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Soleimani N, Ghoshouni H, Mostafavi H, Modiri MH, Attar MHM, Mousavi SM. Addressing conflicts of interest regarding the vaccine in infectious disease outbreaks based on good governance for health approach: a policy brief. BMC Health Serv Res 2023; 23:1028. [PMID: 37749540 PMCID: PMC10521481 DOI: 10.1186/s12913-023-10020-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Accepted: 09/11/2023] [Indexed: 09/27/2023] Open
Abstract
BACKGROUND Infectious disease outbreaks pose a significant threat to public health, and achieving herd immunity highlights the importance of addressing conflicts of interest (COI) in vaccine development and policy-making. This policy brief aims to present policy options that address COI regarding vaccines in infectious disease outbreaks, based on good governance for health approach. METHODS Our study used a scoping review methodology. We conducted a systematic search, which led to identifying 43 eligible articles. A qualitative approach (i.e., content analysis) was employed for data analysis, using "ATLAS.ti 9" software. The primary results underwent a process of cleaning, categorisation, and subsequent discussion in three sessions with the research team. RESULTS Relationships between theindustry and "government/policymakers" as well as "academic institutions/researchers" are prominent origins of COI regarding the vaccine in infectious disease outbreaks. To address this issue, we present nine policy options that target both the root cause of the problem and the adoption of good governance for health approach. CONCLUSIONS The key principles of good governance for health, including, "Transparency", "The Rule of Law", "Effectiveness", "Efficiency", "Participation", "Consensus Orientation", "Equality", "Responsibility", "Responsiveness" and "Accountability" must be taken into account when formulating policy options to address COI regarding the vaccine in infectious disease outbreaks. The effectiveness of the policy options outlined in this policy brief should be assessed in practical contexts, as this evaluation may uncover the need for revisions.
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Affiliation(s)
- Nazanin Soleimani
- Health Management and Economics, School of Public Health, Health Policy and Management Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Hamed Ghoshouni
- Health policy Research center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hakimeh Mostafavi
- Health Equity Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | | | - Seyed Masood Mousavi
- Health Management and Economics, School of Public Health, Health Policy and Management Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
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Li S, Guo B, Yang Q, Yin J, Tian L, Ji Y, Jiang Y, Zhu H. Predictive factors for enhanced community mental health vulnerability in this COVID-19 pandemic era. QJM 2023; 116:41-46. [PMID: 35951743 PMCID: PMC9384724 DOI: 10.1093/qjmed/hcac191] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 07/25/2022] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE Explore the mental health status and its influencing factors of local community residents under the post-epidemic era of coronavirus disease 2019 (COVID-19) in China. METHODS The basic information scale, self-rating depression scale and self-rating anxiety scale were used to carry out an online questionnaire survey among community residents in Jiangsu Province, China, and the influencing factors of depression and anxiety were analyzed by multivariate logistic regression. RESULTS A total of 993 residents completed the mental health survey. It was found that the incidence of depressive and anxiety symptoms was 37.06% and 22.86%. Multivariate logistic regression analysis showed that women [odds ratio (OR) 95% confidence interval (95% CI) = 26.239 (14.743-46.698)], college degree and above [OR (95% CI) = 1.843 (1.085-3.130)] and ordinary residents [OR (95% CI) = 2.222 (1.441-3.425)] were risk factors for depressive symptoms, urban residents had lower risk [OR (95% CI) = 0.655 (0.394-0.829)]. Women [OR (95% CI) = 33.595 (15.812-71.381)] and ordinary residents [OR (95% CI) = 3.017 (1.602-5.680)] were risk factors for anxiety symptoms while the incidence was reduced in professional and technical personnel [OR (95% CI) = 0.271 (0.123-0.597)], workers [OR (95% CI) = 0.383 (0.168-0.876)], soldiers or policemen [OR (95% CI) = 0.200 (0.042-0.961)], married residents [OR (95% CI) = 0.463 (0.230-0.931)] and urban residents [OR (95% CI) = 0.531 (0.251-0.824)]. CONCLUSION The incidence of symptoms of depression and anxiety among residents was relatively high under the post-epidemic era of COVID-19, which could be affected by various factors.
