Introduction:Infectious disease surveillance has long been a challenge for low-income countries like Sierra Leone.Traditional approaches based on paper and Short Message Service(SMS)were subject to severe delays in ob...Introduction:Infectious disease surveillance has long been a challenge for low-income countries like Sierra Leone.Traditional approaches based on paper and Short Message Service(SMS)were subject to severe delays in obtaining,transmitting,and analyzing information.Methods:During the China aid operation for fighting Ebola since the end of 2014,a mobile electronic surveillance system for infectious diseases(MESSID)was developed in collaboration with the Republic of Sierra Leone Armed Forces(RSLAF),which comprised an Android-based reporting system and a complementary web-based program designed by Active Server Page.NET(ASP.NET)with the main functions including surveillance,real-time reporting,and risk assessment of infectious diseases.Results:MESSID was successfully registered in June 2016 and had been used by all medical and health institutions in RSLAF.From June 1,2016 to July 5,2021,34,419 cases were diagnosed with 47 infectious diseases of 5 categories,with a total of 42 clinical symptoms.Compared to traditional approaches based on paper and SMS,the MESSID showed flexibility,high efficiency,convenience,and acceptability.Discussion:MESSID is an accessible tool for surveillance of infectious diseases in Sierra Leone and possibly in other African countries with similar needs,capable of improving timeliness of disease reporting,thus rendering a timely outbreak detection and response.展开更多
Background:The coronavirus disease 2019(COVID-19)is a highly infectious respiratory disease.There is no recommended antiviral treatment approved for COVID-19 in Sierra Leone,and supportive care and protection of vital...Background:The coronavirus disease 2019(COVID-19)is a highly infectious respiratory disease.There is no recommended antiviral treatment approved for COVID-19 in Sierra Leone,and supportive care and protection of vital organ function are performed for the patients.This study summarized the clinical characteristics,drug treatments,and risk factors for the severity and prognosis of COVID-19 in Sierra Leone to provide evidence for the treatment of COVID-19.Methods:Data of 180 adult COVID-19 patients from the 34th Military Hospital in Freetown Sierra Leone between March 31,2020 and August 11,2020 were retrospectively collected.Patients with severe and critically ill are classified in the severe group,while patients that presented asymptomatic,mild,and moderate disease were grouped in the non-severe group.The clinical and laboratory information was retrospectively collected to assess the risk factors and treatment strategies for severe COVID-19.Demographic information,travel history,clinical symptoms and signs,laboratory detection results,chest examination findings,therapeutics,and clinical outcomes were collected from each case file.Multivariate logistic analysis was adopted to identify the risk factors for deaths.Additionally,the clinical efficacy of dexamethasone treatment was investigated.Results:Seventy-six(42.22%)cases were confirmed with severe COVID-19,while 104 patients(57.78%)were divided into the non-severe group.Fever(56.67%,102/180)and cough(50.00%,90/180)were the common symptoms of COVID-19.The death rate was 18.89%(34/180),and severe pneumonia(44.12%,15/34)and septic shock(23.53%,8/34)represented the leading reasons for deaths.The older age population,a combination of hypertension and diabetes,the presence of pneumonia,and high levels of inflammatory markers were significantly associated with severity of COVID-19 development(P<0.05 for all).Altered level of consciousness[odds ratio(OR)=56.574,95%confidence interval(CI)5.645–566.940,P=0.001],high levels of neutrophils(OR=1.341,95%CI 1.109–1.621,P=0.002)and C-reactive protein(CRP)(OR=1.014,95%CI 1.003–1.025,P=0.016)might be indicators for COVID-19 deaths.Dexamethasone treatment could reduce mortality[30.36%(17/56)vs.50.00%(10/20)]among severe COVID-19 cases,but the results were not statistically significant(P>0.05).Conclusions:The development and prognosis of COVID-19 may be significantly correlated with consciousness status,and the levels of neutrophils and CRP.展开更多
基金The China Mega-Project on Infectious Disease Prevention(2018ZX10101003-002)the Key Research and Development Program of China(2019YFC1200604)the National Natural Science Funds(81825019).
