What does the COVID-19 pandemic mean for HIV, tuberculosis, and malaria control?

Amimo, Floriano; Lambert, Ben; Magit, Anthony

doi:10.1186/s41182-020-00219-6

Cited by 136 publications

(124 citation statements)

References 24 publications

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“…For instance, EDCTP vowed to accept a no-cost extension of research projects on top of all these difficulties, we believe that researchers' commitment should not be overwhelmed by COVID-19 and that they should look for options to complete started researches successfully or initiate new researches in the era of COVID-19. Similar to Ethiopia, the links between TB and COVID-19 are most noticed in sub-Saharan Africa, where TB is the leading cause of death and the health system is weak to withstand the two diseases [18,19]. Governments in sub-Saharan Africa African need to exert efforts on preventing the spread of the two diseases and continue the progress towards End TB strategy.…”

Section: Covid-19 Implications On Tb Researchmentioning

confidence: 99%

Containment of COVID-19 in Ethiopia and implications for tuberculosis care and research

et al. 2020

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Background The coronavirus disease 2019 (COVID-19) has emerged as a global health and economic security threat with staggering cumulative incidence worldwide. Given the severity of projections, hospitals across the globe are creating additional critical care surge capacity and limiting patient routine access to care for other diseases like tuberculosis (TB). The outbreak fuels panic in sub-Saharan Africa where the healthcare system is fragile in withstanding the disease. Here, we looked over the COVID-19 containment measures in Ethiopia in context from reliable sources and put forth recommendations that leverage the health system response to COVID-19 and TB. Main text Ethiopia shares a major proportion of the global burden of infectious diseases, while the patterns of COVID-19 are still at an earlier stage of the epidemiology curve. The Ethiopian government exerted tremendous efforts to curb the disease. It limited public gatherings, ordered school closures, directed high-risk civil servants to work from home, and closed borders. It suspended flights to 120 countries and restricted mass transports. It declared a five-month national state of emergency and granted a pardon for 20 402 prisoners. It officially postponed parliamentary and presidential elections. It launched the ‘PM Abiy-Jack Ma initiative’, which supports African countries with COVID-19 diagnostics and infection prevention and control commodities. It expanded its COVID-19 testing capacity to 38 countrywide laboratories. Many institutions are made available to provide clinical care and quarantine. However, the outbreak still has the potential for greater loss of life in Ethiopia if the community is unable to shape the regular behavioral and sociocultural norms that would facilitate the spread of the disease. The government needs to keep cautious that irregular migrants would fuel the disease. A robust testing capacity is needed to figure out the actual status of the disease. The pandemic has reduced TB care and research activities significantly and these need due attention. Conclusions Ethiopia took several steps to detect, manage, and control COVID-19. More efforts are needed to increase testing capacity and bring about behavioral changes in the community. The country needs to put in place alternative options to mitigate interruptions of essential healthcare services and scientific researches of significant impact.

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Section: Covid-19 Implications On Tb Researchmentioning

confidence: 99%

Containment of COVID-19 in Ethiopia and implications for tuberculosis care and research

et al. 2020

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“…The current crisis because of COVID-19 creates all the conditions that have been indicated in previous studies as being associated with HIV and TB treatment non-adherence and lost to follow across the continent. 25,49,[58][59][60][61][62][63][64][65][66][67] The cost-effectiveness of various innovative solutions for service delivery is well documented across the continent, 54,[68][69][70][71][72][73][74][75][76][77][78][79][80][81][82] warranting their utility to mitigate the risks posed by COVID-19 (Table 3); however, some constraints have been reported. In relation to mobile clinics, these include logistical challenges as well as spatial and structural constraints.…”

Section: Discussionmentioning

confidence: 99%

“…24 These might be worsened by the disruption of the international system affecting the supply of essential medical products, as well as reduced capacity of patients to support direct and indirect medical costs, reduced inclination of patients (including those presenting symptoms overlapping with those of the new pandemic) to seek care at a formal health facility due to COVID-19 related fears, and clinical parallels and potential interactions between COVID-19 and these diseases. 25 Here, for the rst time, we systematically review current evidence from studies that employed mathematical models and population surveys to quantify the potential public health consequences of COVID-19 on HIV, TB, and malaria across Africa. Although our focus is on studies that generated quantitative data, we use evidence from studies providing relevant insights to draw comprehensive policy recommendations to mitigate the emerging risks across the continent and improve preparedness of African countries to future crises.…”

Section: Introductionmentioning

confidence: 99%

The potential impact of the COVID-19 pandemic on HIV, tuberculosis, and malaria control in Africa: a systematic review of modelling studies and population surveys