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Affiliation(s)
| | | | - Queping Yang
- The affiliated Wuxi Mental Health Center of Jiangnan University, Wuxi Tongren International Rehabilitation Hospital, Wuxi, Jiangsu, 214151, China
| | - Jieyun Yin
- School of Public Health, Medical College of Soochow University, Suzhou, Jiangsu, 215123, China
| | - Lin Tian
- The affiliated Wuxi Mental Health Center of Jiangnan University, Wuxi Tongren International Rehabilitation Hospital, Wuxi, Jiangsu, 214151, China
| | - Yingying Ji
- The affiliated Wuxi Mental Health Center of Jiangnan University, Wuxi Tongren International Rehabilitation Hospital, Wuxi, Jiangsu, 214151, China
| | - Ying Jiang
- The affiliated Wuxi Mental Health Center of Jiangnan University, Wuxi Tongren International Rehabilitation Hospital, Wuxi, Jiangsu, 214151, China
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Yuan Y, Xu J, Ma B, Chen G, Wang Z, Wang S, Jing N, Zhang J, Wang B, Yan W, Zhang Q, Zhao Q, Li Y. Characteristics of humoral and cellular responses to coronavirus disease 2019 (COVID-19) inactivated vaccine in central China: A prospective, multicenter, longitudinal study. Front Immunol 2023; 14:1107866. [PMID: 36936962 PMCID: PMC10020218 DOI: 10.3389/fimmu.2023.1107866] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 02/20/2023] [Indexed: 03/06/2023] Open
Abstract
Introduction In China, the long-term immunogenicity and adverse effects of inactivated vaccines produced by different or the same manufacturer remain unclear. Therefore, the objective of this study was to evaluate the cellular immune responses and neutralizing antibody kinetics of homologous and heterologous administrations of an inactivated coronavirus disease 2019 (COVID-19) vaccine 240 days after the second vaccination. Methods This prospective, multicenter, observational, longitudinal study involved 595 participants with a negative SARS-CoV-2 polymerase chain reaction result who were serologically tested and followed for 8 months after vaccination. Neutralizing antibodies, interferon-gamma (IFN-γ), interleukin (IL)-6, CD4+ T-lymphocyte, and B-lymphocyte counts were evaluated in serum samples after stimulation with 2 μg/mL SARS-CoV-2 spike protein for 16 h at follow-up intervals of 2 months. Results Most participants [582/595; 146 male participants, 449 female participants; mean age 35 (26-50 years)] rapidly developed neutralizing antibodies after two doses of the vaccine administered 3-weeks apart. The positive rate of neutralizing antibodies peaked at 97.7% at 60-90 days, decreased, and stabilized at 82.9% at 181-240 days post-vaccination. Lower antibody concentrations were correlated with older age, longer duration after vaccination, non-health care workers, mixed-manufacturer vaccinations, and intervals of less than 40 days between two doses of vaccination, whereas lower IFN-γ levels and B-lymphocyte counts were associated with older age, blood type A, and non-health care workers. A higher IL-6 level was associated with older age, mixed-manufacturer vaccinations, intervals of less than 40 days between two doses of vaccination, and medical staff. Adverse reactions were mild or moderate and self-limited, with no serious events reported. Discussion Two doses of the Chinese inactivated vaccine induced robust and rapid antibody expression and cellular immune responses. Boosting vaccination is considered important, as antibodies and cellular immune responses were reduced in susceptible populations.
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Affiliation(s)
- Youhua Yuan
- Department of Clinical Microbiology, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, and People’s Hospital of Henan University, Zhengzhou, Henan, China
| | - Junhong Xu
- Department of Clinical Microbiology, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, and People’s Hospital of Henan University, Zhengzhou, Henan, China
| | - Bing Ma
- Department of Clinical Microbiology, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, and People’s Hospital of Henan University, Zhengzhou, Henan, China
| | - Guohua Chen
- Department of Laboratory, Zhengzhou Municipal Chinese Medicine Hospital, Zhengzhou, Henan, China
| | - Zhibin Wang
- Department of Geotechnical Engineering, Henan Electric Power Survey and Design Institute, Zhengzhou, Henan, China
| | - Shanmei Wang
- Department of Clinical Microbiology, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, and People’s Hospital of Henan University, Zhengzhou, Henan, China
| | - Nan Jing
- Department of Clinical Microbiology, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, and People’s Hospital of Henan University, Zhengzhou, Henan, China
| | - Jiangfeng Zhang
- Department of Clinical Microbiology, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, and People’s Hospital of Henan University, Zhengzhou, Henan, China
| | - Baoya Wang
- Department of Clinical Microbiology, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, and People’s Hospital of Henan University, Zhengzhou, Henan, China
| | - Wenjuan Yan
- Department of Clinical Microbiology, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, and People’s Hospital of Henan University, Zhengzhou, Henan, China
| | - Qi Zhang
- Department of Clinical Microbiology, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, and People’s Hospital of Henan University, Zhengzhou, Henan, China
| | - Qiongrui Zhao
