Aralık 2019’da Çin’in Wuhan bölgesinde başlayan Covid-19 (koronavirus hastalığı 2019) pandemisi, Afrika kıtasında da etkisini göstermektedir. Sağlık personeli sayısı, yoğun bakım yatağı sayısı, laboratuvar kapasitesi, temiz su ve altyapı imkanları, Covid-19 test ve tedavi imkanlarının yetersiz olduğu kıta ülkelerinde salgının daha büyük halk kitlelerini etkisi altına alarak vaka ve ölüm sayılarını artırmasından endişe edilmektedir. Bunların yanı sıra, kıtadaki sıtma, HIV, tüberküloz gibi hastalıklardaki prevalansın hali hazırda yüksek olmasının da mortaliteye katkıda bulunabileceği düşünülmektedir. Afrika Birliği (African Union) çatısı altındaki Afrika Hastalık Kontrolü ve Önleme Merkezleri (Africa Centres for Disease Control and Prevention - Africa CDC), koordineli bir şekilde önlemler alsa da yüksek gelirli ülkelerin dahi tedarik zincirinde ve medikal ekipman stoklarında sorun yaşadığı bu pandemi sürecinde kıta ülkelerinin ekonomik yönden de yardıma ihtiyaç duyduğu açıktır. Dünya Sağlık Örgütü, Afrika Birliği ile Afrika CDC gibi kuruluşların verimli iş birlikleri ve örgütlenmeleri, hükümetlerin sağlık otoriteleriyle ortak ve hızlı bir şekilde karar almaları, medyanın halkı bilinçlendirme noktasında doğru kullanımı, halkın fiziksel mesafe ve sık el yıkama kurallarına uyması, koronavirüs test kitleri, kişisel koruyucu ekipman, maske, ventilatör ve diğer yaşam destek ekipmanlarının sağlanması ve/veya bağışlanması Afrika’da Covid-19’dan mümkün olduğunca az sayıda insanın etkilenmesinin sağlanmasında kritik öneme sahiptir.
Yazarlar, çalışmaya olan katkısından ötürü Sn. Muhammed Bardakçı* için teşekkürlerini sunarlar.
*Koç Üniversitesi, Hukuk Fakültesi Öğrencisi
Kaynakça
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Paintsil E. COVID-19 threatens health systems in sub-Saharan Africa: the eye of the croc-odile. Journal of Clinical Investigation. 2020;138493. doi: 10.1172/JCI138493.
Africa CDC: Coronavirus Disease 2019 (COVID-19). Latest updates on the COVID-19 cri-sis from Africa CDC. 2020. Available at: https://africacdc.org/covid-19/. Accessed 4 May 2020.
Kavanagh MM, Erondu NA, Tomori O, Dzau VJ, Okiro EA, Maleche A, Aniebo I, Rugege U, Holmes CB, Gostin LO. Access to lifesaving medical resources for African countries: COVID-19 testing and response, ethics, and politics. The Lancet. 2020;S0140-6736(20)31093-X. doi: 10.1016/S0140-6736(20)31093-X.
Martinez-Alvarez M, Jarde A, Usuf E, Brotherton H, Bittaye M, Samateh AL, Antonio M, Vives-Tomas J, D’Alessandro U, Roca A. COVID-19 pandemic in west Africa. The Lancet Global Health. 2020;8(5):e631–632. doi:10.1016/S2214-109X(20)30123-6.
Quaresima V, Naldini MM, Cirillo DM. The prospects for the SARS ‐CoV‐2 pandemic in Africa. EMBO Molecular Medicine. 2020;e12488. doi:10.15252/emmm.202012488.
Haider N, Yavlinsky A, Simons D, Osman AY, Ntoumi F, Zumla A, Kock R. Passengers’ destinations from China: low risk of Novel Coronavirus (2019-nCoV) transmission into Africa and South America. Epidemiol Infect. 2020;148:e41. doi: 10.1017/S0950268820000424.
