Browsing by Subject "COVID-19"

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    AGILE: a seamless phase I/IIa platform for the rapid evaluation of candidates for COVID-19 treatment: an update to the structured summary of a study protocol for a randomised platform trial letter
    (2021-07-26) Griffiths, Gareth O; FitzGerald, Richard; Jaki, Thomas; Corkhill, Andrea; Reynolds, Helen; Ewings, Sean; Condie, Susannah; Tilt, Emma; Johnson, Lucy; Radford, Mike; Simpson, Catherine; Saunders, Geoffrey; Yeats, Sara; Mozgunov, Pavel; Tansley-Hancock, Olana; Martin, Karen; Downs, Nichola; Eberhart, Izabela; Martin, Jonathan W B; Goncalves, Cristiana; Song, Anna; Fletcher, Tom; Byrne, Kelly; Lalloo, David G; Owen, Andrew; Jacobs, Michael; Walker, Lauren; Lyon, Rebecca; Woods, Christie; Gibney, Jennifer; Chiong, Justin; Chandiwana, Nomathemba; Jacob, Shevin; Lamorde, Mohammed; Orrell, Catherine; Pirmohamed, Munir; Khoo, Saye
    Background There is an urgent unmet clinical need for the identification of novel therapeutics for the treatment of COVID-19. A number of COVID-19 late phase trial platforms have been developed to investigate (often repurposed) drugs both in the UK and globally (e.g. RECOVERY led by the University of Oxford and SOLIDARITY led by WHO). There is a pressing need to investigate novel candidates within early phase trial platforms, from which promising candidates can feed into established later phase platforms. AGILE grew from a UK-wide collaboration to undertake early stage clinical evaluation of candidates for SARS-CoV-2 infection to accelerate national and global healthcare interventions. Methods/design AGILE is a seamless phase I/IIa platform study to establish the optimum dose, determine the activity and safety of each candidate and recommend whether it should be evaluated further. Each candidate is evaluated in its own trial, either as an open label single arm healthy volunteer study or in patients, randomising between candidate and control usually in a 2:1 allocation in favour of the candidate. Each dose is assessed sequentially for safety usually in cohorts of 6 patients. Once a phase II dose has been identified, efficacy is assessed by seamlessly expanding into a larger cohort. AGILE is completely flexible in that the core design in the master protocol can be adapted for each candidate based on prior knowledge of the candidate (i.e. population, primary endpoint and sample size can be amended). This information is detailed in each candidate specific trial protocol of the master protocol. Discussion Few approved treatments for COVID-19 are available such as dexamethasone, remdesivir and tocilizumab in hospitalised patients. The AGILE platform aims to rapidly identify new efficacious and safe treatments to help end the current global COVID-19 pandemic. We currently have three candidate specific trials within this platform study that are open to recruitment. Trial registration EudraCT Number: 2020-001860-27 14 March 2020 ClinicalTrials.gov Identifier: NCT04746183  19 February 2021 ISRCTN reference: 27106947
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    Aluta continua! digital divide experiences of South African township high school learners during COVID-19 hard lockdown
    (2024) Mxatule, Akhona; De Wet, Jacques
    This research emphasises that the digital divide is a significant human development issue. During the COVID-19 pandemic, the stringent lockdown measures accentuated the challenges faced by many underserved learners in transitioning to remote education due to limited access to digital resources and reliable internet. This study investigated how the COVID-19 hard lockdown period magnified the digital divide experiences of a group of high school learners from Cape Town's Khayelitsha Township. The investigation further revealed the extent to which learners from working-class households could overcome challenges they faced in the context of their education. Understanding the structural problems and the learners' agency from their perspective provides educators and policymakers with valuable insights, which can inform future interventions to address the digital divide. Amartya Sen's Capability Approach facilitated my people-centred examination of the digital divide. Sen's theoretical framework helped reveal that while access to Information Communication Technologies (ICTs) is a crucial step, it alone is insufficient for development. Additionally, this study demonstrates that the capacity to effectively utilise ICTs and transform information into actionable knowledge for comprehensive development is paramount. Therefore, the digital divide extends beyond mere access and literacy, representing a broader developmental challenge that deprives many under-resourced communities of essential capabilities in a world that is increasingly dominated by ICTs. Utilizing a single case study approach, this research interrogates the digital divide as a human development issue. Data collection methods involved documentary analysis, a key informant interview, and a focus group discussion with six high school learners from a Khayelitsha township school. Miles and Huberman's thematic coding approach was used in the data analysis. The findings reveal some contextual nuances in the learners' experiences of unequal access to devices and the Internet, affordability disparities, and varying levels of ICT usage. This study underscores the vulnerabilities of marginalized learners and identifies opportunities that learners create for themselves within the digital divide. This research provides insights into the multifaceted nature of the digital divide within the educational landscape. The study further emphasizes the urgent need for collaborative and coordinated efforts from among stakeholders, including the Department of Basic Education, teachers, learners, parents, the private sector, and civil society, to implement people-centred and tailored intervention strategies informed by a nuanced understanding of the digital divide.
