Post-COVID-19 conditions and health effects in Africa: a scoping review

Introduction
The SARS-CoV-2 pandemic has caused global devastations in social, economic and health systems of every nation, but disproportionately of nations in Africa. In addition to its grave effects on the global systems, there is continuation or development of new symptoms among individuals who have contracted the virus, with the potential to further stress the health systems on the continent. Therefore, the aim of this scoping review was to collate and summarise the existing research evidence on the prevalence and health effects of post–COVID-19 conditions in Africa.

Methods and analysis
Five main databases were thoroughly searched from 1 September 2023 to 10 May 2024 for eligible articles based on the pre-established inclusion and exclusion criteria. These databases included PubMed, Central, Scopus, Dimensions AI and JSTOR. A total of 17 papers were included in the review. The protocol for this review is already published in BMJ Open; doi:10.1136/bmjopen-2023-082519.

Results
The prevalence of post–COVID-19 conditions in Africa ranged from 2% to as high as 94.7%. Fatigue, dyspnoea and brain fog were among the commonly reported symptoms of post–COVID-19 conditions. Reduced functional status as well as physical and psychosocial disorders were the main health effects reported by the studies reviewed, but no study yet reported the effects of post–COVID-19 conditions on the health systems in Africa.

Conclusions
There is an evidence of high prevalence of post–COVID-19 conditions in the African setting. However, there is limited evidence of the health effects of the post–COVID-19 conditions on patients and health systems in Africa.

Ethics and dissemination
This scoping review involved analysis of secondary data; therefore, no ethical approval was needed. Dissemination of the result is being done through international journals and may also be presented at available research conferences.

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Spatiotemporal distribution characteristics and impact factors of hepatitis C in Chongqing, China, 2014-2020

Objectives
This study aimed to explore the spatial and temporal distribution of hepatitis C and its influencing factors in Chongqing, providing a scientific basis for the relevant departments to formulate targeted preventive measures for the high prevalence of hepatitis C in the region and population.

Design
We collected data on hepatitis C cases in Chongqing (located in the southwest of China) from 2014 to 2020, and analysed the spatiotemporal heterogeneity of hepatitis C incidence in different populations and identified factors that might influence the incidence of hepatitis C by constructing a Bayesian spatiotemporal model.

Settings
The study subjects included clinically diagnosed cases and confirmed cases of hepatitis C with current address in Chongqing and onset date between 1 January 2014 and 31 December 2020.

Participants
The study used aggregated data, including 33 900 clinically diagnosed cases and confirmed cases of hepatitis C.

Results
From 2014 to 2020, the high-risk areas of hepatitis C were primarily concentrated in the main and new urban areas of Chongqing. In contrast, the low-risk areas were mainly found in southeast and northeast Chongqing. There was also an increasing trend in the risk of incidence in the low-risk areas. Analysis of different populations revealed that men aged 45–59 years had a higher risk of developing hepatitis C in the main urban area compared with other age groups. Additionally, the risk for this population group showed an increasing trend in the southeast and northeast of Chongqing as well as the main urban area. Among women, the rising trend of hepatitis C risk was stronger for those aged 30–44 years in southeast Chongqing and for those aged 45–59 years in northeast Chongqing compared with other age groups. The analysis of influencing factors found that gross domestic product per capita, population density and the proportion of tertiary industry were associated with an increased risk of hepatitis C.

Conclusions
High-risk areas for hepatitis C virus were mainly located in the main and new urban areas of Chongqing, where the male prime-age population was the focus of prevention and treatment. In the future, the relevant authorities should concentrate on high-risk areas and at the same time strengthen screening and serological surveys for hepatitis C in low-risk areas and various populations, and raise public awareness of prevention, so as to reduce the incidence of hepatitis C.

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Dengue

This JAMA Insights explores several aspects of dengue virus infection, including epidemiology, diagnosis, and clinical management, following a global resurgence in both endemic and nonendemic regions.

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Feasibility and acceptability of multiple methods of recording injecting drug use episode data among people who inject drugs in Melbourne, Australia: a pilot evaluation study protocol

Introduction
Opioid overdose and blood-borne virus transmission are key health risks for people who inject drugs. Existing study methods that record data on injecting drug risks mostly rely on retrospective self-reporting that, while valid, are limited to being broad and subject to recall bias. The In-The-Moment-Expanded (ITM-Ex) study will evaluate the feasibility and acceptability of multiple novel data collection methods to capture in situ drug injecting data.

