COVID-19 is a global health emergency facing many countries around the world. Sex workers in Africa are among one of the vulnerable populations disproportionately affected by the COVID-19 pandemic on the continent. Sex workers are excluded from African government safety net, and this may force some sex workers back to sex work amid the COVID-19 pandemic. Because of the nature of sex work, physical distancing and other precautionary measures are impossible to observe, further compromising COVID-19 response. Sex workers in Africa have been known to face high levels of stigma and discrimination, including limited access to healthcare services. Disruption in HIV care and prevention services due to the pandemic among this key population may have negative impacts on the hard-won achievements in HIV response in Africa. In addition, stigma and discrimination toward sex workers could also make contact tracing challenging and limit access to COVID-19 testing among this vulnerable group. With the adoption of the 2030 Agenda for the UN Development Program, UN member states all pledged to ensure “no one will be left behind” and to “endeavor to reach the furthest behind first.” This could not be more important than now as sex workers as a part of the population are left behind in COVID-19 response in Africa. It is important that the African government should ensure collective and inclusive response in the fight against COVID-19. Sex workers should not be forgotten in Africa’s COVID-19 response because no one is safe, until all are safe.

Infodemics, often including rumors, stigma, and conspiracy theories, have been common during the COVID-19 pandemic. Monitoring social media data has been identified as the best method for tracking rumors in real time and as a possible way to dispel misinformation and reduce stigma. However, the detection, assessment, and response to rumors, stigma, and conspiracy theories in real time are a challenge. Therefore, we followed and examined COVID-19–related rumors, stigma, and conspiracy theories circulating on online platforms, including fact-checking agency websites, Facebook, Twitter, and online newspapers, and their impacts on public health. Information was extracted between December 31, 2019 and April 5, 2020, and descriptively analyzed. We performed a content analysis of the news articles to compare and contrast data collected from other sources. We identified 2,311 reports of rumors, stigma, and conspiracy theories in 25 languages from 87 countries. Claims were related to illness, transmission and mortality (24%), control measures (21%), treatment and cure (19%), cause of disease including the origin (15%), violence (1%), and miscellaneous (20%). Of the 2,276 reports for which text ratings were available, 1,856 claims were false (82%). Misinformation fueled by rumors, stigma, and conspiracy theories can have potentially serious implications on the individual and community if prioritized over evidence-based guidelines. Health agencies must track misinformation associated with the COVID-19 in real time, and engage local communities and government stakeholders to debunk misinformation.

The COVID-19 pandemic is among the deadliest infectious diseases to have emerged in recent history. As with all past pandemics, the specific mechanism of its emergence in humans remains unknown. Nevertheless, a large body of virologic, epidemiologic, veterinary, and ecologic data establishes that the new virus, SARS-CoV-2, evolved directly or indirectly from a β-coronavirus in the sarbecovirus (SARS-like virus) group that naturally infect bats and pangolins in Asia and Southeast Asia. Scientists have warned for decades that such sarbecoviruses are poised to emerge again and again, identified risk factors, and argued for enhanced pandemic prevention and control efforts. Unfortunately, few such preventive actions were taken resulting in the latest coronavirus emergence detected in late 2019 which quickly spread pandemically. The risk of similar coronavirus outbreaks in the future remains high. In addition to controlling the COVID-19 pandemic, we must undertake vigorous scientific, public health, and societal actions, including significantly increased funding for basic and applied research addressing disease emergence, to prevent this tragic history from repeating itself.


We studied sources of variation between countries in per-capita mortality from COVID-19 (caused by the SARS-CoV-2 virus). Potential predictors of per-capita coronavirus-related mortality in 200 countries by May 9, 2020 were examined, including age, gender, obesity prevalence, temperature, urbanization, smoking, duration of the outbreak, lockdowns, viral testing, contact-tracing policies, and public mask-wearing norms and policies. Multivariable linear regression analysis was performed. In univariate analysis, the prevalence of smoking, per-capita gross domestic product, urbanization, and colder average country temperature were positively associated with coronavirus-related mortality. In a multivariable analysis of 196 countries, the duration of the outbreak in the country, and the proportion of the population aged 60 years or older were positively associated with per-capita mortality, whereas duration of mask-wearing by the public was negatively associated with mortality (all P < 0.001). Obesity and less stringent international travel restrictions were independently associated with mortality in a model which controlled for testing policy. Viral testing policies and levels were not associated with mortality. Internal lockdown was associated with a nonsignificant 2.4% reduction in mortality each week (P = 0.83). The association of contact-tracing policy with mortality was not statistically significant (P = 0.06). In countries with cultural norms or government policies supporting public mask-wearing, per-capita coronavirus mortality increased on average by just 16.2% each week, as compared with 61.9% each week in remaining countries. Societal norms and government policies supporting the wearing of masks by the public, as well as international travel controls, are independently associated with lower per-capita mortality from COVID-19.

