levels of detail and consistency across documents varied. They included 4 high-quality systematic reviews: 3 focused on reprocessing (decontamination) of N95 respirators and 1 focused on reprocessing of surgical masks. Vaporized hydrogen peroxide and ultraviolet germicidal irradiation were highlighted as the most promising reprocessing methods, but evidence on the relative efficacy and safety of different methods was limited. We found no well-established methods for reprocessing respirators at scale. Conclusions: Evidence on the impact of extended use and reuse of surgical masks and respirators is limited, and gaps and inconsistencies exist in current guidance. Where extended use or reuse is being practiced, healthcare organizations should ensure that policies and systems are in place to ensure these practices are carried out safely and in line with available guidance.
  • How mental health care is changing in Cameroon because of the COVID-19 pandemic

    Mviena, JLM; Fanne, M; Gondo, R; Mwamelo, AJ; Esso, L; Epee, E; Mballa, GAE; Boum, Y (Elsevier, 2020-10-01)
  • The potential public health consequences of COVID-19 on malaria in Africa.

    Sherrard-Smith, E; Hogan, AB; Hamlet, A; Watson, OJ; Whittaker, C; Winskill, P; Ali, F; Mohammad, AB; Uhomoibhi, P; Maikore, I; et al. (Nature Research, 2020-08-07)
    The burden of malaria is heavily concentrated in sub-Saharan Africa (SSA) where cases and deaths associated with COVID-19 are rising1. In response, countries are implementing societal measures aimed at curtailing transmission of SARS-CoV-22,3. Despite these measures, the COVID-19 epidemic could still result in millions of deaths as local health facilities become overwhelmed4. Advances in malaria control this century have been largely due to distribution of long-lasting insecticidal nets (LLINs)5, with many SSA countries having planned campaigns for 2020. In the present study, we use COVID-19 and malaria transmission models to estimate the impact of disruption of malaria prevention activities and other core health services under four different COVID-19 epidemic scenarios. If activities are halted, the malaria burden in 2020 could be more than double that of 2019. In Nigeria alone, reducing case management for 6 months and delaying LLIN campaigns could result in 81,000 (44,000-119,000) additional deaths. Mitigating these negative impacts is achievable, and LLIN distributions in particular should be prioritized alongside access to antimalarial treatments to prevent substantial malaria epidemics.
  • How COVID-19 could benefit tuberculosis and HIV services in South Africa.

    Keene, C; Mohr-Holland, E; Cassidy, T; Scott, V; Nelson, A; Furin, J; Trivino-Duran, L (Elsevier, 2020-08-03)

View more