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Bonkoungou B, Utunen H, Talisuna AO, O'Connell G, Koua E, Chamla DD, Arabi E, Tokar A, Gueye AS. Online capacity building for the health workforce: the case of the Integrated Disease Surveillance and Response for the African region. J Public Health Afr 2023; 14:2478. [PMID: 38501147 PMCID: PMC10946300 DOI: 10.4081/jphia.2023.2478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/20/2024] Open
Abstract
The World Health Organisation (WHO) Regional Office for Africa (AFRO) has developed a comprehensive capacity devel-opment programme to support the successful implementation of the Integrated Disease Surveillance and Response 3rd edition Technical Guidelines (IDSR). As part of the learning program, a series of asyn-chronous online courses are offered on OpenWHO in English, French and Portuguese. This paper describes the use of five IDSR online courses and reports on feedback received from learners on Course 1 in the English series. An online learner survey was developed, and a descriptive analysis was conducted. This paper also reports on use related empirical metadata from the OpenWHO platform. Overall, learners (97%-n/N) of Course 1 IDSR English series indicated a positive perception toward their online learning experience because of the quality of course content, its organization, ease of use and relevance to their workplace needs. In addition, 88% (n/N) of learners reported that they had used their acquired knowledge at least sometimes and 54.4% (n/N) had shared their learning with others. Lastly, the quiz analyses showed an average of right answers of 78.97% for quiz 1 and 69.94% for quiz 2. Online learning is an essential component of a blended capacity development programme and provides cost effective, equitable and impactful learning. Learners who have a learning goal and find their needs met in courses tend to show more satisfaction and motivation to share their learning.
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Affiliation(s)
- Boukare Bonkoungou
- Training Officer, Emergency Preparedness and Response (EPR) Programme, WHO Regional Office for Africa, Brazzaville, Congo
| | - Heini Utunen
- Learning and Capacity Development Unit, Health Emergencies Programme, World Health Organization, Genève, Switzerland
| | - Ambrose Otau Talisuna
- Emergency Preparedness and Response Cluster, World Health Organisation Regional Office for Africa (EPR), Brazzaville, Congo
| | - Gillian O'Connell
- Learning and Capacity Development Unit, Health Emergencies Programme, World Health Organization, Genève, Switzerland
| | - Etien Koua
- Emergency Preparedness and Response (EPR) Programme, WHO Regional Office for Africa, Cité du Djoué, Brazzaville, Congo
| | - Dick Damas Chamla
- Emergency Preparedness and Response (EPR) Programme, WHO Regional Office for Africa, Cité du Djoué, Brazzaville, Congo
| | - Elham Arabi
- Learning and Capacity Development Unit, Health Emergencies Programme, World Health Organization, Genève, Switzerland
| | - Anna Tokar
- Learning and Capacity Development Unit, Health Emergencies Programme, World Health Organization, Genève, Switzerland
| | - Abdou Salam Gueye
- Regional Emergency Director, Health Emergencies Programme, World Health Organization, Genève, Switzerland
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Zinszer K, Talisuna AO. Fighting insecticide resistance in malaria control. Lancet Infect Dis 2023; 23:138-139. [PMID: 36174593 DOI: 10.1016/s1473-3099(22)00518-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 07/27/2022] [Indexed: 02/01/2023]
Affiliation(s)
- Kate Zinszer
- School of Public Health, University of Montreal, Montreal, QC H3N 1X9, Canada; Centre for Public Health Research, Montreal, QC, Canada.
| | - Ambrose Otau Talisuna
- Emergency Preparedness and Response Cluster, WHO, Regional Office for Africa, Brazzaville, Congo
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Ryan CS, Belizaire MRD, Nanyunja M, Olu OO, Ahmed YA, Latt A, Kol MT, Bamuleke B, Tusiime J, Nsabimbona N, Conteh I, Nyashanu S, Ramadan PO, Woldetsadik SF, Nkata JPM, Ntwari JT, Nzeyimana SD, Ouedraogo L, Batona G, Ndahindwa V, Mgamb EA, Armah M, Wamala JF, Guyo AG, Freeman AYS, Chimbaru A, Komakech I, Kuku M, Firmino WM, Saguti GE, Msemwa F, O-Tipo S, Kalubula PC, Nsenga N, Talisuna AO. Sustainable strategies for Ebola virus disease outbreak preparedness in Africa: a case study on lessons learnt in countries neighbouring the Democratic Republic of the Congo. Infect Dis Poverty 2022; 11:118. [PMID: 36461100 PMCID: PMC9716502 DOI: 10.1186/s40249-022-01040-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 11/02/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND From May 2018 to September 2022, the Democratic Republic of Congo (DRC) experienced seven Ebola virus disease (EVD) outbreaks within its borders. During the 10th EVD outbreak (2018-2020), the largest experienced in the DRC and the second largest and most prolonged EVD outbreak recorded globally, a WHO risk assessment identified nine countries bordering the DRC as moderate to high risk from cross border importation. These countries implemented varying levels of Ebola virus disease preparedness interventions. This case study highlights the gains and shortfalls with the Ebola virus disease preparedness interventions within the various contexts of these countries against the background of a renewed and growing commitment for global epidemic preparedness highlighted during recent World Health Assembly events. MAIN TEXT Several positive impacts from preparedness support to countries bordering the affected provinces in the DRC were identified, including development of sustained capacities which were leveraged upon to respond to the subsequent coronavirus disease 2019 (COVID-19) pandemic. Shortfalls such as lost opportunities for operationalizing cross-border regional preparedness collaboration and better integration of multidisciplinary perspectives, vertical approaches to response pillars such as surveillance, over dependence on external support and duplication of efforts especially in areas of capacity building were also identified. A recurrent theme that emerged from this case study is the propensity towards implementing short-term interventions during active Ebola virus disease outbreaks for preparedness rather than sustainable investment into strengthening systems for improved health security in alignment with IHR obligations, the Sustainable Development Goals and advocating global policy for addressing the larger structural determinants underscoring these outbreaks. CONCLUSIONS Despite several international frameworks established at the global level for emergency preparedness, a shortfall exists between global policy and practice in countries at high risk of cross border transmission from persistent Ebola virus disease outbreaks in the Democratic Republic of Congo. With renewed global health commitment for country emergency preparedness resulting from the COVID-19 pandemic and cumulating in a resolution for a pandemic preparedness treaty, the time to review and address these gaps and provide recommendations for more sustainable and integrative approaches to emergency preparedness towards achieving global health security is now.