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    An Exploratory Study of Western Cape Province NonProfit Organisations response to the COVID-19 Pandemic
    (2022) Tinnion, Charlotte; Atmore, Eric
    This study focuses on the response of NPOs to the COVID-19 pandemic. The main research questions focus on the role of NPO leaders and management in responding to the COVID-19 pandemic. The effect of COVID-19 on the organisations' operations, focusing on service delivery, staff and finances are explored. The study looks at the lessons learned by the NPO sector considering the COVID-19 pandemic, focusing on factors that enabled NPOs to survive (protective factors) and factors that placed NPOs at risk of closure (risk factor). Change Management Theory and Organisation Resilience Theory are used as two theoretical frameworks that underpin the study. The research paradigm of the study is qualitative and the research design and method is exploratory. The exploratory nature of qualitative research was selected given that the COVID-19 pandemic is a recent and hitherto minimally research area with limited information. Twenty participants who held senior leadership positions were interviewed using a semi-structured interview schedule. Due to social distancing regulations, the majority of the interviews were conduct via 45 minute zoom sessions. The data collected was analysed using Tesch's data analysis model. The method of data analysis applied was thematic analysis. The data collected was analysed using Tesch's data analysis model. The study findings include that the COVID-19 crisis has provided an opportunity for NPOs to strategise for growth opportunities and to rethink services and programmes. NPOs with poor crisis and risk management strategies and practices were most at risk of closure during the COVID-19 pandemic. However, NPOs have proved to have resilience in their ability to pivot and adapt services and programmes. Emotional support for staff combined with staff passion fostered a collective organisation culture of teamwork and commitment to their jobs despite the challenges and in some cases, reduced salaries. Integrating technology in service delivery was crucial for NPO survival. During a crisis, a hybrid model of online and face-to-face services can be provided and may be the new normal of rendering services. Donor fatigue is a concern considering the financial shocks from the external environment and marked by the economic downturn in light of the COVID-19 pandemic. The study concludes by providing five suggestions for future research, namely, 1) the cost-benefit of rendering services online, 2) donor fatigue, 3) Government support offered to NPOs during the COVID-19 pandemic, 4) compulsory COVID-19 vaccination in the workplace and 5) the integration of technology in poor socio-economic environment.
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    Analysis of COVID-19 fffects on cybersecurity in South African-based organisations
    (2025) Daya, Mahima; Kyobe, Michael
    The COVID-19 pandemic has significantly impacted cybersecurity practices in South African organisations across various sectors, including financial services, healthcare, retail, and technology, with vulnerabilities arising from remote work, digital infrastructure, and financial strain. This study applied Engström's Activity Theory Framework to explore the effects of the pandemic on cyber-threats, vulnerabilities, and organisational responses. The findings reveal that remote workers faced significant vulnerabilities during the pandemic, making them susceptible to phishing and social engineering attacks. The study highlights the importance of cybersecurity awareness training and education for employees in South African organisations. The economic instability of South Africa during the pandemic led to an increased appeal of cyber-threats, underscoring the need for enhanced cybersecurity strategies. The study's findings provide practical recommendations for enhancing cybersecurity strategies, including the adoption of secure remote work solutions and the development of incident response plans. The results underscore the importance of cybersecurity awareness training and education for employees. The study's methodology involved conducting 30 semi-structured interviews with South African organisations from the financial, healthcare, retail, and technology sectors, employing thematic analysis to delve into the realm of cybersecurity management practices during the pandemic. Despite its limitations, including a limited data sample and potential lack of generalisability to all South African organisations, this study contributes to the existing literature and provides valuable insights for policymakers, organisations, and cybersecurity professionals. The findings suggest that to mitigate risks, organisations should prioritise cybersecurity and invest in comprehensive cybersecurity solutions. Employee training is essential for enhancing cybersecurity awareness and preventing cyberattacks. Regulatory compliance is crucial for ensuring data privacy and security standards are met. Investments in digital infrastructure and cybersecurity education and training are also recommended to equip future professionals with the necessary skills to address emerging cyber threats. Future research should consider expanding data sources and conducting long-term analyses to gain a more comprehensive understanding of the cybersecurity challenges during and beyond the pandemic.
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    Bayasibulala: #AmINext? an analysis of Instagram as a tool for activism against Sexual Gender-Based Violence in South Africa
    (2022) Mazana, Nandipha Nwabisa; Ndlovu, Musawenkosi
    Research over the years has shown that there is a global rise in hashtag activism, this type of activism has also inspired what scholars call - hashtag feminism. Hashtag feminism utilizes Social Networking Sites to raise awareness about issues that are often not covered in traditional news media outlets such as TV, newspapers, and Radio Stations. Through this paper, I seek to investigate how Instagram has become one of the Social Networking Sites that has recently started being used for online activism in South Africa. This is done by conducting a qualitative analysis of 700 posts from the hashtag #AmINext, with a period focus of 3 months during South Africa's COVID-19 Level-5 Lockdown. The findings suggest that activists follow similar lines of the hashtag and social media activism parameters such as those of the #MeToo and #BeenRapedNeverReported movements. The analysis found that activists use Instagram to participate in Citizen Journalism by sharing information, raising awareness, organizing, mobilizing, and advocating (Vegh, 2003). Furthermore, there is clear Civic Engagement and Citizen Journalism through things such as sharing information and having calls to action while utilizing hashtags as a way to gain momentum and attention. The findings suggest that these hashtags are able to cultivate a community of activists all around the country while also making sure to encourage more participation. The analysis also shows how there is an importance of such activism when movement is restricted due to national Lockdowns implemented to curb COVID-19, as many victims of SGBV found themselves at home and trapped with their abusers. In paying attention to this analysis, I conclude that perhaps through the exploration of new ways of activism, we can ensure that no voice is ever left behind. Furthermore, despite the possibilities of these new ways of raising awareness and activism, it is always important to see how we can apply the old with the new.
