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Sangeda RZ, James D, Mariki H, Mbwambo ME, Mwenesi ME, Nyaki H, Tinuga F, Manyanga DP. Childhood vaccination trends during 2019 to 2022 in Tanzania and the impact of the COVID-19 pandemic. Hum Vaccin Immunother 2024; 20:2356342. [PMID: 38780570 PMCID: PMC11123454 DOI: 10.1080/21645515.2024.2356342] [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: 12/22/2023] [Accepted: 05/14/2024] [Indexed: 05/25/2024] Open
Abstract
The COVID-19 pandemic has significantly disrupted healthcare systems at all levels globally, notably affecting routine healthcare services, such as childhood vaccination. This study examined the impact of these disruptions on routine childhood vaccination programmes in Tanzania. We conducted a longitudinal study over four years in five Tanzanian regions: Mwanza, Dar es Salaam, Mtwara, Arusha, and Dodoma. This study analyzed the trends in the use of six essential vaccines: Bacille Calmette-Guérin (BCG), bivalent Oral Polio Vaccine (bOPV), Diphtheria Tetanus Pertussis, Hepatitis-B and Hib (DTP-HepB-Hib), measles-rubella (MR), Pneumococcal Conjugate Vaccine (PCV), and Rota vaccines. We evaluated annual and monthly vaccination trends using time-series and regression analyses. Predictive modeling was performed using an autoregressive integrated moving average (ARIMA) model. A total of 32,602,734 vaccination events were recorded across the regions from 2019 to 2022. Despite declining vaccination rates in 2020, there was a notable rebound in 2021, indicating the resilience of Tanzania's immunization program. The analysis also highlighted regional differences in vaccination rates when standardized per 1000 people. Seasonal fluctuations were observed in monthly vaccination rates, with BCG showing the most stable trend. Predictive modeling of BCG indicated stable and increasing vaccination coverage by 2023. These findings underscore the robustness of Tanzania's childhood immunization infrastructure in overcoming the challenges posed by the COVID-19 pandemic, as indicated by the strong recovery of vaccination rates post-2020. We provide valuable insights into the dynamics of vaccination during a global health crisis and highlight the importance of sustained immunization efforts to maintain public health.
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Affiliation(s)
- Raphael Zozimus Sangeda
- Department of Pharmaceutical Microbiology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Daniel James
- Department of Pharmaceutical Microbiology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Harrison Mariki
- Department of Research and Development, Afya Intelligence, Dar es Salaam, Tanzania
| | - Mbonea Erick Mbwambo
- Department of Research and Development, Afya Intelligence, Dar es Salaam, Tanzania
| | - Mwendwa E. Mwenesi
- Immunization and Vaccine Development, Ministry of Health Tanzania, Dodoma, Tanzania
| | - Honesti Nyaki
- Immunization and Vaccine Development, Ministry of Health Tanzania, Dodoma, Tanzania
| | - Florian Tinuga
- Immunization and Vaccine Development, Ministry of Health Tanzania, Dodoma, Tanzania
| | - Daudi Peter Manyanga
- Department of Universal Health Coverage, Communicable & Non-Communicable Diseases, World Health Organization Inter-Country Support Team for East and Southern African Countries, Harare, Zimbabwe
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Littlecott H, Krishnaratne S, Burns J, Rehfuess E, Sell K, Klinger C, Strahwald B, Movsisyan A, Metzendorf MI, Schoenweger P, Voss S, Coenen M, Müller-Eberstein R, Pfadenhauer LM. Measures implemented in the school setting to contain the COVID-19 pandemic. Cochrane Database Syst Rev 2024; 5:CD015029. [PMID: 38695826 PMCID: PMC11064884 DOI: 10.1002/14651858.cd015029.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/04/2024]
Abstract
BACKGROUND More than 767 million coronavirus 2019 (COVID-19) cases and 6.9 million deaths with COVID-19 have been recorded as of August 2023. Several public health and social measures were implemented in schools to contain the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and prevent onward transmission. We built upon methods from a previous Cochrane review to capture current empirical evidence relating to the effectiveness of school measures to limit SARS-CoV-2 transmission. OBJECTIVES To provide an updated assessment of the evidence on the effectiveness of measures implemented in the school setting to keep schools open safely during the COVID-19 pandemic. SEARCH METHODS We searched the Cochrane COVID-19 Study Register, Educational Resources Information Center, World Health Organization (WHO) COVID-19 Global literature on coronavirus disease database, and the US Department of Veterans Affairs Evidence Synthesis Program COVID-19 Evidence Reviews on 18 February 2022. SELECTION CRITERIA Eligible studies focused on measures implemented in the school setting to contain the COVID-19 pandemic, among students (aged 4 to 18 years) or individuals relating to the school, or both. We categorized studies that reported quantitative measures of intervention effectiveness, and studies that assessed the performance of surveillance measures as either 'main' or 'supporting' studies based on design and approach to handling key confounders. We were interested in transmission-related outcomes and intended or unintended consequences. DATA COLLECTION AND ANALYSIS Two review authors screened titles, abstracts and full texts. We extracted minimal data for supporting studies. For main studies, one review author extracted comprehensive data and assessed risk of bias, which a second author checked. We narratively synthesized findings for each intervention-comparator-outcome category (body of evidence). Two review authors assessed certainty of evidence. MAIN RESULTS The 15 main studies consisted of measures to reduce contacts (4 studies), make contacts safer (7 studies), surveillance and response measures (6 studies; 1 assessed transmission outcomes, 5 assessed performance of surveillance measures), and multicomponent measures (1 study). These main studies assessed outcomes in the school population (12), general population (2), and adults living with a school-attending child (1). Settings included K-12 (kindergarten to grade 12; 9 studies), secondary (3 studies), and K-8 (kindergarten to grade 8; 1 study) schools. Two studies did not clearly report settings. Studies measured transmission-related outcomes (10), performance of surveillance measures (5), and intended and unintended consequences (4). The 15 main studies were based in the WHO Regions of the Americas (12), and the WHO European Region (3). Comparators were more versus less intense measures, single versus multicomponent measures, and measures versus no measures. We organized results into relevant bodies of evidence, or groups of studies relating to the same 'intervention-comparator-outcome' categories. Across all bodies of evidence, certainty of evidence ratings limit our confidence in findings. Where we describe an effect as 'beneficial', the direction of the point estimate of the effect favours the intervention; a 'harmful' effect does not favour the intervention and 'null' shows no effect either way. Measures to reduce contact (4 studies) We grouped studies into 21 bodies of evidence: moderate- (10 bodies), low- (3 bodies), or very low-certainty evidence (8 bodies). The evidence was very low to moderate certainty for beneficial effects of remote versus in-person or hybrid teaching on transmission in the general population. For students and staff, mostly harmful effects were observed when more students participated in remote teaching. Moderate-certainty evidence showed that in the general population there was probably no effect on deaths and a beneficial effect on hospitalizations for remote versus in-person teaching, but no effect for remote versus hybrid teaching. The effects of hybrid teaching, a combination of in-person and remote teaching, were mixed. Very low-certainty evidence showed that there may have been a harmful effect on risk of infection among adults living with a school student for closing playgrounds and cafeterias, a null effect for keeping the same teacher, and a beneficial effect for cancelling extracurricular activities, keeping the same students together and restricting entry for parents and caregivers. Measures to make contact safer (7 studies) We grouped studies into eight bodies of evidence: moderate- (5 bodies), and low-certainty evidence (3 bodies). Low-certainty evidence showed that there may have been a beneficial effect of mask mandates on transmission-related outcomes. Moderate-certainty evidence showed full mandates were probably more beneficial than partial or no mandates. Evidence of a beneficial effect of physical distancing on risk of infection among staff and students was mixed. Moderate-certainty evidence showed that ventilation measures probably reduce cases among staff and students. One study (very low-certainty evidence) found that there may be a beneficial effect of not sharing supplies and increasing desk space on risk of infection for adults living with a school student, but showed there may be a harmful effect of desk shields. Surveillance and response measures (6 studies) We grouped studies into seven bodies of evidence: moderate- (3 bodies), low- (1 body), and very low-certainty evidence (3 bodies). Daily testing strategies to replace or reduce quarantine probably helped to reduce missed school days and decrease the proportion of asymptomatic school contacts testing positive (moderate-certainty evidence). For studies that assessed the performance of surveillance measures, the proportion of cases detected by rapid antigen detection testing ranged from 28.6% to 95.8%, positive predictive value ranged from 24.0% to 100.0% (very low-certainty evidence). There was probably no onward transmission from contacts of a positive case (moderate-certainty evidence) and replacing or shortening quarantine with testing may have reduced missed school days (low-certainty evidence). Multicomponent measures (1 study) Combining multiple measures may have led to a reduction in risk of infection among adults living with a student (very low-certainty evidence). AUTHORS' CONCLUSIONS A range of measures can have a beneficial effect on transmission-related outcomes, healthcare utilization and school attendance. We rated the current findings at a higher level of certainty than the original review. Further high-quality research into school measures to control SARS-CoV-2 in a wider variety of contexts is needed to develop a more evidence-based understanding of how to keep schools open safely during COVID-19 or a similar public health emergency.
