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Original Articles
Clinical Features and Risk Factors of Post-COVID-19 Condition in Korea
Myungwon Jang, Dongkwon Choi, Jonghyuk Choi, Ho-Jang Kwon
J Prev Med Public Health. 2023;56(5):431-439.   Published online September 8, 2023
DOI: https://doi.org/10.3961/jpmph.23.124
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AbstractAbstract AbstractSummary PDFSupplementary Material
Objectives
Numerous studies have explored the causes and spread of outbreaks, yet there is a lack of research on post-coronavirus disease 2019 condition (PCC) in Korea. The goal of this study was to identify the various types of PCC and associated factors in discharged patients and to provide directions for the ongoing health management of confirmed patients.
Methods
A telephone survey was conducted among 680 coronavirus disease 2019 (COVID-19) patients diagnosed between July 7, 2021 and August 26, 2021, in Dangjin, Chungnam, Korea. A descriptive analysis of characteristics, univariate analysis, and regression were performed using data from basic epidemiological surveys conducted at the time of diagnosis and post-discharge questionnaires.
Results
Of the 585 patients who responded, 159 (27.2%) developed PCC. Of the 211 patients with no initial symptoms, 27 (12.8%) developed PCC, versus 132 (35.3%) of the 374 patients with initial symptoms. Among the initial symptoms, fever or chills, cough or sputum, loss of smell, and sore throat were associated with PCC. Compared to patients with less than 10 days of hospitalization, those with a hospitalization period of 21 days to 30 days (odds ratio [OR], 2.3; 95% confidence interval [CI], 1.0 to 5.2) and 31 days or more (OR, 5.8; 95% CI, 1.9 to 18.1) had a higher risk of PCC.
Conclusions
More than a quarter of COVID-19 patients, including those who had no initial symptoms, experienced PCC in Korea. People with the initial symptoms of fever, chills, and respiratory symptoms and those who had prolonged hospital stays had a high risk of PCC.
Summary
Korean summary
코로나19 후유증은 진단 시 초기증상과 연관되며, 입원기간이 길어질수록 후유증 발병 위험이 높았다. 코로나19 후유증의 위험인자에 대한 추가적인 연구가 필요하며, 이러한 특징을 갖는 확진환자를 대상으로 퇴원 후 지속직인 환자관리가 필요하다.
Key Message
Post-coronavirus disease 2019 condition (PCC) are associated with initial symptoms at diagnosis, and the risk of this increases with longer hospital stays. Further research on the risk factors for PCC is needed, and continued patient care is necessary for confirmed patients with these characteristics after discharge.
Changes in the Hospital Standardized Mortality Ratio Before and During the COVID-19 Pandemic: A Disaggregated Analysis by Region and Hospital Type in Korea
EunKyo Kang, Won Mo Jang, Min Sun Shin, Hyejin Lee, Jin Yong Lee
J Prev Med Public Health. 2023;56(2):180-189.   Published online March 20, 2023
DOI: https://doi.org/10.3961/jpmph.22.479
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AbstractAbstract AbstractSummary PDF
Objectives
The coronavirus disease 2019 (COVID-19) pandemic has led to a global shortage of medical resources; therefore, we investigated whether COVID-19 impacted the quality of non-COVID-19 hospital care in Korea by comparing hospital standardized mortality rates (HSMRs) before and during the pandemic.
Methods
This retrospective cohort study analyzed Korean National Health Insurance discharge claim data obtained from January to June in 2017, 2018, 2019, and 2020. Patients’ in-hospital deaths were classified according to the most responsible diagnosis categories. The HSMR is calculated as the ratio of expected deaths to actual deaths. The time trend in the overall HSMR was analyzed by region and hospital type.
