Prevalence and risk factors of sars-cov-2 infection among parturients and newborns from luanda, angola

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Study Justification:
– The study aimed to investigate the prevalence and risk factors of SARS-CoV-2 infection among parturients (pregnant women) and newborns in Luanda, Angola.
– This research is important because it addresses the uncertainty regarding the transmission of SARS-CoV-2 from mothers to newborns.
– The findings of this study can contribute to the understanding of COVID-19 cases in late pregnancy and inform the management of SARS-CoV-2 infection among pregnant women in Angola.
Study Highlights:
– A cross-sectional study was conducted with 3633 parturients from Lucrécia Paim maternity in Luanda, Angola, between January and April 2021.
– The study found that 0.4% of parturients tested positive for SARS-CoV-2 on the day of delivery.
– Parturients from urbanized areas had a lower chance of infection.
– None of the newborns tested positive within the first 24 hours after birth, but one newborn tested positive with pharyngeal swabs seven days after birth.
– The mother’s residence, education level, antenatal follow-up, and delivery category were related to SARS-CoV-2 transmission.
– The study suggests a relatively low transmission rate of SARS-CoV-2 from parturients to newborns, regardless of the severity of the maternal disease.
Recommendations:
– Further studies are needed to investigate the consequences of SARS-CoV-2 among pregnant women and neonates in Angola.
– Intensive management of SARS-CoV-2 infection among parturients in Angola may be necessary based on the early assessment of COVID-19 cases in late pregnancy.
Key Role Players:
– Researchers and scientists involved in conducting further studies on the consequences of SARS-CoV-2 among pregnant women and neonates.
– Healthcare providers and policymakers responsible for implementing and managing intensive management strategies for SARS-CoV-2 infection among parturients in Angola.
– National ethics committee of the Ministry of Health of Angola for reviewing and approving research studies.
– General director of Lucrécia Paim maternity for providing approval and support for the study.
Cost Items for Planning Recommendations:
– Research funding for conducting further studies on the consequences of SARS-CoV-2 among pregnant women and neonates.
– Budget allocation for implementing intensive management strategies for SARS-CoV-2 infection among parturients, including isolation facilities and healthcare resources.
– Resources for training healthcare providers on managing SARS-CoV-2 infection among pregnant women.
– Funding for public health campaigns and education programs to raise awareness about SARS-CoV-2 prevention and management among pregnant women and the general population.

SARS-CoV-2 emerged in China in December 2019, creating a massive public health concern. Although previous studies have identified SARS-CoV-2 in pregnant women, the possibility of transmission to newborns remains uncertain. Herein, we investigated SARS-CoV-2 infection and risk factors among parturients and newborns. This was a cross-sectional study carried out with 3633 parturients from Luanda, Angola, between January and April 2021, with an age ranging from 13 to 48 years. SARS-CoV-2 infection of the parturients was further confirmed with RT-PCR after COVID-19 Ag Rapid Testing. About 0.4% of parturients tested positive on the day of delivery. Surprisingly, parturients from urbanized areas (OR: 0.18, p = 0.025) had a low chance of infection. None of the newborns tested positive in the first 24 h after birth, while one (9.1%, 1/10) of the newborns tested positive with pharyngeal swabs seven days after birth. However, whether the case was due to vertical transmission from mother to child remains to be confirmed. The mother’s residence, education level, antenatal follow-up, and delivery category were related to SARS-CoV-2 transmission (p < 0.05). Our findings showed a relatively low SARS-CoV-2 infection from parturients to newborns, regardless of the severity of the maternal disease. Furthermore, these findings are an early assessment of COVID-19 cases in late pregnancy, which could indicate the need for intensive management of SARS-CoV-2 infection among parturients in Angola. Further studies are needed on the consequences of SARS-CoV-2 among pregnant women and neonates from Angola.