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Affiliation(s)
| | | | | | | | - Yahaya Ali Ahmed
- grid.463718.f0000 0004 0639 2906WHO Regional Office for Africa, Brazzaville, Congo
| | - Anderson Latt
- grid.452949.7WHO Sub-Regional Office for Africa, Dakar, Senegal
| | - Matthew Tut Kol
- grid.508167.dAfrica Centres for Disease Control and Prevention, Addis Ababa, Ethiopia
| | - Bertrand Bamuleke
- grid.463718.f0000 0004 0639 2906WHO Country Office, Brazzaville, Congo
| | - Jayne Tusiime
- grid.463718.f0000 0004 0639 2906WHO Regional Office for Africa, Brazzaville, Congo
| | - Nadia Nsabimbona
- grid.463718.f0000 0004 0639 2906WHO Regional Office for Africa, Brazzaville, Congo
| | - Ishata Conteh
- grid.463718.f0000 0004 0639 2906WHO Regional Office for Africa, Brazzaville, Congo
| | | | - Patrick Otim Ramadan
- grid.463718.f0000 0004 0639 2906WHO Regional Office for Africa, Brazzaville, Congo
| | | | | | | | | | | | - Georges Batona
- grid.463718.f0000 0004 0639 2906WHO Country Office, Brazzaville, Congo
| | | | | | - Magdalene Armah
- grid.463718.f0000 0004 0639 2906WHO Regional Office for Africa, Brazzaville, Congo
| | | | | | | | | | | | | | | | | | | | - Shikanga O-Tipo
- grid.439056.d0000 0000 8678 0773WHO Country Office, Lusaka, Zambia
| | | | - Ngoy Nsenga
- WHO Country Office, Bangui, Central African Republic
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Talisuna AO, D'Alessandro U. Interplay between sickle cell anaemia and Plasmodium falciparum malaria. Lancet Child Adolesc Health 2022; 6:594-595. [PMID: 35785795 DOI: 10.1016/s2352-4642(22)00169-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 05/27/2022] [Indexed: 06/15/2023]
Affiliation(s)
- Ambrose Otau Talisuna
- Emergency Preparedness and Response Cluster, World Health Organization, Regional Office for Africa, Brazzaville, Congo.
| | - Umberto D'Alessandro
- Medical Research Council Unit The Gambia at the London School of Hygiene & Tropical Medicine, London, UK
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Rumunu J, Wamala JF, Sakaya R, Konga SB, Igale AL, Adut AA, Lonyik SK, Lasu RM, Kaya RD, Guracha G, Nsubuga P, Ndenzako F, Talisuna AO. Evaluation of integrated disease surveillance and response (IDSR) and early warning and response network (EWARN) in South Sudan 2021. Pan Afr Med J 2022; 42:6. [PMID: 36158929 PMCID: PMC9474832 DOI: 10.11604/pamj.supp.2022.42.1.33780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 03/05/2022] [Indexed: 11/11/2022] Open
Abstract
Introduction South Sudan has been implementing the Integrated Disease Surveillance and Response (IDSR) strategy since 2006, along with Early Warning and Alert Response and Network (EWARN). The IDSR/EWARN stakeholders commissioned an independent evaluation to establish performance at national, state, county, health facility, and community levels in the first half of 2021. Methods the evaluation was conducted between June and September 2021 (during the COVID-19 pandemic) and was based on the World Health Organization (WHO) protocols for monitoring and evaluating communicable disease surveillance and response systems and the guidelines for evaluating EWARN. Results integrated disease surveillance and response/early warning and alert response and network indicator data showed improving timeliness and completeness from the beginning of 2021 to week 16 and then a slight depression of timeliness by week 32, while completeness remained high. Event-based surveillance was active at the beginning of 2021 and in week 32. However, there was inadequate sample collection to investigate acute watery diarrhea, bloody diarrhea, and acute jaundice syndrome alerts. Respondents in all cadres had substantial experience working in IDSR/EWARN. All respondents performed the various IDSR/EWARN tasks and duties as expected, but needed more resources and training. Conclusion while IDSR/EWARN is performing relatively well, confirmation of priority diseases by the laboratories needs to be strengthened. Health facilities need more regular supervision from the higher levels. Community health workers need more training on IDSR/EWARN. The whole IDSR/EWARN system needs more resources, particularly for communication and transport and to confirm priority diseases. Staff at all levels requested more training in IDSR/EWARN.