Results
The final analysis included 2 252 824 patients. In 2020, the HSMR increased nationwide (HSMR, 99.3; 95% confidence interval [CI], 97.7 to 101.0) in comparison to 2019 (HSMR, 97.3; 95% CI, 95.8 to 98.8). In the COVID-19 pandemic zone, the HSMR increased significantly in 2020 (HSMR, 112.7; 95% CI, 107.0 to 118.7) compared to 2019 (HSMR, 101.7; 95% CI, 96.9 to 106.6). The HSMR in all general hospitals increased significantly in 2020 (HSMR, 106.4; 95% CI, 104.3 to 108.5) compared to 2019 (HSMR, 100.3; 95% CI, 98.4 to 102.2). Hospitals participating in the COVID-19 response had a lower HSMR (HSMR, 95.6; 95% CI, 93.9 to 97.4) than hospitals not participating in the COVID-19 response (HSMR, 124.3; 95% CI, 119.3 to 129.4).
Conclusions
This study suggests that the COVID-19 pandemic may have negatively impacted the quality of care in hospitals, especially general hospitals with relatively few beds. In light of the COVID-19 pandemic, it is necessary to prevent excessive workloads in hospitals and to properly employ and coordinate the workforce.
Summary
Korean summary
코로나19 대유행 지역은 비감염 지역과 달리 2019년에 비해 2020년에 HSMR이 크게 증가했고, 상대적으로 병상 수가 적은 종합병원에서 HSMR이 증가했다. 코로나19 대응에 참여하는 병원은 병원 규모와 관계없이 HSMR이 낮은 경향을 보였다. 감염병 유행 시 병원의 과도한 업무량이 부여되지 않게하고 인력을 적절하게 고용하여 조정하는 것이 필요하다.
In-depth Correlation Analysis of SARS-CoV-2 Effective Reproduction Number and Mobility Patterns: Three Groups of Countries
Mounir Ould Setti, Sylvain Tollis
J Prev Med Public Health. 2022;55(2):134-143.   Published online February 10, 2022
DOI: https://doi.org/10.3961/jpmph.21.522
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  • 157 Download
  • 1 Web of Science
  • 2 Crossref
AbstractAbstract PDFSupplementary Material
Objectives
Many governments have imposed—and are still imposing—mobility restrictions to contain the coronavirus disease 2019 (COVID-19) pandemic. However, there is no consensus on whether policy-induced reductions of human mobility effectively reduce the effective reproduction number (Rt) of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Several studies based on country-restricted data reported conflicting trends in the change of the SARS-CoV-2 Rt following mobility restrictions. The objective of this study was to examine, at the global scale, the existence of regional specificities in the correlations between Rt and human mobility.
Methods
We computed the Rt of SARS-CoV-2 using data on worldwide infection cases reported by the Johns Hopkins University, and analyzed the correlation between Rt and mobility indicators from the Google COVID-19 Community Mobility Reports in 125 countries, as well as states/regions within the United States, using the Pearson correlation test, linear modeling, and quadratic modeling.
Results
The correlation analysis identified countries where Rt negatively correlated with residential mobility, as expected by policymakers, but also countries where Rt positively correlated with residential mobility and countries with more complex correlation patterns. The correlations between Rt and residential mobility were non-linear in many countries, indicating an optimal level above which increasing residential mobility is counterproductive.
Conclusions
Our results indicate that, in order to effectively reduce viral circulation, mobility restriction measures must be tailored by region, considering local cultural determinants and social behaviors. We believe that our results have the potential to guide differential refinement of mobility restriction policies at a country/regional resolution.
Summary