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    Changes in trauma-related emergency medical services during the COVID-19 lockdown in the Western Cape, South Africa
    (BioMed Central, 2023-06-27) Pettke, Aleksandra; Stassen, Willem; Laflamme, Lucie; Wallis, Lee A.; Hasselberg, Marie
    Abstract Background To limit virus spread during the COVID pandemic, extensive measures were implemented around the world. In South Africa, these restrictions included alcohol and movement restrictions, factors previously linked to injury burden in the country. Consequently, reports from many countries, including South Africa, have shown a reduction in trauma presentations related to these restrictions. However, only few studies and none from Africa focus on the impact of the pandemic restrictions on the Emergency Medical System (EMS). Methods We present a retrospective, observational longitudinal study including data from all ambulance transports of physical trauma cases collected during the period 2019–01-01 and 2021–02-28 from the Western Cape Government EMS in the Western Cape Province, South Africa (87,167 cases). Within this timeframe, the 35-days strictest lockdown level period was compared to a 35-days period prior to the lockdown and to the same 35-days period in 2019. Injury characteristics (intent, mechanism, and severity) and time were studied in detail. Ambulance transport volumes as well as ambulance response and on-scene time before and during the pandemic were compared. Significance between indicated periods was determined using Chi-square test. Results During the strictest lockdown period, presentations of trauma cases declined by > 50%. Ambulance transport volumes decreased for all injury mechanisms and proportions changed. The share of assaults and traffic injuries decreased by 6% and 8%, respectively, while accidental injuries increased by 5%. The proportion of self-inflicted injuries increased by 5%. Studies of injury time showed an increased share of injuries during day shift and a reduction of total injury volume during the weekend during the lockdown. Median response- and on-scene time remained stable in the time-periods studied. Conclusion This is one of the first reports on the influence of COVID-19 related restrictions on EMS, and the first in South Africa. We report a decline in trauma related ambulance transport volumes in the Western Cape Province as well as changes in injury patterns, largely corresponding to previous findings from hospital settings in South Africa. The unchanged response and on-scene times indicate a well-functioning EMS despite pandemic challenges. More studies are needed, especially disaggregating the different restrictions.
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    Clinical features and outcomes of COVID-19 admissions in a population with a high prevalence of HIV and tuberculosis: a multicentre cohort study
    (2022-06-20) Parker, Arifa; Boloko, Linda; Moolla, Muhammad S; Ebrahim, Nabilah; Ayele, Birhanu T; Broadhurst, Alistair G B; Mashigo, Boitumelo; Titus, Gideon; de Wet, Timothy; Boliter, Nicholas; Rosslee, Michael-Jon; Papavarnavas, Nectarios; Abrahams, Riezaah; Mendelson, Marc; Dlamini, Sipho; Taljaard, Jantjie J; Prozesky, Hans W; Mowlana, Abdurasiet; Viljoen, Abraham J; Schrueder, Neshaad; Allwood, Brian W; Lalla, Usha; Dave, Joel A; Calligaro, Greg; Levin, Dion; Maughan, Deborah; Ntusi, Ntobeko A B; Nyasulu, Peter S; Meintjes, Graeme; Koegelenberg, Coenraad F N; Mnguni, Ayanda T; Wasserman, Sean
    Background There is still a paucity of evidence on the outcomes of coronavirus disease 2019 (COVID-19) among people living with human immunodeficiency virus (PWH) and those co-infected with tuberculosis (TB), particularly in areas where these conditions are common. We describe the clinical features, laboratory findings and outcome of hospitalised PWH and human immunodeficiency virus (HIV)-uninfected COVID-19 patients as well as those co-infected with tuberculosis (TB). Methods We conducted a multicentre cohort study across three hospitals in Cape Town, South Africa. All adults requiring hospitalisation with confirmed COVID-19 pneumonia from March to July 2020 were analysed. Results PWH comprised 270 (19%) of 1434 admissions. There were 47 patients with active tuberculosis (3.3%), of whom 29 (62%) were PWH. Three-hundred and seventy-three patients (26%) died. The mortality in PWH (n = 71, 26%) and HIV-uninfected patients (n = 296, 25%) was comparable. In patients with TB, PWH had a higher mortality than HIV-uninfected patients (n = 11, 38% vs n = 3, 20%; p = 0.001). In multivariable survival analysis a higher risk of death was associated with older age (Adjusted Hazard Ratio (AHR) 1.03 95%CI 1.02–1.03, p < 0.001), male sex (AHR1.38 (95%CI 1.12–1.72, p = 0.003) and being “overweight or obese” (AHR 1.30 95%CI 1.03–1.61 p = 0.024). HIV (AHR 1.28 95%CI 0.95–1.72, p 0.11) and active TB (AHR 1.50 95%CI 0.84–2.67, p = 0.17) were not independently associated with increased risk of COVID-19 death. Risk factors for inpatient mortality in PWH included CD4 cell count < 200 cells/mm3, higher admission oxygen requirements, absolute white cell counts, neutrophil/lymphocyte ratios, C-reactive protein, and creatinine levels. Conclusion In a population with high prevalence of HIV and TB, being overweight/obese was associated with increased risk of mortality in COVID-19 hospital admissions, emphasising the need for public health interventions in this patient population.