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Affiliation(s)
- John Rumunu
- Doctoral Program in Global Health, Humanitarian Aid and Disaster Medicine, Universita Del Pemonte Orientale and Vrije University Brussel, Juba, South Sudan,Corresponding author John Rumunu, Doctoral Program in Global Health, Humanitarian Aid and Disaster Medicine, Universita Del Pemonte Orientale and Vrije University Brussel, Juba, South Sudan.
| | | | | | - Sheila Baya Konga
- World Health Organization Country Office for South Sudan, Juba, South Sudan
| | - Alice Lado Igale
- World Health Organization Country Office for South Sudan, Juba, South Sudan
| | | | | | - Robert Martin Lasu
- World Health Organization Country Office for South Sudan, Juba, South Sudan
| | - Rose Dagama Kaya
- World Health Organization Country Office for South Sudan, Juba, South Sudan
| | - Guyo Guracha
- World Health Organization Country Office for South Sudan, Juba, South Sudan
| | | | - Fabian Ndenzako
- World Health Organization Country Office for South Sudan, Juba, South Sudan
| | - Ambrose Otau Talisuna
- World Health Organization Regional Office for Africa, Brazzaville, Republic of Congo
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Moeti M, Cabore J, Kasolo F, Yoti Z, Zawaira F, Chibi M, Rajatonirina S, Karamagi H, Rees H, Mihigo R, Yao M, Impouma B, Okeibunor JC, Talisuna AO. The COVID-19 pandemic: research and health development in the World Health Organisation Africa region. Pan Afr Med J 2021; 35:50. [PMID: 33623575 PMCID: PMC7875729 DOI: 10.11604/pamj.supp.2020.35.2.23628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 05/25/2020] [Indexed: 12/04/2022] Open
Abstract
Concerns have been expressed about the view point of WHO AFRO concerning research for health in the African Region. WHO AFRO considers research a critical component in the improvement of health in the Africa region. Ensuring the effectiveness of our strategies, policies and programmes requires evidence. In the context of the ongoing COVID-19 outbreak, WHO research interests cover key areas of the response. The WHO AFRO consider research as critical in our efforts at protecting people against health emergencies and pandemics like the COVID-19 and ensuring universal access to proven interventions. In view of this, the WHO has taken steps to strengthen capacity for research in the region. The results of these efforts may take time to manifest but will surely do as we persist in our drive, with support from our partners.
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Affiliation(s)
| | | | | | - Zabulon Yoti
- WHO Regional Office for Africa, Brazzaville, Congo
| | | | | | | | | | - Helen Rees
- Witwatersrand Reproductive Health and HIV Institute, South Africa
| | | | - Michel Yao
- WHO Regional Office for Africa, Brazzaville, Congo
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Malinga T, Wiysonge CS, Ndwandwe D, Okeibunor JC, Talisuna AO. A scoping review of the impact of long-distance truck drivers on the spread of COVID-19 infection. Pan Afr Med J 2021; 38:27. [PMID: 33777295 PMCID: PMC7955595 DOI: 10.11604/pamj.2021.38.27.26691] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 01/08/2021] [Indexed: 11/11/2022] Open
Abstract
Introduction long-distance truck drivers have been identified as a high-risk group for coronavirus disease (COVID-19) infection. Thus, the aim of this scoping review is to map out the existing evidence on the impact of long-distance truck drivers on the spread of COVID-19 and measures that countries can implement to mitigate this route of spread in the African region. Methods we searched the PubMed database and the website of the World Health Organization (WHO) in March 2020 for eligible studies. Results the search strategy identified 669 citations, of which six met the inclusion criteria. The most frequently reported interventions were maintaining hand hygiene, social distance, testing truck drivers, regulation of trade and transport e.g. only trucks with the food, medical supplies, fuels, agricultural supplies will be allowed to operate in interstate operations and regulating and controlling trucks carrying essential goods and services e.g. truck drivers are required to declare their final destination and are urged to stop only at designated points. Two studies from the African region reported about border closures and entry and exit screening, two studies from the US reported about the threat for public safety and risks and mitigation plans and 2 guidelines reported about harmonisation and facilitation of cross border in the context of the COVID-19 outbreak. Conclusion this review highlights the countries response to mitigate the impact of the pandemic by implementing measures to facilitate safe cross-border trade and adopting regional harmonization of trucking regulations.
