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    COVID-19 MESHD Mortality in Malaria Endemic MESHD Countries: An Ecological Study

    Authors: Michael, U. Anyanwu

    doi:10.21203/rs.3.rs-152325/v1 Date: 2021-01-21 Source: ResearchSquare

    IntroductionThe number of persons infected with COVID-19 MESHD continue to increase with deaths MESHD reported daily across the globe. High income countries such as the US, the UK, Italy and Belgium have reported high COVID-19 MESHD related deaths but low-and-middle-income countries have recorded fewer deaths despite having poor healthcare system. This study aimed to investigate the association between malaria MESHD prevalence and COVID-19 MESHD mortality.MethodsThis is an ecological study with data from 195 countries. Spearman’s correlation was used to test the association between the population variables and COVID-19 MESHD mortality. Generalized linear model with Poisson distribution was used to determine the significant predictors of COVID-19 MESHD mortality. ResultsThere was a significant positive correlation between median age, life expectancy, 65+ mortality and COVID-19 MESHD mortality while malaria MESHD prevalence, sex ratio and cardiovascular mortality were negatively correlated with COVID-19 MESHD mortality. Malaria MESHD prevalence, life expectancy and mortality rate were significant on multivariate regression analysis.ConclusionThe results of this study support the hypotheses that there is reduced COVID-19 MESHD deaths in malaria MESHD endemic countries, although the results need to be proved further by clinical trials.

    Myanmar Continues to Curb Malaria amid Coronavirus Disease-2019 Crisis

    Authors: Badri Thapa; Aung Thi; Wint Phyo Than; Kyawt Mon Win; San Kyaw Khine

    doi:10.21203/rs.3.rs-101547/v1 Date: 2020-11-01 Source: ResearchSquare

    Background: Myanmar has targeted Plasmodium falciparum malaria MESHD elimination by 2025 and all human malaria MESHD elimination by 2030. Coronavirus Disease-2019 ( COVID-19 MESHD) pandemic could jeopardize the current gains. The objective of the study is to assess the impact of COVID-19 MESHD on epidemiology and malaria MESHD services in Myanmar. Methods: This is cross sectional study using retrospective routine programme data reported by Ministry of Health and Sports (for COVID-19 MESHD) and National Malaria MESHD Control Programme (NMCP) (for malaria MESHD) during January – September 2019 and 2020. Results: Myanmar implemented whole of society COVID-19 MESHD response since its first 2 cases were detected on 23 March 2020. NMCP mobilized US$ 7 mil to support, protect and mitigate COVID-19 MESHD impact on malaria MESHD through implementation of tailored guidelines, job aids and risk communication materials starting April 2020. Front line health workers were protected through supplies of surgical masks, hand sanitizer, aprons, gloves, non-contact digital thermometers among others. During January-September 2020, reported malaria MESHD cases, severe cases and deaths declined MESHD by 11%, 34% and 27%, respectively in the same period in 2019. Total P. falciparum cases declined by 55% with minimal increase in tests (0.14%). 80% of cases and 98% of foci were investigated in 2020 in comparison to 68% and 54% in 2019, respectively (p<0.05). In 2020, NMCP distributed 72% of the targeted long-lasting insecticidal nets (vs 49% in 2019) (p<0.05). Integrated Community Malaria Volunteers MESHD (ICMVs) trained in 2020 was 49% in comparison to 94% in 2019 (P<0.05), while number of functional ICMVs remained at 91% (vs 94% in 2019). Overall monthly reports from all reporting units received slightly dropped by 5%. In 2020, NMCP was able to conduct 59% supervision visits at various levels, which was higher than 2019 (56%). Conclusions: Malaria MESHD cases, severe cases and deaths MESHD continued to decline amid COVID-19 MESHD in Myanmar with 55% decline in P. falciparum . Programme need to continue essential malaria MESHD services during the upsurge of COVID-19 MESHD and simultaneously plan proactively to ensure uninterrupted supply of essential malaria MESHD commodities for 2021 to ensure P. falciparum elimination by 2025.

