World Health Organization COVID-19 Preparedness and Response Team, Juba, Republic of South Sudan.
Infect Dis Poverty. 2021 Mar 17;10(1):30. doi: 10.1186/s40249-021-00795-7.
The ongoing coronavirus disease 2019 (COVID-19) pandemic has put a strain on health systems globally. Although Africa is the least affected region to date, it has the weakest health systems and an exponential rise in cases as has been observed in other regions, is bound to overwhelm its health systems. Early detection and isolation of suspected and confirmed COVID-19 cases are pivotal to the prevention and control of the pandemic. The World Health Organization (WHO) recommends that all laboratory-confirmed cases should be isolated and treated in a health care facility; however, where this is not possible due to the health system capacity, patients can be isolated in re-purposed facilities or at home. An already very apparent future challenge for Africa is facility-based isolation of COVID-19 cases, given the already limited health infrastructure and health workforce, and the risk of nosocomial transmission. Use of repurposed facilities requires additional resources, including health workers. Home isolation, on the other hand, would be a challenge given the poor housing, overcrowding, inadequate access to water and sanitation, and stigma related to infectious disease that is prevalent in many African societies. Conflict settings on the continent pose an additional challenge to the prevention and control of COVID-19 with the resultant population displacements in overcrowded camps where access to social services is limited. These unique cultural, social, economic and developmental differences on the continent, call for a tailored approach to COVID-19 case management strategies. This article proposes three broad case management strategies based on the transmission scenarios defined by WHO, and the criteria and package of care for each option, for consideration by policy makers and governments in African countries. Moving forward, African countries should generate local evidence to guide the development of realistic home-grown strategies, protocol and equipment for the management of COVID-19 cases on the continent .
持续的 2019 年冠状病毒病（COVID-19）大流行使全球卫生系统承受了压力。尽管非洲是迄今为止受影响最小的地区，但它的卫生系统最薄弱，而且随着其他地区病例呈指数级增长，其卫生系统势必不堪重负。早期发现和隔离疑似和确诊的 COVID-19 病例是预防和控制大流行的关键。世界卫生组织（WHO）建议所有实验室确诊的病例都应在医疗机构中隔离和治疗；然而，由于卫生系统能力不足，如果无法做到这一点，患者可以在重新利用的设施或家中隔离。对于非洲来说，一个已经非常明显的未来挑战是在医疗机构中隔离 COVID-19 病例，考虑到已经有限的卫生基础设施和卫生工作者，以及医院内传播的风险。重新利用的设施需要额外的资源，包括卫生工作者。另一方面，由于住房条件差、过度拥挤、获得水和卫生设施不足以及与传染病相关的污名在许多非洲社会普遍存在，家庭隔离将是一个挑战。非洲大陆的冲突环境对 COVID-19 的预防和控制构成了额外的挑战，导致人口在过度拥挤的难民营中流离失所，这些地方获得社会服务的机会有限。非洲大陆存在独特的文化、社会、经济和发展差异，需要采取量身定制的方法来制定 COVID-19 病例管理策略。本文根据世界卫生组织定义的传播情景，以及每种选择的护理标准和一揽子计划，提出了三种广泛的病例管理策略，供非洲国家的决策者和政府考虑。展望未来，非洲国家应生成本地证据，以指导制定适合非洲大陆的现实本土战略、协议和设备，用于管理 COVID-19 病例。