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Affiliation(s)
- Hannah Littlecott
- Institute for Medical Information Processing, Biometry and Epidemiology - IBE, Chair of Public Health and Health Services Research, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Shari Krishnaratne
- Institute for Medical Information Processing, Biometry and Epidemiology - IBE, Chair of Public Health and Health Services Research, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
- Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - Jacob Burns
- Institute for Medical Information Processing, Biometry and Epidemiology - IBE, Chair of Public Health and Health Services Research, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Eva Rehfuess
- Institute for Medical Information Processing, Biometry and Epidemiology - IBE, Chair of Public Health and Health Services Research, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Kerstin Sell
- Institute for Medical Information Processing, Biometry and Epidemiology - IBE, Chair of Public Health and Health Services Research, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Carmen Klinger
- Institute for Medical Information Processing, Biometry and Epidemiology - IBE, Chair of Public Health and Health Services Research, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Brigitte Strahwald
- Institute for Medical Information Processing, Biometry and Epidemiology - IBE, Chair of Public Health and Health Services Research, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Ani Movsisyan
- Institute for Medical Information Processing, Biometry and Epidemiology - IBE, Chair of Public Health and Health Services Research, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Maria-Inti Metzendorf
- Institute of General Practice, Medical Faculty of the Heinrich-Heine University, Düsseldorf, Germany
| | - Petra Schoenweger
- Institute for Medical Information Processing, Biometry and Epidemiology - IBE, Chair of Public Health and Health Services Research, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Stephan Voss
- Institute for Medical Information Processing, Biometry and Epidemiology - IBE, Chair of Public Health and Health Services Research, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Michaela Coenen
- Institute for Medical Information Processing, Biometry and Epidemiology - IBE, Chair of Public Health and Health Services Research, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Roxana Müller-Eberstein
- Institute for Medical Information Processing, Biometry and Epidemiology - IBE, Chair of Public Health and Health Services Research, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Lisa M Pfadenhauer
- Institute for Medical Information Processing, Biometry and Epidemiology - IBE, Chair of Public Health and Health Services Research, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
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Hong S, Woo S, Kim S, Park J, Lee M, Kim S, Koyanagi A, Smith L, Kim MS, López Sánchez GF, Dragioti E, Rahmati M, Fond G, Boyer L, Oh J, Lee H, Yon DK. National prevalence of smoking among adolescents at tobacco tax increase and COVID-19 pandemic in South Korea, 2005-2022. Sci Rep 2024; 14:7823. [PMID: 38570551 PMCID: PMC10991517 DOI: 10.1038/s41598-024-58446-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 03/29/2024] [Indexed: 04/05/2024] Open
Abstract
Prior research has predominantly focused on the overall effects of the tobacco tax increase and the COVID-19 pandemic on adolescent smoking behavior. However, there is a need to examine both the immediate and sustained associations of these two factors on subgroups of adolescents, employing an interrupted time-series model. We aimed to investigate the immediate and sustained association of tobacco tax increase and the COVID-19 pandemic on adolescent smoking prevalence. This study utilized data from the Korea Youth Risk Behavior Web-Based Survey to analyze the prevalence of current smoking among all participants (CSP) and the prevalence of daily smoking among current smokers (DSP) of Korean adolescents (n = 1,159,995; mean, age 14.99; male 51.5%) over 18 years from 2005 to 2022. The study examined 18-year trends in CSP and DSP among Korean adolescents, emphasizing the influences of the 2015 tobacco tax increase and the COVID-19 pandemic, using β coefficients and their differences (βdiff) from an interrupted time-series ARIMA model. While CSP exhibited a decreasing trend, DSP exhibited an increasing trend. Tobacco tax increase was associated with both the short and long terms in smoking prevalence, however, the short-term association on prevalence (CSP, - 3.076 [95% CI, - 3.707 to - 2.445]; DSP, - 4.112 [95% CI, - 6.488 to - 1.735]) was stronger. The pandemic was associated with an immediate increase in DSP (9.345 [95% CI, 5.285-13.406]). These effects were strongest among adolescents from low economic status and those exposed to familial secondhand smoking. Supportive programs for adolescents in low-income families will help overcome the effects associated with the pandemic. As a tobacco tax increase was associated with a reduction in smoking prevalence, this could be one method to overcome the effects of the pandemic.
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Affiliation(s)
- Seohyun Hong
- Department of Medicine, Kyung Hee University College of Medicine, Seoul, South Korea
| | - Selin Woo
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, South Korea
| | - Seokjun Kim
- Department of Medicine, Kyung Hee University College of Medicine, Seoul, South Korea
| | - Jaeyu Park
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, South Korea
- Department of Regulatory Science, Kyung Hee University, Seoul, South Korea
| | - Myeongcheol Lee
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, South Korea
- Department of Regulatory Science, Kyung Hee University, Seoul, South Korea
| | - Sunyoung Kim
- Department of Family Medicine, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, South Korea
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Deu, Barcelona, Spain
| | - Lee Smith
- Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Min Seo Kim
- Cardiovascular Disease Initiative, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Guillermo F López Sánchez
- Division of Preventive Medicine and Public Health, Department of Public Health Sciences, School of Medicine, University of Murcia, Murcia, Spain
| | - Elena Dragioti
- Pain and Rehabilitation Centre, and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
- Research Laboratory Psychology of Patients, Families, and Health Professionals, Department of Nursing, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Masoud Rahmati
- Department of Physical Education and Sport Sciences, Faculty of Literature and Human Sciences, Lorestan University, Khoramabad, Iran
- Department of Physical Education and Sport Sciences, Faculty of Literature and Humanities, Vali-e-Asr University of Rafsanjan, Rafsanjan, Iran
- CEReSS-Health Service Research and Quality of Life Center, Assistance Publique Des Hôpitaux de Marseille, Aix-Marseille University, Marseille, France
| | - Guillaume Fond
- CEReSS-Health Service Research and Quality of Life Center, Assistance Publique Des Hôpitaux de Marseille, Aix-Marseille University, Marseille, France
| | - Laurent Boyer
- CEReSS-Health Service Research and Quality of Life Center, Assistance Publique Des Hôpitaux de Marseille, Aix-Marseille University, Marseille, France
| | - Jiyeon Oh
- Department of Medicine, Kyung Hee University College of Medicine, Seoul, South Korea
| | - Hojae Lee
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, South Korea
- Department of Regulatory Science, Kyung Hee University, Seoul, South Korea
| | - Dong Keon Yon
- Department of Medicine, Kyung Hee University College of Medicine, Seoul, South Korea.
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, South Korea.
- Department of Regulatory Science, Kyung Hee University, Seoul, South Korea.
- Department of Pediatrics, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, 23 Kyungheedae-ro, Dongdaemun-gu, Seoul, 02447, South Korea.
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Sharififar S, Moradi M. Evaluating the performance of selected military hospitals in Tehran in response to Covid-19 pandemic: A cross-sectional study. Health Sci Rep 2024; 7:e2030. [PMID: 38605727 PMCID: PMC11007256 DOI: 10.1002/hsr2.2030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 11/06/2023] [Accepted: 03/10/2024] [Indexed: 04/13/2024] Open
Abstract
Background and Aims The rapid spread of coronavirus disease 2019 (Covid-19) led the need to admit a large number of infected people to hospitals in a short period of time, turning them into one of the most important responsive organizations. This study aims to evaluate the performance of selected military hospitals because they carried out a military operation in Tehran in response to the recent pandemic. Methods This is a descriptive-analytical study. The statistical population of this study consisted of military hospitals responding to Covid-19 pandemic in Tehran. A checklist to evaluate the performance of hospitals in response to Covid-19 pandemic (six areas, 23 sub-areas and 152 items) was used as a data collection tool in this study. This tool had six domains, including risk management and planning, coordination and communication, infection prevention and control, diagnosis and treatment, education and training, and resource management. Results The overall performance of selected hospitals was 63%, which indicated a good performance. The domain of coordination and communication obtained the lowest score. Conclusion The investigated hospitals had good performance because they had a desirable access to resources. Periodic self-assessment and accreditation is recommended to improve the performance of these hospitals.
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Affiliation(s)
- Simintaj Sharififar
- Department of Health in Disaster and EmergenciesSchool of NursingAja University of Medical SciencesTehranIran
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Méndez-Astudillo J. The impact of comorbidities and economic inequality on COVID-19 mortality in Mexico: a machine learning approach. Front Big Data 2024; 7:1298029. [PMID: 38562649 PMCID: PMC10982366 DOI: 10.3389/fdata.2024.1298029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 03/04/2024] [Indexed: 04/04/2024] Open
Abstract
Introduction Studies from different parts of the world have shown that some comorbidities are associated with fatal cases of COVID-19. However, the prevalence rates of comorbidities are different around the world, therefore, their contribution to COVID-19 mortality is different. Socioeconomic factors may influence the prevalence of comorbidities; therefore, they may also influence COVID-19 mortality. Methods This study conducted feature analysis using two supervised machine learning classification algorithms, Random Forest and XGBoost, to examine the comorbidities and level of economic inequalities associated with fatal cases of COVID-19 in Mexico. The dataset used was collected by the National Epidemiology Center from February 2020 to November 2022, and includes more than 20 million observations and 40 variables describing the characteristics of the individuals who underwent COVID-19 testing or treatment. In addition, socioeconomic inequalities were measured using the normalized marginalization index calculated by the National Population Council and the deprivation index calculated by NASA. Results The analysis shows that diabetes and hypertension were the main comorbidities defining the mortality of COVID-19, furthermore, socioeconomic inequalities were also important characteristics defining the mortality. Similar features were found with Random Forest and XGBoost. Discussion It is imperative to implement programs aimed at reducing inequalities as well as preventable comorbidities to make the population more resilient to future pandemics. The results apply to regions or countries with similar levels of inequality or comorbidity prevalence.
