Chloroquine and Hydroxychloroquine for the Prevention or Treatment of COVID-19 in Africa: Caution for Inappropriate Off-label Use in Healthcare Settings

Abena, Pascale M.; Decloedt, Eric H.; Bottieau, Emmanuel; Suleman, Fátima; Adejumo, Prisca Olabisi; Sam-Agudu, Nadia A.; Tamfum, Jean Jacques Muyembe; Seydi, Moussa; Eholié, Serge; Mills, Edward J.; Kallay, Oscar; Zumla, Alimuddin; Nachega, Jean B.

doi:10.4269/ajtmh.20-0290

Cited by 131 publications

(140 citation statements)

References 38 publications

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“…Up to 7.8 billion people will be in dire need of a limited supply 28 . There has already been a deluge of public health problems from quackery to substandard and falsified products, such as chloroquine, masks, diagnostic tests, ‘vaccines’ and hand sanitiser (see IDDO Medicine Quality Monitoring Globe ) 28 , 29 . A ‘living’ system will help identify the most promising medical product interventions to prompt crucial pro-active planning for coordinated production and logistics for equitable access, optimal and appropriate prevent, detect and respond monitoring of product quality 30 and trials of portable devices for empowering post-market surveillance 31 .…”

Section: Discussionmentioning

confidence: 99%

Baseline results of a living systematic review for COVID-19 clinical trial registrations

Maguire¹,

McLean²,

Rashan³

et al. 2020

Wellcome Open Res

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Background: Since the coronavirus disease 2019 (COVID-19) outbreak was first reported in December 2019, many independent trials have been planned that aim to answer similar questions. Tools allowing researchers to review studies already underway can facilitate collaboration, cooperation and harmonisation. The Infectious Diseases Data Observatory (IDDO) has undertaken a living systematic review (LSR) to provide an open, accessible and frequently updated resource summarising characteristics of COVID-19 study registrations. Methods: Review of all eligible trial records identified by systematic searches as of 3 April 2020 and initial synthesis of clinical study characteristics were conducted. In partnership with Exaptive, an open access, cloud-based knowledge graph has been created using the results. Results: There were 728 study registrations which met eligibility criteria and were still active. Median (25th, 75th percentile) sample size was 130 (60, 400) for all studies and 134 (70, 300) for RCTs. Eight lower middle and low income countries were represented among the planned recruitment sites. Overall 109 pharmacological interventions or advanced therapy medicinal products covering 23 drug categories were studied. Majority (57%, 62/109) of them were planned only in one study arm, either alone or in combination with other interventions. There were 49 distinct combinations studied with 90% (44/49) of them administered in only one or two study arms. The data and interactive platform are available at https://iddo.cognitive.city/. Conclusions: Baseline review highlighted that the majority of investigations in the first three months of the outbreak were small studies with unique treatment arms, likely to be unpowered to provide solid evidence. The continued work of this LSR will allow a more dependable overview of interventions tested, predict the likely strength of evidence generated, allow fast and informative filtering of relevant trials for specific user groups and provide the rapid guidance needed by investigators and funders to avoid duplication of efforts.

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Section: Discussionmentioning

confidence: 99%

Baseline results of a living systematic review for COVID-19 clinical trial registrations

Maguire¹,

McLean²,

Rashan³

et al. 2020

Wellcome Open Res

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“…However, a tiny fraction of this number achieved herd immunity. [23][24][25][26] In another study, 21 percent of residents in the community have had COVID-19 antibodies already, making the area not just the deadliest community for COVID-19 pandemic infection but also the most infected area and, by outcome, the farthest to herd immunity. 27,28 In similar studies, about 32 percent of individuals who were tested for COVID-19 infection have already had the antibodies, which showed that in the area, the disease was not as severe as it might have seemed at first glance, and the community as a whole was halfway to herd immunity.…”

mentioning

confidence: 99%

Addressing the challenges that affect COVID-19 prevention in the rural areas of Abia State, Nigeria

Enwereji

Ezeama

2020

Int J Community Med Public Health

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Background: Using directives have been the standard approach of changing public behavior. But studies have shown that directives fail because people hate being told what to do. Telling individuals to use limited resources and other social amenities in rural areas to prevent coronavirus disease 2019 (COVID-19) infection may lead to skepticism in practice of public health recommendations on COVID-19 prevention. Even non-availability of basic hand washing facilities (soap and clean water) which form fundamental mechanism to prevent COVID-19 can expose people to infection. Study assesses factors and conditions that influence the practice of Center for disease control (CDC) preventive measures against COVID-19 in rural areas.Methods: This is a qualitative study that utilized information from 36 health care professionals under the aegis of committee for COVID-19 prevention. These committee members are working together in partnership with state government to provide services to control, prevent and cushion effects of COVID-19 pandemic.Results: Findings from 36 health care professionals made up of 10 (27.8%) females and 26 (72.2%) males showed that factors such as denial of existence of the virus, labeling virus as only urban limited, poor knowledge of mode of transmission, terming virus as ploy politicians use to siphon resources meant for rural development contributed to non-observation of CDC guidelines for COVID-19 prevention.Conclusions: Denying existence of COVID-19 and not observing CDC guidelines will increase community transmission thereby, expose people in communities to infection. Therefore, education is needed to enlighten people in communities on benefits of observing CDC guidelines.

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“…7 Patients with COVID-19 who require hospitalization are at risk for complications including electrolyte derangements, which are risk factors for QTc prolongation. 8 Our patient had several risk factors for conduction abnormalities: administration of HCQ, lopinavir/ritonavir, and inotropes, and hypocalcemia. Lopinavir/ritonavir is also associated with the prolongation of QTc, but the ECG after starting this medication was normal.…”

Section: Discussionmentioning

confidence: 81%

Case Report: Right Bundle Brunch Block and QTc Prolongation in a Patient with COVID-19 Treated with Hydroxychloroquine

Asli

Abdullah

Chong

et al. 2020

The American Journal of Tropical Medicine and Hygiene

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Chloroquine and Hydroxychloroquine for the Prevention or Treatment of COVID-19 in Africa: Caution for Inappropriate Off-label Use in Healthcare Settings

Cited by 131 publications

References 38 publications

Baseline results of a living systematic review for COVID-19 clinical trial registrations

Baseline results of a living systematic review for COVID-19 clinical trial registrations

Addressing the challenges that affect COVID-19 prevention in the rural areas of Abia State, Nigeria

Case Report: Right Bundle Brunch Block and QTc Prolongation in a Patient with COVID-19 Treated with Hydroxychloroquine

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