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Affiliation(s)
- Thobile Malinga
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa.,Department of Global Health, Stellenbosch University, Cape Town, South Africa
| | - Charles Shey Wiysonge
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa.,Department of Global Health, Stellenbosch University, Cape Town, South Africa.,School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Duduzile Ndwandwe
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
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Talisuna AO, Bonkoungou B, Mosha FS, Struminger BB, Lehmer J, Arora S, Conteh IN, Appiah JA, Nel J, Mehtar S, Diaz JV, Lado M, Ramers CB, Ousman KB, Gaturuku P, Tiendrebeogo A, Mihigo R, Yoti Z, Kasolo FC, Cabore JW, Moeti MR. The COVID-19 pandemic: broad partnerships for the rapid scale up of innovative virtual approaches for capacity building and credible information dissemination in Africa. Pan Afr Med J 2020; 37:255. [PMID: 33598070 PMCID: PMC7864260 DOI: 10.11604/pamj.2020.37.255.23787] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 08/18/2020] [Indexed: 01/27/2023] Open
Abstract
The Corona Virus Disease 2019 (COVID-19) pandemic has rapidly spread in Africa, with a total of 474,592 confirmed cases by 11th July 2020. Consequently, all policy makers and health workers urgently need to be trained and to access the most credible information to contain and mitigate its impact. While the need for rapid training and information dissemination has increased, most of Africa is implementing public health social and physical distancing measures. Responding to this context requires broad partnerships and innovative virtual approaches to disseminate new insights, share best practices, and create networked communities of practice for all teach, and all learn. The World Health Organization (WHO)-Africa region, in collaboration with the Extension for Community Health Outcome (ECHO) Institute at the University of New Mexico Health Sciences Center (UNM HSC), the West Africa college of nurses and the East Central and Southern Africa college of physicians, private professional associations, academia and other partners has embarked on a virtual training programme to support the containment of COVID-19. Between 1st April 2020 and 10th July 2020, about 7,500 diverse health professionals from 172 locations in 58 countries were trained in 15 sessions. Participants were from diverse institutions including: central ministries of health, WHO country offices, provincial and district hospitals and private medical practitioners. A range of critical COVID-19 preparedness and response interventions have been reviewed and discussed. There is a high demand for credible information from credible sources about COVID-19. To mitigate the "epidemic of misinformation" partnerships for virtual trainings and information dissemination leveraging existing learning platforms and networks across Africa will augment preparedness and response to COVID-19.
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Affiliation(s)
- Ambrose Otau Talisuna
- World Health Organization, Regional Office for Africa, Brazzaville, Republic of Congo
| | - Boukare Bonkoungou
- World Health Organization, Regional Office for Africa, Brazzaville, Republic of Congo
| | | | | | - Jutta Lehmer
- University of New Mexico ECHO Institute, New Mexico, USA
| | - Sanjeev Arora
- University of New Mexico ECHO Institute, New Mexico, USA
| | - Ishata Nannie Conteh
- World Health Organization, Regional Office for Africa, Brazzaville, Republic of Congo
| | | | - Jeremy Nel
- University of the Witwatersrand, Johannesburg, South Africa
| | - Shaheen Mehtar
- Infection Control Africa Network, Cape Town, South Africa
- University of Stellenbosch, Cape Town, South Africa
| | | | | | - Christian Boyd Ramers
- Laura Rodríguez Research Institute, Family Health Centers of San Diego, San Diego, USA
- University of California, San Diego School of Medicine, California, USA
| | - Kevin Babila Ousman
- World Health Organization, Regional Office for Africa, Brazzaville, Republic of Congo
| | - Peter Gaturuku
- World Health Organization, Regional Office for Africa, Brazzaville, Republic of Congo
| | | | - Richard Mihigo
- World Health Organization, Regional Office for Africa, Brazzaville, Republic of Congo
| | - Zabulon Yoti
- World Health Organization, Regional Office for Africa, Brazzaville, Republic of Congo
| | | | - Joseph Waogodo Cabore
- World Health Organization, Regional Office for Africa, Brazzaville, Republic of Congo
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Shey M, Okeibunor JC, Yahaya AA, Herring BL, Tomori O, Coulibaly SO, Gumede-Moeletsi HN, Mwenda JM, Yoti Z, Wiysonge CS, Talisuna AO. Genome sequencing and the diagnosis of novel coronavirus (SARS-COV-2) in Africa: how far are we? Pan Afr Med J 2020; 36:80. [PMID: 32774639 PMCID: PMC7386276 DOI: 10.11604/pamj.2020.36.80.23723] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Accepted: 05/27/2020] [Indexed: 12/14/2022] Open
Abstract
The coronavirus disease (COVID-19) caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) has become a pandemic. There is currently no vaccine or effective treatment for COVID-19. Early diagnosis and management is key to favourable outcomes. In order to prevent more widespread transmission of the virus, rapid detection and isolation of confirmed cases is of utmost importance. Real time reverse transcriptase polymerase chain reaction (RT-PCR) is currently the "gold standard" for the detection of SARS-COV-2. There are several challenges associated with this test from sample collection to processing and the longer turnaround time for the results to be available. More rapid and faster diagnostic tests that may produce results within minutes to a few hours will be instrumental in controlling the disease. Serological tests that detect specific antibodies to the virus may be such options. In this review, we extensively searched for studies that compared RT-PCR with serological tests for the diagnosis of COVID-19. We extracted the data from the various selected studies that compared the different tests and summarised the available evidence to determine which test is more appropriate especially in Africa. We also reviewed the current evidence and the challenges for the genome sequencing of SARS-COV-2 in Africa. Finally, we discuss the relevance of the different diagnostic tests and the importance of genome sequencing in identifying potential therapeutic options for the control of COVID-19 in Africa.