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Hauwanga WN, El Husseini N, El Ghazzawi AA, Mansoor Z, Chaudhary A, Elamin A, McBenedict B. The Impact of the Novel Coronavirus Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Pandemic on Case Fatality Rates and Cost of Surgical Care in Brazil. Cureus 2024; 16:e56624. [PMID: 38646404 PMCID: PMC11032005 DOI: 10.7759/cureus.56624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/21/2024] [Indexed: 04/23/2024] Open
Abstract
Background The coronavirus disease 2019 (COVID-19) pandemic provoked disruptions in healthcare delivery. Following the recommendations of major surgical societies and surgical departments globally, most surgeries were widely canceled or postponed, causing significant disruptions to healthcare delivery worldwide, including in Brazil. Brazil's public healthcare system - Sistema Único de Saúde (SUS) was particularly affected, with a substantial decline in elective procedures, especially during the pandemic's early stages. The impact of the pandemic on surgical services in Brazil has not been adequately studied since most studies only cover the early phases of the pandemic. Thus, this study aims to analyze the case fatality rates and costs, associated with the different surgical procedure subgroups performed during the pre-pandemic, pandemic, recovery, and post-pandemic periods in all five regions of Brazil. Methods A retrospective cross-sectional design was used to examine surgical cases from 2019 to 2022. Data was divided into four time periods, named as the pre-pandemic (March-December 2019), pandemic (March-December 2020), recovery (March-December 2021), and post-pandemic (March-December 2022), and was analyzed for the cost of surgical procedures in the aforementioned four periods. In addition, the case fatality rates and rate ratios in the four periods stratified according to region were calculated. Results The cost of surgical procedures decreased during the pandemic and recovery period compared with pre-pandemic for all procedures except thoracic surgery where it was higher in the recovery period than pre-pandemic. No statistically significant change in cost was observed in surgeries of the central and peripheral nervous system, circulatory system, obstetric, and oncology. Case fatality rates increased among all five regions of Brazil in pandemic and recovery periods compared to pre-pandemic and post-pandemic periods. Case fatality rates increased during the pandemic and/or recovery as compared to pre-pandemic in all procedures except visual apparatus and obstetric surgeries were not affected by the pandemic in terms of case fatality rates. Conclusion The COVID-19 pandemic had a significant impact on surgical care costs and case fatality rates for surgery in Brazil. There was a decreasing trend in the costs of procedures during the pandemic, followed by a gradual recovery to baseline values, except for thoracic surgery. Case fatality rates rose initially and then declined, ultimately reaching baseline levels. The pandemic posed significant challenges to the healthcare system, affecting medical services, including surgical care.
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Affiliation(s)
- Wilhelmina N Hauwanga
- Family Medicine, Faculty of Medicine, Federal University of the State of Rio de Janeiro, Rio de Janeiro, BRA
| | | | | | - Zaeemah Mansoor
- Faculty of Health Sciences, Karachi Medical and Dental College, Karachi, PAK
| | - Abhishek Chaudhary
- Medicine, Smt. Nathiba Hargovandas Lakhmichand Municipal Medical College, Ahmedabad, IND
| | - Aisha Elamin
- Faculty of Medicine, National University of Sudan, Khartoum, SDN
| | - Billy McBenedict
- Medicine, Hospital Universitário Antônio Pedro (Antonio Pedro University Hospital), Niteroi, BRA
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Gannon H, Chappell E, Ford D, Gibb DM, Chimwaza A, Manika N, Wedderburn CJ, Nenguke ZM, Cowan FM, Gibb T, Phillips A, Mushavi A, Fitzgerald F, Heys M, Chimhuya S, Bwakura-Dangarembizi M. Effects of the COVID-19 pandemic on the outcomes of HIV-exposed neonates: a Zimbabwean tertiary hospital experience. BMC Pediatr 2024; 24:16. [PMID: 38183019 PMCID: PMC10768266 DOI: 10.1186/s12887-023-04473-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 12/07/2023] [Indexed: 01/07/2024] Open
Abstract
INTRODUCTION The COVID-19 pandemic has globally impacted health service access, delivery and resources. There are limited data regarding the impact on the prevention of mother to child transmission (PMTCT) service delivery in low-resource settings. Neotree ( www.neotree.org ) combines data collection, clinical decision support and education to improve care for neonates. Here we evaluate impacts of COVID-19 on care for HIV-exposed neonates. METHODS Data on HIV-exposed neonates admitted to the neonatal unit (NNU) at Sally Mugabe Central Hospital, Zimbabwe, between 01/06/2019 and 31/12/2021 were analysed, with pandemic start defined as 21/03/2020 and periods of industrial action (doctors (September 2019-January 2020) and nurses (June 2020-September 2020)) included, resulting in modelling during six time periods: pre-doctors' strike (baseline); doctors' strike; post-doctors' strike and pre-COVID; COVID and pre-nurses' strike; nurses' strike; post nurses' strike. Interrupted time series models were used to explore changes in indicators over time. RESULTS Of 8,333 neonates admitted to the NNU, 904 (11%) were HIV-exposed. Mothers of 706/765 (92%) HIV-exposed neonates reported receipt of antiretroviral therapy (ART) during pregnancy. Compared to the baseline period when average admissions were 78 per week (95% confidence interval (CI) 70-87), significantly fewer neonates were admitted during all subsequent periods until after the nurses' strike, with the lowest average number during the nurses' strike (28, 95% CI 23-34, p < 0.001). Across all time periods excluding the nurses strike, average mortality was 20% (95% CI 18-21), but rose to 34% (95% CI 25, 46) during the nurses' strike. There was no evidence for heterogeneity (p > 0.22) in numbers of admissions or mortality by HIV exposure status. Fewer HIV-exposed neonates received a PCR test during the pandemic (23%) compared to the pre-pandemic periods (40%) (RR 0.59, 95% CI 0.41-0.84, p < 0.001). The proportion of HIV-exposed neonates who received antiretroviral prophylaxis during admission was high throughout, averaging between 84% and 95% in each time-period. CONCLUSION While antiretroviral prophylaxis for HIV-exposed neonates remained high throughout, concerning data on low admissions and increased mortality, similar in HIV-exposed and unexposed neonates, and reduced HIV testing, suggest some aspects of care may have been compromised due to indirect effects of the pandemic.
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Affiliation(s)
- Hannah Gannon
- UCL Great Ormond Street Institute of Child Health, University College London, London, UK.
| | | | | | | | | | - Ngoni Manika
- Ministry of Health and Child Care, Harare, Zimbabwe
| | - Catherine J Wedderburn
- MRC Clinical Trials Unit at UCL, London, UK
- Department of Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa
| | | | - Frances M Cowan
- Centre for Sexual Health and HIV/AIDS Research (CeSHHAR), Harare, Zimbabwe
- Liverpool School of Tropical Medicine, Liverpool, UK
| | | | | | | | | | - Michelle Heys
- UCL Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Simbarashe Chimhuya
- Child and Adolescent Health Unit, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Mutsa Bwakura-Dangarembizi
- Child and Adolescent Health Unit, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe
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8
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Kwiringira JN, Rujumba J, Ariho P, Mugisha J, Zakumumpa H, Mohling EWP, Akugizibwe M, Tumwebaze IK, Onyutha C. "Here, your only relative is money…" why slum social networks do not facilitate neighborhood community development: insights through a sanitation lens. BMC Public Health 2023; 23:2341. [PMID: 38007444 PMCID: PMC10676606 DOI: 10.1186/s12889-023-17176-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Accepted: 11/07/2023] [Indexed: 11/27/2023] Open
Abstract
INTRODUCTION Though social networks which are deemed vehicles of community development exist in slum areas, underdevelopment still persists in these areas. We explored the nature and role of social networks in facilitating community development in the slums of Kampala through a sanitation lens. METHODS Qualitative Social Network Analysis (SNA) was done to understand the nature of slum social networks primarily through the analysis of sanitation behavior. Data were collected through six Focus Group Discussions (FGD), six In-depth Interviews (IDIs), and 18 Key Informant Interviews (KII) with Government, civil society and private stakeholders. We used both inductive and deductive thematic analysis. RESULTS Four themes emerged in our analysis; i); Unsupportive environments, uncooperative neighbours and uncertainty of tenure: participants reported slums as unsupportive of community development due to a shortage of space, poverty and unplanned services. Tenants perceived landlords as exploitative and predatory and wished the tables are turned. This notion of cyclic exploitation did not encourage collective action for community good. Short-term economic survival trumped long-term community interests ii) Patronage and poor service delivery: varying degrees of patronage led to multiple forms of illegalities and violations such as tax evasion. Due to vested interests and corruption among public officials, the slum population was lethargic. iii) Intersecting realities of poverty and unemployment: slum dwellers lived on the margins daily. Hence, poor living conditions were a secondary concern. iv) Social relations for personal development: Slum social networks were driven by individual interests rather than community good. Slum dwellers prioritized connections with people of common socio-economic interests. As such social networks were instrumental only if they 'added value'. CONCLUSION Social networks in slums are only concerned about survival needs. Slums require responses that address the complexity of slum formation and broader livelihood challenges, as well as re-assessing the meaning of community. We posit that more needs to be done in understanding the meaning and workings of a sociology beyond physical societies. Poverty is a modifier of social systems and processes and should be a concern for all stakeholders involved in slum development.
