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COVID-19 Vaccine Breakthrough Infections and Associated Factors in kwekwe City, Zimbabwe, 2021

Open Journal of Epidemiology 2022年第2期12卷 170-184页

作者： Nyashadzashe Cosmas Makova Mary Muchekeza Addmore Chadambuka Emmanuel Govha Tsitsi Patience Juru Notion Tafara Gombe Mufuta Tshimanga Department of Primary Health Care Sciences University of Zimbabwe Harare Zimbabwe kwekwe City Council Department of Health Kwekwe Zimbabwe African Field Epidemiology Network Harare Zimbabwe

Background: To break the spread of COVID-19, people must adopt preven-tive health measures such as vaccination. A vaccine breakthrough infection is the detection of SARS-CoV-2 RNA or antigen in a specimen collected from a person ≥ 14 days after receipt of all recommended vaccine doses. kwekwe City experienced an increase in breakthrough cases from one case (12 June 2021) to 39 cases (7 July 2021). The study was conducted to determine factors associated with breakthrough infections. Methods: We conducted an un-matched 1:2 case-control study. A case is defined as a patient who had two doses of a COVID-19 vaccine and had a positive SARS-CoV-2 antigen/PCR test at least two weeks after the date of receiving the second dose of the vac-cine in kwekwe City from June 12, 2021. An interviewer-administered ques-tionnaire was used to collect data. We used the Epi Info software to generate means, frequencies, and proportions, to calculate measures of associations that include odds ratios. Results: Fifty-four cases in the records met the case definition for breakthrough infections, and two had died giving a case fatality rate of 3.7%. Fifty-one of the remaining 52 cases and 102 controls were re-cruited. Being within the age of 55 - 64 years (aOR = 12.22;95% CI (1.15 - 129.81) and being unemployed (aOR = 0.26;95% CI (0.07 - 0.93) were the independent factors associated with breakthrough infection. The median dura-tion in days between getting the second dose of the vaccine and getting tested was 57.0 (Q1 = 33;Q3 = 81) and 46 (Q1 = 33;Q3 = 64) for cases and controls respectively. There were significant differences in overall knowledge, controls had good knowledge compared to cases (p = 0.01). Conclusion: Individuals who were within the 55 - 64 years age group were more likely to have break-through infections. Those who had breakthrough infections had overall poor knowledge of COVID-19. Non-pharmacological interventions such as mask-wearing

关键词： Breakthrough Infections COVID-19 kwekwe

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Trends for Tuberculosis Treatment Outcomes, New Sputum Smear Positive Patients in kwekwe District, Zimbabwe, 2007-2011: A Cohort Analysis

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Journal of Tuberculosis Research 2015年第4期3卷 126-135页

作者： Meggie Gabida Mufuta Tshimanga Milton Chemhuru Notion Gombe Donewell Bangure Department of Community Medicine University of Zimbabwe Harare Zimbabwe Provincial Medical Directorate Midlands Province Ministry of Health and Child Welfare Gweru Zimbabwe

Introduction: Tuberculosis remains a public health problem in Zimbabwe. Understanding the treatment outcomes is an important proxy indicator on the performance of the tuberculosis program. This study analyzed treatment outcomes of new sputum smear positive tuberculosis patients in kwekwe district. Materials and Methods: A retrospective records review of new sputum smear positive tuberculosis patients registered in the district tuberculosis register in kwekwe was conducted. Treatment outcomes were categorized according to the national tuberculosis control program and multivariate logistic regression model was used. P values less than 0.05 were considered statistically significant. Results: From a total of 1115 new sputum smear positive tuberculosis patients, cure rate ranged from 40.8% to 62.8% and death rate of patients decreased from 11 (8.0%) in 2007 to 17 (5.3%) in 2011 (p = 0.016). However, defaulter rate increased from 10 (7.3%) in 2007 to 30 (9.3%) in 2011. In multivariate logistic model, HIV positive tuberculosis patients were more likely to experience (adjusted RR = 1.84, 95% CI: 1.10 - 3.08) unfavorable treatment outcome when compared to negative counterparts. Urban residents were also at risk 1.91 (95% CI: 1.14 - 3.20) unfavorable outcome compared to rural residents. Conclusion: The cure rate was low (ranged from 40.8% to 62.8%) and the defaulter rate needed urgent attention. The district should conduct defaulter tracing and follow up.

关键词： Sputum Smear Positive Treatment Outcome Tuberculosis kwekwe Zimbabwe

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