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Mapingure M, Chingombe I, Dzinamarira T, Moyo B, Samba C, Murigo D, Mugurungi O, Mbunge E, Makota RB, Murewanhema G, Musuka G. Correction: Presence of tuberculosis symptoms among HIV-positive men who have sex with men (MSM) in Zimbabwe. AIDS Res Ther 2024; 21:26. [PMID: 38685106 PMCID: PMC11059734 DOI: 10.1186/s12981-024-00617-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/12/2024] [Indexed: 05/02/2024] Open
Affiliation(s)
| | | | | | - Brian Moyo
- AIDS and TB Programmes, Ministry of Health and Child Care, Harare, Zimbabwe
| | | | | | - Owen Mugurungi
- AIDS and TB Programmes, Ministry of Health and Child Care, Harare, Zimbabwe
| | - Elliot Mbunge
- Department of Computer Science, Faculty of Science and Engineering, University of Eswatini, Kwaluseni, Eswatini
| | - Rutendo Birri Makota
- Department of Biological Sciences and Ecology, University of Zimbabwe, Harare, Zimbabwe
| | - Grant Murewanhema
- Unit of Obstetrics and Gynaecology, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Godfrey Musuka
- International Initiative for Impact Evaluation, Harare, Zimbabwe.
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Moyo E, Dzinamarira T, Moyo P, Murewanhema G, Ross A. Men's involvement in maternal health in sub-Saharan Africa: A scoping review of enablers and barriers. Midwifery 2024; 133:103993. [PMID: 38626505 DOI: 10.1016/j.midw.2024.103993] [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: 11/18/2023] [Revised: 03/17/2024] [Accepted: 04/05/2024] [Indexed: 04/18/2024]
Abstract
BACKGROUND Globally, there are about 800 maternal deaths every day, with low-to-middle-income countries accounting for most of these deaths. A lack of access to maternal healthcare services is one of the main causes of these deaths. In sub-Saharan Africa (SSA), one of the barriers to accessing maternal healthcare services by women is a lack of their male partners' involvement. This scoping review aimed to assess the enablers and barriers to men's involvement in maternal healthcare services. METHODS The Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews (PRISMA-ScR) checklist was used as a guide for this review. We searched for peer-reviewed articles published between 2013 and 2023 in the English language from SCOPUS, ScienceDirect, PubMed, Africa Journals Online (AJOL), and Google Scholar databases. Two reviewers independently conducted the data extraction and article selection. All of the authors discussed and decided on the codes and categories for enablers and barriers after using NVivo to generate them. RESULTS Twenty-seven articles were used in this review. Of these, seventeen were qualitative studies, six were quantitative studies, and four were mixed-methods studies. The enablers of men's involvement in maternal healthcare were grouped into sociodemographic factors, health system factors, and policy factors, while barriers were grouped into sociodemographic, cultural, economic, and health system barriers. The lack of maternal health knowledge, insufficient economic resources, and unfriendly staff at healthcare facilities all contributed to a lack of involvement by men. CONCLUSION To improve men's involvement in maternal healthcare in SSA, there should be economic empowerment of both men and women, health education, and the provision of adequate infrastructure in healthcare facilities to accommodate men.
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Affiliation(s)
- Enos Moyo
- University of Kwa-Zulu Natal, College of Health Sciences, School of Nursing & Public Health, Durban, South Africa.
| | - Tafadzwa Dzinamarira
- School of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa.
| | | | - Grant Murewanhema
- University of Zimbabwe, Faculty of Medicine and Health Sciences, Unit of Obstetrics and Gynaecology, Harare, Zimbabwe
| | - Andrew Ross
- University of Kwa-Zulu Natal, College of Health Sciences, School of Nursing & Public Health, Durban, South Africa
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Mapingure M, Chingombe I, Dzinamarira T, Moyo B, Samba C, Murigo D, Mugurungi O, Mbunge E, Makota RB, Murewanhema G, Musuka G. Presence of tuberculosis symptoms among HIV-positive men who have sex with men (MSM) in Zimbabwe. AIDS Res Ther 2024; 21:18. [PMID: 38549087 PMCID: PMC10979552 DOI: 10.1186/s12981-024-00605-8] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 03/14/2024] [Indexed: 04/01/2024] Open
Abstract
We conducted secondary data analysis using a biobehavioral survey dataset of 1538 MSM from Zimbabwe. Survey participants were screened for the four symptoms suggestive of tuberculosis infection using the WHO TB screening algorithm. Results: All participants experienced at least one symptom suggestive of tuberculosis. 40% of HIV-positive MSM reported having had a cough in the last month and 13% of them experienced unexpected weight loss. The prevalence of experiencing any of the four TB symptoms amongst HIV-positive MSM was 23%. Contribution There is an urgent need for active TB case finding and treatment amongst HIV-positive MSM in Zimbabwe. Clinicians will need to ensure that MSM who need TB testing receive it timeously.
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Affiliation(s)
| | | | | | - Brian Moyo
- AIDS and TB Programmes, Ministry of Health and Child Care, Harare, Zimbabwe
| | | | | | - Owen Mugurungi
- AIDS and TB Programmes, Ministry of Health and Child Care, Harare, Zimbabwe
| | - Elliot Mbunge
- Department of Computer Science, Faculty of Science and Engineering, University of Eswatini, Kwaluseni, Eswatini
| | - Rutendo Birri Makota
- Department of Biological Sciences and Ecology, University of Zimbabwe, Harare, Zimbabwe
| | - Grant Murewanhema
- Unit of Obstetrics and Gynaecology, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Godfrey Musuka
- International Initiative for Impact Evaluation, Harare, Zimbabwe.
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Dzinamarira T, Moyo E, Moyo B, Murewanhema G, Cuadros D, Kouamou V, Mpofu A, Musuka G. Strengthening and enhancing national antiretroviral drug resistance surveillance in Zimbabwe-A country that has reached UNAIDS 95-95-95 amongst adults. Front Public Health 2024; 12:1346027. [PMID: 38420022 PMCID: PMC10899673 DOI: 10.3389/fpubh.2024.1346027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 02/02/2024] [Indexed: 03/02/2024] Open
Affiliation(s)
- Tafadzwa Dzinamarira
- School of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa
- International Center for AIDS Care and Treatment Programs, Columbia University, Lusaka, Zambia
| | - Enos Moyo
- Department of Public Health Medicine, University of KwaZulu Natal, Durban, South Africa
| | - Brian Moyo
- Ministry of Health and Child Care, Harare, Zimbabwe
| | - Grant Murewanhema
- Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Diego Cuadros
- University of Cincinnati, Cincinnati, OH, United States
| | - Vinie Kouamou
- Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Amon Mpofu
- National AIDS Council of Zimbabwe, Harare, Zimbabwe
| | - Godfrey Musuka
- International Initiative for Impact Evaluation, Harare, Zimbabwe
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Dzinamarira T, Moyo E, Murewanhema G. Correspondence on "A case for the inclusion of doxycycline post-exposure prophylaxis for sexually transmitted infections among men who have sex with men in sub-Saharan African countries' guidelines for the management of sexually transmitted infections" by "Dzinamarira et al". Sex Transm Infect 2024; 100:57. [PMID: 37833057 DOI: 10.1136/sextrans-2023-055943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2023] Open
Affiliation(s)
- Tafadzwa Dzinamarira
- School of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa
- ICAP at Columbia University, Lusaka, Zambia
| | - Enos Moyo
- Department of Nusing and Public Health Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Grant Murewanhema
- Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe
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Mangoya D, Moyo E, Murewanhema G, Moyo P, Chitungo I, Dzinamarira T. The HIV/AIDS responses pre and during the COVID-19 pandemic in sub-Saharan Africa: A basis for sustainable health system strengthening post-COVID-19. IJID Reg 2023; 9:38-41. [PMID: 37854317 PMCID: PMC10579951 DOI: 10.1016/j.ijregi.2023.09.006] [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] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 09/22/2023] [Indexed: 10/20/2023]
Abstract
In May 2023, the World Health Organization announced that COVID-19 was no longer a global emergency. The impact of COVID-19 on the provision of HIV/AIDS services was not that severe due to the reprogramming of key resources. For health systems in sub-Saharan Africa to become resilient to future pandemics, lessons should be learned from the successful HIV/AIDS response in the region, and how the HIV/AIDS services were successfully adapted to the COVID-19 pandemic. In this article, we reviewed the 6 World Health Organization health system building blocks on how the best practices from the provision of HIV/AIDS services and the services' response to the COVID-19 pandemic can be used as a basis for restoring and strengthening health systems to offer universal access to quality essential health services. The success of the leadership and governance for universal access to anti-retroviral therapy can be a blueprint for the realization of universal health coverage. Significant efficiencies that resulted in the reduction in anti-retroviral therapy costs can be leveraged to ensure cheaper essential drugs while differentiated service delivery models can be used to improve health service accessibility. New technologies that have proven to be successful in HIV/AIDS care can also be used in the care of other diseases, including disease outbreaks. The strong health information systems developed for HIV programs can be used as a foundation for developing health information systems for the whole health sector while the healthcare professionals trained for the provision of HIV/AIDS services can be trained to provide services for a variety of other conditions.
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Affiliation(s)
- Derek Mangoya
- The Centre for HIV and AIDS Prevention Studies, Windhoek, Namibia
| | - Enos Moyo
- University of Kwa-Zulu Natal, College of Health Sciences, School of Nursing & Public Health, Durban, South Africa
| | - Grant Murewanhema
- Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | | | - Itai Chitungo
- School of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa
| | - Tafadzwa Dzinamarira
- School of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa
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Moyo E, Chimene M, Moyo P, Musuka G, Mangoya D, Murewanhema G, Dzinamarira T. Risk factors and clinical presentations of long COVID in Africa: A scoping review. J Infect Public Health 2023; 16:1982-1988. [PMID: 37890221 DOI: 10.1016/j.jiph.2023.09.021] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 09/18/2023] [Accepted: 09/20/2023] [Indexed: 10/29/2023] Open
Abstract
COVID-19-related complications can last for years, even in patients who are asymptomatic during the acute phase, a phenomenon referred to as long COVID. This scoping review aimed to summarize the risk factors and clinical symptoms of long COVID in Africa between 2020 and 2022. Five studies were included. Three of the studies used in this review were retrospective cross-sectional studies, one was a prospective cohort study while another one was a case-control study. The review identified several risk factors for long COVID, including being female, being older than 40 years, having more than four acute COVID-19 symptoms, and having concomitant conditions such as asthma, hypertension, and depression. General, respiratory, cardiovascular, otolaryngological, gastrointestinal, and neurological symptoms were among the reported long COVID symptoms. To ensure that patients with long COVID are diagnosed and treated early, the risk factors and clinical symptoms of long COVID need to be identified for different population groups.
