The COVID-19 Impact on the Trends in Yellow Fever and Lassa Fever Infections in Nigeria

Lassa fever (LF) and yellow fever (YF) belong to a group of viral hemorrhagic fevers (VHFs). These viruses have common features and damages the organs and blood vessels; they also impair the body's homeostasis. Some VHFs cause mild disease, while some cause severe disease and death such as in the case of Ebola or Marburg. LF virus and YF virus are two of the most recent emerging viruses in Africa, resulting in severe hemorrhagic fever in humans. Lassa fever virus is continuously on the rise both in Nigeria and neighboring countries in West Africa, with an estimate of over 500,000 cases of LF, and 5000 deaths, annually. YF virus is endemic in temperate climate regions of Africa, Central America (Guatemala, Honduras, Nicaragua, El Salvador), and South America (such as Brazil, Argentina, Peru, and Chile) with an annual estimated cases of 200,000 and 30,000 deaths globally. This review examines the impact of the COVID-19 pandemic on the trend in epidemiology of these two VHFs to delineate responses that are associated with protective or pathogenic outcomes.

Management of Salter-Harris Type 1 Fracture Complicated with Osteomyelitis in a Sickle Cell Disease Patient: A Case Report and Review of Literature

Salter-Harris fractures may occur due to a single injury or repetitive stress fractures on the extremities. Type I to III fractures are managed medically, while types IV and V, which are rare, are treated surgically. In the pediatric population, Salter-Harris I fractures of the distal tibia are commonly seen, and management of such fractures are well established in the literature. Despite the availability of a wide range of treatment for such fractures, osteonecrosis or avascular necrosis of the proximal femur can subsequently develop. Avascular necrosis is cell death secondary to metabolic disturbances, trauma, adverse effects of certain medications, or sickle cell disease. Avascular necrosis commonly affects the talus, humerus, or tibia in addition to the femoral head. Radiographic images are essential for prompt diagnosis and to minimize negative health outcomes in these patients. However, Salter-Harris I fracture in sickle cell patients can be very challenging due to these patients' vulnerability to bone infections and sickle cell crisis. In this case report, our patient with a history of sickle cell disease and with a diagnosis of Salter-Harris I fracture was treated with surgical intervention as type V, which is discussed in this article, and responded well to treatment. Thus, this case suggests a new approach to managing Salter-Harris I fractures complicated with osteomyelitis in sickle cell patients.

Mapping evidence on factors contributing to maternal and child mortality in sub-Saharan Africa: A scoping review protocol

Background

Maternal and child mortality remains a major public health issue in sub-Saharan Africa (SSA), with the region having the highest under-five mortality rates, where approximately 1 in 11 children, dies before the age of 5 years. This is nearly 15 times the average in high-income countries (HICs). This scoping review is aimed at mapping evidence on the factors contributing to maternal and child mortality in SSA.

Methods

This study will be conducted using a scoping review to map existing literature on the factors contributing to maternal and child mortality in SSA. The search will comprise of peer-reviewed and grey literature, using the EBSCOhost platform. Keyword search from electronic databases such as PubMed/MEDLINE, Google Scholar, Science Direct and World Health Organization library, will be conducted. Information will be obtained from the included studies, using a data charting table. We will use NVIVO version 10 software to analyse the data, and the narrative account of the study will be presented by means of a thematic content analysis.

Discussion

We expect to find relevant literature that can help us in mapping evidence on the factors contributing to maternal and child mortality in SSA. This study results are anticipated to identify research gaps and in turn, guide the design of future primary studies.

Systematic review protocol registration

Open Science Framework registration number (DOI 10.17605/OSF.IO/XF5VN).

Lung cancer awareness and palliative care interventions implemented in low-and middle-income countries: a scoping review

BACKGROUND

Lung cancer is the most diagnosed cancer worldwide. In low- and middle-income countries (LMICs), lung cancer is often diagnosed at a late stage due to poor knowledge and awareness of its signs and symptoms. Increasing lung cancer awareness is likely to reduce the diagnosis and treatment delays. The implementation of early palliative care has also been reported to improve a patient's quality of life, and even survival. The aim of this scoping review was to map evidence on lung cancer awareness and palliative care interventions implemented in sub-Saharan Africa (SSA) and other LMICs.

METHODS

This scoping review was guided by Arksey and O'Malley's framework. Databases such as the EBSCOhost, PubMed, Science Direct, Google Scholar, World Health Organization (WHO) library and grey literature were used to perform systematic searches of relevant articles. The methodological quality assessment of included primary studies was assessed using the Mixed Method Appraisal Tool (MMAT). NVivo version 10 software was used to perform the thematic content analysis of the included studies.

RESULTS

A total number of screened articles was 2886, with 236 meeting the eligibility criteria and 167 further excluded following abstract screening. Sixty-nine (69) articles qualified for full-article screening and 9 were selected for detailed data extraction and methodological quality assessment. Of the included nine studies, eight described at least one lung cancer warning signs and symptoms, while one described the effectiveness of palliative care for lung cancer. Eight articles recognized the level of lung cancer knowledge, risk factors awareness of warning signs and symptoms in LMICs, mostly Africa and Asia.

CONCLUSIONS

Most of the participants were aware of tobacco use as the major risk factor for lung cancer but lacked knowledge on the other pre-disposing risk factors. Evidence on palliative care is scarce, therefore, awareness interventions packaged with evidence on the value of timely access to palliative care services in improving the quality of life of the lung cancer patients and their families, are required.

Health systems influence on the pathways of care for lung cancer in low- and middle-income countries: a scoping review

Background

Globally, lung cancer is the most common cancer and cause of cancer-related deaths, responsible for nearly one in five deaths. Many health systems in low- and middle-income countries, including sub-Saharan Africa have weak organizational structure, which results in delayed lead time for lung cancer patient care continuum from diagnosis to palliative care.

Aim

To map evidence on the health systems issues impacting on the delays in timely lung cancer care continuum from diagnosis to palliative care in LMICs, including sub-Saharan Africa.

Methods

A scoping review was performed following the method of Arksey and O’Malley. Systematic searches were performed using EBSCOhost platform, a keyword search from the following electronic databases were conducted: PubMed/MEDLINE, Google Scholar, Science Direct, World Health Organization (WHO) library, and grey literature. The screening was guided by the inclusion and exclusion criteria. The quality of the included studies was determined by Mixed Method Appraisal Tool (MMAT).

Results

A total of 2886 articles were screened, and 236 met the eligibility criteria for this scoping review study. Furthermore, 155 articles were also excluded following abstract screening. Eighty-one articles were selected for full-article screening by two researchers with 10 being selected for independent detailed data extraction for synthesis. These studies were also subjected to methodological quality assessment. All included studies were conducted in LMICs mostly Asia, the Middle East, and Latin America and published between January 2008 and June 2018. The ten included studies described at least one interval in lung cancer care.

Conclusions

Reducing wait time across this care continuum is needed to improve easy access to healthcare, quality care, survival and patient outcomes, as many patients still face longer wait times for diagnosis and treatment of lung cancer than recommended in several healthcare settings. A multidisciplinary team approach will help to reduce wait time and ensure that all patients receive appropriate care. Interventions are needed to address delays in lung cancer care in LMICs. Health-care providers at all levels of care should be educated and equipped with skills to identify lung cancer symptoms and perform or refer for appropriate diagnostic tests.