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Wallace DJ, Angus DC, Seymour CW, Barnato AE, Kahn JM. Critical care bed growth in the United States: a comparison of regional and national trends. Am J Respir Crit Care Med. 2015;191:410-416. doi: 10.1164/rccm.201409-1746OC.
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Payne C. COVID-19 in Africa. Nature human behaviour. 2020;4(5):436-437. doi: 10.1038/s41562-020-0870-5.
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Covid-19 and Africa
Yıl 2020,
Sayı: Special Issue on COVID 19, 300 - 311, 20.03.2020
The coronavirus disease 2019 (Covid-19) pandemic, which started at Wuhan, China in December 2019, has also affected Africa. It is worried that the pandemic might affect mass populations as the rates of cases and mortality might raise in African countries due to the lack of healthcare personnel, intensive care unit beds, laboratory capacities, clean water facilities or infrastructural features. In addition, the high prevalence of malaria, HIV and tuberculosis within the continent may also contribute to the possibility of increased mortality rates. Despite the precautions taken by the Africa Centres for Disease Control and Prevention (Africa CDC), under the supervision of the African Union, it is obvious that African countries are in need of help in such a pandemic where even high-income countries encounter problems in terms of medical equipment and consumables. In order minimize the number of people to be affected by Covid-19, it is of critical importance to take preventive measures including the collaboration of the World Health Organization, the African Union and the Africa CDC, the commitment between governments and health authorities, the appropriate utilization of the media in order to raise awareness, the adaptation of the population to social distance and hand washing principles, and the procurement and/or donation of coronavirus test kits, personal protective equipment, masks, ventilators as well as other life support equipments.
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Paintsil E. COVID-19 threatens health systems in sub-Saharan Africa: the eye of the croc-odile. Journal of Clinical Investigation. 2020;138493. doi: 10.1172/JCI138493.
Africa CDC: Coronavirus Disease 2019 (COVID-19). Latest updates on the COVID-19 cri-sis from Africa CDC. 2020. Available at: https://africacdc.org/covid-19/. Accessed 4 May 2020.
Kavanagh MM, Erondu NA, Tomori O, Dzau VJ, Okiro EA, Maleche A, Aniebo I, Rugege U, Holmes CB, Gostin LO. Access to lifesaving medical resources for African countries: COVID-19 testing and response, ethics, and politics. The Lancet. 2020;S0140-6736(20)31093-X. doi: 10.1016/S0140-6736(20)31093-X.
Martinez-Alvarez M, Jarde A, Usuf E, Brotherton H, Bittaye M, Samateh AL, Antonio M, Vives-Tomas J, D’Alessandro U, Roca A. COVID-19 pandemic in west Africa. The Lancet Global Health. 2020;8(5):e631–632. doi:10.1016/S2214-109X(20)30123-6.
Quaresima V, Naldini MM, Cirillo DM. The prospects for the SARS ‐CoV‐2 pandemic in Africa. EMBO Molecular Medicine. 2020;e12488. doi:10.15252/emmm.202012488.
Haider N, Yavlinsky A, Simons D, Osman AY, Ntoumi F, Zumla A, Kock R. Passengers’ destinations from China: low risk of Novel Coronavirus (2019-nCoV) transmission into Africa and South America. Epidemiol Infect. 2020;148:e41. doi: 10.1017/S0950268820000424.
WHO. COVID-19 Situation update for WHO African Region 19 May 2020. 2020. Availab-le at: https://apps.who.int/iris/bitstream/handle/10665/332150/SITREP_COVID-19_WHOAFRO_20200520-eng.pdf . Accessed 20 May 2020.
Nearly quarter of a billion people in Africa will catch coronavirus and up to 190,000 could die. BMJ Newsroom. 2020. Available at https://www.bmj.com/company/newsroom/nearly-quarter-of-a-billion-people-in-africa-will-catch-coronavirus-and-up-to-190000-could-die/. Accessed 16 May 2020.
