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      Impact of the COVID-19 pandemic on gastrointestinal endoscopy in Africa

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          Abstract

          Background and study aims  As with all other fields of medical practice, gastrointestinal endoscopy has been impacted by the COVID-19 pandemic. However, data on the impact of the pandemic in Africa, especially sub-Saharan Africa are lacking.

          Methods  A web-based survey was conducted by the International Working Group of the European Society for Gastrointestinal Endoscopy and the World Endoscopy Organization to determine the impact and effects the COVID-19 pandemic has had on endoscopists in African countries.

          Results  Thirty-one gastroenterologists from 14 countries in north, central, and sub-Saharan Africa responded to the survey. The majority of respondents reduced their endoscopy volume considerably. Personal protective equipment including FFP-2 masks were available in almost all participating centers. Pre-endoscopy screening was performed as well.

          Conclusion  The COVID-19 pandemic has had a substantial impact on gastrointestinal endoscopy in most African countries; however, the impact may not have been as devastating as expected.

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          Most cited references15

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          Early Transmission Dynamics in Wuhan, China, of Novel Coronavirus–Infected Pneumonia

          Abstract Background The initial cases of novel coronavirus (2019-nCoV)–infected pneumonia (NCIP) occurred in Wuhan, Hubei Province, China, in December 2019 and January 2020. We analyzed data on the first 425 confirmed cases in Wuhan to determine the epidemiologic characteristics of NCIP. Methods We collected information on demographic characteristics, exposure history, and illness timelines of laboratory-confirmed cases of NCIP that had been reported by January 22, 2020. We described characteristics of the cases and estimated the key epidemiologic time-delay distributions. In the early period of exponential growth, we estimated the epidemic doubling time and the basic reproductive number. Results Among the first 425 patients with confirmed NCIP, the median age was 59 years and 56% were male. The majority of cases (55%) with onset before January 1, 2020, were linked to the Huanan Seafood Wholesale Market, as compared with 8.6% of the subsequent cases. The mean incubation period was 5.2 days (95% confidence interval [CI], 4.1 to 7.0), with the 95th percentile of the distribution at 12.5 days. In its early stages, the epidemic doubled in size every 7.4 days. With a mean serial interval of 7.5 days (95% CI, 5.3 to 19), the basic reproductive number was estimated to be 2.2 (95% CI, 1.4 to 3.9). Conclusions On the basis of this information, there is evidence that human-to-human transmission has occurred among close contacts since the middle of December 2019. Considerable efforts to reduce transmission will be required to control outbreaks if similar dynamics apply elsewhere. Measures to prevent or reduce transmission should be implemented in populations at risk. (Funded by the Ministry of Science and Technology of China and others.)
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            Coronavirus (COVID-19) outbreak: what the department of endoscopy should know

            Italy recorded its first case of confirmed acute respiratory illness because of coronavirus on February 18, 2020, soon after the initial reports in China. Since that time, Italy and nations throughout the world have adopted very stringent and severe measures to protect populations from spread of infection. Despite these measures, the number of infected people is growing exponentially, with a significant number of patients developing acute respiratory insufficiency. Endoscopy departments face significant risk for diffusion of respiratory diseases that can be spread via an airborne route, including aspiration of oral and fecal material via endoscopes. The purpose of this article is to discuss the measures, with specific focus on personal protection equipment and dress code modalities, implemented in our hospital to prevent further dissemination of COVID-19 infection.
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              ESGE and ESGENA Position Statement on gastrointestinal endoscopy and the COVID-19 pandemic

              We are currently living in the throes of the COVID-19 pandemic that imposes a significant stress on health care providers and facilities. Europe is severely affected with an exponential increase in incident infections and deaths. The clinical manifestations of COVID-19 can be subtle, encompassing a broad spectrum from asymptomatic mild disease to severe respiratory illness. Health care professionals in endoscopy units are at increased risk of infection from COVID-19. Infection prevention and control has been shown to be dramatically effective in assuring the safety of both health care professionals and patients. The European Society of Gastrointestinal Endoscopy ( www.esge.com ) and the European Society of Gastroenterology and Endoscopy Nurses and Associates ( www.esgena.org ) are joining forces to provide guidance during this pandemic to help assure the highest level of endoscopy care and protection against COVID-19 for both patients and endoscopy unit personnel. This guidance is based upon the best available evidence regarding assessment of risk during the current status of the pandemic and a consensus on which procedures to perform and the priorities on resumption. We appreciate the gaps in knowledge and evidence, especially on the proper strategy(ies) for the resumption of normal endoscopy practice during the upcoming phases and end of the pandemic and therefore a list of potential research questions is presented. New evidence may result in an updated statement.
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                Author and article information

                Journal
                Endosc Int Open
                Endosc Int Open
                10.1055/s-00025476
                Endoscopy International Open
                © Georg Thieme Verlag KG (Stuttgart · New York )
                2364-3722
                2196-9736
                August 2020
                07 August 2020
                : 8
                : 8
                : E1097-E1101
                Affiliations
                [ 1 ]Department of Gastroenterology, Universitätsklinikum Augsburg, Augsburg, Germany
                [ 2 ]Gastrounit, Hvidovre Hospital Dept of Clinical Medicine, University of Copenhagen
                [ 3 ]Australian National University School of Medicine, Australian National University, Canberra, Australia
                [ 4 ]Gastroenterology Unit, Department of Medicine, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, Nigeria
                [ 5 ]Department of Internal Medicine, St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
                [ 6 ]Department of Internal Medicine, Lagos University Teaching Hospital, Idi-Araba, Lagos, Nigeria
                [ 7 ]Department of Internal Medicine, Black lion Specialized Tertiary Hospital, Addis Ababa, Ethiopia
                [ 8 ]European Society of Gastrointestinal Endoscopy (ESGE) Secretariat, Hamilton Services GmbH, Munich, Germany
                [ 9 ]Endoscopy Unit, Azienda Ospedaliera Sant'Andrea, "Sapienza" University of Rome, Rome, Italy.
                [10 ]Dept of transplantation medicine, Oslo University Hospital – Rikshospitalet, Oslo, Norway and Faculty of Medicine, University of Oslo, Norway
                [11 ]Endoscopy Unit, Nuovo Regina Margherita Hospital, Rome, Italy
                Author notes
                Corresponding author Cesare Hassan, MD Endoscopy Unit Nuovo Regina Margherita Hospital Via Morosini 30Rome 00153Italy+39-06-58446533 cesareh@ 123456hotmail.com
                Article
                10.1055/a-1210-4274
                7413826
                32782923
                934a11e1-0e23-417b-83f6-58472f04d3e0

                This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License, which permits unrestricted reproduction and distribution, for non-commercial purposes only; and use and reproduction, but not distribution, of adapted material for non-commercial purposes only, provided the original work is properly cited.

                History
                : 05 June 2020
                : 24 June 2020
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