COVID-19 in malaria-endemic regions: potential consequences for malaria intervention coverage, morbidity, and mortality

Teboh-Ewungkem, Miranda I.; Ngwa, Gideon A.

doi:10.1016/s1473-3099(20)30763-5

Cited by 24 publications

(19 citation statements)

References 8 publications

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“…For example, some malaria prevention interventions like ITN distribution and malaria-related training were halted because of discouraging gatherings. The observed pattern has been reported elsewhere [ 62 , 63 ]. Educational gatherings are helpful in supporting behaviors to prevent and control malaria.…”

Section: Discussionsupporting

confidence: 88%

Treatment-seeking and uptake of malaria prevention strategies among pregnant women and caregivers of children under-five years during COVID-19 pandemic in rural communities in South West Uganda: a qualitative study

et al. 2022

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Background Despite efforts to avert the negative effects of malaria, there remain barriers to the uptake of prevention measures, and these have hindered its eradication. This study explored the factors that influence uptake of malaria prevention strategies among pregnant women and children under-five years and the impact of COVID-19 in a malaria endemic rural district in Uganda. Methods This was a qualitative case study that used focus group discussions, in-depth interviews, and key informant interviews involving pregnant women, caregivers of children under-five years, traditional birth attendants, village health teams, local leaders, and healthcare providers to explore malaria prevention uptake among pregnant women and children under-five years. The interviews were audio-recorded, transcribed and data were analyzed using thematic content approach. Results Seventy-two participants were enrolled in the Focus Group Discussions, 12 in the in-depth interviews, and 2 as key informants. Pregnant women and caregivers of children under-five years were able to recognize causes of malaria, transmission, and symptoms. All participants viewed malaria prevention as a high priority, and the use of insecticide-treated mosquito bed nets (ITNs) was upheld. Participants' own experiences indicated adverse effects of malaria to both pregnant women and children under-five. Home medication and the use of local herbs were a common practice. Some participants didn’t use any of the malaria prevention methods due to deliberate refusal, perceived negative effects of the ITNs, and family disparity. The Corona Virus Disease-2019 (COVID-19) control measures did not abate the risk of malaria infection but these were deleterious to healthcare access and the focus of malaria prevention. Conclusions Although pregnant women and caregivers of children under-five years recognized symptoms of malaria infection, healthcare-seeking was not apt as some respondents used alternative approaches and delayed seeking formal healthcare. It is imperative to focus on the promotion of malaria prevention strategies and address drawbacks associated with misconceptions about these interventions, and promotion of health-seeking behaviors. As COVID-19 exacerbated the effect of malaria prevention uptake and healthcare seeking, it’s critical to recommit and integrate COVID-19 prevention measures in normative living and restrict future barriers to healthcare access.

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Section: Discussionsupporting

confidence: 88%

Treatment-seeking and uptake of malaria prevention strategies among pregnant women and caregivers of children under-five years during COVID-19 pandemic in rural communities in South West Uganda: a qualitative study

et al. 2022

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“…The low occurrence of severe disease in Africa compared with other continents underlines the importance of minimizing the potential collateral damage of the COVID-19 pandemic. Such damage includes diversion of financial and personnel resources from other services to the COVID-19 response, changes in healthcare seeking behavior, reduced availability of medicines for acute and chronic diseases, and disruption of routine vaccination services (29)(30)(31)(32)(33).…”

Section: Discussionmentioning

confidence: 99%

Intense and Mild First Epidemic Wave of Coronavirus Disease, The Gambia

Abatan¹,

Agboghoroma²,

Akemoke³

et al. 2021

Emerg. Infect. Dis.

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B y the end of October 2020, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic had spread to 6 continents and caused >45 million coronavirus disease (COVID-19) cases and 1.1 million deaths (1). Despite having 15.6% of the worldwide population (2), by October 31, 2020, Africa had only 3.9% (1.76 million) of the world's COVID-19 cases and 3.6% (42,233) of deaths during the pandemic (1). Data suggest that the pandemic is evolving differently in sub-Saharan Africa compared with the rest of the world and that the outbreak started later (3).Of note, severe COVID-19 cases seem to occur less frequently in Africa than in the rest of the world (4). Several factors have been proposed to explain this. Age is likely a major factor because older persons are at higher risk for severe disease, but Africa has an extremely young population; >60% of persons are <25 years of age (5). However, variation of CO-VID-19 severity with age alone does not fully explain the observed differences (4). Clinical cases and deaths in Africa likely are underreported because systematic surveillance is limited and no systematic death registration exists; thus, the true SARS-CoV-2 burden probably is underestimated (4). Nevertheless, local health systems in Africa, which have a lower capacity to deal with COVID-19 patients than healthcare systems in high-resource settings, were not overwhelmed, even at the peak of the epidemic (6). Although potential

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“…The low (compared to other continents) levels of severe disease observed underlines the importance of minimizing the potential collateral damage of the COVID-19 pandemic in Africa. Such damage includes diversion of financial and personnel resources from other services to COVID-19 response, health seeking behaviour changes, reduced availability of medicines for acute and chronic diseases and disruptions of routine vaccination services (28-32). The pandemic has also worsened, particularly in low- and middle-income countries (33), the economic stability of households and lower food security; mitigating short and mid-term impact should be prioritized.…”

Section: Discussionmentioning

confidence: 99%

Intense and Mild Wave of COVID-19 in The Gambia: a Cohort Analysis

Roca

2020

Preprint

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BackgroundThe SARS-CoV-2 pandemic is evolving differently in Africa compared to other regions, with lower transmission and milder clinical presentation. Reasons for this are not fully understood. Recent data from Eastern and Southern Africa suggest that transmission may be higher than measured. Detailed epidemiological data in different African settings is urgently needed.MethodsWe calculated cumulative rates of SAR-CoV-2 infections per 1,000 people at risk in The Gambia (2.42 million individuals) using publicly available data. We evaluated these rates in a cohort of 1,366 employees working at the MRC Unit The Gambia @LSHTM (MRCG) where systematic surveillance of symptomatic cases and contact tracing was implemented. Cumulative rates among the Gambian population were stratified by age groups and, among MRCG staff, by occupational exposure risk. SARS-CoV-2 testing was conducted on oropharyngeal/nasopharyngeal samples with consistent sampling and laboratory procedures across cohorts.FindingsBy September 2020, 3,579 cases of SARS-CoV-2 and 115 deaths had been identified; with 67% of cases detected in August. Among them, 191 cases were MRCG staff; all of them were asymptomatic/mild, with no deaths. The cumulative incidence rate for SARS-CoV-2 infection among MRCG staff (excluding those with occupational exposure risk) was 129 per 1,000, at least 20-fold higher than the estimations based on diagnosed cases in the adult Gambian population.InterpretationOur findings are consistent with recent African sero-prevalence studies reporting high community transmission of SAR-CoV-2. Enhanced community surveillance is essential to further understand and predict the future trajectory of the pandemic in Africa.

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COVID-19 in malaria-endemic regions: potential consequences for malaria intervention coverage, morbidity, and mortality

Cited by 24 publications

References 8 publications

Treatment-seeking and uptake of malaria prevention strategies among pregnant women and caregivers of children under-five years during COVID-19 pandemic in rural communities in South West Uganda: a qualitative study

Treatment-seeking and uptake of malaria prevention strategies among pregnant women and caregivers of children under-five years during COVID-19 pandemic in rural communities in South West Uganda: a qualitative study

Intense and Mild First Epidemic Wave of Coronavirus Disease, The Gambia

Intense and Mild Wave of COVID-19 in The Gambia: a Cohort Analysis

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