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Affiliation(s)
- Enos Moyo
- Medical Center Oshakati, Oshakati, Namibia
| | | | | | - Godfrey Musuka
- International Initiative for Impact Evaluation, Harare, Zimbabwe
| | - Derek Mangoya
- The Centre for HIV and AIDS Prevention Studies, Windhoek, Namibia
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Murewanhema G, Moyo E, Dzinamarira T. Making every baby count - An urgent reproductive health priority as sub-Saharan Africa continues to witness a high incidence of stillbirths. Afr J Reprod Health 2023; 27:15-17. [PMID: 38051180 DOI: 10.29063/ajrh2023/v27i11.2] [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] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2023]
Abstract
The expected culmination of a positive pregnancy experience is a healthy mother and a bouncing live baby. Unfortunately, globally an estimated 2 million babies are still born every year, with the largest incidence of stillbirths of about 50% of the global burden occurring in sub-Saharan Africa (SSA). Significant gaps in access to quality antenatal care (ANC) and labour and delivery remain in SSA. It is estimated that only 24% of women receive at least four ANC visits in SSA. Women are prepared for labour and delivery during this period, and risk factors are identified, and potential complications can be averted. Access to labour and delivery services is critical for picking up foetal compromise. Women must deliver in facilities that can offer assisted delivery and offer foetal and neonatal resuscitation, to prevent stillbirths and early neonatal deaths. In SSA, many primary healthcare facilities are unable to offer these services, whilst higher level facilities that can offer these may be difficult to access. The majority of stillbirths are preventable if women access quality ANC and can access modern facilities for labour and delivery. Therefore, stakeholders in reproductive health must ensure access to ANC for a positive pregnancy experience.
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Affiliation(s)
- Grant Murewanhema
- University of Zimbabwe, Faculty of Medicine and Health Sciences, Unit of Obstetrics and Gynaecology, Harare, Zimbabwe
| | - Enos Moyo
- University of Kwa-Zulu Natal, College of Health Sciences, School of Nursing & Public Health, Durban, South Africa
| | - Tafadzwa Dzinamarira
- School of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa
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Dzobo M, Dzinamarira T, Murewanhema G, Chishapira T, Dube Mandishora RS, Fitzpatrick M, Mashamba-Thompson T. Co-creation of human papillomavirus self-sampling delivery strategies for cervical cancer screening in rural Zimbabwe: nominal group technique. Front Public Health 2023; 11:1275311. [PMID: 38035305 PMCID: PMC10687562 DOI: 10.3389/fpubh.2023.1275311] [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] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 10/24/2023] [Indexed: 12/02/2023] Open
Abstract
Background Human papillomavirus (HPV) self-sampling is recommended for cervical cancer screening, particularly among women who do not participate in or have access to current screening methods offered in Zimbabwe. Key stakeholder involvement is critical in co-creating acceptable delivery strategies for implementing HPV self-sampling to ensure demand and facilitate uptake by the target population. The main objective of this study was to engage key stakeholders in co-creating acceptable HPV self-sampling delivery strategies for cervical cancer screening in rural Zimbabwe. Methods We invited key stakeholders and employed a nominal group technique (NGT) for data collection. We employed the NGT to (1) identify barriers to access and utilisation of available cervical cancer screening services and (2) co-create delivery strategies for HPV self-sampling. The workshop included 8 participants (women n = 4, health workers n = 2 and policymakers n = 2). Quantitative data was gathered by ranking ideas and qualitative data were collected from participant group discussions and analysed thematically. The results of the ranking exercise were fed back to the participants for comments. Results The most significant barriers to accessing and utilising current cervical cancer screening services by women were: Inadequate information and education on cervical cancer, lack of resources and funding for cervical cancer programmes, long distances to nearest health facilities, and low perceived personal risk of cervical cancer. Key stakeholders recommended enhanced education and awareness, results notification, linkage to care, community-based self-sampling, and the choice of sampling devices as potential HPV self-sampling delivery strategies. Conclusion Our study demonstrated the utility of the NGT for reaching a consensus. Using the NGT, we established priority delivery strategies for HPV self-sampling cervical cancer screening. Adequate education and awareness, early results notification, choice of sampling device and community-based self-sampling were crucial to HPV self-sampling screening in rural Zimbabwe. The proposed delivery strategies can guide the development of guidelines for designing and implementing an HPV self-sampling intervention. We recommend a study to determine women's most preferred HPV self-sampling delivery strategies before implementing the intervention.
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Affiliation(s)
- Mathias Dzobo
- School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Tafadzwa Dzinamarira
- School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
- Centre for International Programmes Zimbabwe Trust, Harare, Zimbabwe
| | - Grant Murewanhema
- Unit of Obstetrics and Gynaecology, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Tatenda Chishapira
- Medical Microbiology Unit, Department of Laboratory Diagnostics and Investigative Sciences, University of Zimbabwe Faculty of Medicine and Health Sciences, Harare, Zimbabwe
| | - Racheal S. Dube Mandishora
- Medical Microbiology Unit, Department of Laboratory Diagnostics and Investigative Sciences, University of Zimbabwe Faculty of Medicine and Health Sciences, Harare, Zimbabwe
- Moffitt Cancer Center, Center for Immunization and Infection Research in Cancer (CIIRC), Tampa, FL, United States
| | - Megan Fitzpatrick
- Department of Pathology and Laboratory Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States
| | - Tivani Mashamba-Thompson
- School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
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Chikava T, Eghtessadi R, Chingombe I, Murewanhema G, Cheza A, Dzinamarira T, Herrera H, Musuka GN. Zimbabwean law and its impact on HIV programmes for key populations. Front Public Health 2023; 11:1272775. [PMID: 37920588 PMCID: PMC10619717 DOI: 10.3389/fpubh.2023.1272775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 10/02/2023] [Indexed: 11/04/2023] Open
Affiliation(s)
- Tendai Chikava
- Independent Consultant, Independent Legal Consultancy Services, Harare, Zimbabwe
| | | | - Innocent Chingombe
- Independent Consultant, Independent Public Health Consultancy, Harare, Zimbabwe
| | - Grant Murewanhema
- College of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Alexander Cheza
- Discipline of Public Health, University of KwaZulu Natal, Durban, South Africa
| | - Tafadzwa Dzinamarira
- School of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa
| | - Helena Herrera
- School of Pharmacy and Biomedical Sciences, University of Portsmouth, Portsmouth, United Kingdom
| | - Godfrey N. Musuka
- Public Health Consultants, International Initiative for Impact Evaluation, Harare, Zimbabwe
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Murewanhema G, Mpabuka E, Moyo E, Tungwarara N, Chitungo I, Mataruka K, Gwanzura C, Musuka G, Dzinamarira T. Accessibility and utilization of antenatal care services in sub-Saharan Africa during the COVID-19 pandemic: A rapid review. Birth 2023; 50:496-503. [PMID: 36877622 DOI: 10.1111/birt.12719] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 02/03/2023] [Accepted: 02/08/2023] [Indexed: 03/07/2023]
Abstract
Control measures for the COVID-19 pandemic brought unprecedented challenges to health care delivery. Some countries in sub-Saharan Africa (SSA) stopped the provision of essential health care except for those services that were deemed emergencies or life-threatening. A rapid review was conducted on March 18, 2022, on the accessibility and utilization of antenatal care services in sub-Saharan Africa during the COVID-19 pandemic. PubMed, Google Scholar, SCOPUS, and the World Health Organization library databases were searched for relevant studies. A modified Population, Intervention, Control, and Outcomes (PICO) framework informed the development of the search strategy. The review included studies conducted within Africa that described the availability, access, and utilization of antenatal services during the COVID-19 pandemic. Eighteen studies met the inclusion criteria. This review revealed a reduction in access to ANC services, an increase in the number of home deliveries, and a reduction in the number of women attending ANC visits during the COVID-19 pandemic. A decrease in ANC service utilization was reported in some studies in the review. Barriers to ANC access and utilization during the COVID-19 pandemic included movement restrictions, limited transport access, fear of contracting COVID-19 at the health facilities, and facility barriers. The use of telemedicine needs to be improved in African countries to allow for the continued provision of health services during pandemics. In addition, there should strengthening of community involvement in the provision of maternal health services post-COVID-19 so that services may be able to better withstand future public health emergencies.
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Affiliation(s)
- Grant Murewanhema
- Unit of Obstetrics and Gynaecology, Department of Primary Health Care Sciences, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | | | - Enos Moyo
- Medical Centre Oshakati, Oshakati, Namibia
| | - Nigel Tungwarara
- Department of Health Studies, University of South Africa, Pretoria, South Africa
| | - Itai Chitungo
- Chemical Pathology Unit, Department of Laboratory Diagnostic and Investigative Sciences, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Kidson Mataruka
- Biomedical Research and Training Institute, Harare, Zimbabwe
| | - Chipo Gwanzura
- Unit of Obstetrics and Gynaecology, Department of Primary Health Care Sciences, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | | | - Tafadzwa Dzinamarira
- ICAP at Columbia University, Kigali, Rwanda
- ICAP at Columbia University, Harare, Zimbabwe
- School of Health Systems & Public Health, University of Pretoria, Pretoria, South Africa
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Mapingure M, Dzinamarira T, Mukandavire Z, Chingombe I, Cuadros DF, Eghtessadi R, Mutenherwa F, Herrera H, Madziva R, Mukwenha S, Murewanhema G, Musuka G. Understanding the role of intimate partner violence on HIV transmission in Zimbabwe: Secondary data analysis of data from the Zimbabwe demographic survey 2015-2016. Health Promot Perspect 2023; 13:113-119. [PMID: 37600546 PMCID: PMC10439455 DOI: 10.34172/hpp.2023.14] [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: 08/22/2022] [Accepted: 01/18/2023] [Indexed: 08/22/2023] Open
Abstract
Background Gender-based violence (GBV) has been shown to have significant and long-lasting impacts on women's physical and mental health. It is, therefore, important to study its occurrence in a population and its intersect with infectious diseases such as HIV to inform the wider health promotion agenda. This study aimed to determine the association between GBV and HIV status in women and adolescent girls in Zimbabwe. Methods A secondary data analysis of data from a cross-sectional Zimbabwe Demographic and Health Survey (ZDHS) was conducted. Statistical analysis was employed to establish the association between GBV and HIV status. Geospatial mapping was conducted using a kernel smoothing method was employed to generate a continuous kernel density surface to illustrate the local spatial variations of female HIV and GBV prevalence. Results Women and adolescent girls suffering emotional GBV, such as those subjected to humiliation by their husbands or partners, were 1.45 (1.14-1.84) [OR (95% CIs)] times more likely to be HIV positive than those who were never humiliated. The same was true for women and adolescent girls whose husbands or partners threatened to harm them or someone they love, 1.33 (1.04-1.68). There is a relationship between women's HIV status and intimate partner aggression, such as when their partners pushed, shook, or threw something at them or physically abused them. This was also the case for those who reported that partners kicked, dragged, or beat them, tried to choke or burn them on purpose, or threatened or attacked them with a knife, gun, or other weapons. Women who experienced forced sexual violence with threats were more likely 1.61 (1.08-2.41), to be HIV positive than those women who did not experience the same. Conclusion GBV is widely spread in Zimbabwe. There is a need for the government to implement creative strategies to reach out to survivors, especially those that are forced to have unprotected sex and are at increased risk of HIV acquisition. This manuscript raises issues that can be addressed by robust health promotion strategies to reduce the impact of the syndemic of GBV and HIV acquisition in Zimbabwe.