    Dominant Factors Determining Differences of COVID-19 MESHD Fatalities Between India and Other Large-Population Regions

    Authors: Sudhakar Yarlagadda; Satyaki Kar

    id:10.20944/preprints202004.0517.v2 Date: 2020-07-05 Source: Preprints.org

    We analyze the Covid-19 MESHD mortality scenario in India and compare it with those in other large-population regions such as Asia-excluding-China, Africa, European Union, South America, and USA. We compare existing fatality data and offer an interpretation for low fatality based on immunity due to endemic malaria MESHD and TB. We identify the hot climate in the past summer as a possible cause for low death MESHD count in southern-hemisphere countries without endemic malaria MESHD and TB. We also make India-specific observations for easing the lockdown and estimations for the time required to attain herd immunity. Whatever optimism we present should be viewed as a guarded optimism. There should not be room for complacency.

    Comparative analyses revealed reduced spread of COVID-19 MESHD in malaria endemic countries

    Authors: Azhar Muneer; Kiran Kumari; Manish Tripathi; Rupesh Srivastava; Asif Mohmmed; Sumit Rathore

    doi:10.1101/2020.05.11.20097923 Date: 2020-05-14 Source: medRxiv

    In late 2019, SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2) infection MESHD started in Hubei province of China and now it has spread like a wildfire in almost all parts of the world except some. WHO named the disease caused by SARS-CoV-2 as COVID-19 MESHD ( CoronaVirus Disease MESHD-2019). It is very intriguing to see a mild trend of infection in some countries which could be attributed to mitigation efforts, lockdown strategies, health infrastructure, demographics and cultural habits. However, the lower rate of infection and death MESHD rates in mostly developing countries, which are not placed at higher levels in terms of healthcare facilities, is a very surprising observation. To address this issue, we hypothesize that this lower rate of infection is majorly been observed in countries which have a higher transmission/prevalence of protozoan parasite borne disease MESHD, malaria MESHD. We compared the COVID-19 MESHD spread and malaria MESHD endemicity of 108 countries which have shown at least 200 cases of COVID-19 MESHD till 18th April 2020. We found that the number of COVID-19 MESHD cases per million population correlates negatively with the malaria MESHD endemicity of respective countries. The malaria MESHD free countries not only have higher density of COVID-19 MESHD infections but also the higher case fatality rates as compared to highly malaria MESHD endemic countries. We also postulate that this phenomenon is due to natural immune response against malaria infection MESHD, which is providing a heterologous protection against the virus. Unfortunately, there is no licensed vaccine against SARS-CoV-2 yet, but this information will be helpful in design of future strategies against fast spreading COVID-19 MESHD disease.

    Using Supervised Machine Learning and Empirical Bayesian Kriging to reveal Correlates and Patterns of COVID-19 MESHD Disease outbreak in sub-Saharan Africa: Exploratory Data Analysis

    Authors: Amobi Andrew Onovo; Akinyemi Atobatele; Abiye Kalaiwo; Christopher Obanubi; Ezekiel James; Pamela Gado; Gertrude Odezugo; Doreen Magaji; Dolapo Ogundehin; Michele Russell

