Publications & Abstracts

Elliot Koranteng Tannor¹, John H. Amuasi¹, Wilm Quentin, Reinhard Busse²

Kwame Nkrumah university of Science and Technology, Kumasi, Ghana¹

Faculty of Economics and Management at Technische Universität Berlin, Germany²

Introduction

COVID-19 has had devastating consequences on health systems globally and in low- and lower-middle income countries(LLMICs).  The COVID-19 pandemic has exposed weaknesses in most health systems. Non-communicable diseases(NCDs) increase risk of infection, morbidity and mortality in COVID-19. Health service utilization(HSU) is a reflection of health seeking behaviour of people. The impact of COVID-19 on HSU in the management of NCDs in Ghana and the global south is however unknown. We therefore set out to determine the change in HSU in the management of NCDs during the pandemic and determine the predictors and impact of the pandemic on HSU in the management of NCDs.

Methods

A scoping review will be conducted on HSU in LLMIC and Africa with searches of articles from Pubmed, Embasse, Cochrane, African Journal Online, Web of Science, WHO Global Health Library for articles in English and French. We will collect primary data and secondary data from primary, secondary and tertiary institutions in Ghana on the admission and outpatient cases of NCDs before and during the pandemic. The study will be conducted from January 2023 to December 2023. A survey will be conducted to determine the predictors of changes in HSU and the impact of the pandemic on HSU.  Interviews and focus group discussion of patients, health staff and institutional heads for qualitative data to explore the barriers to HSU from patient and health care provider perspective.

Results

Data will be generated on the changes in HSU on the management of NCDs and provide recommendations on building strong health systems to lessen the impact of future pandemics on NCDs which are the leading cause of mortality in LLMICs.

Conclusion

COVID-19 may have had significant impact on HSU in the management of NCDs and may have increased morbidity and mortality due to NCDs during the COVID-19 pandemic

Jonathan Gmanyami

ABSTRACT

Background: The COVID-19 pandemic has been marked by a massive death toll. There is also evidence that some of the pandemic control measures may have inadvertently contributed to increased mortality. However, the overall effect of the pandemic on mortality remains poorly understood in low- and lower-middle-income countries (LLMICs). This study aims to summarize the available literature on excess mortality in LLMICs, focusing on the methods and data sources used in estimating excess mortality, factors influencing excess mortality and excess mortality estimates across socio-economic groupings. The findings of the review will also inform the methods and data source points that will be used in a different study to estimate excess mortality in Ghana and the factors that might have influenced any excess mortality we estimate.

Methods: We will review the literature in line with the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. We will search the following electronic bibliographic databases: PubMed, Embase, Web of Science, Cochrane Library, Google Scholar and Scopus. All published studies that will report on the estimates of excess mortality in populations of LLMICs will be included. These will include those with a publication date of 2019 to date and those with at least a one-year non-COVID-19 period as the comparator in the estimation of excess mortality during the pandemic.  

Discussion: This systematic review will provide an overview of the published literature on excess mortality in LLMICs, thus contributing to a better understanding of the impact of the pandemic on mortality. In addition, by providing an overview of some of the highly innovative digital and statistical methods which find relevance in the Global South, it may also inform future analyses of excess mortality. In Ghana, the findings of this review will inform the methods and data source points to estimate excess mortality and to identify the drivers of any excess mortality we will estimate.

Systematic review registration: PROSPERO registration ID: CRD42022378267

Level of research: Proposal stage

Background

Community engagement within health is critical to promoting people-centered health service delivery and achieving primary healthcare. According to US-CDC, Community engagement is the process of working collaboratively with and for groups of people affiliated by geographical proximity, special interest, or similar situations to address issues affecting the well-being of those people. It’s crucial to support buy-in and sustainability of health interventions, health advocacy, improved quality, and satisfaction of services, and contribute to health systems responsiveness and strengthening. However, there is concern over the lack of involvement of communities and ‘bottom-up’ approaches used during pandemic responses This study will examine the effects, challenges, and opportunities of community engagement practices targeted at preventing and responding to pandemics in Ghana.

Methods

The study will employ both qualitative and quantitative methods to collect data on the processes of implementation of community engagement practices relating to pandemic prevention and responses in Ghana using a range of methods, including  in-depth qualitative interviews with policymakers at national levels, sub-national and at community level. Ii will also include a focused group discussion of marginalised groups in the community and a survey of community members on their views on community engagement.

Results

The result of this study is expected to bring to understanding the process of adoption and policy change with regards to community engagement during pandemic preparedness and response and to understand diverse approaches, strategies and the challenges of the bottom-up implementation of community engagement for pandemic response.