- Center of Clinical Research Service, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, and People’s Hospital of Henan University, Zhengzhou, Henan, China
| | - Yi Li
- Department of Clinical Microbiology, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, and People’s Hospital of Henan University, Zhengzhou, Henan, China
- *Correspondence: Yi Li,
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Ait Hamdan Y, El Amerany F, Desbrières J, Aghrinane A, Oudadesse H, Rhazi M. The evolution of the global COVID-19 epidemic in Morocco and understanding the different therapeutic approaches of chitosan in the control of the pandemic. Polym Bull (Berl) 2022; 80:1-27. [PMID: 36466080 PMCID: PMC9685138 DOI: 10.1007/s00289-022-04579-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Revised: 11/03/2022] [Accepted: 11/14/2022] [Indexed: 11/24/2022]
Abstract
In 2020, Coronavirus disease (COVID-19), a new viral respiratory disease caused by a virus that belongs to Coronaviridae family, has been identified. It is a very severe flu that negatively affects the functions of the lung and other respiratory organs. COVID-19 virus can be transmitted between people either by touching an infected person or by direct contact with their respiratory droplets. Therefore, the COVID-19 virus has become a global concern due to its rapid spread and severity. Based on the World Health Organization report from 2 March 2020 to 24 October 2022, the total infected cases and deaths in Morocco are around 1,265,389 (3.46%) and 16,280 (0.04%), respectively. Recently, some scientists have found that chitosan, a polymer existed in nature, can inhibit COVID-19 infection and repair damaged tissue. Therefore, understanding chitosan mechanisms in controlling COVID-19, might lead to innovative strategies in the medical field, such as developing drugs against SARS-CoV-2, and replacing vaccines, which have negative side effects. This review aims to show the evolution of the COVID-19 pandemic worldwide, specifically in Morocco, its pathophysiology, and its ability to silence the immune system. This review also provides an overview of the treatments and measures applied to protect human beings and how chitosan acts and controls COVID-19.
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Affiliation(s)
- Youssef Ait Hamdan
- Interdisciplinary Laboratory in Bio-Resources, Environment and Materials, Higher Normal School, Department of Biology, Cadi Ayyad University, 40000 Marrakech, Morocco
- Univ Rennes, CNRS, ISCR-UMR 6226, F-35000 Rennes, France
| | - Fatima El Amerany
- Interdisciplinary Laboratory in Bio-Resources, Environment and Materials, Higher Normal School, Department of Biology, Cadi Ayyad University, 40000 Marrakech, Morocco
- Laboratory of Sustainable Development and Health Research, Department of Chemistry, Faculty of Science and Technology of Marrakech, Cadi Ayyad University, PO Box 549, 40000 Marrakech, Morocco
| | - Jacques Desbrières
- IPREM, University of Pau and Adour Countries (UPPA), Hélioparc Pau Pyrénées, 2 Avenue P. Angot, 64053 PAU Cedex 09, France
| | - Abdessadek Aghrinane
- Laboratory of Plant Biotechnology, Ecology and Ecosystem Valorization, Faculty of Sciences, University Chouaib Doukkali, 24000 El Jadida, Morocco
| | | | - Mohammed Rhazi
- Interdisciplinary Laboratory in Bio-Resources, Environment and Materials, Higher Normal School, Department of Biology, Cadi Ayyad University, 40000 Marrakech, Morocco
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Škunca Herman J, Marić G, Ravlić MM, Knežević L, Jerković I, Sušić E, Marić V, Vicković IP, Vatavuk Z, Polašek O. Diplopia, COVID-19 and Vaccination: Results from a Cross-Sectional Study in Croatia. Vaccines (Basel) 2022; 10:vaccines10091558. [PMID: 36146636 PMCID: PMC9503164 DOI: 10.3390/vaccines10091558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 08/30/2022] [Accepted: 09/16/2022] [Indexed: 11/16/2022] Open
Abstract
The aim of this study was to explore diplopia as a symptom of undetected COVID-19 infection or as a possible side effect of COVID-19 vaccination. We examined 380 patients with diplopia admitted to the Department of Ophthalmology of the University Hospital Centre Sestre milosrdnice in Zagreb, Croatia, from July 2020 to June 2022. After excluding patients with confirmed organic underlying diplopia causes or monocular diplopia, we linked the patient information with the national COVID-19 and vaccination registries. Among the 91 patients included in this study, previously undetected COVID-19 infection as the possible cause of diplopia was confirmed in five of them (5.5%). An additional nine patients (9.9%) were vaccinated within one month from the onset of their symptoms, while the remaining 77 had neither and were therefore considered as controls. The breakdown according to the mechanism of diplopia showed no substantial difference between the vaccinated patients and the controls. We detected marginally insignificant excess abducens nerve affection in the COVID-positive group compared with that in the controls (p = 0.051). Post-vaccination diplopia was equally common in patients who received vector-based or RNA-based vaccines (21.4 vs. 16.7%; p = 0.694). COVID-19 testing should be performed for all cases of otherwise unexplained diplopia. The risk of post-vaccination diplopia was similar in both types of vaccines administered, suggesting a lack of evidence linking specific vaccine types to diplopia.