Lewnard JA, Lo NC. Scientific and ethical basis for social-distancing interventions against COVID-19. The Lancet Infectious diseases. 2020. doi:10.1016/S1473-3099(20)30190-0.
El-Sadr WM, Justman J. Africa in the Path of Covid-19. New England Journal of Medicine. 2020. doi: 10.1056/NEJMp2008193.
Ghana Statistical Services.Demographic and Health Survey 2014.2015. Available at: http://www2.statsghana.gov.gh/docfiles/publications/2014%20GDHS%20%20Report.pdf. Accessed 17 May 2020.
Mo Ibrahim Foundation. Covid-19 in Africa: A call for coordinated governance, improved health structures and better data. 2020. Available at: https://mo.ibrahim.foundation/sites/default/files/2020-04/2020-COVID-19-in-Africa.pdf. Accessed 25 April 2020.
Nachega JB, Seydi M, Zumla A. The Late Arrival of COVID-19 in Africa - Mitigating pan-continental spread. Clinical Infectious Diseases. 2020;ciaa353. doi:10.1093/cid/ciaa353.
United Nations.World Population Ageing 2019 Highlights. 2019. Available at: https://www.un.org/en/development/desa/population/publications/pdf/ageing/WorldPopulationAgeing2019-Highlights.pdf.
International Diabetes Federation.Diabetes Atlas 9th Edition. 2019. Avaliable at: https://www.diabetesatlas.org/en/. Accessed 7 May 2020.
Kearney PM, Whelton M, Reynolds K, Muntner P, Whelton PK, He J. Global burden of hypertension: analysis of worldwide data. The Lancet. 2005;365(9455):217–223. doi: 10.1016/S0140-6736(05)17741-1.
WHO. Atlas of African Health Statistics 2018. 2018. Available at: https://apps.who.int/iris/bitstream/handle/10665/311460/9789290234135-eng.pdf?sequence=1&isAllowed=y. Accessed 24 May 2020.
Chopera D, Müller E. Can Africa withstand COVID-19? Project Syndicate. 2020. Available at: https://www.project-syndicate.org/commentary/africa-covid19-advantages-disadvantages-by-denis-chopera-2020-03-2020-03. Accessed 9 April 2020.
Drysdale C, Stewart S. WHO urges countries to move quickly to save lives from malaria in sub-Saharan Africa. World Health Organization. 2020. Available at https://www.who.int/news-room/detail/23-04-2020-who-urges-countries-to-move-quickly-to-save-lives-from-malaria-in-sub-saharan-africa.Accessed 6 May 2020. Accessed 28 Ap-ril 2020.
Hopman J, Allegranzi B, Mehtar S. Managing COVID-19 in low- and middle-income co-untries. JAMA. 2020. doi: 10.1001/jama.2020.4169.
Mwisongo A., Nabyonga-Orem J. Global health initiatives in Africa - governance, priori-ties, harmonisation and alignment. BMC Health Serv Res. 2016;16(Suppl 4):212. doi: 10.1186/s12913-016-1448-9.
The World Bank.GDP per capita (current US$). 2018. Avaliable at: https://data.worldbank.org/indicator/NY.GDP.PCAP.CD?most_recent_value_desc=fals. Accessed 7 May 2020.
World Health Organization. e-SPAR Public. 2020. Available at: https://extranet.who.int/e-spar. Accessed 10 May 2020.
World Health Organization. Global Health Observatory Repository. 2020. Available at: https://www.who.int/data/gho. Accessed 7 May 2020.
World Health Organization. Global Health Expenditure Database. Avaliable at: https://apps.who.int/nha/database/. Accessed 7 May 2020.