Citations

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  • The effect of social movements on COVID-19 case increases and death in Turkey
    Mehmet Akif Gun, Onder Hanci
    Clinical Epidemiology and Global Health.2023; 20: 101260.     CrossRef
  • The effects of weather and mobility on respiratory viruses dynamics before and during the COVID-19 pandemic in the USA and Canada
    Irma Varela-Lasheras, Lilia Perfeito, Sara Mesquita, Joana Gonçalves-Sá, Ryan S. McGinnis
    PLOS Digital Health.2023; 2(12): e0000405.     CrossRef
COVID-19: Original Article
Sources of Infection Among Confirmed Cases of COVID-19 in Jeju Province, Korea
Moonkyong Hwang, Jong-Myon Bae
J Prev Med Public Health. 2021;54(4):245-250.   Published online June 30, 2021
DOI: https://doi.org/10.3961/jpmph.21.286
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AbstractAbstract AbstractSummary PDFSupplementary Material
Objectives
Jeju Province in Korea reported 627 coronavirus disease 2019 (COVID-19) cases between January 20, 2020, and March 31, 2021. This study analyzed the sources of infection among confirmed cases in Jeju Province, a self-governed island.
Methods
The sources of infection were broadly categorized as follows: (1) infections from overseas (confirmed patients who reported travel overseas or contact with overseas travelers); (2) infections from outside Jeju Province (confirmed patients who had visited other provinces or had contact with individuals who had traveled to other provinces in Korea); and (3) unknown sources of infection (confirmed patients who were infected following contact with an infected person whose source of infection was unknown). The chi-square test was used to analyze the differences in the distributions of related variables for each source of infection.
Results
Of the 627 confirmed cases, 38 (6.1%) were infections from overseas sources, 199 (31.7%) were from outside of Jeju Province, and 390 (62.2%) were from unknown sources. Jeju Province had no cases with an unknown source of infection during the first and second waves of the nationwide outbreak.
Conclusions
Infections from overseas sources could be blocked from spreading to local communities in Jeju Province by conducting screening at the airport, along with the preemptive suspension of visa-free entry. In addition, considering the scale of the nationwide outbreak, measures must be established to delay outbreaks from unknown sources of infection caused by sources outside Jeju Province.
Summary
Korean summary
제주도 COVID-19 확진지의 감염원은 다음의 3가지로 대분할 수 있었다. (1) 해외유입 감염원: 해외 방문력이 있거나 해외 방문력이 있는 확진자와 접촉한 적이 있는 확진자; (2) 도외유입 감염원: 국내 타시도 방문력이 있거나 타시도 확진자와 접촉한 적이 있는 확진자; (3) 감염원 미상: 감염경로를 특정할 수 없는 도내 확진자와 이들과 접촉하여 확진자가 된 경우. 이중 해외유입군에 대하여는 선제적인 무비자 중지 결정과 함께 공항만에서의 선별검사를 시행하여 해외유입에 의한 지역사회 전파 가능성을 막을 수 있음을 확인하였다. 반면, 전국의 유행 크기와 맞물러, 도외 유입군으로 인한 감염미상군 발생 시점을 최대한 미룰 수 있는 방안들을 개발할 필요가 있겠다.

Citations

Citations to this article as recorded by  
  • The Impact of the South Korean Local Government's Public Health and Healthy Urban Planning Policies in Combating COVID-19
    Fatih ULAŞAN
    Kent Akademisi.2023;[Epub]     CrossRef
  • Clinical Characteristics and Risk Factors for Severe Disease of Coronavirus Disease 2019 in a Low Case Fatality Rate Region in Korea
    Misun Kim, Jeong Rae Yoo, Sang Taek Heo, Hyang Ran Lee, Hyunjoo Oh
    Infection & Chemotherapy.2021; 53(4): 718.     CrossRef
COVID-19: Brief Report
Association of Lower Socioeconomic Status and SARS-CoV-2 Positivity in Los Angeles, California
Lao-Tzu Allan-Blitz, Cameron Goldbeck, Fred Hertlein, Isaac Turner, Jeffrey D. Klausner
J Prev Med Public Health. 2021;54(3):161-165.   Published online April 13, 2021
DOI: https://doi.org/10.3961/jpmph.21.126
  • 3,601 View
  • 199 Download
  • 10 Web of Science
  • 16 Crossref
AbstractAbstract PDF
Objectives
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spreads heterogeneously, disproportionately impacting poor and minority communities. The relationship between poverty and race is complex, with a diverse set of structural and systemic factors driving higher rates of poverty among minority populations. The factors that specifically contribute to the disproportionate rates of SARS-CoV-2 infection, however, are not clearly understood.
Methods
We evaluated SARS-CoV-2 test results from community-based testing sites in Los Angeles, California, between June and December, 2020. We used tester zip code data to link those results with United States Census report data on average annual household income, rates of healthcare coverage, and employment status by zip code.
Results
We analyzed 2 141 127 SARS-CoV-2 test results, of which 245 154 (11.4%) were positive. Multivariable modeling showed a higher likelihood of SARS-CoV-2 test positivity among Hispanic communities than among other races. We found an increased risk for SARS-CoV-2 positivity among individuals from zip codes with an average annual household income Conclusions
Residence in zip codes with lower average annual household income, lower rates of employment, or lower rates of health insurance was associated with SARS-CoV-2 positivity. Further research is needed into how those factors increase the spread of SARS-CoV-2 infection among populations of lower socioeconomic status in order to develop targeted public health interventions.
Summary

