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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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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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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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Dzinamarira T, Murewanhema G, Mhango M, Iradukunda PG, Chitungo I, Mashora M, Makanda P, Atwine J, Chimene M, Mbunge E, Mapingure MP, Chingombe I, Musuka G, Nkambule SJ, Ngara B. COVID-19 Prevalence among Healthcare Workers. A Systematic Review and Meta-Analysis. Int J Environ Res Public Health 2021; 19:ijerph19010146. [PMID: 35010412 PMCID: PMC8750782 DOI: 10.3390/ijerph19010146] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [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: 11/26/2021] [Revised: 12/18/2021] [Accepted: 12/20/2021] [Indexed: 12/16/2022]
Abstract
Understanding the burden of SARS-CoV-2 infections among healthcare workers is a critical component to inform occupational health policy and strategy. We conducted a systematic review and meta-analysis to map and analayse the available global evidence on the prevalence of SARS-CoV-2 infections among healthcare workers. The random-effects adjusted pooled prevalence of COVID-19 among those studies that conducted the test using the antibody (Ab) method was 7% [95% CI: 3 to 17%]. The random-effects adjusted pooled prevalence of COVID-19 among those studies that conducted the test using the PCR method was 11% [95% CI: 7 to 16%]. We found the burden of COVID-19 among healthcare workers to be quite significant and therefore a cause for global health concern. Furthermore, COVID-19 infections among healthcare workers affect service delivery through workers’ sick leave, the isolation of confirmed cases and quarantine of contacts, all of which place significant strain on an already shrunken health workforce.
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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; (M.P.M.); (I.C.); (G.M.)
- Correspondence:
| | - Grant Murewanhema
- Unit of Obstetrics and Gynaecology, Department of Primary Health Care Sciences, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe;
| | - Malizgani Mhango
- School of Public Health, University of Western Cape, Cape Town 7535, South Africa;
| | - Patrick Gad Iradukunda
- London School of Hygiene and Tropical Medicine, University of London, London WC1E 7HT, UK;
| | - Itai Chitungo
- Faculty of Medicine, College of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe; (I.C.); (B.N.)
| | | | - Pelagia Makanda
- Department of Medicine, Jinzhou Medical University, Jinzhou 121001, China; (P.M.); (J.A.)
| | - James Atwine
- Department of Medicine, Jinzhou Medical University, Jinzhou 121001, China; (P.M.); (J.A.)
| | - Munashe Chimene
- Department of Health Sciences, Africa University, Mutare, Zimbabwe;
| | - Elliot Mbunge
- Department of Information Technology, Faculty of Accounting and Informatics, Durban University of Technology, Durban 4000, South Africa;
| | | | | | - Godfrey Musuka
- ICAP at Columbia University, Harare, Zimbabwe; (M.P.M.); (I.C.); (G.M.)
| | - Sphamandla Josias Nkambule
- Department of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban 4001, South Africa;
| | - Bernard Ngara
- Faculty of Medicine, College of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe; (I.C.); (B.N.)
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