College of Health Sciences, Makerere University, Kampala, Uganda.
Faculty of Health Sciences, Islamic University in Uganda.
Afr Health Sci. 2023 Mar;23(1):1-15. doi: 10.4314/ahs.v23i1.2.
There are many uncertainties on the future management of the coronavirus disease 19 (COVID-19) in Africa. By July 2021, Africa had lagged behind the rest of the world in Covid-19 vaccines uptake, accounting for just 1.6% of doses administered globally. During that time COVID 19 was causing an average death rate of 2.6% in Africa, surpassing the then global average of 2.2%. There were no clear therapeutic guidelines, yet inappropriate and unnecessary treatments may have led to unwanted adverse events such as worsening of hyperglycemia and precipitating of ketoacidosis in administration of steroid therapy. in order to provide evidence-based policy guidelines, we examined peer-reviewed published articles in PubMed on COVID 19, or up-to date data, we focused our search on publications from 1st May 2020 to 15th July, 2021. For each of the studies, we extracted data on pathophysiology, selected clinical chemistry and immunological tests, clinical staging and treatment. Our review reports a gross unmet need for vaccination, inadequate laboratory capacity for immunological tests and the assessment of individual immune status, clinical staging and prediction of disease severity. We recommend selected laboratory tools in the assessment of individual immune status, prediction of disease severity and determination of the exact timing for suitable therapy, especially in individuals with co-morbidities.
非洲未来对 2019 年冠状病毒病(COVID-19)的管理存在诸多不确定因素。到 2021 年 7 月,非洲在新冠疫苗接种方面落后于世界其他地区,仅占全球接种剂量的 1.6%。当时,COVID-19 在非洲的平均死亡率为 2.6%,超过当时全球 2.2%的平均死亡率。没有明确的治疗指南,但不适当和不必要的治疗可能导致不必要的不良事件,如在使用类固醇治疗时使高血糖恶化和酮症酸中毒恶化。为了提供循证政策指南,我们检查了在 PubMed 上发表的关于 COVID-19 的同行评议文章,或最新数据,我们的搜索重点放在 2020 年 5 月 1 日至 2021 年 7 月 15 日期间发表的出版物上。对于每项研究,我们都提取了关于病理生理学、选择的临床化学和免疫学检测、临床分期和治疗的数据。我们的综述报告表明,在疫苗接种方面存在巨大的未满足需求,免疫学检测和评估个体免疫状态、临床分期和预测疾病严重程度的实验室能力不足。我们建议在评估个体免疫状态、预测疾病严重程度和确定合适治疗的确切时机方面使用选定的实验室工具,特别是在合并症患者中。