Citations

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  • Occurrence of COVID-19 and serum per- and polyfluoroalkyl substances: A case-control study among workers with a wide range of exposures
    Anna K. Porter, Sarah E. Kleinschmidt, Kara L. Andres, Courtney N. Reusch, Ryan M. Krisko, Oyebode A. Taiwo, Geary W. Olsen, Matthew P. Longnecker
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    Alessio Gili, Marta Caminiti, Chiara Lupi, Salvatore Zichichi, Ilaria Minicucci, Patrizio Pezzotti, Chiara Primieri, Carla Bietta, Fabrizio Stracci
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    Nikhita Kathuria-Prakash, Lauren Antrim, Nicholas Hornstein, Alexander W. Sun, Irene M. Kang, Nikita V. Baclig, Trevor E. Angell, Melissa G. Lechner, Noah Wald-Dickler, Gino K. In
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  • SARS-CoV-2 Transmission and Prevention in the Era of the Delta Variant
    Eric A. Meyerowitz, Aaron Richterman
    Infectious Disease Clinics of North America.2022; 36(2): 267.     CrossRef
  • Severe Acute Respiratory Syndrome Coronavirus 2 Antibody Seroprevalence in Decedents Undergoing Forensic Postmortem Examination: Feasibility for 
Real-Time Pandemic Surveillance
    Sally B Coburn, Yukari C Manabe, Oliver Laeyendecker, Susan G Sherman, Owen R Baker, Thomas C Quinn, Lindsey A Graham, F Dennis Thomas, Pamela Southall, Victor W Weedn, Johnathon Ehsani, Ethan Klock, Rong Li, Wendy C Shields, Jeffrey Paul Michael, Ling Li
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    Eric Meyerowitz, Aaron Richterman
    SSRN Electronic Journal .2021;[Epub]     CrossRef
COVID-19: Perspective
New Obligations of Health Insurance Review and Assessment Service: Taking Full-fledged Action Against the COVID-19 Pandemic
Seung Mi Yoo, Seol Hee Chung, Won Mo Jang, Kyoung Chang Kim, Jin Yong Lee, Sun Min Kim
J Prev Med Public Health. 2021;54(1):17-21.   Published online January 26, 2021
DOI: https://doi.org/10.3961/jpmph.20.594
  • 3,669 View
  • 180 Download
  • 3 Web of Science
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AbstractAbstract AbstractSummary PDF
In 2020, the coronavirus disease 2019 (COVID-19) pandemic has caused unprecedented disruptions to global health systems. The Korea has taken full-fledged actions against this novel infectious disease, swiftly implementing a testing-tracing-treatment strategy. New obligations have therefore been given to the Health Insurance Review and Assessment Service (HIRA) to devote the utmost effort towards tackling this global health crisis. Thanks to the universal national health insurance and state-of-the-art information communications technology (ICT) of the Korea, HIRA has conducted far-reaching countermeasures to detect and treat cases early, prevent the spread of COVID-19, respond quickly to surging demand for the healthcare services, and translate evidence into policy. Three main factors have enabled HIRA to undertake pandemic control preemptively and systematically: nationwide data aggregated from all healthcare providers and patients, pre-existing ICT network systems, and real-time data exchanges. HIRA has maximized the use of data and pre-existing network systems to conduct rapid and responsive measures in a centralized way, both of which have been the most critical tactics and strategies used by the Korean healthcare system. In the face of new obligations, our promise is to strive for a more responsive and resilient health system during this prolonged crisis.
Summary
Korean summary
건강보험심사평가원은 전 국민과 전체 요양기관의 축적된 정보, 전체 요양기관과 연결된 네트워크, 실시간 데이터 공유를 통해 이번 코로나19 위기 대응에 기여했다. 건강보험심사평가원은 1) 진단검사∙약제 등재, 2) 요양기관 내 고위험군 감지, 3) 마스크 중복구매 방지 시스템 구축, 4) 주요 보건의료자원 가동현황 모니터링 시스템 구축, 5) 환자관리 정보시스템 구축 및 익명화된 환자 데이터 공개로 국제협력연구 촉진의 다섯 가지 전략을 성공적으로 수행했다. 건강보험심사평가원은 현재의 보건위기 상황을 극복하고, 코로나19 시대 이후로도 새롭게 주어진 위기대응의 역할과 소명을 다할 것이다.