World Health Organization. Key facts from JMP 2015 report. 2015. Available at: https://www.who .int/water_sanitation_health/publications/ JMP-2015-keyfacts-en-rev.pdf. Accessed 15 May 2020.
Afrika CDC, African Union Commission. Africa joint continental strategy for COVID-19 outbreak. 2020. Available at: https://au.int/sites/default/files/documents/38264-doc-africa_joint_continental_strategy_for_covid-19_outbreak.pdf. Accessed 2 May 2020.
Kapata N, Ihekweazu C, Ntoumi F, Raji T, Chanda-Kapata P, Mwaba P, Mukonka V, Bates M, Tembo J, Corman V, Mfinanga S, Asogun D, Elton L, Arruda L, Thomason M, Mboera L, Yavlinsky A, Haider N, Simons D, Hollmann L, Lule S, Veas F, Abdel Hamid M, DaR O, Edwards S, Vairo F, McHugh T, Drosten C, Kock R, Ippolito G, Zumla A. Is Africa pre-pared for tackling the COVID-19 (SARS-CoV-2) epidemic. Lessons from past outbreaks, ongoing pan-African public health efforts, and implications for the future. International Journal of Infectious Diseases. 2020;93:233–236. doi: 10.1016/j.ijid.2020.02.049.
Wallace DJ, Angus DC, Seymour CW, Barnato AE, Kahn JM. Critical care bed growth in the United States: a comparison of regional and national trends. Am J Respir Crit Care Med. 2015;191:410-416. doi: 10.1164/rccm.201409-1746OC.
Nkengasong JN. Let Africa into the market for COVID-19 diagnostics. Nature. 2020;580(7805):565. doi: 10.1038/d41586-020-01265-0.
Payne C. COVID-19 in Africa. Nature human behaviour. 2020;4(5):436-437. doi: 10.1038/s41562-020-0870-5.
Yunpeng J, Zhongren M, Maikel PP, Qiuwei P. Potential association between COVID-19 mortality and health-care resource availability. The Lancet Global Health. 2020. doi: 10.1016/S2214-109X(20)30068-1.
He X, Lau EHY, Wu P, Deng X, Wang J, Hao X, Lau YC, Wong JY, Guan Y, Tan X, Mo X, Chen Y, Liao B, Chen W, Hu F, Zhang Q, Zhong M, Wu Y, Zhao L, Zhang F, Cowling BJ, Li F, Leung GM. Temporal dynamics in viral shedding and transmissibility of COVID-19. Nature Medicine. 2020. doi: 10.1038/s41591-020-0869-5.
Nkengasong J. Africa CDC leads continental response to COVID-19 outbreak in Africa: statement by the Director of Africa CDC.Africa Centers for Disease Control and Preven-tion.2020. Available at: https://africacdc.org/news-item/africa-cdc-leads-continental-response-to-covid-19-outbreak-in-africa-statement-by-the-director-of-africa-cdc/. Acces-sed 10 April 2020.
Johns Hopkins Coronavirus Resource Center. COVID-19 Case Tracker. Available at: https://coronavirus.jhu.edu/. Accessed 25 April 2020.
Worldometer. COVID-19 virus pandemic. 2020. Available at: https://www.worldometers.info/coronavirus/#countries. Accessed 2 April 2020.
Wiah SO, Subah M, Varpilah B, Waters A, Ly J, Ballard M, Price M, Panjabi R. Prevent, detect, respond: how community health workers can help in the fight against covid-19. BMJ. 2020. Available at: https://blogs.bmj.com/bmj/2020/03/27/prevent-detect-respond-how-community-health-workers-can-help-fight-covid-19/. Accessed 13 April 2020.
WHO. Advice on the use of point-of-care immunodiagnostic tests for COVID-19. 2020. Available at: https://www.who.int/news-room/commentaries/detail/advice-on-the-use-of-point-of-care-immunodiagnostic-tests-for-covid-19. Accessed 13 April 2020.