A cross-sectional study was carried out with 3633 parturients from Lucrécia Paim maternity, located in Luanda, the capital city of Angola, between January and April 2021. Lucrécia Paim maternity is a public health unit and reference center for providing health care to pregnant women and newborns from all provinces of Angola. The study was reviewed and approved by the national ethics committee of the Ministry of Health of Angola (approval no. 35/2020) and by the general director of Lucrécia Paim maternity (approval no. 840/GDG/MLP/2020). In addition, informed consent was presented to participants where they, their parent or legal guardian, freely accepted to participate in the study and follow the newborn. All data used in the analyses were coded and restricted access was given only to the research team in order to anonymize the personal data of the studied participants. A structured questionnaire prepared by the research team was used to collect sociodemographic, epidemiological, and clinical data before proceeding with the test to detect SARS-CoV-2 infection. After, a nasopharyngeal smear sample was collected from all participants before labor began. The collected samples were used for the screening of the SARS-CoV-2 antigen using a COVID-19 Ag Rapid Test Device kit (Panbio, Seoul, Korea, Abbott) [14]. The entire technical procedure and interpretation of the results were carried out according to the instructions provided by the manufacturer [14]. This test allows for rapid in vitro diagnostics for the qualitative detection of the SARS-CoV-2 antigen. The research team worked with the health unit’s clinical staff to guarantee clinical assistance in case of any positive results for SARS-CoV-2. The parturients who tested negative had normal care according to the maternity’s protocol. On the other hand, parturients who tested positive for SARS-CoV-2 were isolated in a section established for the management of pregnant women infected with SARS-CoV-2 in the Lucrecia Paim maternity unit. Newborns of mothers positive for SARS-CoV-2 were also screened for SARS-CoV-2 infection in the first 24 h of life, repeating the test after seven days. In addition, a new sample was collected from all reactive participants and sent to the SARS-CoV-2 testing reference center of the Angolan Ministry of Health to perform real-time reverse transcriptase-polymerase chain reaction (RT-PCR) for SARS-CoV-2 nucleic acid of nasopharyngeal swabs in order to confirm SARS-CoV-2 infection. Statistical analysis was performed using SPSS version 25 (IBM SPSS Statistics, Armonk, NY, USA). Frequencies and percentages were part of the descriptive analysis. The normally distributed data are presented as mean and standard deviation (SD). The variables were categorized, and the chi-square (X2) and logistic regression tests were applied to verify the relationship between the categorical variables. In addition, the odds ratio (OR) and 95% confidence intervals (CIs) were calculated to determine the strength and direction of relationships. All reported p-values are two-tailed and were deemed statistically significant when p < 0.05.

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Based on the provided information, here are some potential innovations that could improve access to maternal health:

1. Mobile Health (mHealth) Solutions: Develop mobile applications or SMS-based systems to provide pregnant women with information, reminders, and access to healthcare services. This could include appointment reminders, prenatal care guidelines, and emergency contact information.

2. Telemedicine: Implement telemedicine services to allow pregnant women to consult with healthcare providers remotely. This could be particularly beneficial for women in remote or underserved areas who may have limited access to healthcare facilities.

3. Community Health Workers: Train and deploy community health workers to provide education, support, and basic healthcare services to pregnant women in their communities. These workers can help bridge the gap between healthcare facilities and pregnant women, especially in rural areas.

4. Transportation Solutions: Develop transportation systems or partnerships to ensure that pregnant women have reliable and affordable transportation to healthcare facilities for prenatal care, delivery, and postnatal care.

5. Maternal Health Clinics: Establish dedicated maternal health clinics that provide comprehensive care for pregnant women, including prenatal care, delivery services, and postnatal care. These clinics could be strategically located in areas with high maternal health needs.

6. Health Education Programs: Implement targeted health education programs that focus on maternal health, including prenatal care, nutrition, breastfeeding, and newborn care. These programs can be conducted in community settings, schools, or through digital platforms.

7. Maternal Health Vouchers: Introduce voucher programs that provide pregnant women with financial assistance to access maternal health services. These vouchers can cover the cost of prenatal care, delivery, and postnatal care, ensuring that cost is not a barrier to accessing care.

8. Public-Private Partnerships: Foster collaborations between public and private sectors to improve access to maternal health services. This could involve leveraging private healthcare providers, technology companies, and NGOs to expand the reach and quality of maternal health services.

It’s important to note that the specific context and needs of the community should be considered when implementing these innovations. Additionally, further research and evaluation are needed to assess the effectiveness and feasibility of these recommendations in improving access to maternal health in Angola.
AI Innovations Description
Based on the information provided, the following recommendation can be developed into an innovation to improve access to maternal health:

1. Implement targeted interventions for pregnant women in urbanized areas: The study found that parturients from urbanized areas had a lower chance of SARS-CoV-2 infection. This suggests that there may be specific factors in urban areas that contribute to lower infection rates. To improve access to maternal health, targeted interventions can be developed and implemented in urban areas to address these factors and reduce the risk of infection among pregnant women.