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Affiliation(s)
| | - Tafadzwa Dzinamarira
- ICAP at Columbia University, Harare, Zimbabwe
- School of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa
| | - Zindoga Mukandavire
- Emirates Aviation University, Centre for Data Science and Artificial Intelligence, Dubai, UAE
| | | | - Diego F. Cuadros
- Department of Geography and Geographic Information Science, University of Cincinnati, Cincinnati, USA
| | | | | | | | - Roda Madziva
- School of Sociology and Social Policy, University of Nottingham, Nottingham, United Kingdom
| | | | - Grant Murewanhema
- Unit of Obstetrics and Gynecology, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe
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Mgodi NM, Murewanhema G, Moyo E, Samba C, Musuka G, Dzinamarira T, Brown JM. Advancing the use of Long-Acting Extended Delivery formulations for HIV prevention in sub-Saharan Africa: challenges, opportunities, and recommendations. J Int AIDS Soc 2023; 26 Suppl 2:e26115. [PMID: 37439069 DOI: 10.1002/jia2.26115] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 05/11/2023] [Indexed: 07/14/2023] Open
Abstract
INTRODUCTION The burden of HIV in sub-Saharan Africa (SSA) remains unacceptably high, and disproportionately affects girls and women. While the introduction of oral HIV pre-exposure prophylaxis (PrEP) in 2012 revolutionized HIV prevention, its effectiveness is dependent on user adherence and its implementation in SSA has faced numerous challenges. Patient-level, interpersonal and structural barriers, including, for example, daily pill burden, side effects, lack of partner support, testing and disclosure, and costs have been found to reduce adherence to oral PrEP. DISCUSSION Long-acting extended delivery (LAED) formulations for PrEP, such as injectable long-acting cabotegravir (CAB-LA) and dapivirine vaginal ring (DPV-VR) are critical additions to the HIV prevention toolkit and are especially important for populations such as adolescent girls and young women (AGYW) and other key populations who remain at significant risk of HIV acquisition while facing substantial barriers to preventive services. These LAED formulations have been shown to result in better adherence and fewer side effects, with CAB-LA being superior to oral PrEP in reducing the risk of HIV acquisition. They can be used to overcome user burden and adherence challenges. However, the successful rollout of the DPV-VR and CAB-LA may be hampered by issues such as a shortage of healthcare providers (HCPs), inadequate parenteral medication infrastructure, increased workload for HCPs, patient concerns, the price of the medications and the possibility of drug resistance. CONCLUSIONS SSA must develop laboratory capabilities for monitoring patients on LAED formulations and enhance research on developing more non-injectable LAED formulations. There is a need to train and retain more HCPs, implement task shifting, invest in healthcare infrastructure and integrate healthcare services. To reduce costs and improve availability, the region must advocate for patent license waivers for LAED formulations and procure drugs collectively as a region.
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Affiliation(s)
- Nyaradzo M Mgodi
- University of Zimbabwe Clinical Trials Research Centre, Harare, Zimbabwe
| | - Grant Murewanhema
- Unit of Obstetrics and Gynecology, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | | | | | - Godfrey Musuka
- International Initiative for Impact Evaluation, Harare, Zimbabwe
| | - Tafadzwa Dzinamarira
- School of Health Systems and Public Health, University of Pretoria, Pretoria, 0084, South Africa
| | - Joelle M Brown
- Department of Epidemiology & Biostatistics, University of California San Francisco School of Medicine, San Francisco, California, 94158, USA
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14
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Moyo E, Nhari LG, Moyo P, Murewanhema G, Dzinamarira T. Health effects of climate change in Africa: A call for an improved implementation of prevention measures. Eco Environ Health 2023; 2:74-78. [PMID: 38075293 PMCID: PMC10702879 DOI: 10.1016/j.eehl.2023.04.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 04/24/2023] [Accepted: 04/26/2023] [Indexed: 12/23/2023]
Abstract
The world's climate, particularly in Africa, has changed substantially during the past few decades, contributed by several human activities. Africa is one of the continents that is most vulnerable to climate change globally. Since the beginning of 2022, extreme weather events in Africa have affected about 19 million people and killed at least 4,000 individuals. Cyclones, floods, heatwaves, wildfires, droughts, and famine were among the severe weather occurrences. Natural disasters and extreme weather events brought on by climate change may compromise access to clean water, sanitation systems, and healthcare facilities, making people more vulnerable to a number of illnesses. Floods and drought can lead to both communicable and non-communicable diseases. The African population is more likely to experience more mental health disorders than before because of natural disasters, which result in the loss of property and sometimes loss of lives more frequently. We, therefore, call for an improved implementation of strategies to prevent the health effects of climate change so that the health of the people in Africa can be maintained.
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Affiliation(s)
- Enos Moyo
- Oshakati Medical Centre, Oshakati, Namibia
| | - Leroy Gore Nhari
- National Pathology Research and Diagnostic Center, Midlands State University, Gweru, Zimbabwe
| | | | - Grant Murewanhema
- College of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Tafadzwa Dzinamarira
- School of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa
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15
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Moyo E, Moyo P, Murewanhema G, Mhango M, Chitungo I, Dzinamarira T. Key populations and Sub-Saharan Africa's HIV response. Front Public Health 2023; 11:1079990. [PMID: 37261232 PMCID: PMC10229049 DOI: 10.3389/fpubh.2023.1079990] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 04/28/2023] [Indexed: 06/02/2023] Open
Affiliation(s)
- Enos Moyo
- Department of Public Health, Medical Centre Oshakati, Oshakati, Namibia
| | - Perseverance Moyo
- Department of Public Health, Medical Centre Oshakati, Oshakati, Namibia
| | - Grant Murewanhema
- College of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Malizgani Mhango
- Department of Public Health, University of Western Cape, Bellville, South Africa
| | - Itai Chitungo
- College of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Tafadzwa Dzinamarira
- International Center for AIDS Care and Treatment Program (ICAP) at Columbia University, Harare, Zimbabwe
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16
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Moyo E, Mhango M, Moyo P, Dzinamarira T, Chitungo I, Murewanhema G. Emerging infectious disease outbreaks in Sub-Saharan Africa: Learning from the past and present to be better prepared for future outbreaks. Front Public Health 2023; 11:1049986. [PMID: 37228735 PMCID: PMC10203177 DOI: 10.3389/fpubh.2023.1049986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 03/13/2023] [Indexed: 05/27/2023] Open
Affiliation(s)
- Enos Moyo
- School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
| | - Malizgani Mhango
- School of Public Health, University of Western Cape, Bellville, South Africa
| | - Perseverance Moyo
- Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Tafadzwa Dzinamarira
- School of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa
| | - Itai Chitungo
- College of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Grant Murewanhema
- College of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe
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17
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Dzinamarira T, Moyo E, Pierre G, Mpabuka E, Kahere M, Tungwarara N, Chitungo I, Murewanhema G, Musuka G. Postnatal care services availability and utilization during the COVID-19 era in sub-Saharan Africa: A rapid review. Women Birth 2023; 36:e295-e299. [PMID: 36253282 PMCID: PMC9550672 DOI: 10.1016/j.wombi.2022.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 09/09/2022] [Accepted: 10/03/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND Considerable progress has been made globally in improving maternal and newborn babies' health. The COVID-19 pandemic has posed considerable challenges for countries to maintain the provision of high-quality, essential maternal and newborn healthcare services. METHODS A rapid review was carried out on 20 March 2022 on postnatal care (PNC) services availability and utilization during the COVID-19 era in sub-Saharan Africa. PubMed, Google Scholar, and Africa Journals Online (AJOL) databases were searched for relevant studies. Studies included in the review utilized both primary data and secondary data. FINDINGS Nineteen studies met the inclusion criteria. The review revealed that there were significant declines in the availability and utilization of PNC services during and after the COVID-19 lockdown. Several reasons were found to contribute to the decline. DISCUSSION New, innovative strategies are therefore required to ensure that mothers and their newborn babies receive essential PNC to reduce maternal and neonatal morbidity and mortality in sub-Saharan Africa. Some of the strategies that can be used include home-based PNC visits, the use of telemedicine, phone-based referral networks, social media, and community radios.
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Affiliation(s)
| | - Enos Moyo
- Oshakati Medical Centre, Oshakati, Namibia
| | - Gashema Pierre
- College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | | | - Morris Kahere
- College of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Nigel Tungwarara
- College of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Itai Chitungo
- College of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Grant Murewanhema
- College of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe
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18
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Murewanhema G, Dzobo M, Dzinamarira T. Mothers still die due to blood shortages in developing countries: A call for ethical consideration. Transfus Clin Biol 2023; 30:19-20. [PMID: 36122869 DOI: 10.1016/j.tracli.2022.09.064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 09/09/2022] [Accepted: 09/13/2022] [Indexed: 02/07/2023]
Affiliation(s)
- Grant Murewanhema
- Department of Primary Health Care Sciences, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Mathias Dzobo
- School of Health Systems & Public Health, University of Pretoria, Pretoria 0002, South Africa
| | - Tafadzwa Dzinamarira
- School of Health Systems & Public Health, University of Pretoria, Pretoria 0002, South Africa.