ET Healthworld. Africa dangerously behind in global race for virus gear. 2020. Available at: https://health.economictimes.indiatimes.com/news/industry/africa-dangerously-behind-in-global-race-for-virus-gear/75352237. Accessed 26 May 2020.
Muronzi C. In Zimbabwe, lack of tests sparks fear COVID-19 goes undetected. Al Jazeera. 2020. Available at: https://www.aljazeera.com/ news/2020/04/zimbabwe-lack-tests-sparks-fear-covid-19- undetected-200409173206798. Accessed 10 April 2020.
Phua J, Faruq MO, Kulkarni AP, Redjeki IS, Detleuxay K, Mendsaikhan N, Sann KK, Shrestha BR, Hashmi M, Palo JEM, Haniffa R, Wang C, Hashemian SMR, Konkayev A, Nor MBM, Patjanasoontorn B, Nafees KMK, Ling L , Nishimura M, Al Bahrani MJ, Arabi YM, Lim CM , Fang WF, Asian Analysis of Bed Capacity in Critical Care (ABC) Study Investigators, and the Asian Critical Care Clinical Trials Group. Critical care bed capacity in Asian countries and regions. Crit Care Med. 2020;48:654-662. doi: 10.1097/CCM.0000000000004222.
Manda-Taylor L, Mndolo S, Baker T. Critical care in Malawi: The ethics of beneficence and justice. Malawi Medical Journal. 2017;29(3):268-271. doi: 10.4314/mmj.v29i3.8.
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Tunç Eren
İstanbul Medeniyet Üniversitesi Tıp Fakültesi, Göztepe Eğitim ve Araştırma Hastanesi, Genel Cerrahi Anabilim Dalı0000-0001-7651-4321Türkiye
Nuray Çolapkulu
İstanbul Medeniyet Üniversitesi Tıp Fakültesi, Göztepe Eğitim ve Araştırma Hastanesi, Genel Cerrahi Anabilim Dalı0000-0002-3033-8702Türkiye
Berna Dinçer
Bu kişi benim
İstanbul Medeniyet Üniversitesi Sağlık Bilimleri Fakültesi, İç Hastalıkları Hemşireliği Anabilim Dalı / İstanbul Medeniyet Üniversitesi Afrika Sağlık Çalışmaları Uygulama ve Araştırma Merkezi (MASAM)0000-0001-7284-7495Türkiye
Metin Leblebici
İstanbul Medeniyet Üniversitesi Tıp Fakültesi, Göztepe Eğitim ve Araştırma Hastanesi, Genel Cerrahi Anabilim Dalı / İstanbul Medeniyet Üniversitesi Afrika Sağlık Çalışmaları Uygulama ve Araştırma Merkezi (MASAM)0000-0002-1403-7643Türkiye
Fahri Ovalı
İstanbul Medeniyet Üniversitesi Tıp Fakültesi, Göztepe Eğitim ve Araştırma Hastanesi, Çocuk Sağlığı ve Hastalıkları Anabilim Dalı / İstanbul Medeniyet Üniversitesi Afrika Sağlık Çalışmaları Uygulama ve Araştırma Merkezi (MASAM)0000-0002-9717-313XTürkiye
Orhan Alimoğlu
İstanbul Medeniyet Üniversitesi Tıp Fakültesi, Göztepe Eğitim ve Araştırma Hastanesi, Genel Cerrahi Anabilim Dalı / İstanbul Medeniyet Üniversitesi Afrika Sağlık Çalışmaları Uygulama ve Araştırma Merkezi (MASAM)0000-0003-2130-2529Türkiye
Dedeler M, Özdilek Yİ, Şimşek Fİ, Abdullahoğlu SD, Eren T, Çolapkulu N, Dinçer B, Leblebici M, Ovalı F, Alimoğlu O. Covid-19 ve Afrika. Anadolu Klin. 2020;25(Special Issue on COVID 19):300-11.