Amimo

Lambert

Magit

et al. 2020

Preprint

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Background We reviewed current evidence on the impact of COVID-19 on HIV, tuberculosis, and malaria across Africa.Methods We searched medical databases up to 15 September 2020 for epidemiological studies that investigated the impact of COVID-19 on HIV, tuberculosis, and malaria in terms of morbidity, mortality, or healthcare accessibility, covering African countries. We consulted global health and government sources for population surveys providing relevant primary data. We employed meta-study to assess evidence. This study is registered with PROSPERO, number CRD42020209265.Results Of the 128 records screened, 14 epidemiological studies were included in the analysis. We identified 5 population surveys. The largest effect of COVID-19 related disruption of HIV, TB, and malaria services is projected to result from interruption of ART, decline in TB case detection, and interruption of insecticide treated bed nets distribution campaigns, respectively. However, most modelling studies substantially underestimated the potential implications of COVID-19 on HIV, TB, and malaria in Africa and focused on the disruption of healthcare resulting from reduction in the capacity of healthcare provider. Reduced capacity of patients to use health services and adhere to treatment may also contribute to poor outcomes even when health systems capabilities are restored or unaffected. Moreover, these models do not account for any potential interaction of HIV, TB, and malaria with COVID-19, although empirical evidence shows that coinfection between HIV and TB with COVID-19 is significantly associated with increased mortality risk in Africa.Conclusions Current evidence is largely speculative. Innovative COVID-19 resilient solutions calibrated to local vulnerabilities are vital to ensure continuity of care and prevent the emergence of further potentially larger crises.

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“…Despite low numbers of cases, and limited direct morbidity and mortality related to Covid-19, health care systems in many southern African countries remain vulnerable to indirect effects on non-Covid-19 health outcomes, especially maternal and newborn health (6). Fear of the virus, shortages of resources, and disruption of healthcare infrastructure and systems as a result of lockdown measures, present increased barriers for access to healthcare services and may result in breakdown of routine health programmes (6,7). Similar issues during the Ebola outbreak in west Africa in 2014 resulted in a sustained reduction in use of essential maternal and child health services (8).…”

Section: Introductionmentioning

confidence: 99%

“…Already in some European countries reduction in use of child health services has been observed during the Covid-19 pandemic, raising fears about additional morbidity and mortality resulting from delayed presentations (10,11). Models based on estimates of disruption to routine maternal and child health services and food insecurity as an indirect result of Covid-19 in low and middle income countries (LMICs) predict up to 38.6% increase in maternal deaths per month across 118 countries (6).…”

Section: Introductionmentioning

confidence: 99%

Resilience and vulnerability of maternity services in Zimbabwe: a comparative analysis of the effect of Covid-19 and lockdown control measures on maternal and perinatal outcomes at Mpilo Central Hospital.

Shakespeare

Dube

Moyo

et al. 2020

Preprint

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Background: On 27th March the Zimbabwean government declared the Covid-19 pandemic a ‘national disaster’. Travel restrictions and emergency regulations have had significant impacts on maternity services, including staff shortages, resource stock-outs, and closure of antenatal clinics. Estimates of the indirect impact of Covid-19 on maternal and perinatal mortality expect it to be considerable, but little data is yet available.This study aims to examine the impact of Covid-19 and lockdown control measures on non-Covid outcomes in a government tertiary level maternity unit in Bulawayo, Zimbabwe, by comparing maternal and perinatal morbidity and mortality before and after lockdown was implemented.Methods: This is a retrospective, observational study, using a cross-sectional design to compare routine monthly maternal and perinatal statistics three months before and after Covid-19 emergency measures at Mpilo Central Hospital.Results: Between January-March and April-June 2020, average monthly deliveries fell from 747 to 681 and Caesarean section rates from 29.8% to 26.6%. Women with unbooked pregnancies presenting in labour almost doubled from 4.4% to 8%. There was no substantial change, however, in maternal mortality or severe maternal morbidity (post-partum haemorrhage (PPH), uterine rupture, severe preeclampsia/eclampsia), stillbirth rate or special care baby unit (SCBU) admission. There was a small increase in early neonatal death (ENND) from an average of 18.7 to 24.0 deaths per month.Conclusion: Maternal and perinatal outcomes must continue to be monitored to assess the impact of Covid-19 and lockdown measures as the epidemic in Zimbabwe unfolds. Despite the vulnerability of the healthcare system, the resilience and commitment of maternity units and healthcare workers to providing care in the most difficult circumstances should not be underestimated.

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What does the COVID-19 pandemic mean for HIV, tuberculosis, and malaria control?

Abstract: Despite its current relatively

Cited by 136 publications

References 24 publications

Containment of COVID-19 in Ethiopia and implications for tuberculosis care and research

Containment of COVID-19 in Ethiopia and implications for tuberculosis care and research

The potential impact of the COVID-19 pandemic on HIV, tuberculosis, and malaria control in Africa: a systematic review of modelling studies and population surveys

Resilience and vulnerability of maternity services in Zimbabwe: a comparative analysis of the effect of Covid-19 and lockdown control measures on maternal and perinatal outcomes at Mpilo Central Hospital.

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