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Affiliation(s)
- Jelena Škunca Herman
- Department of Ophthalmology, University Hospital Centre Sestre Milosrdnice, 10000 Zagreb, Croatia
| | - Goran Marić
- Department of Ophthalmology, University Hospital Centre Sestre Milosrdnice, 10000 Zagreb, Croatia
| | - Maja Malenica Ravlić
- Department of Ophthalmology, University Hospital Centre Sestre Milosrdnice, 10000 Zagreb, Croatia
| | - Lana Knežević
- Department of Ophthalmology, University Hospital Centre Sestre Milosrdnice, 10000 Zagreb, Croatia
| | - Ivan Jerković
- Department of Ophthalmology, University Hospital Centre Sestre Milosrdnice, 10000 Zagreb, Croatia
| | - Ena Sušić
- Department of Ophthalmology, University Hospital Centre Sestre Milosrdnice, 10000 Zagreb, Croatia
| | - Vedrana Marić
- Croatian Institute of Public Health, 10000 Zagreb, Croatia
| | - Ivanka Petric Vicković
- Department of Ophthalmology, University Hospital Centre Sestre Milosrdnice, 10000 Zagreb, Croatia
| | - Zoran Vatavuk
- Department of Ophthalmology, University Hospital Centre Sestre Milosrdnice, 10000 Zagreb, Croatia
| | - Ozren Polašek
- Department of Public Health, University of Split School of Medicine, 21000 Split, Croatia
- Algebra LAB, Algebra University College, 10000 Zagreb, Croatia
- Correspondence:
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Song Y, Li J, Chen Y, Guo R, Alonso-Coello P, Zhang Y. The development of clinical guidelines in China: insights from a national survey. Health Res Policy Syst 2021; 19:151. [PMID: 34949195 PMCID: PMC8705156 DOI: 10.1186/s12961-021-00799-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 12/03/2021] [Indexed: 11/24/2022] Open
Abstract
Background Previous research suggests that the quality of clinical guidelines (CGs) in China is suboptimal. However, little is known about the methodology that CGs follow. We conducted a national survey of methods used by Chinese CG developers for CG development, adaptation, and updating. Methods We used a previously piloted questionnaire based on methodologies of CG development, adaptation, and updating, which was distributed during September–November 2020 to 114 organizations identified from published Chinese CGs (searched 2017–2020), recommended by Chinese CG developers, and recommended by clinical discipline experts. Results We collected 48 completed questionnaires (42.1% response). Most organizations developed CGs based on scientific evidence (89.6%), existing CGs (75%), or expert experience and opinion (64.6%). Only a few organizations had a specific CG development division (6.3%), a CG monitoring plan (on clinicians 33.3%; on patients 18.8%), funding (33.3%), or a conflict-of-interest (COI) management policy (23.4%). Thirty (62.5%) organizations reported using a CG development methodology handbook, from international organizations (14/30, 46.7%), methodology or evaluation resources (3/30, 10.0%), expert experience and opinion (3/30, 10.0%), or in-house handbooks (3/30, 10.0%). One organization followed a published adaptation methodology. Thirty-eight organizations (88.4%) reported de novo CG development: 21 (55.3%) formed a CG working group, and 29 (76.3%) evaluated the quality of evidence (21 [72.4%] using a methodological tool). Nineteen organizations (52.8%) reported CG adaptation: three (31.6%) had an adaptation working group, and 12 (63.2%) evaluated the quality of source CGs (2 (16.7%) using the AGREE II instrument). Thirty-three organizations (68.8%) updated their CGs, seven (17.5%) using a formal updating process. Conclusions Our study describes how CGs are developed in a middle-income country like China. To ensure better healthcare, there is still an important need for improvement in the development, adaptation, and updating of CG in China. Supplementary Information The online version contains supplementary material available at 10.1186/s12961-021-00799-7.
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Affiliation(s)
- Yang Song
- Department of Gynaecology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China. .,Iberoamerican Cochrane Centre - Department of Clinical Epidemiology and Public Health, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain.
| | - Jing Li
- Vall d'Hebron University Hospital Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Yaolong Chen
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China.,WHO Collaborating Centre for Guideline Implementation and Knowledge Translation, Lanzhou, China
| | - Ruixia Guo
- Department of Gynaecology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
| | - Pablo Alonso-Coello
- Iberoamerican Cochrane Centre - Department of Clinical Epidemiology and Public Health, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Yuan Zhang
- Department of Health Research Methods, Evidence, and Impact (HEI), McMaster University, Hamilton, Canada
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