    doi:10.1101/2020.04.27.20082057 Date: 2020-05-02 Source: medRxiv

    Introduction: Coronavirus disease 2019 MESHD ( COVID-19 MESHD) is an emerging infectious disease MESHD that was first reported in Wuhan, China, and has subsequently spread worldwide. Knowledge of coronavirus-related risk factors can help countries build more systematic and successful responses to COVID-19 MESHD disease outbreak. Here we used Supervised Machine Learning and Empirical Bayesian Kriging MESHD (EBK) techniques to reveal correlates and patterns of COVID-19 MESHD Disease outbreak in sub-Saharan Africa (SSA). Methods: We analyzed time series aggregate data compiled by Johns Hopkins University on the outbreak of COVID-19 MESHD disease across SSA. COVID-19 MESHD data was merged with additional data on socio-demographic and health indicator survey data for 39 of SSA 48 countries that reported confirmed cases and deaths from coronavirus between February 28, 2020 through March 26, 2020. We used supervised machine learning algorithm, Lasso for variable selection and statistical inference. EBK was used to also create a raster estimating the spatial distribution of COVID-19 MESHD disease outbreak. Results: The lasso Cross-fit partialing out predictive model ascertained seven variables significantly associated with the risk of coronavirus infection MESHD (i.e. new HIV infections MESHD among pediatric, adolescent, and middle-aged adult PLHIV, time (days), pneumococcal MESHD conjugate-based vaccine, incidence of malaria MESHD and diarrhea MESHD treatment). Our study indicates, the doubling time in new coronavirus cases was 3 days. The steady three-day decrease in coronavirus outbreak rate of change (ROC) from 37% on March 23, 2020 to 23% on March 26, 2020 indicates the positive impact of countries' steps to stymie the outbreak. The interpolated maps show that coronavirus is rising every day and appears to be severely confined in South Africa. In the West African region (i.e. Burkina Faso, Ghana, Senegal, CotedIviore, Cameroon, and Nigeria), we predict that new cases and deaths MESHD from the virus are most likely to increase. Interpretation: Integrated and efficiently delivered interventions to reduce HIV MESHD, pneumonia MESHD, malaria MESHD and diarrhea MESHD, are essential to accelerating global health efforts. Scaling up screening and increasing COVID-19 MESHD testing capacity across SSA countries can help provide better understanding on how the pandemic is progressing and possibly ensure a sustained decline in the ROC of coronavirus outbreak. Funding: Authors were wholly responsible for the costs of data collation and analysis.

    Concentration-dependent mortality of chloroquine in overdose

    Authors: James A Watson; Joel Tarning; Richard M Hoglund; Frederic J Baud; Bruno Megarbane; Jean-Luc Clemessy; Nicholas J White

    doi:10.1101/2020.04.24.20078303 Date: 2020-04-29 Source: medRxiv

    Background: Hydroxychloroquine and chloroquine have been used extensively in malaria MESHD and rheumatological conditions. Although generally safe and well tolerated they are potentially lethal in overdose MESHD. These two drugs are now candidates for the prevention and treatment of COVID19 MESHD. In vitro data suggest that high concentrations and thus high doses will be needed if they are to be of benefit, but as yet there is no convincing evidence they are clinically effective. Nevertheless they are already being used very widely and fatal accidental overdoses MESHD have been reported. Methods: Individual data from prospectively studied French patients who had taken intentional chloroquine overdoses MESHD and were managed in the national toxicology intensive care unit in Paris were pooled. Bayesian logistic regression was used to estimate a concentration-fatality curve. The probabilities of fatal iatrogenic toxicity MESHD with the chloroquine regimens currently being trialled for the treatment of COVID19 MESHD were estimated from a combined pharmacokinetic-pharmacodynamic model. Findings: In total, 258 patients were studied of whom 26 died (10%). There was a steep sigmoid relationship between admission whole blood chloroquine concentrations and death MESHD. Concentrations above 13umol/L (95% credible interval (C.I.), 10 to 16) were associated with greater than 1% mortality. Based on peak concentrations, absolute fatality ratios in the high dose arm (chloroquine base equivalent adult dose of 600mg given twice daily for ten days) of a recently terminated trial were estimated between 0.06% (90kg adult, 95%C.I. 0 to 0.3%) and 4.8% (40kg adult, 95% C.I. 1.9 to 9.7%). This regimen results in peak concentrations above 10umol/L in more than 60% of adults weighing 70kg. The other high dose regimens trialled currently for COVID19 MESHD result in peak concentrations above 10umol/L in only 0.2% of adults weighting 70kg. Interpretation:} High-dose chloroquine treatment regimens which result in whole blood chloroquine concentrations below 10umol/L for the majority of patients should not result in life-threatening cardiovascular toxicity MESHD.

