Restoring non-COVID-19 clinical research and surveillance in Oyo state, Nigeria during the SARS-CoV-2 pandemic
Accepted: 21 September 2021
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Background: Many sub-Saharan African patients receive clinical care from extramurally-supported research and surveillance. During the COVID-19 pandemic, pausing these activities reduces patient care, surveillance, and research staff employment, increasing pandemic losses. In Oyo State, Nigeria, we paused a multi-country invasive salmonellosis surveillance initiative and a rural clinical bacteriology project.
Objective: Working with research partners raises health facility con- cerns about SARS-CoV-2 transmission risks and incurs infection pre- vention costs, so we developed and implemented re-opening plans to protect staff and patients and help health facilities deliver care.
Methods: Our reopening plan included appointing safety and personal protective equipment (PPE) managers from existing project staff cadres, writing new standard operating procedures, implementing extensive assessed training, COVID-19 testing for staff, procuring and managing PPE, and providing secondary bacteraemia blood culture support for COVID-19 patients in State isolation facilities.
Results: Surveillance data showed that the pandemic reduced care access and negatively affected patient unsupervised antibacterial use. The re-opening plan repurposed human and material resources from national and international extramurally-supported programs to mitigate these effects on public health.
Conclusions: A structured reopening plan restarted care, surveillance, and infection prevention and control.
Elston JW, Cartwright C, Ndumbi P, Wright J. The health impact of the 2014-15 Ebola outbreak. Public Health. 2017;143:60-70. DOI: https://doi.org/10.1016/j.puhe.2016.10.020
Roberts L. Pandemic brings mass vaccinations to a halt. Science. 2020;368(6487):116-7. DOI: https://doi.org/10.1126/science.368.6487.116
Pai M. Covidization of research: what are the risks? Nature Medicine. 2020;26(8):1159-. DOI: https://doi.org/10.1038/s41591-020-1015-0
O’Reilly-Shah VN, Van Cleve W, Long DR, Moll V, Evans FM, Sunshine JE, et al. Impact of COVID-19 response on global surgical volumes: an ongoing observational study. Bull World Health Organ. 2020;98:671-82. DOI: https://doi.org/10.2471/BLT.20.264044
Blanchet K, Alwan A, Antoine C, Cros MJ, Feroz F, Amsalu Guracha T, et al. Protecting essential health services in low-income and middle-income countries and humanitarian settings while responding to the COVID-19 pandemic. BMJ Glob Health. 2020;5(10). DOI: https://doi.org/10.1136/bmjgh-2020-003675
WHO. Maintaining essential health services: operational guidance for the COVID-19 context interim guidance. Geneva: World Health Organization, 2020 WHO/2019-nCoV/essential_health_services/2020.2.
Roberts L. Polio vaccinators are back after pandemic pause. Science. 2020;369(6502):360- DOI: https://doi.org/10.1126/science.369.6502.360
Kay AW, Ness TE, Martinez L, Mandalakas AM. It Ain't Over Till It's Over: The Triple Threat of COVID-19, TB, and HIV. Am J Trop Med Hyg. 2020. DOI: https://doi.org/10.4269/ajtmh.20-1089
Coyne C, Ballard JD, Blader IJ. Recommendations for future university pandemic responses: What the first COVID-19 shutdown taught us. PLoS Biol. 2020;18(8):e3000889. DOI: https://doi.org/10.1371/journal.pbio.3000889
Makoni M. COVID-19 worsens Zimbabwe's health crisis. The Lancet. 2020;396(10249):457. DOI: https://doi.org/10.1016/S0140-6736(20)31751-7
Rivett L, Sridhar S, Sparkes D, Routledge M, Jones NK, Forrest S, et al. Screening of healthcare workers for SARS-CoV-2 highlights the role of asymptomatic carriage in COVID-19 transmission. Elife. 2020;9.