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19
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Nyirenda T, Nyagumbo E, Murewanhema G, Mukonowenzou N, Kagodora SB, Mapfumo C, Bhebhe M, Mufunda J. Prevalence of dysmenorrhea and associated risk factors among university students in Zimbabwe. Womens Health (Lond) 2023; 19:17455057231189549. [PMID: 37563987 PMCID: PMC10422913 DOI: 10.1177/17455057231189549] [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] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Revised: 06/14/2023] [Accepted: 07/04/2023] [Indexed: 08/12/2023]
Abstract
BACKGROUND Dysmenorrhea is an often incapacitating condition that is characterized by painful menstruation and general body malaise. In Zimbabwe, this condition is understudied, and its associated risk factors are poorly understood. OBJECTIVES To investigate the prevalence and associated risk factors of dysmenorrhea among female students at Midlands State University in Zimbabwe. DESIGN This is a cross-sectional study that employed simple random sampling technique to obtain data from 382 students using pretested and self-administered questionnaires. METHODS Data were analyzed using STATA version 16. Associations between dysmenorrhea, menstrual, sociodemographic, and lifestyle characteristics were measured using chi-square test and logistic regression model. RESULTS The prevalence of dysmenorrhea was 75.9%, with 28.6% of sufferers describing their pain as severe. Dysmenorrhea significantly affected the school/daily activities of respondents (χ2 = 18.22, p < 0.001). Family history (χ2 = 4.28, p = 0.04), age of menarche (χ2 = 14.8, p < 0.001), regularity of menstrual cycle (χ2 = 18.1, p < 0.001), and parity (χ2 = 8.8, p = 0.03) were associated with the prevalence of dysmenorrhea. The risk of developing dysmenorrhea almost doubled with positive family history (prevalence odds ratio = 1.68 (95% confidence interval: 1.03 to 2.75, p = 0.040)); increased with decrease in age of menarche (prevalence odds ratio = 0.19 (95% confidence interval: 0.10 to 0.45, p < 0.001)) and decreased with increase in parity (prevalence odds ratio = 0.15 (95% confidence interval: 0.03 to 0.82, p = 0.029)). However, the risk was low among those with irregular menstrual cycles (prevalence odds ratio = 0.14 (95% confidence interval: 0.10 to 0.33, p < 0.001)). Physical exercise, smoking, alcohol, and coffee consumption were not associated with the prevalence of dysmenorrhea (p > 0.05). CONCLUSION Dysmenorrhea is common among female students at Midlands State University, and it significantly affects their academic activities. Family history, regular menstrual cycle, nulliparity, and lower age of menarche were risk factors. More awareness is recommended including studies on impact and management strategies.
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Affiliation(s)
- Trust Nyirenda
- Department of Anatomy and Cellular Biology, College of Medicine and Health Sciences, Khalifa University, Abu Dhabi, United Arab Emirates
- Department of Physiology, Faculty of Medicine and Health Sciences, Midlands State University, Midlands, Zimbabwe
| | - Elliot Nyagumbo
- Department of Biochemistry, Faculty of Medicine and Health Sciences, Midlands State University, Midlands, Zimbabwe
- Department of Biomedical Sciences, School of Medical and Health Sciences, Great Zimbabwe University, Masvingo, Zimbabwe
| | - Grant Murewanhema
- Unit of Obstetrics and Gynaecology, Department of Primary Health Care Sciences, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Nyasha Mukonowenzou
- Department of Anatomy and Physiology, Faculty of Medicine, National University of Science & Technology, Bulawayo, Zimbabwe
- Department of Physiological Sciences, Faculty of Sciences, Stellenbosch University, Stellenbosch, South Africa
| | | | - Cladnos Mapfumo
- Department of Community Medicine, Faculty of Medicine, National University of Science & Technology, Bulawayo, Zimbabwe
| | - Michael Bhebhe
- Department of Biochemistry, Faculty of Medicine and Health Sciences, Midlands State University, Midlands, Zimbabwe
| | - Jacob Mufunda
- Department of Biomedical Sciences, School of Medical and Health Sciences, Great Zimbabwe University, Masvingo, Zimbabwe
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20
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Murewanhema G, Moyo E, Mhango M, Chitungo I, Moyo P, Musuka G, Dzobo M, Dzinamarira T. Abnormal vaginal discharge among women of reproductive age in sub-Saharan Africa: the need for a paradigm shift from a syndromic approach to specific pathogen identification and directed treatment. IJID Reg 2022; 5:165-168. [PMID: 36467508 PMCID: PMC9713322 DOI: 10.1016/j.ijregi.2022.10.006] [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] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 10/26/2022] [Accepted: 10/26/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND An abnormal vaginal discharge is a frequent manifestation of reproductive tract infections, including sexually transmitted infections (STIs) and vulvovaginal candidiasis. It is also a manifestation of bacterial vaginosis, which has a prevalence of up to 50% among women of reproductive age. Reproductive tract infections are associated with a range of reproductive health challenges and increase the risk of HIV acquisition. METHODS This study was performed to critically review and discuss the current diagnostic and treatment approaches to abnormal vaginal discharge among women of reproductive age in sub-Saharan Africa, and to call for a paradigm shift from the syndromic approach to specific pathogen identification and directed antimicrobial therapy. DISCUSSION Young women have the highest incidence of HIV infection in sub-Saharan Africa. Countries in sub-Saharan Africa where the prevalence of both STIs and bacterial vaginosis is very high have been employing a syndromic approach for the treatment of abnormal vaginal discharge since around 1984. However, the syndromic approach has several limitations, with the potential to miss infections, over-diagnose and over-treat STIs, and propagate antimicrobial resistance, which is one of the greatest global health challenges of the 21st century. CONCLUSIONS The low to middle-income countries of sub-Saharan Africa must innovate and leverage improved diagnostics to capacitate primary health care and other levels for point-of-care diagnostic testing, in order to provide an immediate diagnosis and treatment for women with an abnormal vaginal discharge.
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Affiliation(s)
| | - Enos Moyo
- University of Zimbabwe, Harare, Zimbabwe
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21
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Gwinji PT, Musuka G, Murewanhema G, Moyo P, Moyo E, Dzinamarira T. The re-emergence of wild poliovirus type 1 in Africa and the role of environmental surveillance in interrupting poliovirus transmission. IJID Reg 2022; 5:180-182. [PMID: 36471795 PMCID: PMC9718956 DOI: 10.1016/j.ijregi.2022.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Revised: 10/31/2022] [Accepted: 11/02/2022] [Indexed: 06/17/2023]
Abstract
Although there has been a global reduction in wild poliovirus (WPV) type 1 cases, Africa has experienced a re-emergence of the disease. This article discusses the re-emergence of WPV in Africa, the transmission and pathogenesis of WPV, and the role of environmental surveillance and other strategies used to interrupt all WPV transmission in the region permanently.
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Affiliation(s)
- Phanuel Tawanda Gwinji
- Department of Primary Health Care Sciences, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Godfrey Musuka
- International Initiative for Impact Evaluation, Harare, Zimbabwe
| | - Grant Murewanhema
- Department of Primary Health Care Sciences, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Perseverance Moyo
- Department of Primary Health Care Sciences, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Enos Moyo
- Department of Primary Health Care Sciences, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe
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22
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Dzobo M, Gwinji PT, Murewanhema G, Musuka G, Dzinamarira T. Stigma and public health responses: Lessons learnt from the COVID-19 pandemic to inform the recent monkeypox outbreak. Public Health in Practice 2022; 4:100315. [PMID: 36092530 PMCID: PMC9444576 DOI: 10.1016/j.puhip.2022.100315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 08/31/2022] [Indexed: 11/28/2022] Open
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23
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Dzinamarira T, Moyo E, Dzobo M, Mbunge E, Murewanhema G. Cervical cancer in sub-Saharan Africa: an urgent call for improving accessibility and use of preventive services. Int J Gynecol Cancer 2022; 33:592-597. [PMID: 36368710 DOI: 10.1136/ijgc-2022-003957] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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: 11/13/2022] Open
Abstract
Sub-Saharan Africa has the highest rates of cervical cancer in the world, largely attributed to low cervical cancer screening coverage. Cervical cancer is the most common cause of death among women in 21 of the 48 countries in sub-Saharan Africa. Close to 100% of all cases of cervical cancer are attributable to Human papillomavirus (HPV). HPV types 16 and 18 cause at least 70% of all cervical cancers globally, while types 31, 33, 45, 52, and 58 cause a further 20% of the cases. Women living with HIV are six times more likely to develop cervical cancer than those without HIV. Considering that sub-Saharan Africa carries the greatest burden of cervical cancer, ways to increase accessibility and use of preventive services are urgently required. With this review, we discuss the preventive measures required to reduce the burden of cervical cancer in sub-Saharan Africa, the challenges to improving accessibility and use of the preventive services, and the recommendations to address these challenges.
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Affiliation(s)
- Tafadzwa Dzinamarira
- Department of Public Health, University of Pretoria, Pretoria, South Africa
- ICAP at Columbia University, Harare, Zimbabwe
| | - Enos Moyo
- Department of Public Health, Oshakati Medical Centre, Oshakati, Namibia
| | - Mathias Dzobo
- Department of Public Health, University of Pretoria, Pretoria, South Africa
| | - Elliot Mbunge
- Department of Information Technology, University of Eswatini, Kwaluseni, Swaziland
| | - Grant Murewanhema
- Unit of Obstetrics and Gynaecology, University of Zimbabwe, Harare, Zimbabwe
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24
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Dzinamarira T, Mapingure M, Murewanhema G, Musuka G, Moyo B, Samba C, Sibindi M, Chikava T, Mugurungi O, Chingombe I. Conducting research among key populations in settings with discriminatory laws, policies, and practice: The case of men who have sex with men in Zimbabwe. Public Health in Practice 2022; 4:100337. [DOI: 10.1016/j.puhip.2022.100337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 10/31/2022] [Indexed: 11/06/2022] Open
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25
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Moyo E, Musuka G, Murewanhema G, Moyo P, Dzinamarira T. Monkeypox outbreak: a perspective on Africa's diagnostic and containment capacity. Int J Infect Dis 2022; 123:127-130. [PMID: 36007687 PMCID: PMC9534167 DOI: 10.1016/j.ijid.2022.08.016] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [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: 07/12/2022] [Revised: 08/16/2022] [Accepted: 08/17/2022] [Indexed: 12/14/2022] Open
Abstract
Since the first monkeypox (MPX) case was reported in humans in 1970, there have been several outbreaks of the disease. MPX is endemic in central and western Africa. MPX virus infection is confirmed using the conventional polymerase chain reaction, which detects the viral DNA in samples from the rash. Of concern is that the current outbreak has affected five regions of the world. Although MPX confirmatory tests are available worldwide, there are concerns about Africa's capacity to diagnose and contain the disease. The challenges faced by Africa include a lack of adequate laboratory infrastructure and health care workers, weak disease surveillance systems, and a lack of MPX knowledge among health care workers and communities. These challenges can be addressed by mobilizing resources for MPX virus testing, strengthening surveillance systems, collaboration among countries, training health care workers, task shifting, and engaging communities.