Immediately after declaring COVID-19 as a pandemic, numerous wild conspiracy theories sprouted through social media. Pakistan is quite vulnerable to such conspiracy narratives and has experienced failures of polio vaccination programs because of such claims. Recently, two well-known political figures raised conspiracy theories against COVID-19 vaccines in Pakistan, stating that COVID-19 is a grand illusion and a conspiracy against Muslim countries. This theory is much discussed in the local community, supporting COVID-19 vaccine hesitancy. We urge healthcare authorities in Pakistan to take necessary measures against such claims before they penetrate to the general community. Anti-vaccine movements could undermine efforts to end the COVID-19 pandemic. We believe that ethical and responsible behavior of mass media, a careful advisory from the Pakistan Electronic Media Regulatory Authority, stern measures from healthcare authorities, effective maneuvers to increase public awareness on COVID-19, vigorous analysis of information by data or communications scientists, and publication of counter opinions from health professionals against such theories will go a long way in neutralizing such misleading claims. Because Pakistan is experiencing a large burden of disease, with a sharp rise in confirmed cases, immediate action is of paramount importance to eradicate any potential barriers to a future COVID-19 vaccination program.


There is no proven prognostic marker for patients hospitalized with COVID-19. We conducted a retrospective cohort study of patients hospitalized with COVID-19 from March 14, 2020 to June 17, 2020, at São Paulo Hospital, in São Paulo, Brazil. SARS-CoV-2 viral load was assessed using the cycle threshold (Ct) values obtained from a reverse transcription–PCR assay applied to the nasopharyngeal swab samples. The reactions were performed following the CDC U.S. protocol targeting the N1 and N2 sequences of the SARS-CoV-2 nucleoprotein gene and human ribonuclease P gene serving as an endogenous control. Disease severity and patient outcomes were compared. Among 875 patients, 50.1% (439/875) were categorized as having mild disease (nonhospitalized patients), 30.4% (266/875) moderate (hospitalized in the ward), and 19.5% (170/875) severe disease (admitted to the intensive care unit). A Ct value of < 25 (472/875) indicated a high viral load, which was independently associated with mortality (odds ratio [OR]: 2.93; 95% CI: 1.87–4.60; P < 0.0001). We concluded that admission SARS-CoV-2 viral load was independently associated with mortality among patients hospitalized with COVID-19.

The COVID-19 pandemic is showing an exponential growth, mandating an urgent need to develop an effective treatment. Indeed, to date, a well-established therapy is still lacking. We aimed to evaluate the safety and efficacy of hydroxychloroquine (HCQ) added to standard care in patients with COVID-19. This was a multicenter, randomized controlled trial conducted at three major university hospitals in Egypt. One hundred ninety-four patients with confirmed diagnosis of COVID-19 were included in the study after signing informed consent. They were equally randomized into two arms: 97 patients administrated HCQ plus standard care (HCQ group) and 97 patients administered only standard care as a control arm (control group). The primary endpoints were recovery within 28 days, need for mechanical ventilation, or death. The two groups were matched for age and gender. There was no significant difference between them regarding any of the baseline characteristics or laboratory parameters. Four patients (4.1%) in the HCQ group and 5 (5.2%) patients in the control group needed mechanical ventilation (P = 0.75). The overall mortality did not differ between the two groups, as six patients (6.2%) died in the HCQ group and 5 (5.2%) died in the control group (P = 0.77). Univariate logistic regression analysis showed that HCQ treatment was not significantly associated with decreased mortality in COVID-19 patients. So, adding HCQ to standard care did not add significant benefit, did not decrease the need for ventilation, and did not reduce mortality rates in COVID-19 patients.