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    Correlates of COVID-19 vaccination intentions and opinions about mandates among four groups of adults in South Africa with distinct vaccine intentions: evidence from a large national survey
    (BioMed Central, 2023-09-11) Eyal, Katherine; Njozela, Lindokuhle; Köhler, Timothy; Ingle, Kim; Brophy, Timothy; Buttenheim, Alison; Maughan-Brown, Brendan
    Abstract Introduction Despite a high number of recorded COVID-19 infections and deaths in South Africa, COVID-19 vaccine coverage remained low in March 2022, ten months into the national vaccine roll-out. This study provides evidence on the correlates of vaccine intentions, attitudes towards vaccination and opinions about mandates. Methods We used data from the second COVID-19 Vaccine Survey (CVACS), a telephone survey conducted February-March 2022 among 3,608 South African adults who self-reported not being vaccinated against COVID-19. The survey instrument was designed in consultation with government, policymakers, and civil society; and segmented the sample into four distinct groups with different vaccine intentions (synonymous with vaccine hesitancy levels). Kruskal-Wallis and Mann-Whitney tests were used to examine the sociodemographic characteristics, attitudes and behaviours associated with the different vaccination intentions groups. Thematic coding of responses to open-ended questions elicited insights on reasons for not being vaccinated and attitudes towards mandates. Results Intentions to get vaccinated were greater among individuals with lower socio-economic status (Mann–Whitney Z = -11.3, p < 0.001); those believing the vaccine protects against death (Kruskal–Wallis Χ2 = 494, p < 0.001); and those who perceived themselves at risk of COVID-19-related illness (Χ2 = 126, p < 0.01). Vaccine intentions were lower among individuals who believed that the vaccine causes death (Χ2 = 163, p < 0.001); believed that the vaccine is unsafe for the babies of pregnant/breastfeeding mothers, or the chronically ill (Χ2 = 123, p < 0.01); those not trusting government health information about COVID-19 and the COVID-19 vaccine (Kendall’s τ = -0.41, p < 0.01); and those in opposition to mandates (τ = 0.35, p < 0.001). Only 25% supported mandates, despite 48% thinking mandates would work well, with 54% citing individual rights as their main reason for mandate opposition. Conclusion The profile of individuals not vaccinated against COVID-19 as of March 2022 varied markedly by self-reported vaccination intentions, underscoring the importance of tailored demand-creation efforts. This paper highlights several factors which differ significantly across these groups. These findings could inform the design of future vaccination campaigns, potentially increasing their likelihood of success. This is an important policy objective given widespread vaccine hesitancy, and further work is required on this topic. Mandates remain an option to increase coverage but need to be carefully considered given extensive opposition.
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    Cost‐effectiveness of intensive care for hospitalized COVID-19 patients: experience from South Africa
    (2021-01-22) Cleary, S M; Wilkinson, T; Tamandjou Tchuem, C R; Docrat, S; Solanki, G C
    Background Given projected shortages of critical care capacity in public hospitals during the COVID-19 pandemic, the South African government embarked on an initiative to purchase this capacity from private hospitals. In order to inform purchasing decisions, we assessed the cost-effectiveness of intensive care management for admitted COVID-19 patients across the public and private health systems in South Africa. Methods Using a modelling framework and health system perspective, costs and health outcomes of inpatient management of severe and critical COVID-19 patients in (1) general ward and intensive care (GW + ICU) versus (2) general ward only (GW) were assessed. Disability adjusted life years (DALYs) were evaluated and the cost per admission in public and private sectors was determined. The model made use of four variables: mortality rates, utilisation of inpatient days for each management approach, disability weights associated with severity of disease, and the unit cost per general ward day and per ICU day in public and private hospitals. Unit costs were multiplied by utilisation estimates to determine the cost per admission. DALYs were calculated as the sum of years of life lost (YLL) and years lived with disability (YLD). An incremental cost-effectiveness ratio (ICER) - representing difference in costs and health outcomes of the two management strategies - was compared to a cost-effectiveness threshold to determine the value for money of expansion in ICU services during COVID-19 surges. Results A cost per admission of ZAR 75,127 was estimated for inpatient management of severe and critical COVID-19 patients in GW as opposed to ZAR 103,030 in GW + ICU. DALYs were 1.48 and 1.10 in GW versus GW + ICU, respectively. The ratio of difference in costs and health outcomes between the two management strategies produced an ICER of ZAR 73,091 per DALY averted, a value above the cost-effectiveness threshold of ZAR 38,465. Conclusions Results indicated that purchasing ICU capacity from the private sector during COVID-19 surges may not be a cost-effective investment. The ‘real time’, rapid, pragmatic, and transparent nature of this analysis demonstrates an approach for evidence generation for decision making relating to the COVID-19 pandemic response and South Africa’s wider priority setting agenda.
