Because of the high volume of air traffic and trade between China and Africa,1 Africa is at a high risk for the introduction and spread of the novel coronavirus disease 2019 (COVID-19); although only ...Egypt has reported the first case, from a non-national.2 The greatest concern for public health experts is whether COVID-19 will become a pandemic, with sustained year-round transmission, similar to influenza, as is now being observed in several countries.3 What might happen to Africa—where most countries have weak health-care systems, including inadequate surveillance and laboratory capacity, scarcity of public health human resources, and limited financial means—if a pandemic occurs? The partnership has six work streams: laboratory diagnosis and subtyping; surveillance, including screening at points of entry and cross-border activities; infection prevention and control in health-care facilities; clinical management of people with severe COVID-19; risk communication; and supply-chain management and stockpiles. Because mitigating the potential spread of COVID-19 in Africa will require rapid detection and containment, the laboratory work streams of AFTCOR, Africa CDC, and WHO are working closely to expeditiously scale up diagnostic testing capacity linked to enhanced surveillance and monitoring—eg, at the beginning of February, only two countries in Africa had the diagnostic capacity to test for COVID-19. ...commitment and release of financial resources from partners and donors before a crisis hits Africa will help anticipate demand and address supply chain management, mapping, and stockpiling of COVID-19 response needs, such as large quantities of personal protective equipment, gloves, surgical masks, coveralls, and hoods, and medical countermeasures like antiviral agents.
The puzzle of the COVID-19 pandemic in Africa Maeda, Justin M; Nkengasong, John N
Science (American Association for the Advancement of Science),
01/2021, Letnik:
371, Številka:
6524
Journal Article
Recenzirano
Odprti dostop
More data are needed to understand the determinants of the COVID-19 pandemic across Africa
The COVID-19 pandemic has been puzzling to many public health experts because Africa has reported far fewer ...cases and deaths from COVID-19 than predicted. As of 22 November 2020, the continent of Africa, comprising 1.3 billion people, had recorded 2,070,953 cases of COVID-19 and 49,728 deaths (
1
), representing ∼3.6% of total global cases (
2
,
3
). Because of the continent's overstrained and weak health systems, inadequate financing of health care, paucity in human resources, and challenges posed by existing endemic diseases—including HIV, tuberculosis, and malaria—earlier predictions suggested that up to 70 million Africans may be infected with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) by June, with more than 3 million deaths (
4
). On page 79 of this issue, Uyoga
et al.
(
5
) report a serosurvey study (measuring the occurrence of SARS-CoV-2 antibodies) of blood donors in Kenya that suggested that the incidence of SARS-CoV-2 infection is much higher than expected from case numbers.
Development COVID-19 vaccines in a record time has been an unprecedented global scientific achievement. However, the world has failed to ensure equitable access to what should have been a global ...public good. What options remain available to African countries to ensure immunization of their populations and ultimately overcome the pandemic?
Development COVID-19 vaccines in a record time has been an unprecedented global scientific achievement. However, the world has failed to ensure equitable access to what should have been a global public good. What options remain available to African countries to ensure immunization of their populations and ultimately overcome the pandemic?
Laboratory medicine is essential for disease detection, surveillance, control, and management.1 However, access to quality-assured laboratory diagnosis has been a challenge in low-income and ...middle-income countries (LMICs) resulting in delayed or inaccurate diagnosis and ineffective treatment with consequences for patient safety.1 In the new Lancet Series2–4 on pathology and laboratory medicine (PALM) in LMICs, Michael Wilson and colleagues2 provide a comprehensive analysis of the challenges and gaps that limit access to PALM services. Some of the challenges include the absence of essential infrastructure, laboratory supplies, basic equipment, skilled personnel, supply chain management, and equipment maintenance; reliance on empirical treatment; inadequate quality management systems; and no government standards for laboratory testing. A laboratory medicine leadership programme, similar to the US Centers for Disease Control and Prevention's Field Epidemiology Training Program,12 will provide an opportunity to enhance collaboration between clinicians and laboratorians.
For the past few months, the Africa Centres for Disease Control and Prevention (Africa CDC) in Addis Ababa, where we work, has been developing this, with leaders from the African Union and in global ...health. ...one of us (J.N.) was working in Côte d'Ivoire as part of a US Centers for Disease Control and Prevention project that was struggling to combat HIV in the country without access to medicine. The World Bank estimates that economic growth in sub-Saharan Africa will decline from 2.4% in 2019 to between -2.1 and -5.1% in 2020, the first recession in the region in 25 years. In August, the African Union Bureau of Heads of State and Government endorsed the strategy put forward by Africa CDC, reiterating how past experience in global health shows that Africa must move decisively, effectively and collectively to secure access to vaccines and life-saving therapy.
With rapidly changing ecology, urbanization, climate change, increased travel and fragile public health systems, epidemics will become more frequent, more complex and harder to prevent and contain. ...Here we argue that our concept of epidemics must evolve from crisis response during discrete outbreaks to an integrated cycle of preparation, response and recovery. This is an opportunity to combine knowledge and skills from all over the world-especially at-risk and affected communities. Many disciplines need to be integrated, including not only epidemiology but also social sciences, research and development, diplomacy, logistics and crisis management. This requires a new approach to training tomorrow's leaders in epidemic prevention and response.
Accurate and reliable laboratory methods are needed for estimation of HIV-1 incidence to identify the high-risk populations and target and monitor prevention efforts. We previously described a ...single-well limiting-antigen avidity enzyme immunoassay (LAg-Avidity EIA) to detect recent HIV-1 infection.
We describe here further optimization and characterization of LAg-Avidity EIA, comparing it to the BED assay and a two-well avidity-index (AI) EIA. Specimen sets included longitudinal sera (n = 393), collected from 89 seroconverting individuals from 4 cohorts representing 4 HIV-1 subtypes, and sera from AIDS patients (n = 488) with or without TB co-infections from 3 different cohorts. Ninety seven HIV-1 positive specimens were purchased commercially. The BED assay, LAg-Avidity EIA, AI-EIA and HIV serology were performed, as needed.
Monitoring quality control specimens indicated high reproducibility of the LAg-Avidity EIA with coefficient of variation of <10% in the dynamic range. The LAg-Avidity EIA has an overall mean duration of recency (ω) of 141 days (95% CI 119-160) at normalized optical density (ODn) cutoff of 1.0, with similar ω in different HIV-1 subtypes and populations (132 to 143 days). Antibody avidity kinetics were similar among individuals and subtypes by both the LAg-Avidity EIA and AI-EIA compared to the HIV-IgG levels measured by the BED assay. The false recent rate among individuals with AIDS was 0.2% with the LAg-Avidity EIA, compared to 2.9% with the BED assay. Western blot profiles of specimens with increasing avidity confirm accurate detection of recent HIV-1 infections.
These data demonstrate that the LAg-Avidity EIA is a promising assay with consistent ω in different populations and subtypes. The assay should be very useful for 1) estimating HIV-1 incidence in cross-sectional specimens as part of HIV surveillance, 2) identifying risk factors for recent infections, 3) measuring impact of prevention programs, and 4) studying avidity maturation during vaccine trials.
PDF