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Affiliation(s)
- Muki Shey
- Welcome Centre for Infectious Disease Research in Africa (CIDRI-Africa), Institute of Infectious Disease and Molecular Medicine (IDM), University of Cape Town, Cape Town, South Africa
- Department of Medicine, University of Cape Town, Cape Town, South Africa
| | | | - Ali Ahmed Yahaya
- World Health Organization (WHO), Africa Office, Brazzaville, Congo
| | | | - Oyewale Tomori
- World Health Organization (WHO), Africa Office, Brazzaville, Congo
| | | | | | | | - Zabulon Yoti
- World Health Organization (WHO), Africa Office, Brazzaville, Congo
| | - Charles Shey Wiysonge
- Cochrane Centre, South African Medical Research Council, Cape Town, South Africa
- School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
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Talisuna AO, Okiro EA, Yahaya AA, Stephen M, Bonkoungou B, Musa EO, Minkoulou EM, Okeibunor J, Impouma B, Djingarey HM, Yao NKM, Oka S, Yoti Z, Fall IS. Spatial and temporal distribution of infectious disease epidemics, disasters and other potential public health emergencies in the World Health Organisation Africa region, 2016-2018. Global Health 2020; 16:9. [PMID: 31941554 DOI: 10.1186/s12992-019-050-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Accepted: 12/30/2019] [Indexed: 05/27/2023] Open
Abstract
BACKGROUND Emerging and re-emerging diseases with pandemic potential continue to challenge fragile health systems in Africa, creating enormous human and economic toll. To provide evidence for the investment case for public health emergency preparedness, we analysed the spatial and temporal distribution of epidemics, disasters and other potential public health emergencies in the WHO African region between 2016 and 2018. METHODS We abstracted data from several sources, including: the WHO African Region's weekly bulletins on epidemics and emergencies, the WHO-Disease Outbreak News (DON) and the Emergency Events Database (EM-DAT) of the Centre for Research on the Epidemiology of Disasters (CRED). Other sources were: the Program for Monitoring Emerging Diseases (ProMED) and the Global Infectious Disease and Epidemiology Network (GIDEON). We included information on the time and location of the event, the number of cases and deaths and counter-checked the different data sources. DATA ANALYSIS We used bubble plots for temporal analysis and generated graphs and maps showing the frequency and distribution of each event. Based on the frequency of events, we categorised countries into three: Tier 1, 10 or more events, Tier 2, 5-9 events, and Tier 3, less than 5 or no event. Finally, we compared the event frequencies to a summary International Health Regulations (IHR) index generated from the IHR technical area scores of the 2018 annual reports. RESULTS Over 260 events were identified between 2016 and 2018. Forty-one countries (87%) had at least one epidemic between 2016 and 2018, and 21 of them (45%) had at least one epidemic annually. Twenty-two countries (47%) had disasters/humanitarian crises. Seven countries (the epicentres) experienced over 10 events and all of them had limited or developing IHR capacities. The top five causes of epidemics were: Cholera, Measles, Viral Haemorrhagic Diseases, Malaria and Meningitis. CONCLUSIONS The frequent and widespread occurrence of epidemics and disasters in Africa is a clarion call for investing in preparedness. While strengthening preparedness should be guided by global frameworks, it is the responsibility of each government to finance country specific needs. We call upon all African countries to establish governance and predictable financing mechanisms for IHR implementation and to build resilient health systems everywhere.
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Affiliation(s)
- Ambrose Otau Talisuna
- World Health Organization, Regional Office for Africa, Health Emergencies programme, Brazzaville, Congo.
| | - Emelda Aluoch Okiro
- Population Health Unit, Kenya Medical Research Institute - Wellcome Trust Research Programme, P.O. Box 43640-00100, Nairobi, Kenya
| | - Ali Ahmed Yahaya
- World Health Organization, Regional Office for Africa, Health Emergencies programme, Brazzaville, Congo
| | - Mary Stephen
- World Health Organization, Regional Office for Africa, Health Emergencies programme, Brazzaville, Congo
| | - Boukare Bonkoungou
- World Health Organization, Regional Office for Africa, Health Emergencies programme, Brazzaville, Congo
| | - Emmanuel Onuche Musa
- World Health Organization, Regional Office for Africa, Health Emergencies programme, Brazzaville, Congo
| | | | - Joseph Okeibunor
- World Health Organization, Regional Office for Africa, Health Emergencies programme, Brazzaville, Congo
| | - Benido Impouma
- World Health Organization, Regional Office for Africa, Health Emergencies programme, Brazzaville, Congo
| | - Haruna Mamoudou Djingarey
- World Health Organization, Regional Office for Africa, Health Emergencies programme, Brazzaville, Congo
| | - N'da Konan Michel Yao
- World Health Organization, Regional Office for Africa, Health Emergencies programme, Brazzaville, Congo
| | - Sakuya Oka
- World Health Organization, Regional Office for Africa, Health Emergencies programme, Brazzaville, Congo
| | - Zabulon Yoti
- World Health Organization, Regional Office for Africa, Health Emergencies programme, Brazzaville, Congo
| | - Ibrahima Socé Fall
- World Health Organization, Emergency Response Department, Health Emergencies programme, Geneva, Switzerland
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Fall IS, Rajatonirina S, Yahaya AA, Zabulon Y, Nsubuga P, Nanyunja M, Wamala J, Njuguna C, Lukoya CO, Alemu W, Kasolo FC, Talisuna AO. Integrated Disease Surveillance and Response (IDSR) strategy: current status, challenges and perspectives for the future in Africa. BMJ Glob Health 2019; 4:e001427. [PMID: 31354972 PMCID: PMC6615866 DOI: 10.1136/bmjgh-2019-001427] [Citation(s) in RCA: 62] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2019] [Revised: 05/13/2019] [Accepted: 05/18/2019] [Indexed: 11/04/2022] Open
Abstract
In 1998, the WHO African region adopted a strategy called Integrated Disease Surveillance and Response (IDSR). Here, we present the current status of IDSR implementation; and provide some future perspectives for enhancing the IDSR strategy in Africa. In 2017, we used two data sources to compile information on the status of IDSR implementation: a pretested rapid assessment questionnaire sent out biannually to all countries and quarterly compilation of data for two IDSR key performance indicators (KPI). The first KPI measures country IDSR performance and the second KPI tracks the number of countries that the WHO secretariat supports to scale up IDSR. The KPI data for 2017 were compared with a retrospective baseline for 2014. By December 2017, 44 of 47 African countries (94%) were implementing IDSR. Of the 44 countries implementing IDSR, 40 (85%) had initiated IDSR training at subnational level; 32 (68%) had commenced community-based surveillance; 35 (74%) had event-based surveillance; 33 (70%) had electronic IDSR; and 32 (68%) had a weekly/monthly bulletin for sharing IDSR data. Thirty-two countries (68%) had achieved the timeliness and completeness threshold of at least 80% of the reporting units. However, only 12 countries (26%) had the desired target of at least 90% IDSR implementation coverage at the peripheral level. After 20 years of implementing IDSR, there are major achievements in the indicator-based surveillance systems. However, major gaps were identified in event-based surveillance. All African countries should enhance IDSR everywhere.