文摘Introduction:Infectious disease surveillance has long been a challenge for low-income countries like Sierra Leone.Traditional approaches based on paper and Short Message Service(SMS)were subject to severe delays in obtaining,transmitting,and analyzing information.Methods:During the China aid operation for fighting Ebola since the end of 2014,a mobile electronic surveillance system for infectious diseases(MESSID)was developed in collaboration with the Republic of Sierra Leone Armed Forces(RSLAF),which comprised an Android-based reporting system and a complementary web-based program designed by Active Server Page.NET(ASP.NET)with the main functions including surveillance,real-time reporting,and risk assessment of infectious diseases.Results:MESSID was successfully registered in June 2016 and had been used by all medical and health institutions in RSLAF.From June 1,2016 to July 5,2021,34,419 cases were diagnosed with 47 infectious diseases of 5 categories,with a total of 42 clinical symptoms.Compared to traditional approaches based on paper and SMS,the MESSID showed flexibility,high efficiency,convenience,and acceptability.Discussion:MESSID is an accessible tool for surveillance of infectious diseases in Sierra Leone and possibly in other African countries with similar needs,capable of improving timeliness of disease reporting,thus rendering a timely outbreak detection and response.
基金This work was supported by the National Grand Program on Key Infectious Disease(No.2018ZX10103002-001-007)the Biosafety Special Program(No.19SWAQ 13).
文摘Background:The coronavirus disease 2019(COVID-19)is a highly infectious respiratory disease.There is no recommended antiviral treatment approved for COVID-19 in Sierra Leone,and supportive care and protection of vital organ function are performed for the patients.This study summarized the clinical characteristics,drug treatments,and risk factors for the severity and prognosis of COVID-19 in Sierra Leone to provide evidence for the treatment of COVID-19.Methods:Data of 180 adult COVID-19 patients from the 34th Military Hospital in Freetown Sierra Leone between March 31,2020 and August 11,2020 were retrospectively collected.Patients with severe and critically ill are classified in the severe group,while patients that presented asymptomatic,mild,and moderate disease were grouped in the non-severe group.The clinical and laboratory information was retrospectively collected to assess the risk factors and treatment strategies for severe COVID-19.Demographic information,travel history,clinical symptoms and signs,laboratory detection results,chest examination findings,therapeutics,and clinical outcomes were collected from each case file.Multivariate logistic analysis was adopted to identify the risk factors for deaths.Additionally,the clinical efficacy of dexamethasone treatment was investigated.Results:Seventy-six(42.22%)cases were confirmed with severe COVID-19,while 104 patients(57.78%)were divided into the non-severe group.Fever(56.67%,102/180)and cough(50.00%,90/180)were the common symptoms of COVID-19.The death rate was 18.89%(34/180),and severe pneumonia(44.12%,15/34)and septic shock(23.53%,8/34)represented the leading reasons for deaths.The older age population,a combination of hypertension and diabetes,the presence of pneumonia,and high levels of inflammatory markers were significantly associated with severity of COVID-19 development(P<0.05 for all).Altered level of consciousness[odds ratio(OR)=56.574,95%confidence interval(CI)5.645–566.940,P=0.001],high levels of neutrophils(OR=1.341,95%CI 1.109–1.621,P=0.002)and C-reactive protein(CRP)(OR=1.014,95%CI 1.003–1.025,P=0.016)might be indicators for COVID-19 deaths.Dexamethasone treatment could reduce mortality[30.36%(17/56)vs.50.00%(10/20)]among severe COVID-19 cases,but the results were not statistically significant(P>0.05).Conclusions:The development and prognosis of COVID-19 may be significantly correlated with consciousness status,and the levels of neutrophils and CRP.