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Affiliation(s)
| | - Joseph Rujumba
- College of Health Sciences, Makerere University, Kampala, Uganda
| | - Paulino Ariho
- Department of Sociology and Population Studies, Kyambogo University, Kampala, Uganda
| | - James Mugisha
- Department of Social Work and Social Administration, Kyambogo University, Kampala, Uganda
| | - Henry Zakumumpa
- School of Public Health, Makerere University, Kampala, Uganda
| | - Elizabeth W Perry Mohling
- Center for Research on Interpersonal Violence, School of Public Health, National Safe Care Training and Research Center, Georgia State University, Georgia, USA
| | - Mathias Akugizibwe
- Department of Sociology and Population Studies, Kyambogo University, Kampala, Uganda
| | | | - Charles Onyutha
- Department of Civil and Environmental Engineering, Kyambogo University, Kampala, Uganda
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9
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Gulumbe BH, Sahal MR, Abdulrahim A, Faggo AA, Yusuf ZM, Sambo KH, Usman NI, Bagwai MA, Muhammad WN, Adamu A, Aminu U, Abubakar MT, Lawan KA. Antibiotic resistance and the COVID-19 pandemic: A dual crisis with complex challenges in LMICs. Health Sci Rep 2023; 6:e1566. [PMID: 37711678 PMCID: PMC10498429 DOI: 10.1002/hsr2.1566] [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: 03/22/2023] [Revised: 08/17/2023] [Accepted: 08/30/2023] [Indexed: 09/16/2023] Open
Abstract
Background and Aims Antimicrobial resistance (AMR), a global health crisis of mounting urgency, has been further complicated by the ongoing COVID-19 pandemic. The intricate relationship between these two phenomena is especially pronounced in low- and middle-income countries (LMICs) due to the distinct obstacles encountered by their healthcare systems and policy structures. This study aims to explore the complex challenges arising from the coexistence of these two crises in LMICs and proffer specific recommendations for holistic management. Methods An exhaustive bibliographic survey was executed, employing search queries in specialized databases such as PubMed, SCOPUS, and Web of Science's SCI-EXPANDED index. The timeframe for the literature search extended from January 2020 to January 2023. The search strategy employed key terms including antibiotic resistance, AMR, COVID-19 pandemic, low- and middle-income countries, SARS-CoV-2, and LMICs. Results The pandemic has aggravated various drivers of AMR in LMICs, including limited capabilities, weak frameworks, and socioeconomic factors. New challenges have emerged, such as disruptions in the antibiotic supply chain and an increased risk of healthcare-associated infections. The interaction between these drivers presents a complex problem that demands a coordinated response. Specific recommendations include strengthening health systems, funding research and innovation, and enhancing infection prevention control measures. Conclusion The coexistence of AMR and the COVID-19 pandemic in LMICs demands an integrated approach involving multiple stakeholders. Emphasis must be placed on constructing aligned regulatory frameworks, nurturing regional collaborations, and focusing on accessible therapeutic options. The study underscores the necessity for actionable strategies to achieve sustainable access to clean water and sanitation and also highlights the importance of long-term planning, funding, and specialized expertise in emerging modalities like phage therapy.
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Affiliation(s)
- Bashar Haruna Gulumbe
- Department of Microbiology, Faculty of ScienceFederal University Birnin KebbiBirninKebbiNigeria
| | - Muhammed Rabiu Sahal
- Department of Biological SciencesAbubakar Tafawa Balewa University BauchiBauchiBauchi StateNigeria
| | - Abdulrakib Abdulrahim
- Department of Microbiology, Faculty of ScienceFederal University Birnin KebbiBirninKebbiNigeria
| | | | | | - Kabir Hassan Sambo
- Department of MicrobiologyBauchi State UniversityGadauBauchi StateNigeria
| | - Nazeef Idris Usman
- Department of MicrobiologyBauchi State UniversityGadauBauchi StateNigeria
| | | | - Wada Nafiu Muhammad
- Department of Laboratory TechnologyFederal Polytechnic BauchiBauchiBauchi StateNigeria
| | - Aliyu Adamu
- Department of MicrobiologyBauchi State UniversityGadauBauchi StateNigeria
| | - Uzairu Aminu
- Department of Microbiology, Faculty of ScienceFederal University Birnin KebbiBirninKebbiNigeria
| | | | - Kadai Alhaji Lawan
- Department of Microbiology and Immunology, Faculty of Biomedical SciencesKampala International UniversityKampalaUganda
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10
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CONTARINO FABIO, DI PIETRO ERMINIO, RANDAZZO CONCETTA, BELLA FRANCESCA, CONTRINO MARIALIA. Effectiveness of a vaccine recovery plan after the COVID-19 pandemic in the Siracusa Local Health Authority, Italy. Results of one year follow-up. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2023; 64:E289-E297. [PMID: 38125998 PMCID: PMC10730062 DOI: 10.15167/2421-4248/jpmh2023.64.3.3001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 09/15/2023] [Indexed: 12/23/2023]
Abstract
Introduction The COVID-19 pandemic has strongly impacted on the immunization services around the world, threatening the gains made in the control of vaccine-preventable diseases. Methods A vaccination recovery plan of missed vaccinations has been put in place in the LHA of Siracusa after the pandemic. We compared 2021 and 2020 vaccination coverage by age group and vaccine type after one year of follow-up of the recovery plan. The Chi-square test was executed on proportions for the years 2021 vs 2020. Results were considered statistically significant at a two-tailed p-value ≤ 0.05. Results 36-month coverage rates were 92.5% for polio and 93.7% for measles-containing-vaccine, representing -0.3% and -1.8% decreases, respectively, as compared to 2020. By 8 years of age (booster doses), immunisation coverage was 80.7% for polio and 80.1% for measles, representing a -5.7% and -3.7%, respectively, compared to 2020. 36-month coverage was 56.6% for Men B (-5.0% as compared to 2020), 73.2% for Men ACW135Y/C (+1.1% as compared to 2020) and 86.9% for PNC vaccine (-1.7%, as compared to 2020). Regarding HPV vaccination, in 2021, vaccine coverage was 44.2% (-4.4% compared to 2020). Compared to the previous report, the VC difference among the cohorts narrowed for all almost vaccinations, except for the anti-men B and the anti-HPV vaccination, for which we recorded an increase in VC difference, and for men ACW135Y/C, for which a significant increase has been recorded. Conclusions Despite the efforts to organize and realize an extensive and well-designed vaccination recovery, our data show that even after the 1-year follow-up, globally deficits in coverage for these routine vaccinations persist, although there has been a substantial and significant recovery of missed vaccinations, especially among younger children and for primary cycles.
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Affiliation(s)
- FABIO CONTARINO
- Department of Public Health, Epidemiology Unit,
Provincial Health Authority of Siracusa,
Italy
| | - ERMINIO DI PIETRO
- Department of Public Health, Epidemiology Unit,
Provincial Health Authority of Siracusa,
Italy
| | - CONCETTA RANDAZZO
- Department of Public Health, Epidemiology Unit,
Provincial Health Authority of Siracusa,
Italy
| | - FRANCESCA BELLA
- Siracusa Cancer Registry, Provincial Health Authority of
Siracusa, Italy
| | - MARIA LIA CONTRINO
- Head of Department of Public Health,
Provincial Health Authority of Siracusa,
Italy
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11
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Ouedraogo P, Pietra V, Schumacher RF. Impact of COVID-19 on Outpatient Malnutrition Centers in Urban and Rural Burkina Faso. Am J Trop Med Hyg 2023; 109:460-465. [PMID: 37308103 PMCID: PMC10397440 DOI: 10.4269/ajtmh.22-0714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 04/25/2023] [Indexed: 06/14/2023] Open
Abstract
Although the numbers of SARS-CoV-2 infections and related deaths are relatively low in sub-Saharan Africa, the pandemic might lead to a high indirect death toll there. We determined the impact of the COVID-19 pandemic on the management of malnourished children in urban and rural areas. We analyzed data from two Centers for Rehabilitation, Education & Nutrition (CRENs), one in the capital and one in a rural center, both run by the Camillian Fathers. We compared data from the year before the pandemic (2019) with the first 2 years during the pandemic (2020/2021). In the urban CREN, there was a sharp reduction in new patients enrolled, from 340 in the pre-pandemic year to 189 during the first pandemic year and 202 in the second year. The follow-up was significantly shorter during the first pandemic year, with a rebound in the second year (pre: 57 days versus 42 and 63 days for the first and second years, respectively). In the rural CREN, the situation was different: The numbers of patients did not show any significant variation between the pre-pandemic year (191) and the first and second pandemic years (223 and 179, respectively). Different perceptions of the pandemic in urban (high, more testing, more COVID) and rural (low, less information and testing) areas may partly explain this difference. The discrepancy between the decreasing numbers of malnourished children in specialized care during the pandemic-especially in the urban area-is contrary to the lockdown-induced increase in food insecurity and warrants attention to avoid an increase in the silent epidemic of malnourished children in Africa.
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Affiliation(s)
- Paul Ouedraogo
- Hôpital St Camille de Ouagadougou, Ouagadougou, Burkina Faso
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12
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Silva CF, Bezerra ICDS, Soares AR, Leal ASLG, Faustino WDM, Reichert APDS. Implications of the COVID-19 pandemic on breastfeeding and health promotion: perceptions of breastfeeding women. CIENCIA & SAUDE COLETIVA 2023; 28:2183-2192. [PMID: 37531527 DOI: 10.1590/1413-81232023288.05882023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Accepted: 03/28/2023] [Indexed: 08/04/2023] Open
Abstract
This article aims to understand the implications of the COVID-19 pandemic on breastfeeding and health promotion actions within primary care from the perception of breastfeeding women. This qualitative study was developed with 24 women who breastfed during the first year of the pandemic. Data were analyzed using Content Analysis and interpreted in the light of the Interactive Breastfeeding Theory (IBT). The pandemic affected the vulnerability of the mental health of breastfeeding women, entailed difficulties for the continuity of breastfeeding and early insertion of formulas, impacted COVID-19 preventive measures in breastfeeding, and produced changes in the work of breastfeeding women. Furthermore, areas for improvement were identified in health promotion actions and the mother-child binomial support due to the interruption of childcare visits. Actions to promote child health in primary care were unsatisfactory. However, most study participants maintained exclusive breastfeeding for the first six months, which could adversely affect child morbimortality.