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Affiliation(s)
- Enos Moyo
- Medical Centre Oshakati, Oshakati, Namibia
| | - Godfrey Musuka
- International Initiative for Impact Evaluation, Harare, Zimbabwe
| | | | | | - Tafadzwa Dzinamarira
- ICAP at Columbia University, Kigali, Rwanda,Corresponding author: Tafadzwa Dzinamarira, ICAP at Columbia University, Kigali, Rwanda
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26
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Murewanhema G, Musuka G, Denhere K, Mulqueeny D, Dzinamarira T. The HIV epidemic and the COVID-19 pandemic: A double tragedy for sub-Saharan African women. Afr J Prim Health Care Fam Med 2022; 14:e1-e3. [PMID: 36073132 PMCID: PMC9452919 DOI: 10.4102/phcfm.v14i1.3397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 05/17/2022] [Accepted: 05/18/2022] [Indexed: 11/08/2022] Open
Abstract
After four decades of the HIV epidemic, women from sub-Saharan Africa remain at a differentially high risk of acquisition. The Joint United Nations Programme on HIV and AIDS (UNAIDS) statistics show that the majority of HIV infections occur in this population and region. Evidence from previous humanitarian crises demonstrated adverse maternal consequences as a result of neglect for the provision of essential maternal, sexual and reproductive health services. The ongoing COVID-19 pandemic has had a similar effect, including an additional risk of HIV acquisition amongst women in sub-Saharan Africa. The COVID-19 pandemic has aggravated the risk of sub-Saharan Africa women to HIV infection because of a multitude of factors including child marriages, teenage pregnancies, dropping out of school, increase in incidence of sexual and gender-based violence and reduced access to preventive and treatment services for HIV and sexually transmitted infections. These include provision of care for rape and sexual and gender-based violence victims and provision of pre-exposure and postexposure prophylaxis for HIV and other STIs. Failure to urgently restore and maintain robust HIV prevention and treatment during the ongoing COVID-19 pandemic poses a risk of reversing the gains made over the years in reducing the incidence and morbidity from HIV amongst the population of sub-Saharan Africa women. There is need for an urgent and robust discourse to formulate effective interventions for protecting women and girls living in sub-Saharan Africa from an aggravated risk of HIV infection during the ongoing COVID-19 pandemic and other future humanitarian crises.
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Affiliation(s)
- Grant Murewanhema
- Department of Primary Health Care Sciences, Faculty of Medicine, University of Zimbabwe, Harare.
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27
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Dzinamarira T, Moyo E, Moyo P, Pierre G, Mpabuka E, Kahere M, Tungwarara N, Chitungo I, Murewanhema G, Musuka G. Childhood immunization services accessibility and utilization during the COVID-19 pandemic in Africa. J Infect 2022; 85:436-480. [PMID: 35914610 PMCID: PMC9338170 DOI: 10.1016/j.jinf.2022.07.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 07/25/2022] [Indexed: 11/28/2022]
Affiliation(s)
| | - Enos Moyo
- Oshakati Medical Centre, Oshakati, Namibia
| | | | - Gashema Pierre
- College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | | | - Morris Kahere
- College of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Nigel Tungwarara
- College of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Itai Chitungo
- College of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Grant Murewanhema
- College of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe
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28
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Madziva R, Nachipo B, Musuka G, Chitungo I, Murewanhema G, Phiri B, Dzinamarira T. The role of social media during the COVID-19 pandemic: Salvaging its 'power' for positive social behaviour change in Africa. Health Promot Perspect 2022; 12:22-27. [PMID: 35854855 PMCID: PMC9277293 DOI: 10.34172/hpp.2022.03] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [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: 03/06/2022] [Accepted: 03/10/2022] [Indexed: 11/09/2022] Open
Abstract
The ongoing coronavirus disease 2019 (COVID-19) pandemic remains a significant global public health crisis. The unique evolution of the COVID-19 pandemic has seen social media emerging and growing into an important vehicle for rapid information dissemination. This has in turn given rise to multiple sources of information, leading to what has come to be known as ‘infodemic’, associated with the plethora of misinformation and conspiracy theories. In this perspective, we explore the growth of the social media industry and the impact it has had during the ongoing COVID-19 crisis. We argue that while the multiple information pieces circulating on social media cause misinformation and panic, this might not necessarily and in all the cases influence sustained behaviours in the target population groups. We offer suggestions on how the power of social media can be harnessed and integrated into social and public health for a better digital balance for communication for development.
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Affiliation(s)
- Roda Madziva
- School of Sociology and Social Policy, University of Nottingham, United Kingdom
| | | | | | - Itai Chitungo
- Chemical Pathology Unit, Department of Laboratory Diagnostic and Investigative and Sciences, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Grant Murewanhema
- Unit of Obstetrics and Gynaecology, Department of Primary Health Care Sciences, Faculty of Medicine and Health Sciences, University of Zimbabwe, Zimbabwe
| | - Bright Phiri
- ICAP at Columbia University, Pretoria, South Africa
| | - Tafadzwa Dzinamarira
- ICAP at Columbia University, Pretoria, South Africa.,School of Health Sciences & Public Health, University of Pretoria, Pretoria, 002, South Africa
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29
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Denhere K, Dzinamarira T, Tungwarara N, Kampira V, Chitungo I, Mataruka K, Mukwenha S, Musuka G, Murewanhema G. Towards equitable and sustainable availability of blood products in Zimbabwe: An analysis of strengths, weaknesses, opportunities and challenges. Transfus Clin Biol 2022; 29:273-275. [PMID: 35781073 DOI: 10.1016/j.tracli.2022.06.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 05/19/2022] [Revised: 06/09/2022] [Accepted: 06/23/2022] [Indexed: 10/17/2022]
Abstract
Blood transfusion can be a lifesaving intervention in a number of medical emergencies. To attain sustainable and equitable availability of blood products, it is important to understand the strengths, weaknesses, opportunities, and challenges of the national blood services programme. We, therefore, with this letter to the editor, discuss some of the strengths, weaknesses, opportunities and threats to the Zimbabwean programme since its inception. Despite several strengths and opportunities that the national blood services of Zimbabwe (NBSZ) leverages on, we argue that among other challenges, donor shortages and an upsurge of transfusion transmittable infections in the eligible donor population continue to be the biggest threats to the achievement of the programme objectives. These can be addressed through expanding the blood donor base and the catchment area. Additionally, improving the level of knowledge and attitude towards blood donation in the communities is critical for driving the sustainable and equitable distribution of safe blood products to the population.
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Affiliation(s)
- K Denhere
- University of Western Cape, Cape Town, South Africa
| | - T Dzinamarira
- ICAP at Columbia University, Harare, Zimbabwe; School of Health Systems & Public Health, University of Pretoria, Pretoria 0002, South Africa.
| | - N Tungwarara
- University of South Africa, Pretoria, South Africa
| | - V Kampira
- National TB Reference Laboratory, Bulawayo, Zimbabwe
| | - I Chitungo
- Department of Primary Health Care Sciences, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - K Mataruka
- Biomedical Research and Training Institute, Harare, Zimbabwe
| | - S Mukwenha
- ICAP at Columbia University, Harare, Zimbabwe
| | - G Musuka
- ICAP at Columbia University, Harare, Zimbabwe
| | - G Murewanhema
- Biomedical Research and Training Institute, Harare, Zimbabwe
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Murewanhema G, Musuka G, Gwinji PT, Dzobo M, Dzinamarira T. Sexually transmitted infections among artisanal miners in Zimbabwe: An urgent need for enhanced preventive measures. Public Health Pract (Oxf) 2022; 4:100284. [PMID: 36588767 PMCID: PMC9801009 DOI: 10.1016/j.puhip.2022.100284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 06/13/2022] [Indexed: 01/04/2023] Open
Affiliation(s)
- Grant Murewanhema
- College of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | | | | | - Mathias Dzobo
- School of Health Systems and Public Health, University of Pretoria, South Africa
| | - Tafadzwa Dzinamarira
- ICAP at Columbia University, Harare, Zimbabwe
- ICAP at Columbia University, Kigali, Rwanda
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Dzobo M, Dzinamarira T, Murewanhema G, Madziva R, Herrera H, Musuka G. Limited syphilis testing for key populations in Zimbabwe: A silent public health threat. S Afr J Infect Dis 2022; 37:385. [PMID: 35815225 PMCID: PMC9257705 DOI: 10.4102/sajid.v37i1.385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Accepted: 03/31/2022] [Indexed: 11/01/2022] Open
Abstract
In this article, the authors discuss the problem of high prevalences of active syphilis amongst key populations (KPs) in Zimbabwe, in combination with low testing rates, partly because of a difficult legal and social environment for these populations. The article highlights the need to develop strategies to address the high prevalence of syphilis amongst KPs. The authors discuss requirements for addressing deficits in existing clinical services, predominantly primary care settings, in providing primary healthcare, including sexually transmitted infection (STI) management, to Zimbabwe’s KP communities and utility of point-of-care testing and self-testing and other innovations to improve testing uptake.