Methods and analysis
ITM-Ex will purposively recruit 50 participants from an existing longitudinal cohort (SuperMIX study) of people who inject drugs in Melbourne, Australia. Over a 4-week study period, participants will be asked to complete baseline/endline spirometry, continuously wear a heart rate monitoring device, complete short-form ecological momentary assessment (EMA) questionnaires for every injecting episode during the study period and return previously used needles/syringes for drug residue testing. These multiple data sources will be combined to conduct a comprehensive analysis of the physiological and risk characteristics of an estimated 800 individual injecting drug use episodes (if participants inject four times weekly). Finally, post-participation qualitative interviews will explore the acceptability of the data collection methods.

Ethics and dissemination
Ethics approval for ITM-Ex was obtained from Alfred Hospital Ethics Committee (project number 368/22). Results will be disseminated via national and international scientific and public health conferences and peer-reviewed journal publications.
Results from ITM-Ex may demonstrate vastly more complete and accurate methods of capturing data on injecting drug use risk and support future development and evaluation of devices to monitor and intervene during drug overdose. Further, ITM-Ex may demonstrate innovative methodologies to support myriad future public health research studies.

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Factors associated with preterm birth and mother-to-child transmission in HIV-positive pregnant women in Henan, China, 2016-2022: a retrospective cohort study

Introduction
HIV can greatly impact the quality of life of pregnant women and may cause adverse pregnancy outcomes, such as preterm birth (PB) and mother-to-child transmission (MTCT). The purpose of this study was to analyse the influencing factors of PB and MTCT in HIV-positive pregnant women.

Methods
HIV-positive pregnant women in Henan Province between January 2016 and December 2022 were selected for the study. Data were collected through the Management Information System for the Prevention of MTCT of HIV, syphilis and hepatitis B. Information on their demographic and clinical characteristics, treatment status and pregnancy outcomes was collected. A logistic regression model and 2 automatic interaction detector (CHAID) decision tree model were used to analyse the correlation factors of PB and MTCT.

Results
The average age of the 1073 study participants was 28.44 years, with an incidence of 11.93% for PB and 6.71% for MTCT. Hepatitis B virus or hepatitis C virus coinfection (OR=3.686, 95% CI 1.630 to 8.333) and Han nationality (OR=0.426, 95% CI 0.194 to 0.936) were risk factors for PB. Unknown HIV infection prior to pregnancy (OR=2.006, 95% CI 1.233 to 3.264) and primipara (OR=5.125, 95% CI 1.202 to 21.849) were risk factors for MTCT. The CHAID decision tree model was used to screen for the six and two influencing factors of PB and MTCT in HIV-positive women, respectively.

Conclusion
Early HIV testing, scientific counselling, precise maternal HIV infection assessment and targeted prevention measures can help prevent PB and MTCT in HIV-positive pregnant women.

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Efficacy and safety of individual nutrition support in patients with hepatitis B virus-related acute-on-chronic liver failure at nutrition risk: a study protocol for a randomised controlled clinical trial

Introduction
Malnutrition is a common complication of hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF) typically associated with poor prognosis. Despite nutritional treatment, the outcomes for these patients are limited by the symptoms and complications associated with ACLF. So far, the benefits of nutritional interventions in these populations have not been proven. This study aims to explore a new nutritional intervention method for patients with HBV-ACLF and evaluate its safety and efficacy.

Methods and analysis
This study is an investigator-initiated, nonblind, randomised controlled clinical trial. We will recruit 60 patients with HBV-ACLF according to the Chinese Group on the Study of Severe Hepatitis B criteria hospitalised in the Infectious Diseases Department of the Third Affiliated Hospital of Sun Yat-Sen University. Eligible patients will be randomly allocated to the nutrition support group (intervention group) and the control group in a 1:1 ratio. Patients in the nutrition support group will receive 10 days of tailor-made nutrition therapy consisting of oral nutritional supplements and supplementary parenteral nutrition. Patients in the control group will receive standard nutrition with dietary advice. All assessments will be conducted at baseline, 30 days and 90 days. The primary outcome measure is the liver transplant-free mortality rate. The secondary indicators include the incidence of clinical adverse outcomes and changes in indicators such as muscle mass, muscle strength, physical function and quality of life (EQ-5D scale).

Ethics and dissemination
This study has been approved by the Medical Ethics Committee of the Third Affiliated Hospital of Sun Yat-Sen University (approval number: II2023-242-03). The results and conclusions of the clinical trial will be published in academic conferences or journals.

Trial registration number
NCT06128421.

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