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Affiliation(s)
- Clariana Falcão Silva
- Universidade Federal da Paraíba (UFPB). Campus I Lot. Cidade Universitária. 58051-900 João Pessoa PB Brasil.
| | | | - Anniely Rodrigues Soares
- Universidade Federal da Paraíba (UFPB). Campus I Lot. Cidade Universitária. 58051-900 João Pessoa PB Brasil.
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13
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Bazrafshan A, Sadeghi A, Bazrafshan MS, Mirzaie H, Shafiee M, Geerts J, Sharifi H. Health risk communication and infodemic management in Iran: development and validation of a conceptual framework. BMJ Open 2023; 13:e072326. [PMID: 37518081 PMCID: PMC10387647 DOI: 10.1136/bmjopen-2023-072326] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 07/16/2023] [Indexed: 08/01/2023] Open
Abstract
OBJECTIVE The COVID-19 pandemic exposed significant gaps in Iran's and other health systems' risk communication. The accompanying infodemic undermined policy responses, amplified distrust in government and reduced adherence to public health recommendations among the Iranian population. This study aimed to develop a conceptual framework for health risk communication and infodemic management (RCIM) during epidemics and health emergencies in Iran that could have potential applications in other contexts. DESIGN This study was designed in two phases. Phase 1 involved semistructured qualitative interviews with key informants to explore effective RCIM strategies across public health settings in Iran and to develop a conceptual framework. Phase 2 involved revising the framework based on feedback from an online expert panel regarding its comprehensiveness and validity. SETTING Provincial/national public health settings in Iran. PARTICIPANTS Twenty key informants from provincial and national public health authorities who contributed to COVID-19 response programmes participated in interviews. Nine experts from diverse academic disciplines, provincial and national settings, and geographical locations participated in an online expert panel. RESULTS The conceptual model was created based on qualitative interviews and expert panel discussions and was structured according to six pillars of the WHO health system framework: leadership and governance, information, health workforce and financial resources, along with media and community. Leadership and governance, including trustworthy leaders, were recommended as the foundation for developing RCIM in Iran. Developing an official strategy with information infrastructures, including high-quality surveillance systems, identified personnel and training for specialists among the health workforce, financial resources, communication channels and community engagement were recognised as other dimensions for developing health risk communication in Iran. CONCLUSION The proposed framework represents a step toward establishing a national RCIM strategy in Iran. Further validation of the conceptual framework and experiments on how it could potentially influence policy and practice is recommended. This model has the potential to be applied in other contexts in its current form or as the foundation for customised local versions.
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Affiliation(s)
- Azam Bazrafshan
- HIV/STI Surveillance Research Center, and WHO Collaborative Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran (the Islamic Republic of)
| | - Azadeh Sadeghi
- HIV/STI Surveillance Research Center, and WHO Collaborative Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran (the Islamic Republic of)
- Deputy of Health, Department of Communicable Diseases, Kerman University of Medical Sciences, Kerman, Iran (the Islamic Republic of)
| | - Maliheh Sadat Bazrafshan
- HIV/STI Surveillance Research Center, and WHO Collaborative Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran (the Islamic Republic of)
| | - Hossein Mirzaie
- HIV/STI Surveillance Research Center, and WHO Collaborative Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran (the Islamic Republic of)
| | - Mehdi Shafiee
- HIV/STI Surveillance Research Center, and WHO Collaborative Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran (the Islamic Republic of)
- Deputy of Health, Department of Communicable Diseases, Kerman University of Medical Sciences, Kerman, Iran (the Islamic Republic of)
| | - Jaason Geerts
- Research and Leadership Development, Canadian College of Health Leaders, Ottawa, Ontario, Canada
- Bayes Business School, University of London, London, UK
| | - Hamid Sharifi
- HIV/STI Surveillance Research Center, and WHO Collaborative Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran (the Islamic Republic of)
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14
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Osório D, Liasse ST, Cassia U, Sidat M, Taunde S, Mate B, Pambo E, Mazivila O, Elias B, Lorenzoni C, Buck C. Test positivity and clinical presentation of COVID-19 in Mozambican infants hospitalized during the second wave of the pandemic in 2021. Pan Afr Med J 2023; 44:154. [PMID: 37455880 PMCID: PMC10349623 DOI: 10.11604/pamj.2023.44.154.38926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 03/26/2023] [Indexed: 07/18/2023] Open
Abstract
Introduction during the second wave of the COVID-19 pandemic in Mozambique, there was a surge in pediatric hospitalizations at a time when there was relatively little evidence, but significant concern about clinical outcomes in African children, particularly in higher-risk infants requiring, and health system capacity to respond. Methods a retrospective cohort study was conducted for patients 1-12 months of age admitted to the Breastfeeding ward at Hospital Central de Maputo from January-February 2021. All had routine SARS-CoV-2 PCR testing performed. For patients with positive results, hospital charts were retrospectively reviewed. Descriptive analyses were performed. Results of 209 patients that had SARS-CoV-2 PCR testing performed, 102 (48.8%) received results, of which 37 (36.3%) were positive. Positive results were received prior to discharge for 14 patients (37.8%). Median duration of hospitalization was 3 days. There were two deaths in COVID-positive patients (5.4%), both with complex comorbidities. For the 35 COVID-19 positive patients whose charts were located, the principal admission diagnosis was respiratory for 22 (62.9%), and 14 (40.0%) had oxygen saturation <94% at admission. The white blood cell count was >12.0 x 103cells/mL in 10 patients (28.6%) and the most common abnormal finding on chest radiograph was peribronchial thickening (38.5% of patients with results). Oxygen therapy was needed for 20 patients (57.1%). Conclusion the majority of infants with COVID-19 had a mild, short-duration respiratory illness that did not exceed ward capacity for care, including oxygen treatment. Laboratory capacity for PCR testing was overwhelmed, delaying the return of results and complicating inpatient infection control measures.
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Affiliation(s)
| | | | - Uneisse Cassia
- Universidade Eduardo Mondlane School of Medicine, Maputo, Mozambique
| | - Muhammad Sidat
- Universidade Eduardo Mondlane School of Medicine, Maputo, Mozambique
| | | | | | | | | | | | - Cesaltina Lorenzoni
- Hospital Central de Maputo, Maputo, Mozambique
- Universidade Eduardo Mondlane School of Medicine, Maputo, Mozambique
| | - Chris Buck
- Hospital Central de Maputo, Maputo, Mozambique
- University of California Los Angeles David Geffen School of Medicine, Maputo, Mozambique
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15
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Avila GA, Daza M, Forero-Motta D, Rozo-Gutierrez N, Osorio J, Walteros DM, Ballesteros A, Ovalle O, Rojas-Devia MA, Baez M, Martinez-De la Barrera LI, Beltrán-Higuera SJ, Galvis C, Mercado M, Prieto F. SARS-CoV-2 infection in newborn infants: descriptive epidemiological analysis of cases reported to the Colombian national surveillance system during the first pandemic year, March 2020-February 2021. BMJ Paediatr Open 2023; 7:10.1136/bmjpo-2022-001781. [PMID: 36863763 PMCID: PMC9990166 DOI: 10.1136/bmjpo-2022-001781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 02/15/2023] [Indexed: 03/04/2023] Open
Abstract
OBJECTIVE To describe the clinical and epidemiological characteristics of newborn infants with SARS-CoV-2 infection notified in the Colombian Public Health Surveillance System. DESIGN This epidemiological descriptive analysis was conducted using the data of all cases of newborn infants with confirmed SARS-CoV-2 infection notified in the surveillance system. Absolute frequencies and central tendency measures were calculated and a bivariate analysis comparing variables of interest with symptomatic and asymptomatic disease was performed. SETTING Population-based descriptive analysis. PATIENTS Laboratory-confirmed COVID-19 cases in newborn infants (aged ≤28 days of life) reported to the surveillance system from 1 March 2020 to 28 February 2021. RESULTS 879 newborns were identified, corresponding to 0.04% of all reported cases in the country. The mean age at diagnosis was 13 days (range 0-28 days), 55.1% were male and most (57.6%) were classified as symptomatic. Preterm birth and low birth weight were identified in 24.0% and 24.4% of the cases, respectively. Common symptoms were fever (58.3%), cough (48.3%) and respiratory distress (34.9%). A higher prevalence of symptomatic newborns was seen in individuals with low birth weight for gestational age (prevalence ratio (PR): 1.51, 95% CI: 1.44 to 1.59) and newborns with underlying conditions (PR: 1.33, 95% CI: 1.13 to 1.55). CONCLUSIONS There were a low proportion of confirmed COVID-19 cases in the newborn population. A substantial number of newborns were classified as symptomatic, having low birth weight and being preterm. Clinicians caring for COVID-19-infected newborns should be aware of population characteristics that potentially contribute to disease manifestations and severity.
