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   2020| May  | Volume 13 | Issue 5  
    Online since May 6, 2020

 
 
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REVIEW ARTICLES
The coronavirus disease 2019 (COVID-19) pandemic: A review and an update on cases in Africa
AbdulAzeez A Anjorin
May 2020, 13(5):199-203
DOI:10.4103/1995-7645.281612  
The world has experienced several epidemics posing serious threat to global public health, including the 2002 severe acute respiratory syndrome (SARS) epidemic that caused 800 deaths out of about 8 000 cases, the 2009 H1N1 pandemic with 18 500 deaths, the 2012 Middle East respiratory syndrome (MERS) epidemic that caused 800 deaths out of 2 500 cases, the 2014 Ebola outbreak with 28 616 cases and 11 310 deaths, and the current coronavirus disease (COVID-19) pandemic with more than 35 000 deaths out of over 730 000 confirmed cases till now. Emerging infectious diseases continue to infect and reduce human populations. The COVID-19 pandemic has spread to more than 114 countries before it was officially declared as a pandemic by the WHO on the 11th March 2020. Here, the first set of index cases in Africa, and the differences between SARS-CoV-2 and other coronaviruses in addition to the preventive strategies on the emergence of COVID-19 were reviewed.
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Current trends in the epidemiology and management of enteric fever in Africa: A literature review
Oluwaseyitan A Adesegun, Oluwafunmilola O Adeyemi, Osaze Ehioghae, David F Rabor, Tolulope O Binuyo, Bisola A Alafin, Onyedikachi B Nnagha, Akolade O Idowu, Ayokunle Osonuga
May 2020, 13(5):204-213
DOI:10.4103/1995-7645.283515  
Enteric fever remains a tropical disease of public health significance in Africa, due to its high endemicity and transmission rates, more in sub-Saharan Africa with 7.2 million cases of typhoid fever annually and incidence rate of 762 per 100 000 person-years when compared with Northern Africa with a reported incidence rate of 557 per 100 000 person-years and lower. Recent studies show that almost all regions of sub-Saharan Africa are tending towards high incidence rates, especially Central and Western Africa. Though clinically indistinguishable from paratyphoid fever, typhoid fever causes more morbidity and mortality than paratyphoid fever, with a greater threat to children. Risk factors include consumption of contaminated water, patronizing food vendors and a history of contact with a case or a chronic carrier, amongst others. Environmental factors such as the rainy season, open sewers, contaminated water bodies and areas of low elevation have been implicated. Diagnosis in Africa is challenging due to resource constraints, as many centres still depend on clinical diagnosis and serodiagnosis using Widal test, in an era where more sensitive and specific tests exist. The polymerase chain reaction is one of the most sensitive diagnostic methods, while culture (particularly bone marrow) is considered to be one of the most specific. Quinolones (ciprofloxacin) and third-generation cephalosporins, amongst others, remain potent in the management of enteric fever, with resistance to quinolones gradually on the rise. Poor diagnostics, poor antibiotic stewardship and lack of drug (antibiotic) regulation are contributors to the problem of antibiotic resistance in Africa. Prevention of typhoid fever through vaccination, especially in children is still under investigation, with steady progress being documented. Overall, long term prevention strategies for typhoid fever should be based on improved sources of drinking water, good sanitation and hygiene, food safety and poverty alleviation.
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PERSPECTIVES
Public health preparedness towards COVID-19 outbreak in Nigeria
Jelili Olaide Mustapha, Kamoru Ademola Adedokun, Idris Abdullahi Nasir
May 2020, 13(5):197-198
DOI:10.4103/1995-7645.279650  
  4,138 529 6
COVID-19 in Brazil: Epidemiological update and perspectives
Marli C Cupertino, Graziela A Cupertino, Andréia P Gomes, Nicholas AJ Mayers, R Siqueira-Batista
May 2020, 13(5):193-196
DOI:10.4103/1995-7645.282215  
  1,603 406 2
COVID-19 epidemic control approach in Italy
Massimo Giangaspero, Pasquale Turno
May 2020, 13(5):189-192
DOI:10.4103/1995-7645.283506  
  1,166 378 -
LETTERS TO EDITOR
Mathematical modelling of COVID-19 in South Africa
Aroonkumar Beesham
May 2020, 13(5):235-236
DOI:10.4103/1995-7645.283519  
  1,083 297 1
ORIGINAL ARTICLES
Spatial distribution of cutaneous anthrax in western Iran from 2009 to 2016: Geographic information system mapping for predicting risk of anthrax outbreaks
Ebrahim Ghaderi, Behzad Mohsenpour, Ghobad Moradi, Mohammad Karimi, Fatemeh Najafi, Seiran Nili, Samaneh Rouhi
May 2020, 13(5):227-234
DOI:10.4103/1995-7645.283516  
Objective: To explore the spatial accumulation of diseases and their aggravating factors are essential in all public health. This study attempts to use geographic information system (GIS) to provide more information about the incidence and future of anthrax. Methods: Patients were diagnosed with anthrax in Kurdistan Province from 2009 to 2016. Data was then exported into ArcGIS software version 9 and the required layers for years and areas were added.Final map for each year was drawn up, pointing out the hot spots and predicting its future pattern. Results: Most cases were reported in females (57 cases, 54.80 %), and the lower body limbs were most affected (63 cases, 60.57%). The highest numbers of incidences were related to the cities of Marivan, Saqez and Divandareh, with more concentration in the central parts of the province, rather than borderline areas. The highest percentage of the probable incidence of the disease was in Sanandaj (57.74%) with a potential susceptible area of 1 729.12 km2 and then in Saqez (54.36%) with a potential area of 2 422.4 km2. Conclusions: A vast area of Kurdistan Province is high risk for new cases of anthrax. Therefore, it is important to scale up the surveillance system in the province.