2. Strengthen antenatal care and education: The study found that the mother’s residence, education level, antenatal follow-up, and delivery category were related to SARS-CoV-2 transmission. This highlights the importance of antenatal care and education in preventing and managing infections. Innovations can be developed to strengthen antenatal care services, provide comprehensive education on infection prevention and control, and ensure regular follow-up for pregnant women.

3. Enhance testing and screening protocols: The study used a combination of rapid antigen testing and RT-PCR for SARS-CoV-2 detection. Innovations can be developed to improve the efficiency and accuracy of testing and screening protocols for pregnant women and newborns. This can include the development of new testing technologies, mobile testing units for remote areas, and streamlined processes for sample collection and analysis.

4. Establish specialized units for managing pregnant women with SARS-CoV-2: The study mentioned that parturients who tested positive for SARS-CoV-2 were isolated in a section established for the management of pregnant women infected with the virus. This approach can be further developed into specialized units within maternity facilities that provide comprehensive care for pregnant women with SARS-CoV-2, including medical treatment, psychological support, and neonatal care.

5. Conduct further research on the consequences of SARS-CoV-2 among pregnant women and neonates: The study acknowledged the need for further research on the long-term consequences of SARS-CoV-2 infection among pregnant women and neonates. Innovations can be developed to support and facilitate research efforts, such as establishing research collaborations, providing funding opportunities, and creating platforms for data sharing and analysis.

By implementing these recommendations and developing innovative solutions, access to maternal health can be improved, leading to better outcomes for pregnant women and newborns in Angola.
AI Innovations Methodology
Based on the provided information, here are some potential recommendations to improve access to maternal health:

1. Strengthening Antenatal Care: Implementing comprehensive antenatal care programs that include regular check-ups, screenings, and education on maternal health and COVID-19 prevention measures. This can help identify and manage any potential risks or infections early on.

2. Telemedicine and Remote Monitoring: Utilizing telemedicine platforms and remote monitoring devices to provide virtual consultations and monitoring for pregnant women. This can help reduce the need for in-person visits, especially for those in remote or underserved areas.

3. Mobile Clinics and Outreach Programs: Establishing mobile clinics and outreach programs to reach pregnant women in rural or hard-to-reach areas. These clinics can provide essential maternal health services, including prenatal care, vaccinations, and education.

4. Community Health Workers: Training and deploying community health workers who can provide basic maternal health services, education, and support to pregnant women in their communities. They can also help identify high-risk pregnancies and refer women to appropriate healthcare facilities.

5. Health Information Systems: Implementing robust health information systems to track and monitor maternal health indicators, including COVID-19 infections, in real-time. This can help identify trends, allocate resources effectively, and make data-driven decisions.

To simulate the impact of these recommendations on improving access to maternal health, a methodology could include the following steps:

1. Define the Objectives: Clearly define the objectives of the simulation, such as assessing the potential impact of the recommendations on increasing access to maternal health services and reducing SARS-CoV-2 transmission among pregnant women and newborns.

2. Data Collection: Gather relevant data on the current state of maternal health access, SARS-CoV-2 infections among parturients and newborns, healthcare infrastructure, and resources available in the target area.

3. Model Development: Develop a simulation model that incorporates the recommendations and their potential effects on improving access to maternal health. This model should consider factors such as population demographics, healthcare capacity, geographical distribution, and the effectiveness of the recommendations.

4. Parameter Estimation: Estimate the parameters of the simulation model based on available data and expert knowledge. This may involve conducting surveys, interviews, or literature reviews to gather information on the effectiveness of similar interventions.

5. Scenario Testing: Simulate different scenarios by varying the parameters and assumptions of the model. This can help assess the potential impact of different combinations of recommendations and identify the most effective strategies.

6. Analysis and Interpretation: Analyze the simulation results to evaluate the impact of the recommendations on improving access to maternal health. This may involve comparing key indicators, such as the number of pregnant women receiving antenatal care, the rate of SARS-CoV-2 transmission, and the availability of healthcare resources.

7. Sensitivity Analysis: Conduct sensitivity analysis to assess the robustness of the simulation results to changes in key parameters and assumptions. This can help identify the factors that have the greatest influence on the outcomes and guide decision-making.

8. Communication and Implementation: Communicate the findings of the simulation study to relevant stakeholders, such as policymakers, healthcare providers, and community leaders. Use the results to inform decision-making and guide the implementation of the recommended interventions.

It is important to note that the methodology described above is a general framework and may need to be adapted based on the specific context and available data.

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