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Affiliation(s)
- Greace A Avila
- Public Health Surveillance Division, National Institute of Health, Bogotá, Colombia
| | - Marcela Daza
- Public Health Research Division, National Institute of Health, Bogotá, Colombia
| | - Diana Forero-Motta
- Public Health Surveillance Division, National Institute of Health, Bogotá, Colombia
| | | | - Johana Osorio
- Public Health Research Division, National Institute of Health, Bogotá, Colombia
| | - Diana M Walteros
- Public Health Surveillance Division, National Institute of Health, Bogotá, Colombia
| | - Adriana Ballesteros
- Neonatology Department Coordinator, Fundación Valle del Lili, Cali, Colombia.,Faculty of Medicine, Icesi University, Cali, Colombia.,Colombian Neonatology Association, Bogotá, Colombia
| | - Oscar Ovalle
- Colombian Neonatology Association, Bogotá, Colombia.,Neonatology Department Coordinator, Los Cobos Medical Center, Bogotá, Colombia
| | | | - Martha Baez
- Clinical Research Coordinator, Colombian Neonatology Association, Bogotá, Colombia.,Neonatology Department, Clínica del Country, Bogotá, Colombia
| | - Leslie Ivonne Martinez-De la Barrera
- Colombian Neonatology Association, Bogotá, Colombia.,Neonatology Department Coordinator, Clínica Universitaria Colombia, Bogotá, Colombia.,Faculty of Medicine Fundación Universitaria Sanitas, Bogotá, Colombia
| | - Sandra Jaqueline Beltrán-Higuera
- Paediatric Infectious Disease Department Chief, Clínica Pediátrica Colsanitas, Bogotá, Colombia.,Paediatric Infectious Disease Department Chief, Clínica Universitaria Colombia, Bogotá, Colombia
| | - Clara Galvis
- Colombian Neonatology Association, Bogotá, Colombia.,General Director, Hospital Militar Central, Bogotá, Colombia
| | - Marcela Mercado
- Public Health Research Division, National Institute of Health, Bogotá, Colombia
| | - Franklyn Prieto
- Public Health Surveillance Division, National Institute of Health, Bogotá, Colombia
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16
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El Salih I, Njuguna FM, Widjajanto PH, Kaspers G, Bailey A, Mostert S. Impact of COVID-19 measures on the health and healthcare of children in East-Africa: Scoping review. Int J Health Plann Manage 2023; 38:579-598. [PMID: 36691260 DOI: 10.1002/hpm.3612] [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: 03/22/2022] [Revised: 11/29/2022] [Accepted: 12/22/2022] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic is of grave concern. As scientific data is being collected about the nature of COVID-19, government leaders and policy makers are challenged. They might feel pressured to take strong measures to stop virus spread. However, decisions could cause more harm than do good. This study maps all existing literature regarding the impact of COVID-19 containment measures on the health and healthcare of children in East-Africa. METHODS This scoping review follows Population Concept Context guidelines of Arksey and O'Malley and PRISMA 2020 checklist. PubMed, Web of Science, and Embase were searched. All peer-reviewed literature published in English between January 2020 and October 2022 was considered. Initial screening of titles and abstracts was undertaken independently by two reviewers, with a third available in case of doubt. This was followed by full-text screening involving two independent reviewers. RESULTS In total, 70 studies were included. Eight containment measures affecting children's health and healthcare were distinguished: lockdowns, school closures, physical distancing, travel restrictions, business closures, stay-at-home orders, curfews, quarantine measures with contact tracing. The consensus in the studies is that containment measures could minimise COVID-19 spread but have adverse indirect effects on children in East-Africa. Seven indirect effects were distinguished: economic damage, limited education access, food insecurity, child abuse, limited healthcare access, disrupted health-programs, and mental health challenges. CONCLUSION Government leaders and policy makers should take adverse indirect effects of COVID-19 measures into account, particularly in resource-limited regions such as East-Africa, apply a holistic approach, and strengthen socioeconomic and health-systems to protect the most vulnerable.
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Affiliation(s)
- Ibrahim El Salih
- International Development Studies, Department of Human Geography and Spatial Planning, Utrecht University, Utrecht, The Netherlands
| | - Festus Muigai Njuguna
- Department of Child Health and Pediatrics, Moi Teaching and Referral Hospital, Moi University, Eldoret, Kenya
| | - Pudjo Hagung Widjajanto
- Department of Pediatric Oncology, Dr Sardjito General Hospital, Gadjah Mada University, Yogyakarta, Indonesia
| | - Gertjan Kaspers
- Emma's Children Hospital, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands.,Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Ajay Bailey
- International Development Studies, Department of Human Geography and Spatial Planning, Utrecht University, Utrecht, The Netherlands
| | - Saskia Mostert
- Emma's Children Hospital, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands.,Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
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17
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Skeens MA, Hill K, Olsavsky A, Ralph JE, Udaipuria S, Akard TF, Gerhardt CA. Family functioning buffers the consequences of the COVID-19 pandemic for children's quality of life and loneliness. Front Psychol 2023; 13:1079848. [PMID: 36710839 PMCID: PMC9880325 DOI: 10.3389/fpsyg.2022.1079848] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 12/28/2022] [Indexed: 01/14/2023] Open
Abstract
COVID-19 resulted in mass quarantine measures early in the pandemic. This disruption of daily life widened inequities and made children one of the most vulnerable populations during the crisis. This national, cross-sectional "COVID-Kids" study collected data from almost 500 parent-child dyads using standardized measures to better understand the effects of COVID exposure and impact on children's quality of life and loneliness. Data were collected via social media from May to July 2020. According to parent proxy and child self-report, United States children experienced worse quality of life (p < 0.0001; d = 0.45 and 0.53) and greater child-reported loneliness (p < 0.0001) when compared to normative, healthy samples (i.e., children who do not have a chronic medical condition). Older children (r = 0.16, p = 0.001) and female children (r = 0.11, p = 0.02) reported greater loneliness. Higher child-reported family functioning scores were associated with better quality of life (r = 0.36, p < 0.0001) and less loneliness (r = -0.49, p < 0.0001). Moderated mediation analyses indicated the indirect effect of parent COVID impact on the association between COVID exposure and child quality of life was weaker in the context of better family functioning. Results of this study raise concern for the short-and long-term sequelae of the pandemic on the physical and mental health of children. Healthcare providers and researchers must find new and innovative ways to protect the well-being of children. Strengthening family functioning may buffer the effects of the pandemic and improve overall quality of life in our "COVID Kids."
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Affiliation(s)
- Micah A. Skeens
- Center for Biobehavioral Health, Nationwide Childrens Hospital, Columbus, OH, United States,Department of Pediatrics, The Ohio State University School of Medicine, Columbus, OH, United States,*Correspondence: Micah A. Skeens, ✉
| | - Kylie Hill
- Center for Biobehavioral Health, Nationwide Childrens Hospital, Columbus, OH, United States
| | - Anna Olsavsky
- Center for Biobehavioral Health, Nationwide Childrens Hospital, Columbus, OH, United States
| | - Jessica E. Ralph
- Center for Biobehavioral Health, Nationwide Childrens Hospital, Columbus, OH, United States
| | - Shivika Udaipuria
- Center for Biobehavioral Health, Nationwide Childrens Hospital, Columbus, OH, United States
| | - Terrah Foster Akard
- Vanderbilt School of Nursing, Vanderbilt University, Nashville, TN, United States
| | - Cynthia A. Gerhardt
- Center for Biobehavioral Health, Nationwide Childrens Hospital, Columbus, OH, United States,Department of Pediatrics, The Ohio State University School of Medicine, Columbus, OH, United States
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18
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CONTARINO FABIO, DI PIETRO ERMINIO, BELLA FRANCESCA, RANDAZZO CONCETTA, CONTRINO MARIALIA. Childhood immunization coverage during the COVID-19 pandemic in the province of Siracusa, Italy. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2022; 63:E513-E519. [PMID: 36891007 PMCID: PMC9986988 DOI: 10.15167/2421-4248/jpmh2022.63.4.2587] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Accepted: 11/30/2022] [Indexed: 03/10/2023]
Abstract
Introduction The COVID-19 pandemic has severely impacted routine immunization activities and a decline in vaccination coverage has been documented around the world. The aim of this study was to assess the impact of the direct and indirect effects of the COVID-19 pandemic on routine childhood vaccination coverage in the Province of Siracusa, Italy. Methods We compared 2020 and 2019 vaccination coverage by age group and vaccine type. Results were considered statistically significant at a two-tailed p-value ≤ 0.05. Results Our findings show that vaccination coverage rates for mandatory and recommended vaccinations decreased in 2020 compared with the previous year (range from -1.4% to -7.8%). Anti-rotavirus vaccination increased (+4.8%, as compared to 2019), while the reductions observed for polio vaccination (hexavalent) and human papillomavirus vaccination in males were not statistically significant. The reduction did not hit the population in the same manner, with the greater decreases observed for children aged > 24 months compared to the younger (-5.7% vs -2.2%) and for booster doses compared to the primary vaccinations (-6.4% vs -2.6%). Conclusions This study found that vaccination coverage of routine childhood immunisations was negatively affected during the COVID-19 pandemic in the Province of Siracusa. It is of huge importance to put in place some catch-up programs to ensure vaccinations at the earliest of individuals who missed immunization during the pandemic.