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Affiliation(s)
- Ibrahima Socé Fall
- World Health Organization, Regional Office for Africa, Health Emergencies programme, Brazzaville, Congo
| | - Soatiana Rajatonirina
- World Health Organization, Regional Office for Africa, Health Emergencies programme, Brazzaville, Congo
| | - Ali Ahmed Yahaya
- World Health Organization, Regional Office for Africa, Health Emergencies programme, Brazzaville, Congo
| | - Yoti Zabulon
- World Health Organization, Regional Office for Africa, Health Emergencies programme, Brazzaville, Congo
| | - Peter Nsubuga
- Global Public Health Solutions, Atlanta, Georgia, USA
| | | | - Joseph Wamala
- World Health Organization, Country Office, Juba, South Sudan
| | - Charles Njuguna
- World Health Organization, Country Office, Free Town, Sierra Leone
| | - Charles Okot Lukoya
- World Health Organization, Regional Office for Africa, Health Emergencies programme, Brazzaville, Congo
| | | | - Francis Chisaka Kasolo
- World Health Organization, Regional Office for Africa, Country Support, Brazzaville, Congo
| | - Ambrose Otau Talisuna
- World Health Organization, Regional Office for Africa, Health Emergencies programme, Brazzaville, Congo
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Kajungu DK, Erhart A, Talisuna AO, Bassat Q, Karema C, Nabasumba C, Nambozi M, Tinto H, Kremsner P, Meremikwu M, D’Alessandro U, Speybroeck N. Paediatric pharmacovigilance: use of pharmacovigilance data mining algorithms for signal detection in a safety dataset of a paediatric clinical study conducted in seven African countries. PLoS One 2014; 9:e96388. [PMID: 24787710 PMCID: PMC4006882 DOI: 10.1371/journal.pone.0096388] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2014] [Accepted: 04/07/2014] [Indexed: 11/18/2022] Open
Abstract
Background Pharmacovigilance programmes monitor and help ensuring the safe use of medicines which is critical to the success of public health programmes. The commonest method used for discovering previously unknown safety risks is spontaneous notifications. In this study we examine the use of data mining algorithms to identify signals from adverse events reported in a phase IIIb/IV clinical trial evaluating the efficacy and safety of several Artemisinin-based combination therapies (ACTs) for treatment of uncomplicated malaria in African children. Methods We used paediatric safety data from a multi-site, multi-country clinical study conducted in seven African countries (Burkina Faso, Gabon, Nigeria, Rwanda, Uganda, Zambia, and Mozambique). Each site compared three out of four ACTs, namely amodiaquine-artesunate (ASAQ), dihydroartemisinin-piperaquine (DHAPQ), artemether-lumefantrine (AL) or chlorproguanil/dapsone and artesunate (CD+A). We examine two pharmacovigilance signal detection methods, namely proportional reporting ratio and Bayesian Confidence Propagation Neural Network on the clinical safety dataset. Results Among the 4,116 children (6–59 months old) enrolled and followed up for 28 days post treatment, a total of 6,238 adverse events were reported resulting into 346 drug-event combinations. Nine signals were generated both by proportional reporting ratio and Bayesian Confidence Propagation Neural Network. A review of the manufacturer package leaflets, an online Multi-Drug Symptom/Interaction Checker (DoubleCheckMD) and further by therapeutic area experts reduced the number of signals to five. The ranking of some drug-adverse reaction pairs on the basis of their signal index differed between the two methods. Conclusions Our two data mining methods were equally able to generate suspected signals using the pooled safety data from a phase IIIb/IV clinical trial. This analysis demonstrated the possibility of utilising clinical studies safety data for key pharmacovigilance activities like signal detection and evaluation. This approach can be applied to complement the spontaneous reporting systems which are limited by under reporting.