Citations

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    British Journal of General Practice.2023; 73(728): e220.     CrossRef
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COVID-19: Original Articles
Associations Between General Perceptions of COVID-19 and Posttraumatic Stress Disorder in Korean Hospital Workers: Effect Modification by Previous Middle East Respiratory Syndrome Coronavirus Experience and Occupational Type
Youngrong Lee, Kwanghyun Kim, Sungjin Park, Sun Jae Jung
J Prev Med Public Health. 2021;54(2):86-95.   Published online January 19, 2021
DOI: https://doi.org/10.3961/jpmph.20.540
  • 4,708 View
  • 204 Download
  • 1 Web of Science
  • 2 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Objectives
This study investigated associations between perceptions of coronavirus disease 2019 (COVID-19) and the prevalence of posttraumatic stress disorder (PTSD) in workers at hospitals designated to treat COVID-19, as well as the difference in the magnitude of these associations by occupational type and previous Middle East respiratory syndrome coronavirus (MERS-CoV) experience.
Methods
The participants were workers at hospitals designated to treat COVID-19 who completed a questionnaire about their perceptions related to COVID-19, work experience during the previous MERS-CoV outbreak, and symptoms of PTSD ascertained by the PTSD Checklist for the Diagnostic and Statistical Manual of Mental Disorders. Participants’ characteristics were compared using the chi-square test. Multivariable logistic regression was performed to evaluate the associations between perceptions and the prevalence of PTSD, stratified by occupational type and previous MERS-CoV experience.
Results
Non-medical personnel showed stronger associations with PTSD than medical personnel according to general fear (odds ratio [OR], 6.67; 95% confidence interval [CI], 1.92 to 23.20), shortages of supplies (OR, 1.29; 95% CI, 1.07 to 1.56), and issue-specific fear (OR, 1.29; 95% CI, 1.05 to 1.59). Those with prior MERS-CoV quarantine experience were more prone to PTSD than those without such experience in terms of general fear (OR, 1.70; 95% CI, 1.22 to 2.37), shortages of supplies (OR, 1.24; 95% CI, 1.10 to 1.40), and issue-specific fear (OR, 1.21; 95% CI, 1.06 to 1.38).
Conclusions
During the COVID-19 pandemic, non-medical personnel tended to have higher odds of being categorized as having PTSD. Workers with prior MERS-CoV experience were more susceptible than those without such experience. These findings suggest the need for timely interventions to manage human resources for a sustainable quarantine system.
Summary
Korean summary
본 연구는 COVID-19관련 인식과 COVID-19 안심 병원 근로자들의 외상 후 스트레스 장애 (PTSD) 유병률 사이의 연관성에서 직업 유형과 이전 중동 호흡기 증후군 (MERS-CoV) 방역 경험 여부로 인한 연관성의 크기 차이를 조사하였다. 비의료인이 의료인보다 PTSD유병에 더 강한 연관성을 보였고, 이전 메르스 방역 경험이 있는 근로자들이 COVID-19에 대한 "일반적 공포", "물품 부족 공포" 및 "특정 문제에 따른 공포"로 구분한 인식의 크기가 클 수록 방역 경험이 없는 근로자들보다 PTSD유병과의 관련성이 더 컸다. 결론적으로 COVID-19 대유행 기간 중 비의료 인력은 PTSD유병 확률이 더 높은 경향이 있었다. 이전 MERS-CoV 경험이 있는 근로자는 그러한 경험이 없는 근로자보다 더 취약했다.