The COVID-19 pandemic has struck many countries globally. Jordan has implemented strict nationwide control measures to halt the viral spread, one of which was the closure of universities and shifting to remote teaching. The impact of this pandemic could extend beyond the risk of physical harm to substantial psychological consequences. Our study aimed at assessing 1) psychological status, 2) challenges of distance teaching, and 3) coping activities and pandemic-related concerns among university teachers in Jordan in the midst of COVID-19–related quarantine and control measures. We conducted a cross-sectional study using an anonymous online survey. The measure of psychological distress was obtained using a validated Arabic version of the Kessler Distress Scale (K10). Other information collected included sociodemographic profile, methods used to handle distress, motivation to participate in distance teaching, and challenges of distance teaching as well as the most worrisome issues during this pandemic. Three hundred eighty-two university teachers returned completed surveys. Results of K10 showed that 31.4% of respondents had severe distress and 38.2% had mild to moderate distress. Whereas gender was not associated with distress severity, age had a weak negative correlation (Rho = −0.19, P < 0.0001). Interestingly, most teachers had moderate to high motivation for distance teaching. Engagement with family was the most reported self-coping activity. More than half of the participants were most concerned and fearful about SARS-CoV-2 infection. In conclusion, university teachers have shown to exhibit various levels of psychological distress and challenges during the implementation of precautionary national measures in the battle against COVID-19 in Jordan.

The American Journal of Tropical Medicine and Hygiene

The American Journal of Tropical Medicine and Hygiene is a peer-reviewed journal published monthly by the American Society of Tropical Medicine and Hygiene and consists of two complete, sequentially numbered volumes each calendar year.

Journal Affiliation: The American Journal of Tropical Medicine and Hygiene is the official scientific journal of the American Society of Tropical Medicine and Hygiene (ASTMH). The Society is a nonprofit, professional organization whose mission is to promote world health by the prevention and control of tropical disease through research and education.

Frequency: Monthly

Coverage: 1921 - 

Open access

The Friend

Open access

Central Nervous System Tuberculoma

Open access

Tuberculoma of Eloquent Brain

Journal Facts

  • Impact factor: 2019 Impact Factor is 2.126 : 5-year Impact Factor is 2.439.
  • Manuscripts and number of pages published: Over 500 articles and 3,000 pages are published every year. 
  • Submissions: Over 1,000 submissions each year, mostly unsolicited, with 2/3 from outside the US.
  • Turnaround time: Average time between submission and first decision is 40 days.
  • Frequency: Monthly, with articles online ahead of print on a weekly basis.
  • Circulation: Spans six continents with an average of 65,000+ monthly website visits.


The American Journal of Tropical Medicine and Hygiene, established in 1921, is published monthly by the American Society of Tropical Medicine and Hygiene. It is among the top-ranked tropical medicine journals in the world publishing original scientific articles and the latest science covering new research with an emphasis on population, clinical and laboratory science and the application of technology in the fields of tropical medicine, parasitology, immunology, infectious diseases, epidemiology, basic and molecular biology, virology and international medicine. The Journal publishes unsolicited peer-reviewed manuscripts, review articles, short reports, images in Clinical Tropical Medicine, case studies, reports on the efficacy of new drugs and methods of treatment, prevention and control methodologies,new testing methods and equipment, book reports and Letters to the Editor. Topics range from applied epidemiology in such relevant areas as AIDS to the molecular biology of vaccine development. The Journal is of interest to epidemiologists, parasitologists, virologists, clinicians, entomologists and public health officials who are concerned with health issues of the tropics, developing nations and emerging infectious diseases. Major granting institutions including philanthropic and governmental institutions active in the public health field, and medical and scientific libraries throughout the world purchase the Journal. Two or more supplements to the Journal on topics of special interest are published annually. These supplements represent comprehensive and multidisciplinary discussions of issues of concern to tropical disease specialists and health issues of developing countries.


The American Journal of Tropical Medicine was published by the American Society of Tropical Medicine (ASTM) beginning in 1921. Thirty years later, the ASTM merged with the National Malaria Society (NMS) and the two organizations together became what is now known as the American Society of Tropical Medicine and Hygiene (ASTMH). In 1952 they published Volume 1