Comorbidities and the COVID-19 pandemic dynamics in Africa.

Autor: Anjorin AA; Department of Microbiology (Virology Research), Lagos State University, Ojo, Lagos, Nigeria., Abioye AI; Population Health Science Program & Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA., Asowata OE; Africa Health Research Institute, Durban, South Africa.; School of Laboratory Medicine and Medical Sciences, University of KwaZulu-Natal, Durban, South Africa., Soipe A; Department of Medicine, Division of Nephrology, Upstate Medical University, Syracuse, NY, USA., Kazeem MI; Department of Biochemistry, Lagos State University, Ojo, Lagos, Nigeria., Adesanya IO; Bayou City Physicians, Houston, TX, USA., Raji MA; Department of Microbiology and Immunology, College of Medicine, Alfaisal University, Riyadh, Saudi Arabia., Adesanya M; Department of Microbiology and Immunology, College of Medicine, Alfaisal University, Riyadh, Saudi Arabia.; CPT US Army Reserve, Houston, TX, USA.; Nursing Department, University of Texas at Arlington, Arlington, TX, USA., Oke FA; Department of Internal Medicine, Brookdale University Hospital Medical Centre, New York City, NY, USA., Lawal FJ; Department of Infectious Diseases, Medical College of Georgia, Augusta University, Augusta, GA, USA., Kasali BA; Independent Researcher, Seattle, WA, USA., Omotayo MO; Centre for Global Health and Division of Pediatric Global Health, Massachusetts General Hospital, Boston, MA, USA.; Department of Pediatrics, Harvard Medical School, Boston, MA, USA.
Jazyk: angličtina
Zdroj: Tropical medicine & international health : TM & IH [Trop Med Int Health] 2021 Jan; Vol. 26 (1), pp. 2-13. Date of Electronic Publication: 2020 Oct 23.
DOI: 10.1111/tmi.13504
Abstrakt: The debate around the COVID-19 response in Africa has mostly focused on effects and implications of public health measures, in light of the socio-economic peculiarities of the continent. However, there has been limited exploration of the impact of differences in epidemiology of key comorbidities, and related healthcare factors, on the course and parameters of the pandemic. We summarise what is known about (a) the pathophysiological processes underlying the interaction of coinfections and comorbidities in shaping prognosis of COVID-19 patients, (b) the epidemiology of key coinfections and comorbidities, and the state of related healthcare infrastructure that might shape the course of the pandemic, and (c) implications of (a) and (b) for pandemic management and post-pandemic priorities. There is a critical need to generate empirical data on clinical profiles and the predictors of morbidity and mortality from COVID-19. Improved protocols for acute febrile illness and access to diagnostic facilities, not just for SARS-CoV-2 but also other viral infections, are of urgent importance. The role of malaria, HIV/TB and chronic malnutrition on pandemic dynamics should be further investigated. Although chronic non-communicable diseases account for a relatively lighter burden, they have a significant effect on COVID-19 prognosis, and the fragility of care delivery systems implies that adjustments to clinical procedures and re-organisation of care delivery that have been useful in other regions are unlikely to be feasible. Africa is a large region with local variations in factors that can shape pandemic dynamics. A one-size-fits-all response is not optimal, but there are broad lessons relating to differences in epidemiology and healthcare delivery factors, that should be considered as part of a regional COVID-19 response framework.
(© 2020 John Wiley & Sons Ltd.)
Databáze: MEDLINE
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