Citations

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  • Association between social networks and symptoms of post-traumatic stress during the pandemic: Cohort study in South Korea
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    Roghieh Nooripour, Nikzad Ghanbari, Laurel E. Radwin, Simin Hosseinian, Peyman Hassani-Abharian, Mohsen Hosseinbor, Keyvan Kakabraee, Mojtaba Amiri Majd, Serge Brand, Esmaeil Soleimani, Hossein Ilanloo
    Zahedan Journal of Research in Medical Sciences.2022;[Epub]     CrossRef
The Effectiveness of Community-based Social Distancing for Mitigating the Spread of the COVID-19 Pandemic in Turkey
Hasan Durmuş, Mehmet Enes Gökler, Selma Metintaş
J Prev Med Public Health. 2020;53(6):397-404.   Published online November 2, 2020
DOI: https://doi.org/10.3961/jpmph.20.381
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  • 13 Crossref
AbstractAbstract PDF
Objectives
The objective of this study was to demonstrate the effects of community-based social distancing interventions after the first coronavirus disease 2019 (COVID-19) case in Turkey on the course of the pandemic and to determine the number of prevented cases.
Methods
In this ecological study, the interventions implemented in response to the first COVID-19 cases in Turkey were evaluated and the effect of the interventions was demonstrated by calculating the effective reproduction number (Rt) of severe acute respiratory syndrome coro navirus 2 (SARS-CoV-2) when people complied with community-based social distancing rules.
Results
Google mobility scores decreased by an average of 36.33±22.41 points (range, 2.60 to 84.80) and a median of 43.80 points (interquartile range [IQR], 24.90 to 50.25). The interventions caused the calculated Rt to decrease to 1.88 (95% confidence interval, 1.87 to 1.89). The median growth rate was 19.90% (IQR, 10.90 to 53.90). A positive correlation was found between Google mobility data and Rt (r=0.783; p<0.001). The expected number of cases if the growth rate had not changed was predicted according to Google mobility categories, and it was estimated to be 1 381 922 in total. Thus, community-based interventions were estimated to have prevented 1 299 593 people from being infected.
Conclusions
Community-based social distancing interventions significantly decreased the Rt of COVID-19 by reducing human mobility, and thereby prevented many people from becoming infected. Another important result of this study is that it shows health policy-makers that data on human mobility in the community obtained via mobile phones can be a guide for measures to be taken.
Summary

Citations

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  • OKUL ÇOCUKLARINDA COVID-19 YÖNETİMİNDE UYGULANAN ALGORİTMALAR VE SONUÇLARININ TOPLUMSAL HAREKETLİLİK VERİLERİ ARACILIĞIYLA KARŞILAŞTIRILMASI
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COVID-19: Perspective
Beyond SARS-CoV-2: Lessons That African Governments Can Apply in Preparation for Possible Future Epidemics
Mary Aigbiremo Oboh, Semeeh Akinwale Omoleke, Christian Eseigbe Imafidon, Olumide Ajibola, Eniyou Cheryll Oriero, Alfred Amambua-Ngwa
J Prev Med Public Health. 2020;53(5):307-310.   Published online August 18, 2020
DOI: https://doi.org/10.3961/jpmph.20.259
  • 3,653 View
  • 135 Download
  • 1 Crossref
AbstractAbstract PDF
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has placed unprecedented pressure on healthcare systems, even in advanced economies. While the number of cases of SARS-CoV-2 in Africa compared to other continents has so far been low, there are concerns about under-reporting, inadequate diagnostic tools, and insufficient treatment facilities. Moreover, proactiveness on the part of African governments has been under scrutiny. For instance, issues have emerged regarding the responsiveness of African countries in closing international borders to limit trans-continental transmission of the virus. Overdependence on imported products and outsourced services could have contributed to African governments’ hesitation to shut down international air and seaports. In this era of emerging and re-emerging pathogens, we recommend that African nations should consider self-sufficiency in the health sector as an urgent priority, as this will not be the last outbreak to occur. In addition to the Regional Disease Surveillance Systems Enhancement fund (US$600 million) provided by the World Bank for strengthening health systems and disease surveillance, each country should further establish an epidemic emergency fund for epidemic preparedness and response. We also recommend that epidemic surveillance units should create a secure database of previous and ongoing pandemics in terms of aetiology, spread, and treatment, as well as financial management records. Strategic collection and analysis of data should also be a central focus of these units to facilitate studies of disease trends and to estimate the scale of requirements in preparation and response to any future pandemic or epidemic.
Summary

Citations

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    Bernard Sawadogo, Babacar Fall, Babacar Ndoye, Ibrahim Sonko, Delia Akosua Bandoh, Ernest Kenu, Virgil Lokossou
    Journal of Interventional Epidemiology and Public Health.2022;[Epub]     CrossRef

JPMPH : Journal of Preventive Medicine and Public Health