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Affiliation(s)
- Mathias Dzobo
- School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Tafadzwa Dzinamarira
- School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Grant Murewanhema
- Unit of Obstetrics and Gynecology, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Roda Madziva
- School of Sociology and Social Policy, University of Nottingham, Nottingham, United Kingdom
| | - Helena Herrera
- School of Pharmacy and Biomedical Sciences, University of Portsmouth, Portsmouth, United Kingdom
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Dzinamarira T, Murewanhema G, Chitungo I, Ngara B, Nkambule SJ, Madziva R, Herrera H, Mukwenha S, Cuadros DF, Iradukunda PG, Mashora M, Tungwarara N, Rwibasira GN, Musuka G. Risk of mortality in HIV-infected COVID-19 patients: A systematic review and meta-analysis. J Infect Public Health 2022; 15:654-661. [PMID: 35617829 PMCID: PMC9110010 DOI: 10.1016/j.jiph.2022.05.006] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 04/27/2022] [Accepted: 05/10/2022] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND The relationship between HIV infection and COVID-19 clinical outcomes remains a significant public health research problem. We aimed to determine the association of HIV comorbidity with COVID-19 mortality. METHODS We searched PubMed, Google Scholar and World Health Organization library databases for relevant studies. All searches were conducted from 1st to 7th December 2021. Title, abstract and full text screening was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The relative risk of mortality in HIV-infected COVID-19 patients was computed using a random-effects model. All analyses were performed using Meta and Metasens statistical packages available in R version 4.2.1 software package. The quality of included studies was assessed using the GRADE approach, Egger's test was employed to determine the risk of bias. RESULTS A total of 16 studies were included in this review. Among the COVID-19 patients with HIV infection, the mortality rate due to COVID-19 was 7.97% (4 287/53,801), and among the COVID-19 patients without HIV infection, the mortality rate due to COVID-19 was 0.69% (127, 961/18, 513, 747). In the random effects model, we found no statistically significant relative risk of mortality in HIV-infected COVID-19 patients (RR 1.07, 95% CI 0.86-1.32). The between-studies heterogeneity was substantial (I2 = 91%, P < 0.01), while the risk of publication bias was not significant. CONCLUSION Findings did not link HIV infection with an increased risk of COVID-19 mortality. Our results add to the conflicting data on the relationship between COVID-19 and HIV infection.
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Affiliation(s)
- Tafadzwa Dzinamarira
- School of Health Systems & Public Health, University of Pretoria, Pretoria 0002, South Africa; ICAP at Columbia University, Harare, Zimbabwe.
| | - Grant Murewanhema
- Unit of Obstetrics and Gynaecology, Department of Primary Health Care Sciences, Faculty of Medicine and Health Sciences, University of Zimbabwe, Zimbabwe
| | - Itai Chitungo
- Faculty of Medicine, College of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Bernard Ngara
- Faculty of Medicine, College of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Sphamandla Josias Nkambule
- Department of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban 4001, South Africa
| | | | | | | | | | | | | | - Nigel Tungwarara
- Department of Health Studies, University of South Africa, South Africa
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Murewanhema G, Musuka G, Mukwenha S, Chingombe I, Mapingure MP, Dzinamarira T. Hesitancy, ignorance or uncertainty? The need for effective communication strategies as Zimbabwe’s uptake of COVID-19 vaccine booster doses remains poor. Public Health in Practice 2022; 3:100244. [PMID: 35342889 PMCID: PMC8928722 DOI: 10.1016/j.puhip.2022.100244] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 03/13/2022] [Indexed: 11/08/2022] Open
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Dzinamarira T, Pierre G, Iradukunda PG, Tungwarara N, Mukwenha S, Mpabuka E, Mataruka K, Chitungo I, Musuka G, Murewanhema G. Epidemiological surveillance of enteric viral diseases using wastewater in Africa - A rapid review. J Infect Public Health 2022; 15:703-707. [PMID: 35661916 DOI: 10.1016/j.jiph.2022.05.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 04/27/2022] [Accepted: 05/19/2022] [Indexed: 12/24/2022] Open
Abstract
Viral enteric pathogens remain an important cause of diarrhoeal outbreaks among children in sub-Saharan Africa (SSA). Consequently, diarrhoeal illness remains a significant cause of morbidity and mortality in the under-fives in SSA. These outbreaks associated with viral pathogens tend to be seasonal and early warning systems for impending outbreaks could be very crucial for triggering preventive public health response and building public health resilience to deal with increased demand for medical services. Wastewater surveillance for pathogens is an important epidemiological component that could inform early warning systems. The objective of this rapid review was to evaluate the use of wastewater for epidemiology surveillance of enteric viral pathogens. Nine studies met the inclusion criteria. Eight viral pathogens were reviewed and analysed from 6 countries that performed wastewater analysis. Six studies explored the epidemiologic significance of viral pathogens in wastewater. The findings of this review revealed that monitoring of wastewater can provide an additional tool to determine the epidemiology of viral pathogens circulating in the community thereby providing early warning of potential outbreaks using wastewater-based epidemiology methods. Five of the included studies revealed the occurrence of viral pathogens in raw sewage and treated wastewater as an indication of inefficient elimination of viruses leading to potential release into water sources which presents a public health risk, increasing the risk of inducing gastroenteritis in the population. Six studies revealed the need for public health authorities to realise the potential benefit of environmental surveillance (ES) as an additional tool to determine the epidemiology of viral pathogens circulating in each community. Despite the significant public health challenge associated with enteric viral pathogens in sub-Saharan Africa, there remains remarkable underinvestment in potentially epidemiologically beneficial research, including wastewater-based epidemiology for these infections.
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Affiliation(s)
- Tafadzwa Dzinamarira
- School of Health Systems & Public Health, University of Pretoria, Pretoria 0002, South Africa; ICAP at Columbia University, Kigali, Rwanda.
| | - Gashema Pierre
- College of Medicine and Veterinary Medicine, University of Edinburgh, UK
| | | | - Nigel Tungwarara
- Department of Health Studies, University of South Africa, South Africa
| | | | | | - Kidson Mataruka
- Biomedical Research and Training Institute, Harare, Zimbabwe
| | - Itai Chitungo
- College of Medicine and Health Sciences, Faculty of Medicine, University of Zimbabwe, Harare, Zimbabwe
| | | | - Grant Murewanhema
- College of Medicine and Health Sciences, Faculty of Medicine, University of Zimbabwe, Harare, Zimbabwe
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Madziva R, Murewanhema G, Musuka G, Mapingure MP, Chingombe I, Herrera H, Chiyaka ET, Dzinamarira T. Fighting COVID-19 pandemic fatigue and complacency in Zimbabwe. Public Health in Practice 2022; 3:100236. [PMID: 35169760 PMCID: PMC8830151 DOI: 10.1016/j.puhip.2022.100236] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 01/26/2022] [Accepted: 02/01/2022] [Indexed: 11/24/2022] Open
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Gwinji PT, Murewanhema G, Musuka G, Dzinamarira T. Schools re-opening and the COVID-19 response in Zimbabwe: The need for evidence-based decision making. Public Health in Practice 2022; 3:100231. [PMID: 35128495 PMCID: PMC8802672 DOI: 10.1016/j.puhip.2022.100231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 01/17/2022] [Indexed: 11/18/2022] Open
Affiliation(s)
- Phanuel Tawanda Gwinji
- Humanitarian Conflict and Response Institute, School of Arts Languages and Culture, Faculty of Humanities, The University of Manchester, UK
| | - Grant Murewanhema
- Unit of Obstetrics and Gynaecology, Department of Primary Health Care Sciences, Faculty of Medicine and Health Sciences, University of Zimbabwe, Zimbabwe
| | | | - Tafadzwa Dzinamarira
- ICAP at Columbia University, Harare, Zimbabwe
- School of Health Sciences & Public Health, University of Pretoria, Pretoria, 0002, South Africa
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Gwinji PT, Murewanhema G, Musuka G, Dzinamarira T. Tropical Cyclones and the Eastern Highlands of Zimbabwe: A Call for Enhanced Disaster Preparedness. Disaster Med Public Health Prep 2022; 16:1. [PMID: 35586912 DOI: 10.1017/dmp.2022.114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Phanuel Tawanda Gwinji
- Humanitarian and Conflict Response Institute, School of Arts, Languages and Cultures, Faculty of Humanities, The University of Manchester, UK
| | - Grant Murewanhema
- Unit of Obstetrics and Gynaecology, Department of Primary Health Care Sciences, Faculty of Medicine and Health Sciences, University of Zimbabwe, Zimbabwe
| | | | - Tafadzwa Dzinamarira
- ICAP at Columbia University, Harare, Zimbabwe
- School of Health Sciences and Public Health, University of Pretoria, Pretoria, South Africa
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Musarandega R, Ngwenya S, Murewanhema G, Machekano R, Magwali T, Nystrom L, Pattinson R, Munjanja S. Changes in causes of pregnancy-related and maternal mortality in Zimbabwe 2007-08 to 2018-19: findings from two reproductive age mortality surveys. BMC Public Health 2022; 22:923. [PMID: 35534811 PMCID: PMC9087911 DOI: 10.1186/s12889-022-13321-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 12/30/2021] [Accepted: 04/25/2022] [Indexed: 11/10/2022] Open
Abstract
Background Reducing maternal mortality is a priority of Sustainable Development Goal 3.1 which requires frequent epidemiological analysis of trends and patterns of the causes of maternal deaths. We conducted two reproductive age mortality surveys to analyse the epidemiology of maternal mortality in Zimbabwe and analysed the changes in the causes of deaths between 2007-08 and 2018-19. Methods We performed a before and after analysis of the causes of death among women of reproductive ages (WRAs) (12-49 years), and pregnant women from the two surveys implemented in 11 districts, selected using multi-stage cluster sampling from each province of Zimbabwe (n=10); an additional district selected from Harare. We calculated mortality incidence rates and incidence rate ratios per 10000 WRAs and pregnant women (with 95% confidence intervals), in international classification of disease groups, using negative binomial models, and compared them between the two surveys. We also calculated maternal mortality ratios, per 100 000 live births, for selected causes of pregnancy-related deaths. Results We identified 6188 deaths among WRAs and 325 PRDs in 2007-08, and 1856 and 137 respectively in 2018-19. Mortality in the WRAs decreased by 82% in diseases of the respiratory system and 81% in certain infectious or parasitic diseases' groups, which include HIV/AIDS and malaria. Pregnancy-related deaths decreased by 84% in the indirect causes group and by 61% in the direct causes group, and HIV/AIDS-related deaths decreased by 91% in pregnant women. Direct causes of death still had a three-fold MMR than indirect causes (151 vs. 51 deaths per 100 000) in 2018-19. Conclusion Zimbabwe experienced a decline in both direct and indirect causes of pregnancy-related deaths. Deaths from indirect causes declined mainly due to a reduction in HIV/AIDS-related and malaria mortality, while deaths from direct causes declined because of a reduction in obstetric haemorrhage and pregnancy-related infections. Ongoing interventions ought to improve the coverage and quality of maternal care in Zimbabwe, to further reduce deaths from direct causes. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13321-7.
