Co-epidemics: implications of COVID-19 outbreak associated with human immune-deficiency virus, tuberculosis and Lassa fever in a low resource economy-a call for proactive measures
Keywords:COVID-19, Lassa fever, HIV, Tuberculosis
As the global struggle to combat the quadruple burden of COVID-19, human immunodeficiency virus, tuberculosis and Lassa fever continues to increase, Sub-Saharan Africa has been the most affected region, especially Nigeria. There is a close interaction between these four diseases and a clear understanding of each of these diseases is very crucial. People living with chronic medical conditions such as HIV, TB and Lassa fever are more likely to experience poor outcomes from COVID-19 even though there are still some unknown facts as regards the burden of COVID-19 on patients with TB, Lassa fever and HIV in our low-middle–income nation. This study was conducted to review different researches on COVID-19 associated with HIV, TB and Lassa fever co-infections, to understand the interactions between them and its implications on clinical investigations and health management in high burden countries of COVID-19, especially Nigeria. The research was designed to accommodate research and reports from different geopolitical zones of Nigeria where the diseases has been reported and centering on Ondo State reports. This was done using search engines, with reference to valid studies from academic sources like ResearchGate, PubMed and Google Scholar. We also evaluated various related titles, abstracts and full reports for eligibility. Ondo state was the centre of study as it is one of the states with high prevalence of Lassa fever, TB, HIV and COVID-19 co-infections in Nigeria. Structured diagnostic algorithms and clinical management are suggested to improve COVID-19/HIV/TB/Lassa fever or COVID-19/Lassa fever co-infection outcomes. With low quality of health care facilities for laboratory diagnosis of COVID-19 and Lassa fever, reliance on clinical acumen and high index of suspicion may be the only process that health professionals may rely upon to make early diagnosis.
SARS-Cov-2 Variant Classificatons and definitions. Centers for Disease Control and Prevention, April, 2022. Available at: https://www.cdc.gov/ coronavirus/2019-ncov/variants/variant-classifications.html. Accessed on 01 November 2022.
Katella K. Omicron, Delta, Alpha, and More: What To Know About the Coronavirus Variants. Yale Medicine news. 2022. Available at: https://www. yalemedicine.org/news/covid-19-variants-of-concern-omicron. Accessed on 01 November 2022.
World Health Organization Africa. How Nigeria is tackling COVID-19 variants. 2021. Available at: https://www.afro.who.int/news/how-nigeria-tackling-covid-19-variants. Accessed on 01 November 2022.
Amzat J, Aminu K, Kolo VI, Akinyele AA, Ogundairo JA, Danjibo MC. Coronavirus outbreak in Nigeria: Burden and socio-medical response during the first 100 days. Int J Infect Dis. 2020;98:218-24.
Relief web Lassa fever in Nigeria: Promising results from a new study will improve the quality of care. 2021. Available at: https://reliefweb.int/report/ nigeria/lassa-fever-nigeria-promising-results-new-study-will-improve-quality-care. Accessed on 01 November 2022.
Kanki P, Okonkwo P, Odutolu O. Turning the tide AIDS in Nigeria. New Academia Publishing. 2018;10-1.
Voice of Nigeria. Tuberculosis: Ondo Govt Tasks Individuals On Funding To Save Lives. 2022. Available at: https://von.gov.ng/tuberculosis-ondo-govt-tasks-individuals-on-funding-to-save-lives/. Accessed on 01 November 2022.
8. World Health Organisation (WHO) Lassa fever-Nigeria. 2022. Available at: https://www.who.int/ emergencies/disease-outbreak-news/item/lassa-fever---nigeria. Accessed on 01 November 2022.
9. Osho PO, Fasipe OJ, Osho ES, Adu BS, Akinrotimi OJ, Folayan WA, Wasiu OA. The observed seasonal variation pattern and changing epidemiology of viral hemorrhagic fever disease in Ondo state, Nigeria. Medical Journal of Dr D Y Patil Vidyapeeth. 2020;13:22-7.
National Health Service (NHS) UK. BCG vaccine for tuberculosis overview. https://www.nhs.uk/ conditions/vaccinations/bcg-tuberculosis-tb-vaccine/. Accessed on 01 November 2022.
World Health Organization (WHO), Tuberculosis. 2021. Available at https://www.who.int/news-room/fact-sheets/detail/tuberculosis. Accessed on 01 November 2022.
Nigeria Center for Disease Control (NCDC) Lassa Fever Situation Report EPI Week. 2020. Available at: https:// www.ncdc.gov.ng. Accessed on 01 November 2022.
Nigeria Centre for Disease Control. COVID-19 Case Update 21st April 2021. 2021. Available at: https://www.ncdcgov/ covid19.ncdc.gov.ng. Accessed on 01 November 2022.
Abejegah C, Sampson O, Abiodun TA, Bamidele OA. Lassa fever co-infection with COVID-19 among health care workers: Report of two cases. Ann Med Res Prac. 2021;2:8.