George Agyei¹, Philip El-Duah², Michael Owusu³, Christian Drosten⁴

Affiliations

¹ Department of Clinical Microbiology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana

² Institute of Virology, Charite, Universitätsmedizin Berlin, Berlin, Germany,

³Department of Medical Diagnostics, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana

⁴ Institute of Virology, Charite, Universitätsmedizin Berlin, Berlin, Germany,

Keywords: SARS-CoV-2, nasopharyngeal sampling, viral load, COVID-19, immunofluorescent assay

Background

severe Acute Respiratory Syndrome Coronavirus-2 (SARS-COV-2) and other respiratory viruses (RVs) are responsible for significant proportions of illnesses and death annually. Several efforts have been made to understand the clinical, epidemiological, and immunological characteristics of SARS-COV-2 and other RVs. The inclusion of molecular epidemiology has added to conventional public health tools used to identify SARS-COV-2 and other RVs. Despite the increasing trend in the emergence of new variants of SARS-COV-2 and other RVs as well as advancements in molecular techniques, a significant gap still exists between Ghana and more advanced countries in terms of molecular characterization of SARS-COV-2 and other RVs variants.

Methods

The current study will establish the whole-genome sequencing of the viral specimens by molecular diagnoses which will serve as an analytical strategy to assist in halting the chain of transmission, identifying new variants, or evaluating pathogen evolution, as well as providing real-time statistics on the dynamics of a pandemic. This shall be a housed-based longitudinal study. The population for the study will include individuals above 10 years of age who have symptoms of SARS-COV-2 or other RVs illnesses. SARS-COV-2 and other RVs genomes shall be sequenced.

Expected Results

Various strains detected shall be reported.   A serological analysis will be performed using the serum obtained from the blood and tested for the presence of IgG antibodies to SARS-COV-2 and other RVs using immunofluorescence assay (IFA). Models shall be adjusted for sex, age, residence, education level, occupation, BMI, comorbidities, and CT values. The mean concentration of IgG levels shall be compared within and between locations using one-way ANOVA.

Conclusion

Findings shall provide useful baseline data that will inform further molecular-epidemiological studies on SARS-CoV-2 and other RVs in Africa.

Abstract

Respiratory viruses (RVs) are a major public health concern for many people around the world. Some respiratory viruses are responsible for pandemics. Pandemics and outbreaks such as SARS-CoV-2, Ebola affect both developed and developing countries. However, some outbreaks such as Ebola affects Africans more than those in the developed world whereas others like COVID 19 in contrast kills more people in the developed world than in African countries. It is well documented that Soil Transmitted helminths infections immunomodulate the immune reaction in infected persons, such that the immune reaction to non-specific stimuli are also suppressed. Furthermore, several studies have shown that filarial infection might influence the incidence and severity of viral infections (Hardisty et al., 2021), but how helminth and virus co-infections influence each other remains unknown. Moreover, helminth antigens significantly reduced the frequency of SARS-CoV-2-reactive CD4+ T helper cells. According to WHO, Africans were far less affected by COVID-19 both in terms of disease prevalence and severity than other continents; on the contrary, Africa has greater proportion of helminthiasis than developed countries. In our study, we believe that helminth-driven immunomodulatory responses may reduce hyperinflammation associated with severe COVID-19. We hope to investigate this idea further by exploring a possible link between helminthiasis and RVs infection severity, as well as the immunological underpinnings of this response. This will be a longitudinal study in western north of Ghana. Clinical parameters will include headache, fever, cough, sneezing, runny nose, nasal congestion, fever and diarrhea. COVID-19 and other respiratory virus infections will be diagnosed using RT-PCR while Kato-Katz quantitative technique will be used to diagnose individuals for helminthiasis. Blood will be drawn to determine Th1, Th2, Treg and Th17 immune response. PBMCs shall be isolated and stimulated using helminth and viral antigens to check for the T-cell activation. The proportion of disease severity in each group will be the primary outcome. The association between severity of COVID-19 and other RVs infections in relation to coinfection with helminthiasis will be estimated using ordinal logistic regression. Models will be adjusted for gender, age, education level, occupation, BMI, and comorbidities. The mean cytokine concentrations will be compared across groups (single and co-infected patients) and within groups (symptomatic and asymptomatic) using the student t-test. The p-value of significance at the 95% confidence level will be ≤0.05. Findings of this study may justify the need for new intervention strategies as well as vaccine efficacy in Africa.