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    COVID 19—impact on substance use treatment utilization and provision in South Africa
    (2022-03-03) Harker, Nadine; Johnson, Kim; Erasmus, Jodilee; Myers, Bronwyn
    Background The coronavirus disease 2019 (COVID-19) pandemic has impacted people with substance use disorders (SUDs) worldwide. The aim of this study was to explore, changes in the number of SUD treatment episodes provided during the height of the pandemic and, SUD treatment providers’ perceptions of the impact of COVID-19-related restrictions on people with SUDs and the delivery of SUD treatment services in South Africa. Methods We used administrative data collected as part of the South African Community Epidemiology Network on Drug Use (SACENDU) project to assess whether the number of treatment episodes changed during the height of COVID-19 restrictions. We used data from an online survey of SUD treatment providers to assess providers’ perceptions of the impact of COVID-19 on SUD treatment delivery. Eight seven SUD facilities were recruited to participate in the online survey. Results Sixty-three organisations (out of a total of 86) participated in the survey, yielding a 73.2% response rate. About half (n = 30; 47.6%) of the sample thought the need for SUD treatment had remained the same or had increased during the COVID-19 lockdown. Half the sample (n = 32; 50.7%) reported decreased availability of SUD services during COVID-19 lockdowns. Participants believed that the lack of services during COVID-19 lockdown impacted negatively on patients that were enrolled in their programmes and on individuals who wished to access the service. Furthermore, changes in service provision seemed to increase patients’ anxiety, exacerbate pre-existing mental health problems and in some cases were thought to precipitate relapse. In addition, patient disengagement and attrition from treatment were thought to have increased during this period. Whilst 47.6% (n = 30) of providers agreed with the value of the alcohol ban, 23.8% (n = 15) of providers thought it had unintended negative consequences. Conclusion Based on the findings it is evident that SUD treatment services in South Africa have been significantly affected during the COVID-19 pandemic and more severely during the onset of the pandemic. Together with service providers, more effective ways should be sought on how to feasibly expand access to SUD treatment for all South Africans and enhance the country’s preparedness for future health emergencies.
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    COVID-19 and labour market inequality in South Africa
    (2024) Köhler, Timothy; Bhorat, Haroon
    In 2020, the world was gripped by the COVID-19 pandemic. Beyond its health implications, the pandemic led to unprecedented economic contractions and one of the largest increases in poverty and income inequality to date. Effects on labour markets are of particular interest given their dominant role in determining wellbeing. Existing evidence reveals substantial, regressive effects globally. This holds particular relevance in South Africa, measurably the most unequal country in the world, primarily due to the nature of its labour market, which also experienced one of the most stringent lockdowns globally. This thesis provides a micro-econometric examination of the aggregate and heterogenous labour market effects of the pandemic in South Africa. To do so, it employs descriptive and quasi-experimental econometric techniques applied on nationally representative, individual-level household survey data. After providing a synthesised review of the extensive international literature, the first substantive contribution concerns aggregate and between-group adjustments to employment and working hours. I estimate substantial aggregate job loss accompanied by a surge in inactivity, and document significant regressivity in both the short- and longer-terms, thus reinforcing pre-existing inequalities on both the extensive and intensive margins. I reveal the principal roles of two key features of the pandemic labour market - remote work ability and ‘essential' worker status - in explaining these outcomes. Modelling the evolution of outcome determinants suggests some persistent changes to the structure of the labour market. In my second substantive contribution, I analyse the evolving level and nature of wages and wage inequality. I first characterise the non-negligible, non-randomly distributed missing wage data. After obtaining reliable estimates through parametric techniques, I estimate extremely high and stable pre-pandemic inequality levels. At the pandemic's onset, I show that wages increased primarily due to an inequality-enhancing composition effect, driven by a regressive job loss distribution related to the two aforementioned features. Inequality-reducing within-worker wage gains are also evident, but the dominance of the composition effect resulted in a large but transient increase in inequality on net. Persistent changes to wage determinants drove wages and wage inequality back toward their pre-pandemic levels as the labour market recovered. The third contribution concerns the role of a key policy globally - sector-specific restrictions. I exploit temporal and between-industry variation induced by these to estimate their causal effect on employment. The analysis isolates how much job loss was attributable to this policy relative to other pandemic-related factors. I find significant negative effects, and estimate that they accounted for two-thirds of the total employment decline. This reflects both the severity of South Africa's restrictions but additionally that job loss would have still occurred in their absence, consistent with the literature. I further take advantage of overlap in policy variation and data collection periods to examine heterogeneity by policy stringency and sectoral formality, highlighting disproportionate effects on informal workers. The thesis concludes with a summary of key findings, limitations, and implications for future research.
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    COVID-19 Diagnosis: A Review of Rapid Antigen, RT-PCR and Artificial Intelligence Methods
    (Multidisciplinary Digital Publishing Institute, 2022-04-03) Aruleba, Raphael Taiwo; Adekiya, Tayo Alex; Ayawei, Nimibofa; Obaido, George; Aruleba, Kehinde; Mienye, Ibomoiye Domor; Aruleba, Idowu; Ogbuokiri, Blessing
    As of 27 December 2021, SARS-CoV-2 has infected over 278 million persons and caused 5.3 million deaths. Since the outbreak of COVID-19, different methods, from medical to artificial intelligence, have been used for its detection, diagnosis, and surveillance. Meanwhile, fast and efficient point-of-care (POC) testing and self-testing kits have become necessary in the fight against COVID-19 and to assist healthcare personnel and governments curb the spread of the virus. This paper presents a review of the various types of COVID-19 detection methods, diagnostic technologies, and surveillance approaches that have been used or proposed. The review provided in this article should be beneficial to researchers in this field and health policymakers at large.