Tolossa T, Tsegaye R, Shiferaw S, Wakuma B, Ayala D, Bekele B, Shibiru T. Survival from a Triple Co-Infection of COVID-19, HIV, and Tuberculosis: A Case Report. Int Med Case Rep J. 2021;14:611-615.
Osayomi T, Adeleke R, Taiwo OJ, Gbadegesin AS, Fatayo OC, Akpoterai LE, et al. Cross-national variations in COVID-19 outbreak in West Africa: Where does Nigeria stand in the pandemic? Spat Inf Res. 2020;1-9.
Nnabueze DN, Helen O, Rine CR, Olivier U, Chinasa VO, Anyogu A. The deuce‑ace of Lassa Fever, Ebola virus disease and COVID‑19 simultaneous infections and epidemics in West Africa. Clin Public Health Implications Trop Med Health. 2021;49:102.
Ugwu KO, Agbo MC, Ezeonu IM. Prevalence of tuberculosis, drug-resistant tuberculosis and HIV/TB co-infection in Enugu, Nigeria. Afr J Infect Dis. 2021;15(2):24-30.
Statista. People living with HIV in Nigeria 2020. Published by Statista Research Department Feb 2022. Available at: https://www.statista.com/statistics/ 1128675/people-living-with-hiv-receiving-treatment-in-nigeria/. Accessed on 01 November 2022.
Lassa fever in Nigeria: Promising results from a new study will improve the quality of care. Available at: https://reliefweb.int/report/nigeria/lassa-fever-nigeria-promising-results-new-study-will-improve-quality-care. Accessed on 01 November 2022.
Alau KK, Ogungbemi MK, Ashefor G, Adeyemi A, Anosike AO, Weaver MR, et al. Prevalence of tuberculosis and HIV/AIDS co-infection among HIV clients at global fund supported comprehensive facilities in Nigeria. 2016.
Akande P, Chang C, Ige O. Fighting the HIV and Tuberculosis syndemic, Turning the tide, AIDS in Nigeria. New Academia publishing. 2018.
Yun NE, Walker DH. Pathogenesis of Lassa Fever. Viruses. 2012;4(12):2031-48.
Kanki P, Okonkwo P, Odutulu O. Turning the tide; AIDS in Nigeria. New Academia publishing. 2018.
Mascolo S, Romanelli A, Carleo MA, Esposito V. Could HIV infection alter the clinical course of SARS-CoV-2 infection? When less is better. J Med Virol. 2020;92(10):1777-8.
Lagathu C, Cossarizza A, Bereziat V, Nasi M, Capeau J, Pinti M. Basic science and pathogenesis of ageing with HIV: potential mechanisms and biomarkers. AIDS. National Library of Medicine (NIH) 2017;31:S105-19.
Pai M, Kasaeva T, Swaminathan S. Covid-19's Devastating Effect on Tuberculosis Care - A Path to Recovery. N Engl J Med. 2022;386(16):1490-3.
Yun NE, Walker DH. "Pathogenesis of Lassa Fever". Viruses. 2012;4(12):2031-48.
World Health Organization (WHO), HIV/AIDS. 2022. Available at: https://www.who.int/health-topics/hiv-aids#tab=tab_1. Accessed on 01 November 2022.
Copenhagen consensus center. Nigeria Perspective: Tuberculosis. Available at: https://www.copenhagen consensus.com/publication/nigeria-perspective-tuberculosis. Accessed on 01 November 2022.
Punch newspapers: 2,537 tuberculosis cases recorded in Ondo. 2022. Available at: https://punchng. com/2537-tuberculosis-cases-recorded-in-ondo/ - :~:text=No%20fewer%20than%202%2C537%20people,Ondo%20State%20capital%2C%20on%20Thursday. Accessed on 01 November 2022.
Dushime A, Osele A. Nigeria: An Overview Of The Economic Impact Of The Coronavirus Pandemic In Nigeria September. Mondaq. 2021. Available at: https://www.mondaq.com/nigeria/tax-authorities/ 1107286/an-overview-of-the-economic-impact-of-the-coronavirus-pandemic-in-nigeria#:~:text=The% 20shock%20impact%20of%20the,quarter's%20contribution%20of%207.32%20percent. Accessed on 01 November 2022.
Centre for Disease Control and prevention. COVID-19 in Nigeria. June 2022. Available at http://wwwnc.cdc.gov/travel/notices/covid-1/coronavirus-nigeriaoil. Accessed on 01 November 2022.
Jonathan L. Tara V. The COVID-19 crisis in Nigeria: What’s happening to welfare? New data call for expanded social protection in Africa’s most populous country. Published on Africa can End Poverty. 2021. Available at: https://blogs.worldbank.org/africacan/ covid-19-crisis-nigeria-whats-happening-welfare-new-data-call-expanded-social-protection. Accessed on 01 November 2022.
Relief Web "Between Hunger and the Virus": The Economic Impact of the Covid-19 Pandemic on People Living in Poverty in Lagos, Nigeria. 2021. Available at: https://reliefweb.int/report/nigeria/ between-hunger-and-virus-economic-impact-covid-19-pandemic-people-living-poverty. Accessed on 01 November 2022.