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Predicting the Impact of COVID-19 and the Potential Impact of the Public Health Response on Disease Burden in Uganda.

ABSTRACT: The COVID-19 pandemic and public health "lockdown" responses in sub-Saharan Africa, including Uganda, are now widely reported. Although the impact of COVID-19 on African populations has been relatively light, it is feared that redirecting focus and prioritization of health systems to fight COVID-19 may have an impact on access to non-COVID-19 diseases. We applied age-based COVID-19 mortality data from China to the population structures of Uganda and non-African countries with previously established outbreaks, comparing theoretical mortality and disability-adjusted life years (DALYs) lost. We then predicted the impact of possible scenarios of the COVID-19 public health response on morbidity and mortality for HIV/AIDS, malaria, and maternal health in Uganda. Based on population age structure alone, Uganda is predicted to have a relatively low COVID-19 burden compared with an equivalent transmission in comparison countries, with 12% of the mortality and 19% of the lost DALYs predicted for an equivalent transmission in Italy. By contrast, scenarios of the impact of the public health response on malaria and HIV/AIDS predict additional disease burdens outweighing that predicted from extensive SARS-CoV-2 transmission. Emerging disease data from Uganda suggest that such deterioration may already be occurring. The results predict a relatively low COVID-19 impact on Uganda associated with its young population, with a high risk of negative impact on non-COVID-19 disease burden from a prolonged lockdown response. This may reverse hard-won gains in addressing fundamental vulnerabilities in women and children's health, and underlines the importance of tailoring COVID-19 responses according to population structure and local disease vulnerabilities.

SUBMITTER: Bell D

PROVIDER: S-EPMC7470592 | biostudies-literature | 2020 Sep

REPOSITORIES: biostudies-literature

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Predicting the Impact of COVID-19 and the Potential Impact of the Public Health Response on Disease Burden in Uganda.

Bell David D Hansen Kristian Schultz KS Kiragga Agnes N AN Kambugu Andrew A Kissa John J Mbonye Anthony K AK

The American journal of tropical medicine and hygiene 20200901 3

The COVID-19 pandemic and public health "lockdown" responses in sub-Saharan Africa, including Uganda, are now widely reported. Although the impact of COVID-19 on African populations has been relatively light, it is feared that redirecting focus and prioritization of health systems to fight COVID-19 may have an impact on access to non-COVID-19 diseases. We applied age-based COVID-19 mortality data from China to the population structures of Uganda and non-African countries with previously establis ...[more]

PMID: 32705975

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Project description:COVID-19 restrictions and the pandemic have affected animal health and food production through the disease's effects on human activities. COVID-19 impact on swine health surveillance can be assessed by investigating submissions and test positivity for pathogens before and after COVID-19 restrictions. PRRSV, Influenza A virus, Mycoplasma hyopneumoniae and PCV-2 are considered important and economically challenging respiratory diseases for the swine populations. By reviewing test results from swine samples submitted for diagnostic testing to a regional diagnostic laboratory, and by assessing total submissions, total positive tests, and the proportion of positive tests at weekly intervals with time series techniques and generalized linear regression models, we evaluated COVID-19's impact on the monitoring of these respiratory pathogens in Ontario, Canada. We classified weeks that fell from week 12 through week 24 in each year as pandemic equivalent weeks and the non-pandemic weeks included all other weeks. The pandemic period in 2020 resulted in a significantly higher number of submissions (p < 0.05) and PRRSV positive submission counts (p < 0.05) when compared to equivalent time periods in previous years; however, no changes could be detected in the odds of weekly PRRSV submission positivity. Weekly positive proportions of PCV-2 tests were higher during the pandemic period in 2020 compared with the pandemic equivalent period in 2018 and 2017. The counts of submissions that requested tests for PRRSV, Influenza A virus and M. hyopneumonia combined, as well as the number of submissions and the proportions of submissions that tested negative for these multiple respiratory pathogens were not significantly different between the pandemic period in 2020 and other periods examined. Our findings indicate that swine producers, in conjunction with various private and public veterinary support services, continued monitoring and performing diagnostic screening on farms for economically important animal diseases despite complications resulting from COVID-19 public health restrictions. PRRSV continues to have a serious impact on swine health. The absence of an increased proportion of negative tests for individual or groups of pathogens, or an accompanying increase in submissions during the 2020 pandemic period suggests that no new undetected pathogens with an impact on respiratory signs in swine were introduced during this time.

Project description:BackgroundThe unprecedented impact of COVID-19 on healthcare professionals has implications for healthcare delivery, including the public health guidance provided to patients. This study aims to assess the response and impact of COVID-19 on chiropractors internationally, and examines the public health response of chiropractors to the COVID-19 pandemic practising under a musculoskeletal spine-care versus subluxation-based care paradigm.MethodsA survey was distributed to chiropractors in Australia, Canada, Denmark, Hong Kong, United Kingdom and United States (Oct. 2nd-Dec. 22nd, 2020) via professional bodies/publications, and social media. Questions were categorised into three domains: socio-demographic, public health response and business/financial impact. Multivariable logistic regression explored survey items associated with chiropractors practising under different self-reported paradigms.ResultsA total of 2061 chiropractors representing four global regions completed the survey. Our recruitment method did not allow the calculation of an accurate response rate. The vast majority initiated COVID-19 infection control changes within their practice setting, including increased disinfecting of treatment equipment (95%), frequent contact areas (94%) and increased hand hygiene (94%). While findings varied by region, most chiropractors (85%) indicated that they had implemented regulator advice on the use of personal protective equipment (PPE). Suspension of face-to-face patient care during the peak of the pandemic was reported by 49% of the participants with 26% implementing telehealth since the pandemic began. Chiropractors practising under a musculoskeletal spine-care paradigm were more likely to implement some/all regulator advice on patient PPE use (odds ratio [OR] = 3.25; 95% confidence interval [CI]: 1.57, 6.74) and practitioner PPE use (OR = 2.59; 95% CI 1.32, 5.08); trust COVID-19 public health information provided by government/World Health Organisation/chiropractic bodies (OR = 2.47; 95% CI 1.49, 4.10), and initiate patient telehealth in response to COVID-19 (OR = 1.46; 95% CI 1.02, 2.08) compared to those practising under a subluxation-based paradigm.ConclusionsChiropractors who responded to our survey made substantial infectious control changes in response to COVID-19. However, there was regional variation in the implementation of the advised practitioner and patient use of PPE and limited overall use of telehealth consultations by chiropractors during COVID-19. Musculoskeletal spine-care chiropractors were more adaptive to certain COVID-19 public health changes within their practice setting than subluxation-based chiropractors.

Dataset Information

Predicting the Impact of COVID-19 and the Potential Impact of the Public Health Response on Disease Burden in Uganda.

Publications

Predicting the Impact of COVID-19 and the Potential Impact of the Public Health Response on Disease Burden in Uganda.

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