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    COVID-19 lockdown and natural resources: a global assessment on the challenges, opportunities, and the way forward
    (2022-01-29) Muche, Meseret; Yemata, Getahun; Molla, Eyayu; Muasya, A M; Tsegay, Berhanu A
    Background: The Coronavirus (COVID-19) is a global pandemic caused by SARS-CoV-2, which has an enormous effect on human lives and the global environment. This review aimed to assess the global scientific evidence on the impact of COVID-19 lockdown on natural resources using international databases and search engines. Thus, the unprecedented anthropause due to COVID-19 has positive and negative effects on natural resources. Main body This review showed that the unprecedented pandemic lockdown events brought a negative impact on the physical environment, including pollution associated with a drastic increase in person protective equipment, deforestation, illegal poaching and logging, overfishing, disruption of the conservation program and projects. It is noted that the spread of pandemic diseases could be aggravated by environmental pollution and a rapid increase in the global population. Despite these negative impacts of COVID-19, the anthropause appear to have also several positive effects on natural resources such as short term reduction of indoor and outdoor environmental pollutants (PM2.5, PM10, NO2, SO2, CO, and CO2), reduction in noise pollutions from ships, boats, vehicles, and planes which have positive effects on aquatic ecosystems, water quality, birds behaviour, wildlife biodiversity, and ecosystem restoration. Conclusion Therefore, governments and scientific communities across the globe have called for a green recovery to COVID-19 and implement multi-actor interventions and environmentally friendly technologies to improve and safeguard sustainable environmental and biodiversity management and halt the next pandemic.
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    The effect of COVID-19 on maternal newborn and child health (MNCH) services in Bangladesh, Nigeria and South Africa: call for a contextualised pandemic response in LMICs
    (2021-03-15) Ahmed, Tanvir; Rahman, Ahmed E; Amole, Taiwo G; Galadanci, Hadiza; Matjila, Mushi; Soma-Pillay, Priya; Gillespie, Bronwen M; El Arifeen, Shams; Anumba, Dilly O C
    Global response to COVID-19 pandemic has inadvertently undermined the achievement of existing public health priorities and laregely overlooked local context. Recent evidence suggests that this will cause additional maternal and childhood mortality and morbidity especially in low- and middle-income countries (LMICs). Here we have explored the contextual factors influencing maternal, neonatal and children health (MNCH) care in Bangladesh, Nigeria and South Africa amidst the pandemic. Our findings suggest that between March and May 2020, there was a reduction in utilisation of basic essential MNCH services such as antenatal care, family planning and immunization due to: a) the implementation of lockdown which triggered fear of contracting the COVID-19 and deterred people from accessing basic MNCH care, and b) a shift of focus towards pandemic, causing the detriment to other health services, and c) resource constraints. Taken together these issues have resulted in compromised provision of basic general healthcare. Given the likelihood of recurrent waves of the pandemic globally, COVID-19 mitigation plans therefore should be integrated with standard care provision to enhance system resilience to cope with all health needs. This commentary suggests a four-point contextualised mitigation plan to safeguard MNCH care during the pandemic using the observed countries as exemplars for LMIC health system adaptations to maintain the trajectory of progress regarding sustainable development goals (SDGs).
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    Effects of the COVID-19 pandemic on the outcomes of HIV-exposed neonates: a Zimbabwean tertiary hospital experience
    (BioMed Central, 2024-01-05) Gannon, Hannah; Chappell, Elizabeth; Ford, Deborah; Gibb, Diana M.; Chimwaza, Anesu; Manika, Ngoni; Wedderburn, Catherine J.; Nenguke, Zivai M.; Cowan, Frances M.; Gibb, Tom; Phillips, Andrew; Mushavi, Angela; Fitzgerald, Felicity; Heys, Michelle; Chimhuya, Simbarashe; Bwakura-Dangarembizi, Mutsa
    Abstract Introduction The COVID-19 pandemic has globally impacted health service access, delivery and resources. There are limited data regarding the impact on the prevention of mother to child transmission (PMTCT) service delivery in low-resource settings. Neotree ( www.neotree.org ) combines data collection, clinical decision support and education to improve care for neonates. Here we evaluate impacts of COVID-19 on care for HIV-exposed neonates. Methods Data on HIV-exposed neonates admitted to the neonatal unit (NNU) at Sally Mugabe Central Hospital, Zimbabwe, between 01/06/2019 and 31/12/2021 were analysed, with pandemic start defined as 21/03/2020 and periods of industrial action (doctors (September 2019-January 2020) and nurses (June 2020-September 2020)) included, resulting in modelling during six time periods: pre-doctors’ strike (baseline); doctors’ strike; post-doctors’ strike and pre-COVID; COVID and pre-nurses’ strike; nurses’ strike; post nurses’ strike. Interrupted time series models were used to explore changes in indicators over time. Results Of 8,333 neonates admitted to the NNU, 904 (11%) were HIV-exposed. Mothers of 706/765 (92%) HIV-exposed neonates reported receipt of antiretroviral therapy (ART) during pregnancy. Compared to the baseline period when average admissions were 78 per week (95% confidence interval (CI) 70–87), significantly fewer neonates were admitted during all subsequent periods until after the nurses’ strike, with the lowest average number during the nurses’ strike (28, 95% CI 23–34, p < 0.001). Across all time periods excluding the nurses strike, average mortality was 20% (95% CI 18–21), but rose to 34% (95% CI 25, 46) during the nurses’ strike. There was no evidence for heterogeneity (p > 0.22) in numbers of admissions or mortality by HIV exposure status. Fewer HIV-exposed neonates received a PCR test during the pandemic (23%) compared to the pre-pandemic periods (40%) (RR 0.59, 95% CI 0.41–0.84, p < 0.001). The proportion of HIV-exposed neonates who received antiretroviral prophylaxis during admission was high throughout, averaging between 84% and 95% in each time-period. Conclusion While antiretroviral prophylaxis for HIV-exposed neonates remained high throughout, concerning data on low admissions and increased mortality, similar in HIV-exposed and unexposed neonates, and reduced HIV testing, suggest some aspects of care may have been compromised due to indirect effects of the pandemic.