Chawe A, Mfune RL, Syapiila PM, Zimba SD, Vlahakis PA, Mwale S, et al. Knowledge, attitude and practices of COVID-19 among medical laboratory professionals in Zambia. African Journal of Laboratory Medicine. 2021;10(1):1-7. DOI: https://doi.org/10.4102/ajlm.v10i1.1403
Adesegun OA, Binuyo T, Adeyemi O, Ehioghae O, Rabor DF, Amusan O, et al. The COVID-19 Crisis in Sub-Saharan Africa: Knowledge, Attitudes, and Practices of the Nigerian Public. Am J Trop Med Hyg. 2020. DOI: https://doi.org/10.4269/ajtmh.20-0461
Massinga Loembé M, Tshangela A, Salyer SJ, Varma JK, Ouma AEO, Nkengasong JN. COVID-19 in Africa: the spread and response. Nat Med. 2020;26(7):999-1003. DOI: https://doi.org/10.1038/s41591-020-0961-x
Jones NK, Rivett L, Sparkes D, Forrest S, Sridhar S, Young J, et al. Effective control of SARS-CoV-2 transmission between healthcare workers during a period of diminished community prevalence of COVID-19. Elife. 2020;9. DOI: https://doi.org/10.22541/au.159223897.73814834/v2
Chibwana MG, Jere KC, kamng'ona R, Mandolo J, Katunga-Phiri V, Tembo D, et al. High SARS-CoV-2 seroprevalence in Health Care Workers but relatively low numbers of deaths in urban Malawi. medRxiv. 2020:2020.07.30.20164970. DOI: https://doi.org/10.1101/2020.07.30.20164970
Uyoga S, Adetifa IM, Karanja HK, Nyagwange J, Tuju J, Wanjiku P, et al. Seroprevalence of anti-SARS-CoV-2 IgG antibodies in Kenyan blood donors. medRxiv. 2020. DOI: https://doi.org/10.1101/2020.07.27.20162693
McGriff JA, Denny L. What COVID-19 Reveals about the Neglect of WASH within Infection Prevention in Low-Resource Healthcare Facilities. Am J Trop Med Hyg. 2020. DOI: https://doi.org/10.4269/ajtmh.20-0638
Zangrillo A, Beretta L, Scandroglio AM, Monti G, Fominskiy E, Colombo S, et al. Characteristics, treatment, outcomes and cause of death of invasively ventilated patients with COVID-19 ARDS in Milan, Italy. Critical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine. 2020.
Sieswerda E, De Boer MGJ, Bonten MMJ, Boersma WG, Jonkers RE, Aleva RM, et al. Recommendations for antibacterial therapy in adults with COVID-19 – An evidence based guideline. Clinical Microbiology and Infection.
Irek EO, Amupitan AA, Obadare TO, Aboderin AO. A systematic review of healthcare-associated infections in Africa: An antimicrobial resistance perspective. Afr J Lab Med. 2018;7(2):796. DOI: https://doi.org/10.4102/ajlm.v7i2.796
Sepulveda J, Westblade LF, Whittier S, Satlin MJ, Greendyke WG, Aaron JG, et al. Bacteremia and Blood Culture Utilization during COVID-19 Surge in New York City. J Clin Microbiol. 2020;58(8). DOI: https://doi.org/10.1128/JCM.00875-20
Supporting AgenciesBill & Melinda Gates Foundation, Medical Research Council, Department for International Development
Copyright (c) 2022 Veronica O. Ogunleye, Okainemen P. Oluwalusi, Oluwafemi Popoola, Aderemi Kehinde, Olukemi Adekanmbi, Ifiok Udofia, Sarah Agbi, Ifeoluwa Akintayo, Jolaade J. Ajiboye, Folasade Bamidele, Temitope Alonge, Ondari D. Mogeni, Florian Marks, Iruka N. Okeke
This work is licensed under a Creative Commons Attribution 4.0 International License.