    National Consumption of Antimalarial Drugs and COVID-19 MESHD Deaths Dynamics : an Ecological Study

    Authors: Maxime Izoulet

    doi:10.1101/2020.04.18.20063875 Date: 2020-04-24 Source: medRxiv

    COVID-19 MESHD (Coronavirus Disease-2019) is an international public health problem with a high rate of severe clinical cases. Several treatments are currently being tested worldwide. This paper focuses on anti-malarial drugs such as chloroquine or hydroxychloroquine, which have been currently reviewed by a systematic study as a good potential candidate and that has been reported as the most used treatment by a recent survey of physicians. We compare the dynamics of COVID-19 MESHD death rates in countries using anti- malaria MESHD drugs as a treatment from the start of the epidemic versus countries that do not, the day of the 3rd death MESHD and the following 10 days. We show that the first group have a much slower dynamic in death rates that the second group. This univariate analysis is of course only one additional piece of evidence in the debate regarding the efficiency of anti- malaria MESHD drugs, and it is also limited as the two groups certainly have other systemic differences in the way they responded to the pandemic, in the way they report death MESHD or in their population that better explain differences in dynamics (systematic differences that may also explain their choice to rely on anti- malaria MESHD drugs in the first place). Nevertheless, the difference in dynamics is so striking that we believe that the urgency context commands presenting the univariate analysis before delving into further analysis. In the end, this data might ultimately be either a piece of evidence in favor or anti- malaria MESHD drugs or a stepping stone in understanding further what other ecological aspects place a role in the dynamics of COVID-19 MESHD deaths.

    COVID-19 MESHD COVID-19 MESHD pandemic: examining the faces of spatial differences in the morbidity and mortality in sub-Saharan Africa, Europe and USA.

    Authors: Adebayo A Otitoloju; Ifeoma P Okafor; Mayowa Fasona; Kafilat Adebola Bawa-Allah; Chukwuemeka Isanbor; Chukwudozie Solomon Onyeka; Olawale S Folarin; Taiwo O Adubi; Temitope O Sogbanmu; Anthony E Ogbeibu

    doi:10.1101/2020.04.20.20072322 Date: 2020-04-24 Source: medRxiv

    Background: COVID-19 MESHD, the disease associated with the Severe Acute Respiratory Syndrome Coronavirus-2 MESHD (SARS-CoV-2) is currently a global pandemic with several thousands of confirmed cases of infection and death MESHD. However, the death rate across affected countries shows variation deserving of critical evaluation. Methods: In this study, we evaluated differentials in COVID-19 MESHD confirmed cases of infection and associated deaths MESHD of selected countries in Sub-Sahara Africa (Nigeria and Ghana), South Africa, Europe (Italy, Spain, Sweden and UK) and USA. Data acquired for various standard databases on mutational shift of the SARS-CoV-2 virus based on geographical location, BCG vaccination policy, malaria endemicity MESHD, climatic conditions (temperature), differential healthcare approaches were evaluated over a period of 45 days from the date of reporting the index case. Results: The number of confirmed cases of infection and associated deaths in Sub-Sahara Africa were found to be very low compared to the very high values in Europe and USA over the same period. Recovery rate from COVID-19 MESHD is not correlated with the mutational attributes of the virus with the sequenced strain from Nigeria having no significant difference (p>0.05) from other geographical regions. Significantly higher (p<0.05) infection rate and mortality from COVID-19 MESHD were observed in countries (Europe and USA) without a current universal BCG vaccination policy compared to those with one (Sub-Sahara African countries). Countries with high malaria burden MESHD had significantly lower (p<0.05) cases of COVID-19 MESHD than those with low malaria burden MESHD. A strong negative correlation (-0.595) between mean annual temperature and COVID-19 MESHD infection and death was observed with 14.8% variances between temperature and COVID-19 MESHD occurrence among the countries. A clear distinction was observed in the COVID-19 MESHD disease management between the developed countries (Europe and USA) and Sub-Sahara Africa. Conclusions: The study established that the wide variation in the outcome of the COVID-19 MESHD disease burden in the selected countries are attributable largely to climatic condition (temperature) and differential healthcare approaches to management of the disease. We recommend consideration and mainstreaming of these findings for urgent intervention and management of COVID-19 MESHD across these continents.

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