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    Experiences of returning to campus in the COVID-19 pandemic among administrative faculty staff: a job demands and resources approach
    (2025) Majeke, Vika; Jaga, Ameeta
    The purpose of this study was to explore and develop deep understanding of return to campus experiences of administrative faculty staff- from their remote working to in person working conditions at a South African university. Administrative faculty staff play a crucial role in service delivery of the university, however, their return to campus following COVID-19 was layered with psychological and emotional experiences. A phenomenological focus group study with 11 administrative faculty staff was conducted. Thematic analysis on the focus group data revealed key themes: (1) Remote work as shaping return-to-work; (2) We don't have much choice or voice”: decision-making as one-sided and (3): Long-haul covid: returning to work as a ‘different' person.
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    Exploring meaning-making among those who are identified by scientists as vaccine-resistant, vaccine-hesitant, or vaccine-sceptical
    (2025) Ngomane, Tsholofelo; Ross, Fiona
    Vaccines are an indisputable human right and an important tool in the advancement of world health. Over the last few decades, their function in disease prevention and outbreak management has been increasingly important. Immunization is considered an important investment in one's health, and in South Africa, childhood immunization is an important and effective public health intervention. South Africa uses an opt-out vaccination system. Children receive their first dose of vaccines upon birth unless their parent states otherwise and continue to receive a standard series of vaccinations for common illnesses throughout childhood. These include vaccinations for the BCG, Polio, Rotaviruses, Pneumonia, and Diphtheria. They also receive vaccinations for tetanus, acellular pertussis, inactivated polio vaccine, and a combination of Haemophilus influenzae type B and hepatitis B and measles. Vaccinations and boosters continue until 18 months old. Thereafter, girls and boys ages 6 and 12 receive the Td Vaccine (Tetanus and reduced strength of the Diphtheria Vaccine). Children also receive voluntary vaccines such as the Flu vaccine throughout their lives and the Human Papillomavirus HPV vaccine is given to girls from as early as 9 years and they usually receive a boost later. This suggests that vaccination is already an ordinary part of most South African lives. However, faced with COVID-19, debates erupted about the value, efficacy, and role of vaccinations in the prevention of illness. The dissertation explores debates about vaccination as they arose amid the pandemic. Drawing on three months of research conducted in 2022-3, it reflects on the social anxieties that the vaccine evoked and the nuances of simplistic accounts of vaccine resistance. Several factors have been identified as influencing vaccination resistance. Some are related to mistrust of biomedicine (due, in part, to previous histories of biomedical experimentation and the apartheid state's harmful practices); others are related to specific ideas about the body and how it should be treated, and still, others are related to a lack of access to basic health care resources or negative experiences in state institutions. Some people are skeptical of Covid-19; some are motivated by religious beliefs about post-infection immunity, and some may be the result of specific ways of conceptualizing the relationship between life cycle and risk. The thesis explores people's ideas about vaccination, focusing on those who were ‘vaccine skeptical' and ‘vaccine-hesitant'. It shows that their hesitancy to vaccinate for Covid-19 was influenced by different factors. For most people ‘Time' played a big role in their hesitancy and skepticism to vaccinate. They questioned the time it took to develop the vaccine and presented it to the public and, given both the speed of vaccine development and prior histories of medical abuse, they were reluctant to present their bodies to be used for trials. Another factor that influenced hesitancy was motivated by religious beliefs. Pentecostal Christians in particular did not want to vaccinate because they feared that the vaccine contained “the mark of the beast 666”. The number “666” is associated with the devil by many Christians and they did not want to put themselves in a position that compromised their faith. Social media also had an effect in influencing people to be hesitant to vaccinate, as it is a public platform where people can say anything and that information can be misleading and yet people make decisions based on it. The need to prevent material flow resulted in people not wanting to vaccinate. They believed that the pandemic was politically motivated and a money-making scheme where big pharmaceuticals, the government, and big business people stood the chance to benefit from it hence they did not want to contribute to it by using their bodies. The end result was distrust in the vaccine and the vaccination process.