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Affiliation(s)
- FABIO CONTARINO
- Department of Public Health, Epidemiology Unit, Provincial Health Authority of Siracusa
- Correspondence: Fabio Contarino, Department of Public Health, Epidemiology Unit, Provincial Health Authority of Siracusa. Traversa la Pizzuta, 96100 Siracusa SR, Italy. Tel.: 00393288772055 - E-mail:
| | - ERMINIO DI PIETRO
- Department of Public Health, Epidemiology Unit, Provincial Health Authority of Siracusa
| | - FRANCESCA BELLA
- Siracusa Cancer Registry, Provincial Health Authority of Siracusa
| | - CONCETTA RANDAZZO
- Department of Public Health, Epidemiology Unit, Provincial Health Authority of Siracusa
| | - MARIA LIA CONTRINO
- Head of Department of Public Health, Provincial Health Authority of Siracusa
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19
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Piper JD, Mazhanga C, Chidhanguro D, Prendergast AJ. Impact of COVID-19 on schooling in rural Zimbabwe. Child Care Health Dev 2022; 48:1134-1135. [PMID: 36224615 PMCID: PMC9577473 DOI: 10.1111/cch.12955] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 12/06/2021] [Accepted: 12/20/2021] [Indexed: 01/12/2023]
Affiliation(s)
- Joe D Piper
- Zvitambo Institute for Maternal and Child Health, Harare, Zimbabwe
- Blizard Institute, Queen Mary University of London, London, UK
| | - Clever Mazhanga
- Zvitambo Institute for Maternal and Child Health, Harare, Zimbabwe
| | | | - Andrew J Prendergast
- Zvitambo Institute for Maternal and Child Health, Harare, Zimbabwe
- Blizard Institute, Queen Mary University of London, London, UK
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20
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Varela FH, Sartor ITS, Polese-Bonatto M, Azevedo TR, Kern LB, Fazolo T, de David CN, Zavaglia GO, Fernandes IR, Krauser JRM, Stein RT, Scotta MC. Rhinovirus as the main co-circulating virus during the COVID-19 pandemic in children. J Pediatr (Rio J) 2022; 98:579-586. [PMID: 35490727 PMCID: PMC9015957 DOI: 10.1016/j.jped.2022.03.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 02/10/2022] [Accepted: 02/28/2022] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVE Changes in the epidemiology of respiratory infections during the restrictions imposed as a response to the coronavirus disease 2019 (COVID-19) pandemic have been reported elsewhere. The present study's aim was to describe the prevalence of a large array of respiratory pathogens in symptomatic children and adolescents during the pandemic in Southern Brazil. METHODS Hospitalized and outpatients aged 2 months to 18 years with signs and symptoms of acute COVID-19 were prospectively enrolled in the study from May to November 2020 in two hospitals in a large metropolitan area in a Brazilian city. All participants performed a real-time PCR panel assessing 20 respiratory pathogens (three bacteria and 17 viruses). RESULTS 436 participants were included, with 45 of these hospitalized. Rhinovirus was the most prevalent pathogen (216/436) followed by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, 97/436), with a coinfection of these two viruses occurring in 31/436 participants. The remaining pathogens were found in 24 symptomatic participants (adenovirus, n = 6; Chlamydophila pneumoniae, n = 1; coronavirus NL63, n = 2; human enterovirus, n = 7; human metapneumovirus, n = 2; Mycoplasma pneumoniae, n = 6). Hospitalization was more common among infants (p = 0.004) and those with pathogens other than SARS-CoV-2 (p = 0.001). CONCLUSION During the period of social distancing in response to COVID-19, the prevalence of most respiratory pathogens was unusually low. Rhinovirus remained as the main virus co-circulating with SARS-CoV-2. COVID-19 in symptomatic children was less associated with hospitalization than with other respiratory infections in children and adolescents.
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Affiliation(s)
- Fernanda Hammes Varela
- Social Responsibility, Hospital Moinhos de Vento, Porto Alegre, RS, Brazil; Escola de Medicina, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | | | | | | | | | - Tiago Fazolo
- Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil
| | | | | | | | | | - Renato T Stein
- Social Responsibility, Hospital Moinhos de Vento, Porto Alegre, RS, Brazil; Escola de Medicina, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Marcelo Comerlato Scotta
- Social Responsibility, Hospital Moinhos de Vento, Porto Alegre, RS, Brazil; Escola de Medicina, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil.
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21
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Asghar Z, Sharaf K, Butt FA, Shaikh OA, Shekha M, Waris A, Ullah I, Nashwan AJ. A global review of racial, ethnic and socio-economic disparities in multisystem inflammatory syndrome in children related to COVID-19. Front Public Health 2022; 10:996311. [PMID: 36339223 PMCID: PMC9632619 DOI: 10.3389/fpubh.2022.996311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Accepted: 09/30/2022] [Indexed: 01/26/2023] Open
Abstract
With over 500 million confirmed cases and 6.2 million deaths worldwide, the novel coronavirus has highlighted the underlying disparities in healthcare, unpreparedness to deal with a new disease and the need for monitoring and surveillance for a post-infectious syndrome as well as complicated diseases. Initially, children were thought to be spared but reports of a new phenomenon manifesting as Kawasaki-like disease, toxic shock syndrome, and multi-system inflammatory syndrome, which developed after a few weeks of severe COVID-19 infection, emerged in the pediatric population. As the pandemic progressed, increased prevalence of multi-system inflammatory syndrome in children (MIS-C) related to COVID-19 was seen in non-Hispanic blacks, Asians, and Latinos as compared to the white population drawing attention to a possible role of ethnicity and socio-economic disparities. The CDC currently reports that 31% of MIS-C cases were seen in Black Non-Hispanics and 26% in Latinos, who were historically more affected in previous pandemics. Furthermore, MIS-C cases in developing countries showed higher mortality as compared to high-income countries, which points toward the role of social determinants of health and limitations in a low-resource set up in increasing the disease burden of MIS-C, which should be treated as a public health emergency. Our review highlights the role of ethnicity, socio-economic factors, comorbidities, and differences in populations affected by MIS-C in high-income vs. low- and middle-income countries.
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Affiliation(s)
- Zoha Asghar
- Department of Medicine, Ziauddin University, Karachi, Pakistan
| | - Kanza Sharaf
- Department of Medicine, Ziauddin University, Karachi, Pakistan
| | | | | | - Manahil Shekha
- Department of Medicine, Ziauddin University, Karachi, Pakistan
| | - Abdul Waris
- Kabir Medical College, Gandhara University, Peshawar, Pakistan
| | - Irfan Ullah
- Kabir Medical College, Gandhara University, Peshawar, Pakistan
- Institute of Public Health and Social Science (IPH&SS), Khyber Medical University, Peshawar, Pakistan
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22
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Daum T, Biesalski HK, Blaschke N, Bosch C, Güttler D, Heni J, Kariuki J, Katusiime R, Seidel A, Senon Z, Woode G, Birner R. Nutrition-sensitive lockdowns: conceptual framework and empirical insights from Africa during COVID-19. DEVELOPMENT POLICY REVIEW : THE JOURNAL OF THE OVERSEAS DEVELOPMENT INSTITUTE 2022; 41:e12666. [PMID: 36245567 PMCID: PMC9538056 DOI: 10.1111/dpr.12666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 07/14/2022] [Accepted: 08/28/2022] [Indexed: 06/16/2023]
Abstract
Motivation Countries facing challenges of nutrition security confront a trade-off when dealing with pandemics such as COVID-19. Implementing lockdown measures, widely used worldwide, can help "flatten the curve" (of disease), but such measures may worsen nutrition security. Purpose We aim to identify and justify nutrition-sensitive lockdown measures to reduce trade-offs with nutrition security. Methods and approach We propose a conceptual framework which distinguishes eight lockdown measures and six pathways to nutrition security. To demonstrate the relevance of the pathways, we reviewed emerging literature on COVID-19 and nutrition security. We analysed the content of 1,188 newspaper articles on lockdown effects in five African countries - Benin, Ghana, Kenya, Uganda and Zambia. Findings Some lockdown measures, such as closing workplaces and restricting movement, potentially worsen nutrition far more than others - banning events and public gatherings have far lesser impacts on nutrition. This can be seen from the framework, literature, and is supported by the analysis of newspaper reports in the five countries. Policy implications It is better when possible to test and trace disease than to lockdown. But when lockdowns are needed, then first recourse should be to measures that have few nutritional consequences, such as banning public events. When more drastic measures are necessary, look to mitigate nutritional harm by, for example, exempting farm labour from restrictions on movement, by replacing school meals with take-home rations, and, above all, providing income support to households most affected and most vulnerable.