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Affiliation(s)
- Dan K. Kajungu
- Research Institute of Health and Society (IRSS), Université catholique de Louvain, Brussels, Belgium
- Uganda Malaria Surveillance project/Infectious Disease Research Collaboration, Kampala, Uganda
- Santé Stat. and Analytical Research Institute (SSARI), Kampala, Uganda
- * E-mail:
| | | | - Ambrose Otau Talisuna
- Malaria Public Health Department, University of Oxford-KEMRI-Wellcome Trust Programme, Nairobi, Kenya
- Uganda Malaria Surveillance project/Infectious Disease Research Collaboration, Kampala, Uganda
| | - Quique Bassat
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique/Barcelona Centre for International Health Research (CRESIB, Hospital Clínic-Universitat de Barcelona), Barcelona, Spain
| | - Corine Karema
- National Malaria Control Program–TRAC Plus, Ministry of Health, Kigali, Rwanda
| | - Carolyn Nabasumba
- Epicentre, Paris, France/Mbarara University of Science and Technology, Faculty of Medicine, Mbarara, Uganda
| | | | - Halidou Tinto
- Institut de Recherches en Sciences de la Santé, Bobo Dioulasso, Burkina Faso/Centre Muraz, Bobo Dioulasso, Burkina Faso
| | - Peter Kremsner
- Institut für Tropenmedizin, Universität Tübingen, Germany and Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
| | - Martin Meremikwu
- Department of Paediatrics, University of Calabar, Calabar, Nigeria/Institute of Tropical Diseases Research & Prevention, Calabar, Nigeria
| | - Umberto D’Alessandro
- Institute of Tropical Medicine, Antwerp, Belgium
- Medical Research Council Unit, Fajara, The Gambia
| | - Niko Speybroeck
- Research Institute of Health and Society (IRSS), Université catholique de Louvain, Brussels, Belgium
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Nsubuga P, Brown WG, Groseclose SL, Ahadzie L, Talisuna AO, Mmbuji P, Tshimanga M, Midzi S, Wurapa F, Bazeyo W, Amri M, Trostle M, White M. Implementing Integrated Disease Surveillance and Response: Four African countries' experience, 1998-2005. Glob Public Health 2010; 5:364-80. [PMID: 19916090 DOI: 10.1080/17441690903334943] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The Integrated Disease Surveillance and Response (IDSR) strategy was developed by the Africa Regional Office (AFRO) of the World Health Organisation (WHO) and proposed for adoption by member states in 1998. The goal was to build WHO/AFRO countries' capacity to detect, report and effectively respond to priority infectious diseases. This evaluation focuses on the outcomes in four countries that implemented this strategy. Major successes included: integration of the surveillance function of most of the categorical disease control programmes; implementation of standard surveillance, laboratory and response guidelines; improved timeliness and completeness of surveillance data and increased national-level review and use of surveillance data for response. The most challenging aspects were: strengthening laboratory networks; providing regular feedback and supervision on surveillance and response activities; routine monitoring of IDSR activities and extending the strategy to sub-national levels.
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Affiliation(s)
- P Nsubuga
- Coordinating Office for Global Health, Centres for Disease Control and Prevention, Atlanta, GA, USA.
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14
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Talisuna AO, Langi P, Mutabingwa TK, Watkins W, Van Marck E, Egwang TG, D'Alessandro U. Population-based validation of dihydrofolate reductase gene mutations for the prediction of sulfadoxine-pyrimethamine resistance in Uganda. Trans R Soc Trop Med Hyg 2004; 97:338-42. [PMID: 15228255 DOI: 10.1016/s0035-9203(03)90163-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Mutations in the dihydrofolate reductase gene (dhfr) of Plasmodium falciparum have been proposed as molecular markers for the surveillance of sulfadoxine-pyrimethamine (SP)-resistant malaria, but such proposals have not been validated. At 7 Ugandan sites in 1999, we determined the population-based prevalence of infections with mutations and the mutant allele frequency of dhfr codons 108, 51, and 59 using a random sample of infected individuals aged 1-45 years. Sulfadoxine-pyrimethamine treatment failure was independently estimated by in vivo tests in 327 children aged 6-59 months with clinical malaria. The prevalence of infections with the single point mutations and the dhfr codons 108 and 51 mutant allele frequency were not correlated to SP treatment failure. However, the dhfr codon 59 mutant allele frequency was positively correlated to SP treatment failure (r = 0.72, P = 0.06). The ratio of the infections with the mutant to wild genotype (M/W) and that of the mutant to wild allele (MA/WA) had the same values. Both dhfr codon 59 M/W and MA/WA ratio were significantly and positively correlated to SP treatment failure (r = 0.73, P = 0.05). Moreover, the prevalence of infections with only 2 mutations (Asn-108 plus Ile-51) was significantly and inversely correlated to the prevalence of infections with 3 mutations (Asn-108 plus Ile-51 plus Arg-59) (r = 0.92, P = 0.004), suggesting the stepwise accumulation of the dhfr mutations is Asn-108 Ile-51 Arg-59 and further supporting the idea of using the dhfr codon 59 M/W ratio as a molecular index for the prediction of SP treatment failure. Atthe population level, the dhfr codon 59 M/W ratio is a simple and stable index for the estimation of SP treatment failure.
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Abstract
Chloroquine (CQ) resistance was first documented in Uganda in 1988. Subsequent surveillance of antimalarial drug resistance, conducted by the Ugandan Ministry of Health and several research organizations, suggests that resistance to CQ is now widespread, reaching critical levels in many areas of the country. In June 2000, the Ministry of Health held a National Consensus Meeting to evaluate the available drug efficacy data and review the national antimalarial drug policy. After extensive debate, the combination of CQ + sulfadoxine-pyrimethamine (SP) was chosen to replace CQ as the first-line treatment of uncomplicated malaria as an interim policy. This review evaluates the in vivo drug efficacy studies conducted in Uganda since 1988 and issues confronted in revision of the drug policy. The Ugandan experience illustrates the challenges faced by sub-Saharan African countries confronted with rising CQ resistance but limited data on potential alternative options. The choice of CQ + SP as a provisional policy in the absence of prerequisite efficacy, safety and cost-effectiveness data reflects the urgency of the malaria treatment problem, and growing pressure to adopt combination therapies. Surveillance of CQ + SP treatment efficacy, collection of additional data on alternative regimens and active consensus building among key partners in the malaria community will be necessary to develop a rational long-term antimalarial treatment policy in Uganda.