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Affiliation(s)
- Reuben Musarandega
- School of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa. .,Unit of Obstetrics and Gynaecology, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe.
| | - Solwayo Ngwenya
- Department of Obstetrics and Gynaecology, National University of Science and Technology, and Mpilo Central Hospital, Bulawayo, Zimbabwe
| | - Grant Murewanhema
- Unit of Obstetrics and Gynaecology, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Rhoderick Machekano
- Biostatistics and Epidemiology Department, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Thulani Magwali
- Unit of Obstetrics and Gynaecology, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Lennarth Nystrom
- Department of Epidemiology and Global Health, Umea University, Umea, Sweden
| | - Robert Pattinson
- Research Centre for Maternal, Fetal, Newborn & Child Health Care Strategies, University of Pretoria, Pretoria, South Africa
| | - Stephen Munjanja
- Unit of Obstetrics and Gynaecology, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe
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Murewanhema G, Gwinji PT, Musuka G, Dzinamarira T. Prioritising preventive cancer services in Zimbabwe as the country struggles with unaffordable healthcare. S Afr Med J 2022; 112:13567. [PMID: 35587239] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 04/29/2022] [Indexed: 06/15/2023] Open
Affiliation(s)
- G Murewanhema
- Unit of Obstetrics and Gynaecology, Department of Primary Health Care Sciences, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe.
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Murewanhema G, Dzinamarira T. The COVID-19 Pandemic: Public Health Responses in Sub-Saharan Africa. Int J Environ Res Public Health 2022; 19:ijerph19084448. [PMID: 35457314 PMCID: PMC9027442 DOI: 10.3390/ijerph19084448] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 04/06/2022] [Indexed: 11/16/2022]
Abstract
The World Health Organisation declared the ongoing COVID-19 global health challenge a pandemic in March 2020. Since then, countries across the globe have implemented different public health control strategies-including global vaccination programs-in attempts to mitigate the further transmission of severe acute respiratory syndrome coronavirus 2. However, to date, the virus has continued to spread rapidly despite these interventions. Countries across sub-Saharan Africa have implemented variable control strategies to combat the pandemic; however, despite the continent being among the least affected in terms of direct case burden, morbidity, and mortality, it has experienced marked socioeconomic disruption. Therefore, economic resuscitation is an urgent priority. The continent is vastly underrepresented in the body of scientific evidence due to limited research resources, testing capacity and genomic surveillance leading to empirical responses or responses guided by evidence from elsewhere. To inform the ongoing pandemic, and to prepare for the future, this Special Issue calls for manuscripts on global COVID-19 responses, and encourages researchers and stakeholders from resource-limited settings, particularly from sub-Saharan Africa, to share their COVID-19 public health responses. Areas to be covered include, but are not limited to, surveillance, case management, infection prevention and control, risk communication and community engagement, logistics, laboratory, ports of entry, and co-ordination. Manuscripts including primary research, viewpoints/perspectives, and comprehensive literature reviews are all welcome.
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Affiliation(s)
- Grant Murewanhema
- Unit of Obstetrics and Gynaecology, Department of Primary Health Care Sciences, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare P.O. Box MP167, Zimbabwe;
| | - Tafadzwa Dzinamarira
- ICAP at Columbia University, Harare P.O. Box MP167, Zimbabwe
- School of Health Systems & Public Health, University of Pretoria, Pretoria 0002, South Africa
- Correspondence:
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Murewanhema G. Public health sector capacity and resilience building in Zimbabwe: An urgent priority as further waves of COVID-19 are imminent. S Afr Med J 2022; 112:249-250. [PMID: 35587801] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 04/04/2022] [Indexed: 06/15/2023] Open
Affiliation(s)
- G Murewanhema
- Unit of Obstetrics and Gynaecology, Department of Primary Health Care Sciences, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe.
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Dzinamarira T, Nkambule SJ, Hlongwa M, Mhango M, Iradukunda PG, Chitungo I, Dzobo M, Mapingure MP, Chingombe I, Mashora M, Madziva R, Herrera H, Makanda P, Atwine J, Mbunge E, Musuka G, Murewanhema G, Ngara B. Risk factors for COVID-19 infection among healthcare workers. A first report from a living systematic review and meta-analysis. Saf Health Work 2022; 13:263-268. [PMID: 35433073 PMCID: PMC9004144 DOI: 10.1016/j.shaw.2022.04.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 03/30/2022] [Accepted: 04/03/2022] [Indexed: 12/23/2022] Open
Abstract
Health care workers (HCWs) are more than ten times more likely to be infected with coronavirus infectious disease 2019 (COVID-19) than the general population, thus demonstrating the burden of COVID-19 among HCWs. Factors that expose HCWs to a differentially high-risk of COVID-19 acquisition are important to elucidate, enable appropriate public health interventions to mitigate against high risk and reduce adverse outcomes from the infection. We conducted a systematic review and meta-analysis to summarize and critically analyze the existing evidence on SARS-CoV-2 risk factors among HCWs. With no geographical limitation, we included studies, in any country, that reported (i) the PCR laboratory diagnosis of COVID-19 as an independent variable (ii) one or more COVID-19 risk factors among HCWs with risk estimates (relative risk, odds ratio, or hazard ratio) (iii) original, quantitative study design, and published in English or Mandarian. Our initial search resulted in 470 articles overall, however, only 10 studies met the inclusion criteria for this review. Out of the 10 studies included in the review, inadequate/lack of protective personal equipment, performing tracheal intubation, and gender were the most common risk factors of COVID-19. Based on the random effects adjusted pooled relative risk, HCWs who reported the use of protective personal equipment were 29% (95% CI: 16% to 41%) less likely to test positive for COVID-19. The study also revealed that HCWs who performed tracheal intubations were 34% (95% CI: 14% to 57%) more likely to test positive for COVID-19. Interestingly, this study showed that female HCWs are at 11% higher risk (RR 1.11 95% CI 1.01–1.21) of COVID-19 than their male counterparts. This article presents initial findings from a living systematic review and meta-analysis, therefore, did not yield many studies; however, it revealed a significant insight into better understanding COVID-19 risk factors among HCWs; insights important for devising preventive strategies that protect them from this infection. PROSPERO registration number CRD42020193508 available for public comments via the link below https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020193508).
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Affiliation(s)
- Tafadzwa Dzinamarira
- School of Health Systems & Public Health, University of Pretoria, Pretoria, 0002, South Africa
- ICAP at Columbia University, Harare, Zimbabwe
- Corresponding author. School of Health Systems & Public Health, University of Pretoria, Pretoria, 0002, South Africa..
| | - Sphamandla Josias Nkambule
- Department of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, 4001, South Africa
| | - Mbuzeleni Hlongwa
- Department of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, 4001, South Africa
| | - Malizgani Mhango
- School of Public Health, University of Western Cape, 7535, Cape Town, South Africa
| | | | - Itai Chitungo
- College of Medicine and Health Sciences, Faculty of Medicine, University of Zimbabwe, Harare, Zimbabwe
| | - Mathias Dzobo
- School of Health Systems & Public Health, University of Pretoria, Pretoria, 0002, South Africa
| | | | | | | | - Roda Madziva
- School of Sociology and Social Policy, University of Nottingham, United Kingdom
| | - Helena Herrera
- School of Pharmacy and Biomedical Sciences, University of Portsmouth, United Kingdom
| | - Pelagia Makanda
- Department of Medicine, Jinzhou Medical University, Jinzhou 121001, China
| | - James Atwine
- Department of Medicine, Jinzhou Medical University, Jinzhou 121001, China
| | - Elliot Mbunge
- Department of Information Technology, Faculty of Accounting and Informatics, Durban University of Technology, P O Box 1334, Durban 4000, South Africa
| | | | - Grant Murewanhema
- College of Medicine and Health Sciences, Faculty of Medicine, University of Zimbabwe, Harare, Zimbabwe
| | - Bernard Ngara
- College of Medicine and Health Sciences, Faculty of Medicine, University of Zimbabwe, Harare, Zimbabwe
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Mukwenha S, Murewanhema G, Madziva R, Dzinamarira T, Herrera H, Musuka G. Increased illicit substance use among Zimbabwean adolescents and youths during the COVID-19 era: an impending public health disaster. Addiction 2022; 117:1177-1178. [PMID: 34729833 DOI: 10.1111/add.15729] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 10/12/2021] [Indexed: 11/30/2022]
Affiliation(s)
| | - Grant Murewanhema
- Unit of Obstetrics and Gynecology, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Roda Madziva
- School of Sociology and Social Policy, University of Nottingham, Nottingham, UK
| | - Tafadzwa Dzinamarira
- ICAP at Columbia University, Harare, Zimbabwe.,School of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa
| | - Helena Herrera
- School of Pharmacy and Biomedical Sciences, University of Portsmouth, Portsmouth, UK
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Murewanhema G, Musuka G, Gwanzura C, Makurumidze R, Chitungo I, Chimene M, Tungwarara N, Dzinamarira T, Madziyire MG. Maternal, Sexual and Reproductive Health in Marginalised Areas: Renewing Community Involvement Strategies beyond the Worst of the COVID-19 Pandemic. Int J Environ Res Public Health 2022; 19:3431. [PMID: 35329118 PMCID: PMC8953553 DOI: 10.3390/ijerph19063431] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 03/05/2022] [Accepted: 03/13/2022] [Indexed: 01/27/2023]
Abstract
The COVID-19 pandemic and resultant lockdowns have brought unprecedented challenges for Maternal, Sexual and Reproductive Health (MSRH) services. Components of MSRH services adversely affected include antenatal, postnatal, and newborn care; provision of family planning and post-abortion care services; sexual and gender-based violence care and prevention; and care and treatment for sexually transmitted infections including HIV. Resuscitating, remodeling or inventing interventions to restore or maintain these essential services at the community level, as a gateway to higher care, is critical to mitigating short and long-term effects of the COVID-19 pandemic on essential MSRH. We propose a possible framework for community involvement and propose integrating key information, education, and communication of MSRH messages within COVID-19 messages.