  1,040 206 -
LETTERS TO EDITOR
Coronavirus disease 2019 (COVID-19) outbreak: Strengthening the treatment component in health care establishments to minimize case fatality
Saurabh RamBihariLal Shrivastava, Prateek Saurabh Shrivastava
May 2020, 13(5):237-238
DOI:10.4103/1995-7645.281615  
  1,051 181 -
ORIGINAL ARTICLES
Outpatient prevention counseling for malaria in northwest Nigeria: A single-centre descriptive cross-sectional study
Godpower Chinedu Michael, Bukar Alhaji Grema, Ibrahim Aliyu, Muhammad Baba Usman, Zainab Abdulazeez Umar
May 2020, 13(5):214-220
DOI:10.4103/1995-7645.283517  
Objective: To assess the proportion of caregivers of children and patients who received malaria prevention counseling from their healthcare provider at the time of outpatient malaria treatment. Methods: This was a descriptive cross-sectional study involving 353 randomly selected adult patients and caregivers of children attending the general and paediatric outpatient clinics of a Nigerian hospital. An interviewer-administered questionnaire was used to collect data on participants’ sociodemographics and last malaria-episode characteristics. Chi square test and logistic regression analysis were used to determine factors associated with and predictors of receiving malaria-prevention counseling, respectively. Results: The mean age of the respondents was (33.6±9.6) years; they were predominantly females (257, 72.8%). Most had at least secondary-level education (304, 86.1%); the family size was mostly 1-6 persons in 202 (57.2%) respondents. They were treated mostly by doctors 256 (72.5%), but only 132 (37.4%) received malaria prevention counseling. Educational-level (χ2 =5.42, P=0.02), family size (Fisher’s exact, P=0.01), place of treatment (Fisher’s exact, P=0.0002), pretreatment malaria test (χ2 =9.48, P=0.002), who prescribed treatment (Fisher’s exact P=0.001), consultation time (χ2 =22.09, P<0.001), and previous demand for malaria prevention counseling (X2=36.59, P<0.001) were associated with receiving malaria prevention counseling. However, consultation time [Odd ratio (OR)=2.38, 95% confidence interval (CI): 1.28, 4.40, P =0.006] and previous demand for malaria prevention counseling (OR =3.62, 95% CI: 2.15, 6.10, P<0.001) were independent predictors of receiving counseling. Conclusions: The proportion of respondents that received malaria prevention counseling was surprisingly low. This offers opportunity for policy review towards improving the quality of outpatient malaria care through alternative strategies for giving malaria prevention information, especially in busy clinics where consultation time is constrained.
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Lesson learned: Retrospective analysis of ‘missed out’ dengue NS1 positives among IgM negative population
Mahadevan Ganesan, Robert Sudha, Murugesan Amudhan, Ganesan Sucila Thangam
May 2020, 13(5):221-226
DOI:10.4103/1995-7645.283518  
Objective: To determine the proportion of dengue non-structural protein 1 (NS1) positives among laboratory confirmed dengue IgM negative patients. Methods: Data for 1 732 samples received from January to October 2017 at the Virus Research and Diagnostic Laboratory (VRDL) for dengue diagnosis were downloaded from the National Institute of Epidemiology server. Samples that were previously reported as IgM negative for dengue diagnosis were identified and their NS1 status was determined using ELISA. Thus, ’missed out’ NS1 positives were correlated with the duration of illness. Furthermore, an epidemic curve for the study period was constructed. The increase in positivity rate within and between the months was compared by McNemar’s and Pearson’s chi-square test, respectively. Results: The reported IgM-negatives were 813, of which, 22.5% (183) were retrospectively positive for NS1 antigen. The addition of NS1 positives revealed by this study has raised the reported positivity across the months that ranged from 8.1% to 29.6%. By analyzing the dengue positives per month and the epidemic curve, the period between January and September, 2017 was identified as non-epidemic while the epidemic started from the month of October, 2017. Conclusions: Acute dengue infection is widely confirmed by detecting NS1 antigen in serum. Missing out of NS1 positives happen due to shortened window period and such cases act as reservoir for further viral transmission. Hence, this study highly emphasizes performing all three tests for dengue diagnosis that warrants the accurate dengue proportion in India.
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