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Affiliation(s)
- M R Kamya
- Makerere University Medical School, Kampala, Uganda.
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Talisuna AO, Langi P, Bakyaita N, Egwang T, Mutabingwa TK, Watkins W, Van Marck E, D'Alessandro U. Intensity of malaria transmission, antimalarial-drug use and resistance in Uganda: what is the relationship between these three factors? Trans R Soc Trop Med Hyg 2002; 96:310-7. [PMID: 12174786 DOI: 10.1016/s0035-9203(02)90108-2] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
We studied (in 1998 and 1999) some factors that may be linked to the spread of chloroquine (CQ) and sulfadoxine-pyrimethamine (SP) resistance in 7 discrete communities in Uganda. Exposure to malaria infection was measured by parasitological surveys in children aged 1-9 years, drug use by community surveys and drug resistance by in-vivo tests on children aged 6-59 months with clinical malaria. CQ use was inversely related to parasite prevalence (r = -0.85, P = 0.01). CQ and SP treatment failure rates varied significantly according to parasite prevalence (P = 0.001 and 0.04 respectively). The highest CQ (42.4%, 43.8%) and SP (12.5%, 14.8%) treatment failure rates were observed in sites characterized by high parasite prevalence. Using areas with medium parasite prevalence as reference, the relative risk (RR) for CQ treatment failure was 3.2 (95% CI 1.6-6.4) in high parasite prevalence sites and 3.1 (95% CI 1.2-7.7) in low parasite prevalence sites. The RR for SP treatment failure was also higher in sites with high parasite prevalence but low in those with low parasite prevalence. According to our findings, drug resistance seems to spread faster in higher transmission areas, regardless of drug pressure. In low transmission areas, drug pressure seems to be the critical factor. A decrease in transmission coupled with rational use of drugs may delay the spread of resistance.
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Affiliation(s)
- A O Talisuna
- Ministry of Health, P. O. Box 7272, Kampala, Uganda.
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Legros D, Johnson K, Houpikian P, Makanga M, Kabakyenga JK, Talisuna AO, Taylor WRJ. Clinical efficacy of chloroquine or sulfadoxine-pyrimethamine in children under five from south-western Uganda with uncomplicated falciparum malaria. Trans R Soc Trop Med Hyg 2002; 96:199-201. [PMID: 12055815 DOI: 10.1016/s0035-9203(02)90304-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
We conducted a 14-day study (during March-May 1998) to assess the efficacy of chloroquine and sulfadoxine-pyrimethamine (SP) for treating uncomplicated Plasmodium falciparum malaria in Uganda. Overall treatment failure rates were 43 (81.1%) of 53 chloroquine recipients and 16 (25.0%) of 64 SP patients. Strategies to improve the life-span of standard and affordable anti-malarial drugs are needed.
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Affiliation(s)
- D Legros
- Epicentre, P.O. Box 2362, Kampala, Uganda
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Shulman CE, Dorman EK, Talisuna AO, Lowe BS, Nevill C, Snow RW, Jilo H, Peshu N, Bulmer JN, Graham S, Marsh K. A community randomized controlled trial of insecticide-treated bednets for the prevention of malaria and anaemia among primigravid women on the Kenyan coast. Trop Med Int Health 1998; 3:197-204. [PMID: 9593358 DOI: 10.1046/j.1365-3156.1998.00214.x] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The effectiveness of insecticide-treated bednets (ITBN) in preventing malaria and anaemia among primigravidae living in Kilifi District, Kenya, was assessed by a randomized controlled trial between September 1994 and November 1995. All residents within 28 community clusters received ITBN in July 1993, whilst residents of another 28 clusters served as contemporaneous controls. All resident primigravid women with singleton pregnancies attending antenatal care at Kilifi District Hospital were eligible for recruitment. 503 primigravidae were recruited. 91.4% were anaemic antenatally (Hb < 11 g/dl): 91.0% from the intervention arm and 92.0% from the control arm. Severe anaemia (Hb < 7 g/dl) was found among 15.1% of intervention women and 20.1% of control women (P = 0.28). No significant differences were observed in reports of febrile illness or the presence of chloroquine in the serum or peripheral parasitaemia during the third trimester between the two groups. In the women delivering in hospital (n = 130), there was no association between placental malaria infection and the intervention: 77.4% of placentas from control women had evidence of past or active infection, compared with 72.0% of placentas from intervention women (P = 0.76). Similarly, in the women delivering in hospital, ITBN did not improve birth weight, and there were no differences in perinatal mortality between the two study groups. Despite ITBN having a great impact on paediatric severe malaria and mortality in this transmission setting, there was very little impact of ITBN on the morbidity associated with malaria infection in primigravidae. Alternative strategies are required to tackle this continued public health problem for pregnant women living in endemic areas similar to the Kenyan Coast.
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Affiliation(s)
- C E Shulman
- London School of Hygiene and Tropical Medicine, UK
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