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Affiliation(s)
- Grant Murewanhema
- Unit of Obstetrics and Gynaecology, Department of Primary Health Care Sciences, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare P.O. Box MP167, Zimbabwe; (G.M.); (C.G.); (M.G.M.)
| | - Godfrey Musuka
- ICAP at Columbia University, Harare P.O. Box MP167, Zimbabwe;
| | - Chipo Gwanzura
- Unit of Obstetrics and Gynaecology, Department of Primary Health Care Sciences, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare P.O. Box MP167, Zimbabwe; (G.M.); (C.G.); (M.G.M.)
| | - Richard Makurumidze
- Unit of Community Medicine, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare P.O. Box MP167, Zimbabwe;
| | - Itai Chitungo
- Chemical Pathology Unit, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare P.O. Box MP167, Zimbabwe;
| | - Munashe Chimene
- Department of Health Sciences, Africa University, Mutare P.O. Box 1320, Zimbabwe;
| | - Nigel Tungwarara
- Department of Health Studies, University of South Africa, Pretoria 0002, South Africa;
| | - Tafadzwa Dzinamarira
- ICAP at Columbia University, Harare P.O. Box MP167, Zimbabwe;
- School of Health Systems & Public Health, University of Pretoria, Pretoria 0002, South Africa
| | - Mugove Gerald Madziyire
- Unit of Obstetrics and Gynaecology, Department of Primary Health Care Sciences, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare P.O. Box MP167, Zimbabwe; (G.M.); (C.G.); (M.G.M.)
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Chitungo I, Dzinamarira T, Nyazika TK, Herrera H, Musuka G, Murewanhema G. Inappropriate Antibiotic Use in Zimbabwe in the COVID-19 Era: A Perfect Recipe for Antimicrobial Resistance. Antibiotics (Basel) 2022; 11:antibiotics11020244. [PMID: 35203846 PMCID: PMC8868384 DOI: 10.3390/antibiotics11020244] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 02/07/2022] [Accepted: 02/10/2022] [Indexed: 02/08/2023] Open
Abstract
The global COVID-19 pandemic has resulted in an upsurge in antimicrobial use. The increase in use is multifactorial, and is particularly related to the empirical treatment of SARS-CoV-2 and suspected coinfections with antimicrobials and the limited quality of diagnostics to differentiate viral and bacterial pneumonia. The lack of clear clinical guidelines across a wide range of settings, and the inadequacy of public health sectors in many countries, have contributed to this pattern. The increased use of antimicrobials has the potential to increase incidences of antimicrobial resistance, especially in low-resource countries such as Zimbabwe already grappling with multidrug-resistant micro-organism strains. By adopting the antimicrobial stewardship principles of the correct prescription and optimised use of antimicrobials, as well as diagnostic stewardship, revamping regulatory oversight of antimicrobial surveillance may help limit the occurrence of antimicrobial resistance during this pandemic.
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Affiliation(s)
- Itai Chitungo
- Chemical Pathology Unit, Department of Medical Laboratory Sciences, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe;
| | - Tafadzwa Dzinamarira
- School of Health Systems & Public Health, University of Pretoria, Pretoria 0002, South Africa;
- ICAP at Columbia University, Harare, Zimbabwe
- Correspondence:
| | - Tinashe K. Nyazika
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool L3 5QA, UK;
| | - Helena Herrera
- School of Pharmacy and Biomedical Sciences, University of Portsmouth, Portsmouth PO1 2UP, UK;
| | - Godfrey Musuka
- School of Health Systems & Public Health, University of Pretoria, Pretoria 0002, South Africa;
| | - Grant Murewanhema
- Unit of Obstetrics and Gynaecology, Department of Primary Health Care Sciences, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe;
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Dzinamarira T, Tungwarara N, Chitungo I, Chimene M, Iradukunda PG, Mashora M, Murewanhema G, Rwibasira GN, Musuka G. Unpacking the Implications of SARS-CoV-2 Breakthrough Infections on COVID-19 Vaccination Programs. Vaccines (Basel) 2022; 10:vaccines10020252. [PMID: 35214710 PMCID: PMC8879800 DOI: 10.3390/vaccines10020252] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 01/29/2022] [Accepted: 01/31/2022] [Indexed: 12/13/2022] Open
Abstract
Despite an array of preventive global public health interventions, SARS-CoV-2 has continued to spread significantly, infecting millions of people across the globe weekly. Newer variants of interest and concern have continued to emerge, placing the need for policymakers to rethink prevention strategies to end the pandemic. The approval of SARS-CoV-2 vaccines for public health use in December 2020 was seen as a significant development towards pandemic control and possibly ending the pandemic. However, breakthrough infections have continued to be observed among the ‘fully vaccinated’, and the duration and sustainability of vaccine-induced immunity has remained a topical public health discourse. In the absence of accurate public health communication, the breakthrough infections and waning immunity concepts have potential to further compound vaccine hesitancy. With this viewpoint, we discuss breakthrough SARS-CoV-2 infections, waning immunity, the need for COVID-19 booster shots, vaccine inequities, and the need to address vaccine hesitancy adequately to propel global vaccination programs forward.
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Affiliation(s)
- Tafadzwa Dzinamarira
- School of Health Systems & Public Health, University of Pretoria, Pretoria 0002, South Africa
- ICAP, Columbia University, Harare P.O. Box MP167, Zimbabwe;
- Correspondence:
| | - Nigel Tungwarara
- Department of Health Studies, University of South Africa, Pretoria 0002, South Africa;
| | - Itai Chitungo
- Chemical Pathology Unit, Department of Medical Laboratory Sciences, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare P.O. Box MP167, Zimbabwe;
| | - Munashe Chimene
- Department of Health Sciences, Africa University, Mutare P.O. Box 1320, Zimbabwe;
| | - Patrick Gad Iradukunda
- London School of Hygiene and Tropical Medicine, University of London, London WC1E 7HU, UK;
| | - Moreblessing Mashora
- Department of Public Health, Mount Kenya University, Kigali P.O. Box 5826, Rwanda;
| | - Grant Murewanhema
- Unit of Obstetrics and Gynaecology, Department of Primary Health Care Sciences, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare P.O. Box MP167, Zimbabwe;
| | | | - Godfrey Musuka
- ICAP, Columbia University, Harare P.O. Box MP167, Zimbabwe;
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Murewanhema G, Mutsigiri-Murewanhema F, Kunonga E. Enhancing SARS-CoV-2 surveillance through regular genomic sequencing is an essential element of COVID-19 control in resource-limited settings. Pan Afr Med J 2022; 41:88. [PMID: 35432710 PMCID: PMC8977355 DOI: 10.11604/pamj.2022.41.88.31821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 01/19/2022] [Indexed: 11/26/2022] Open
Affiliation(s)
- Grant Murewanhema
- Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe,,Corresponding author: Grant Murewanhema, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe.
| | | | - Edward Kunonga
- School of Health and Life Sciences, Teesside University, Middlesbrough, England
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Murewanhema G, Gwinji PT, Musuka G, Dzinamarira T. Towards the decriminalization of abortion in Zimbabwe: A public health perspective. Public Health in Practice 2022; 3:100237. [PMID: 36101761 PMCID: PMC9461515 DOI: 10.1016/j.puhip.2022.100237] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Accepted: 02/22/2022] [Indexed: 11/18/2022] Open
Affiliation(s)
- Grant Murewanhema
- Unit of Obstetrics and Gynaecology, Department of Primary Health Care Sciences, Faculty of Medicine and Health Sciences, University of Zimbabwe, Zimbabwe
| | - Phanuel Tawanda Gwinji
- Humanitarian Conflict and Response Institute, School of Arts Languages and Culture, Faculty of Humanities, The University of Manchester, UK
| | | | - Tafadzwa Dzinamarira
- ICAP at Columbia University, Harare, Zimbabwe
- School of Health Sciences & Public Health, University of Pretoria, Pretoria, 002, South Africa
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Murewanhema G, Musuka G, Dzinamarira T. Facilitating sexual and reproductive health services for adolescent girls in the COVID-19 era: An urgent public health priority. Afr J Prim Health Care Fam Med 2022; 14:e1-e2. [PMID: 35144451 PMCID: PMC8831929 DOI: 10.4102/phcfm.v14i1.3357] [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] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 12/09/2021] [Indexed: 11/15/2022] Open
Affiliation(s)
- Grant Murewanhema
- Department of Primary Health Care Sciences, Faculty of Medicine, University of Zimbabwe, Harare.
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Dzinamarira T, Murewanhema G, Iradukunda PG, Madziva R, Herrera H, Cuadros DF, Tungwarara N, Chitungo I, Musuka G. Utilization of SARS-CoV-2 Wastewater Surveillance in Africa-A Rapid Review. Int J Environ Res Public Health 2022; 19:969. [PMID: 35055789 PMCID: PMC8775514 DOI: 10.3390/ijerph19020969] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 01/04/2022] [Accepted: 01/13/2022] [Indexed: 02/06/2023]
Abstract
Wastewater-based epidemiology for SARS-CoV-2 RNA detection in wastewater is desirable for understanding COVID-19 in settings where financial resources and diagnostic facilities for mass individual testing are severely limited. We conducted a rapid review to map research evidence on the utilization of SARS-CoV-2 wastewater surveillance in Africa. We searched PubMed, Google Scholar, and the World Health Organization library databases for relevant reports, reviews, and primary observational studies. Eight studies met the inclusion criteria. Narrative synthesis of the findings from included primary studies revealed the testing methodologies utilized and that detected amount of SARS-CoV-2 viral RNA correlated with the number of new cases in the studied areas. The included reviews revealed the epidemiological significance and environmental risks of SARS-CoV-2 wastewater. Wastewater surveillance data at the community level can be leveraged for the rapid assessment of emerging threats and aid pandemic preparedness. Our rapid review revealed a glaring gap in the primary literature on SARS-CoV-2 wastewater surveillance on the continent, and accelerated and adequate investment into research is urgently needed to address this gap.
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Affiliation(s)
- Tafadzwa Dzinamarira
- School of Health Systems & Public Health, University of Pretoria, Pretoria 0002, South Africa
- ICAP at Columbia University, Harare, Zimbabwe;
| | - Grant Murewanhema
- Unit of Obstetrics and Gynaecology, Department of Primary Health Care Sciences, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe;
| | - Patrick Gad Iradukunda
- London School of Hygiene and Tropical Medicine, University of London, London WC1E 7HU, UK;
| | - Roda Madziva
- School of Sociology and Social Policy, University of Nottingham, Nottingham NG7 2RD, UK;
| | - Helena Herrera
- School of Pharmacy and Biomedical Sciences, University of Portsmouth, Portsmouth PO1 2UP, UK;
| | - Diego F. Cuadros
- Department of Geography and Geographic Information Science, University of Cincinnati, Cincinnati, OH 45221, USA;
| | - Nigel Tungwarara
- Department of Health Studies, University of South Africa, Pretoria 0002, South Africa;
| | - Itai Chitungo
- Chemical Pathology Unit, Department of Laboratory Diagnostic and Investigative Sciences, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe;
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