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    Exploring the impact of COVID-19 on private sector SMME incubation support in South Africa
    (2024) De Waal, Anelia; Hall, Martin
    The COVID-19 pandemic had globally disruptive repercussions, resulting in the resiliency of numerous support systems being tested, including the support ecosystem for small, micro, and medium-sized enterprises (SMMEs). Small business development initiatives, such as incubation and acceleration programmes, ostensibly provide a supportive environment for SMMEs to overcome economic pressures and market failures. They provide a critical role in the development of SMMEs and, by extension, healthy, inclusive economies. Given the catastrophic impact of the COVID-19 pandemic on the number of SMMEs closing down, particularly in South Africa, ensuring that future support mechanisms are geared towards adaptability and resiliency is imperative. In pursuit of this, efforts to understand how enterprise support organisations involved in incubation-style small business development programmes experienced the COVID-19 pandemic is a critical step in developing frameworks for future crisis responses. In aid of this goal, the research project focused on the experiences of 12 practitioners representing enterprise support organisations, using qualitative research methods to code and compare emerging experiences. The research found a correlation between the influence of power and agency on multi-level decision-making, and how this determines capacity to adapt and respond in inclusive and meaningful ways. It is the recommendation of this study that small business development organisations develop adaptive support practices that centre inclusivity and leverage micro-agency. Key mechanisms found in the study include the adoption of limited hierarchical operation practices, open dialogue that prioritises collaboration, and continuous learning and improvement initiatives. Future research needs to be conducted from the perspective of SMMEs within development programmes during COVID-19, to bolster the study findings, and aid in determining the degrees to which support initiatives were effective.
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    Hospital acquired COVID-19 infections amongst patients before the rollout of COVID-19 vaccinations, a scoping review
    (2022-02-10) Ngandu, Nobubelo K; Mmotsa, Tshiamo M; Dassaye, Reshmi; Thabetha, Alice; Odendaal, Willem; Langdown, Natasha; Ndwandwe, Duduzile
    Background Hospital settings are at increased risk of spreading Coronavirus Disease 2019 (COVID-19) infections, hence non-pharmaceutical prevention interventions (NPPIs) and prioritized vaccination of healthcare workers and resident patients are critical. The status of COVID-19 hospital acquired infections (HAIs) in low-income settings is unclear. We aimed to identify and summarize the existing evidence on COVID-19 HAIs amongst patients, prior to the rollout of vaccines in countries worldwide. Methods We conducted a scoping review of English peer-reviewed literature in PubMed, Web of Science and Scopus using a combination of selected search terms. Full texts articles presenting results on COVID-19 HAIs in hospitalised patients before the rollout of vaccines in countries worldwide were eligible. Data extracted from eligible articles included estimates of COVID-19 HAIs, country, and type of hospital setting, and was summarized narratively. Quality assessment of included articles was not possible. Results Literature searches generated a total of 5920 articles, and 45 were eligible for analysis. Eligible articles were from Europe, North America, Asia, and Brazil and none were from low-income countries. The proportion of COVID-19 HAIs ranged from 0% when strict NPPIs were applied, to 65% otherwise. The estimates of COVID-19 HAIs did not differ by country but were lower in studies conducted after implementation of NPPIs and in specialized hospital settings for operative surgery. Studies conducted before the implementation of NPPIs or in long-term care and psychiatric wards often reported high estimates of HAI. Although there was no clear trend in general wards, those situated in academic hospitals managed to reduce HAI rates under strict NPPI protocols. Operative surgery settings, unlike psychiatric settings, effectively prevented COVID-19 HAI using tailored NPPIs. Conclusion The available evidence shows a high risk of COVID-19 HAIs, the feasibility of preventing HAIs in different healthcare settings and the importance of appropriately tailored NPPIs. There were no data from low-income settings, therefore, it is unclear whether the reported NPPI approaches could be equally effective elsewhere. We recommend routine monitoring of COVID-19 HAIs in countries with low vaccination coverage, to identify and close gaps in NPPIs and understand gains made from vaccinating healthcare workers and hospitalized patients.
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    Implications of the distinct or interchangeable use of the terms “ESG” and “sustainability” on reporting by global banks in the context of COVID-19
    (2025) Masemola, Mokganye Mathabo; Herbert, Shelly
    The use of the buzzwords “ESG” and “sustainability” has been on the rise. Although used interchangeably, the terms “ESG” and “sustainability” have different meanings. This study explored the differences and similarities between the ESG disclosures and sustainability disclosures of banks, including whether there is an acknowledgement of the difference between the terms “ESG” and “sustainability” in 2019 and 2021 and the implications regarding reporting practices. The integrated reports and sustainability reports analysed are for a sample of 25 banks, as banks have a dual responsibility in terms of ESG and sustainability reporting. The sampled banks are from South Africa, Japan, the United Kingdom, the United States and France - where integrated reporting and sustainability reporting exist. An interpretative content analysis was performed on the reports, with results being recorded in a template. The implication of the distinction or non-distinction was further investigated in terms of the number of reports used to report on the matters, the purpose of the report, the target audience for each report, what constitutes the definition of materiality in the context of each report and whether Covid-19 contributed towards a change in the materiality constitution of those reports between 2019 and 2021. The results show that banks do not distinguish between “ESG” and “sustainability”. Further, the findings suggest that the non-distinction between the two terms by authoritative guidance, frameworks and standards mandatorily adopted results in no separation between the forms of reporting used to report on ESG matters and sustainability matters. As a result, more than one report is used to report on ESG matters and sustainability matters. However, the ESG matters and sustainability matters are disclosed together, leading to the purpose, target audience and materiality definitions being the same for both ESG matters and sustainability matters. Covid-19 is not listed as a critical contributor to determining material matters in 2021 as opposed to 2019.