Ibrahima Camara

Despite the numerous articles published on the clinical characteristics and outcomes of COVID-19 with regard to high-income countries, little is known about patients in low- and middle-income countries (LMIC) in this context. The objective of this observational, prospective, hospital-based multicentric study was to describe clinical features and outcomes of laboratory-confirmed COVID-19 patients hospitalized in each of the participating centers in Bangladesh, Guinea, Ivory Coast, Lebanon, Madagascar, and Mali during the first year of the pandemic (March 5, 2020 to May 4, 2021). The study outcome was the clinical severity of COVID-19, defined as hospitalization in intensive care unit or death. Multivariate logistic regression models were performed to identify independent variables associated with disease severity. Overall, 1,096 patients were included. The median age was 49.0 years, ranging from 38.0 in Mali to 63.0 years in Guinea. The overall clinical severity of COVID-19 was 12.3%, ranging from 6.4% in Mali to 18.8% in Guinea. In both groups of patients <60 and ≥60 years old, cardiovascular diseases (adjusted odds ratio [aOR]: 1.99; 95% CI: 1.13–3.50, P = 0.02; aOR: 2.47; 95% CI: 1.33–4.57, P = 0.004) were independently associated with clinical severity, whereas in patients <60 years, diabetes (aOR: 2.13; 95% CI: 1.11–4.10, P = 0.02) was also associated with clinical severity. Our findings suggest that COVID-19-related severity and death in LMICs are mainly driven by older age. However, the presence of chronic diseases can also increase the risk of severity especially in younger patients.

Background: The Expanded Program on Immunisation has made it possible to prevent more than 3 million deaths in children under 5 years. The objectives of this study were to estimate the vaccination coverage of children from 0 to 59 months and identify factors associated with incomplete vaccination coverage. Methods: A cross-sectional study was carried out in a dispensary in Conakry, Guinea between January and February 2020. Sociodemographic and vaccination information was collected from mothers of 380 randomly select children aged 0 to 59 months. Information on immunisation coverage was gathered from records vaccination cards and maternal reports. Logistic regression was used to identify factors independently associated with incomplete immunisation coverage. Results: Most (66.5%) children aged < 12 months were up-to-date with their vaccinations. Factors associated with incomplete vaccination in this age group included: unavailability of vaccination cards (adjusted odds ratio [aOR] 7.58; 95% confidence interval [CI]: 2.56-22.44) and lack of prenatal consultation attendance (aOR 2.93; 95% CI: 1.15-7.48). In contrast only 19.8% (95% CI: 13.9-26.7) of children aged 12-59 months were fully immunised. Factors associated with incomplete vaccination coverage in children aged 12-59 months included high birth order (aOR 10.23; 95% CI: 2.06-19.43), and lack of prenatal consultation attendance (aOR 5.34; 95% CI: 1.48-19.23). Conclusion: Child immunisation coverage is low in Guinea. These results highlight the need to develop strategies based on an integrated approach to overcome obstacles to childhood immunisation in Guinea.

The ebola epidemic that raged in West Africa between 2013 and 2016 was the largest since the discovery of the virus in 1976. During this epidemic, more than 11,000 cases were notified with a lethality of over 67%. Several means of transmission have been described. The great difficulty noted during the epidemic was the estimation of the number of asymptomatic and pauci symptomatic cases, however there is evidence that this population has been in contact with the virus for some time. Thus, they could be a source for the spread of the epidemic. In this paper, we report in Guinea-Conakry three stories of probable pauci-symptomatic form of ebola disease that would have been the cause of massive infection in a population sorely tried by the epidemic between 2014 and 2015 in Guinea.

Background: On January 30, 2020, the World Health Organization designated the outbreak as a Public Health Emergency of International Scope (USPPI). Underdeveloped countries, such as the Republic of Guinea, where the health system has been severely impacted by the Ebola virus epidemic between 2013 and 2014, will therefore find it difficult to respond effectively to the predicted epidemic. The purpose of this study was to assess the knowledge, attitudes and practices of medical personnel on the prevention of Covid-2019.Methods:This was a cross-sectional study with an analytical aim carried out from 1st to 29th February 2020 among front-line health workers in the health structures of the city of Conakry. Data were collected using the Kobocollect application by administration of a standardized questionnaire. The knowledge and attitude score was categorized in 2: Good if ≥ at the average score and bad if < 50%. Logistic regression models were conducted to identify factors associated with knowledge and attitude. Odds ratios (OR) with their confidence intervals were calculated.Results :548 health workers surveyed, the mean score for knowledge on the prevention of Covid-19 was 54.81 SD = 9.71, [95% CI: [ 53.9-55.6]. 70.6% had a good knowledge of Covid-19. However, 99.6% of the staff did not know the emergency number in case of a suspected case and about 50% did not know the incubation period of Covid-19.Among the health personnel interviewed, 57.7% had a good attitude towards a suspected case of Covid-19.Although the majority (57.5%) of the health workers had received training in infection prevention and control, infection prevention and control (IPC) practices were not routinely implemented, as the implementation rate was not even 80% for every action.Variables associated with poor knowledge of Covid-19 prevention were sex, health facility, and staff grade. As for poor attitude, the associated variables were knowledge of Ebola cases reported in the facility and the rank of the health staff.Conclusion:This study underlines the difficulties of the appropriation of prevention and protection measures against Covid-19 by health personnel for whom the risk appears remote and limited to a transnational or foreign elite.