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Affiliation(s)
- Thomas Daum
- Institute of Agricultural Sciences in the Tropics (Hans‐Ruthenberg‐Institute)University of HohenheimGermany
| | | | - Nikola Blaschke
- Institute of Agricultural Sciences in the Tropics (Hans‐Ruthenberg‐Institute)University of HohenheimGermany
| | - Christine Bosch
- Institute of Agricultural Sciences in the Tropics (Hans‐Ruthenberg‐Institute)University of HohenheimGermany
| | - Denise Güttler
- Institute of Agricultural Sciences in the Tropics (Hans‐Ruthenberg‐Institute)University of HohenheimGermany
| | - Jakob Heni
- Institute of Agricultural Sciences in the Tropics (Hans‐Ruthenberg‐Institute)University of HohenheimGermany
| | - Juliet Kariuki
- Institute of Agricultural Sciences in the Tropics (Hans‐Ruthenberg‐Institute)University of HohenheimGermany
| | - Roseline Katusiime
- Institute of Agricultural Sciences in the Tropics (Hans‐Ruthenberg‐Institute)University of HohenheimGermany
| | - Anna Seidel
- Institute of Agricultural Sciences in the Tropics (Hans‐Ruthenberg‐Institute)University of HohenheimGermany
| | - Zinsou‐Narcisse Senon
- Regional Agency of Agricultural Development‐PlateauMinistry of Agriculture, Livestock and FisheryRepublic of Benin
| | - George Woode
- Institute of Agricultural Sciences in the Tropics (Hans‐Ruthenberg‐Institute)University of HohenheimGermany
| | - Regina Birner
- Institute of Agricultural Sciences in the Tropics (Hans‐Ruthenberg‐Institute)University of HohenheimGermany
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23
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Cardoso Pinto AM, Ranasinghe L, Dodd PJ, Budhathoki SS, Seddon JA, Whittaker E. Disruptions to routine childhood vaccinations in low- and middle-income countries during the COVID-19 pandemic: A systematic review. Front Pediatr 2022; 10:979769. [PMID: 36034563 PMCID: PMC9403570 DOI: 10.3389/fped.2022.979769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 07/22/2022] [Indexed: 11/16/2022] Open
Abstract
Background The COVID-19 pandemic has disrupted routine childhood vaccinations worldwide with low- and middle-income countries (LMICs) most affected. This study aims to quantify levels of disruption to routine vaccinations in LMICs. Methods A systematic review (PROSPERO CRD42021286386) was conducted of MEDLINE, Embase, Global Health, CINAHL, Scopus and MedRxiv, on the 11th of February 2022. Primary research studies published from January 2020 onwards were included if they reported levels of routine pediatrics vaccinations before and after March 2020. Study appraisal was performed using NHLBI tool for cross-sectional studies. Levels of disruption were summarized using medians and interquartile ranges. Results A total of 39 cross-sectional studies were identified. These showed an overall relative median decline of -10.8% [interquartile range (IQR) -27.6%, -1.4%] across all vaccines. Upper-middle-income countries (upper-MICs) (-14.3%; IQR -24.3%, -2.4%) and lower-MICs (-18.0%; IQR -48.6%, -4.1%) showed greater declines than low-income countries (-3.1%; IQR -12.8%, 2.9%), as did vaccines administered at birth (-11.8%; IQR -27.7%, -3.5%) compared to those given after birth (-8.0%; IQR -28.6%, -0.4%). Declines during the first 3 months of the pandemic (-8.1%; IQR -35.1%, -1.4%) were greater than during the remainder of 2020 (-3.9%; IQR -13.0%, 11.4%) compared to baseline. Conclusion There has been a decline in routine pediatric vaccination, greatest in MICs and for vaccines administered at birth. Nations must prioritize catch-up programs alongside public health messaging to encourage vaccine uptake. Systematic review registration Identifier: CRD42021286386.
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Affiliation(s)
| | - Lasith Ranasinghe
- Academic Foundation Doctor, Imperial College London, London, United Kingdom
| | - Peter J Dodd
- School of Health and Related Research, University of Sheffield, Sheffield, United Kingdom
| | - Shyam Sundar Budhathoki
- Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, United Kingdom
| | - James A Seddon
- Department of Infectious Disease, Imperial College London, London, United Kingdom
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Stellenbosch University, Cape Town, South Africa
| | - Elizabeth Whittaker
- Department of Infectious Disease, Imperial College London, London, United Kingdom
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24
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Baloushah SR, Abu-Hamad N, Mohammadi N, Alkasseh ASM, Salah MS. Gaza Midwives’ Lived Experience of Providing Maternity Care During COVID-19. Eur J Midwifery 2022; 6:51. [PMID: 35974714 PMCID: PMC9348584 DOI: 10.18332/ejm/150490] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 05/26/2022] [Accepted: 05/27/2022] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION The Gaza Strip is densely populated. The COVID-19 pandemic has had a detrimental impact on global healthcare systems, and midwifery practices have transformed in maternity care settings. Our research aimed at understanding the Palestinian midwives’ experiences in providing maternity care in Gaza during the COVID-19 pandemic at Gaza European Hospital which was the only hospital providing care for people diagnosed with COVID-19. METHODS To understand the phenomenon of interest, descriptive phenomenology was used. A purposive sample of eight midwives from the European Gaza Hospital was chosen. Between December 2020 and January 2021, semi-structured interviews were used in the data collection procedure. The collected data were analyzed using the Colaizzi approach. RESULTS The investigation resulted in three main themes: emotionally overwhelmed, work environment challenges, and interpersonal relationship development. CONCLUSIONS Midwives shared both positive and negative experiences from their time working in the European Gaza Hospital during the COVID-19 pandemic. They were confronted with negative emotions such as fear, stress, and anxiety, as well as environmental challenges. Despite this, they created a new interpersonal bond that was positively reflected. To sustain their psychological well-being, COVID-19 care workers require psychological support at work. A strong need exists for equipping the Maternity Department with the essential equipment and supplies to reduce the working environment load, as well as giving the necessary training to staff to be qualified enough to provide such crucial care.
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Affiliation(s)
- Suha R. Baloushah
- Midwifery Department, Faculty of Nursing, Islamic University of Gaza, Gaza City, Palestine
- Department of Reproductive Health, School of Nursing and Midwifery, Tehran University of Medical Science, Tehran, Iran
| | - Nidal Abu-Hamad
- Independent Reproductive Health Researcher, Gaza City, Palestine
| | - Nooredine Mohammadi
- Nursing Care Research Center, School of Nursing and Midwifery, Iran University of Medical Science, Tehran, Iran
| | - Areefa S. M. Alkasseh
- Midwifery Department, Faculty of Nursing, Islamic University of Gaza, Gaza City, Palestine
| | - Motasem S. Salah
- Nursing and Health Sciences Department, University College of Applied Sciences, Gaza City, Palestine
- Faculty of Public Health, Al-Quds University, Jerusalem, Palestine
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25
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McCollum R, Zaizay Z, Dean L, Watson V, Frith L, Alhassan Y, Kollie K, Piotrowski H, Bates I, Anderson de Cuevas R, Harris R, Chowdhury S, Berrian H, Smith JS, Tate WS, El Hajj T, Ozano K, Hastie O, Parker C, Kollie J, Zawolo G, Ding Y, Dacombe R, Taegtmeyer M, Theobald S. Qualitative study exploring lessons from Liberia and the UK for building a people-centred resilient health systems response to COVID-19. BMJ Open 2022; 12:e058626. [PMID: 35914910 PMCID: PMC9344595 DOI: 10.1136/bmjopen-2021-058626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
INTRODUCTION COVID-19 has tested the resilience of health systems globally and exposed existing strengths and weaknesses. We sought to understand health systems COVID-19 adaptations and decision making in Liberia and Merseyside, UK. METHODS We used a people-centred approach to carry out qualitative interviews with 24 health decision-makers at national and county level in Liberia and 42 actors at county and hospital level in the UK (Merseyside). We explored health systems' decision-making processes and capacity to adapt and continue essential service delivery in response to COVID-19 in both contexts. RESULTS Study respondents in Liberia and Merseyside had similar experiences in responding to COVID-19, despite significant differences in health systems context, and there is an opportunity for multidirectional learning between the global south and north. The need for early preparedness; strong community engagement; clear communication within the health system and health service delivery adaptations for essential health services emerged strongly in both settings. We found the Foreign, Commonwealth and Development Office (FCDO) principles to have value as a framework for reviewing health systems changes, across settings, in response to a shock such as a pandemic. In addition to the eight original principles, we expanded to include two additional principles: (1) the need for functional structures and mechanisms for preparation and (2) adaptable governance and leadership structures to facilitate timely decision making and response coordination. We find the use of a people-centred approach also has value to prompt policy-makers to consider the acceptance of service adaptations by patients and health workers, and to continue the provision of 'routine services' for individuals during health systems shocks. CONCLUSION Our study highlights the importance of a people-centred approach, placing the person at the centre of the health system, and value in applying and adapting the FCDO principles across diverse settings.
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Affiliation(s)
- Rosalind McCollum
- Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, UK
| | | | - Laura Dean
- Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Victoria Watson
- Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Lucy Frith
- Centre for Social Ethics & Policy, School of Law, The University of Manchester, Manchester, UK
| | - Yussif Alhassan
- Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Karsor Kollie
- Neglected Tropical Disease Programme, Ministry of Health, Monrovia, Liberia
| | - Helen Piotrowski
- Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Imelda Bates
- Centre for Capacity Research, Liverpool School of Tropical Medicine, Liverpool, UK
| | | | - Rebecca Harris
- Institute of Population Health, University of Liverpool, Liverpool, UK
| | - Shahreen Chowdhury
- Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Hannah Berrian
- Pacific Institute for Research and Evaluation, University of Liberia, Monrovia, Liberia
| | - John Solunta Smith
- Pacific Institute for Research and Evaluation, University of Liberia, Monrovia, Liberia
| | - Wede Seekey Tate
- Pacific Institute for Research and Evaluation, University of Liberia, Monrovia, Liberia
| | - Taghreed El Hajj
- Centre for Capacity Research, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Kim Ozano
- Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Olivia Hastie
- Liverpool School of Tropical Medicine, Liverpool, UK
| | - Colleen Parker
- Department of Planning, Policy and M&E, Ministry of Health, Monrovia, Liberia
| | - Jerry Kollie
- Pacific Institute for Research and Evaluation, University of Liberia, Monrovia, Liberia
| | - Georgina Zawolo
- Pacific Institute for Research and Evaluation, University of Liberia, Monrovia, Liberia
| | - Yan Ding
- Centre for Capacity Research, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Russell Dacombe
- Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Miriam Taegtmeyer
- Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, UK
- Tropical Infectious Diseases Institute, Liverpool University Hospitals Foundation Trust, Liverpool, UK
| | - Sally Theobald
- Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, UK
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26
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Ali HA, Hartner AM, Echeverria-Londono S, Roth J, Li X, Abbas K, Portnoy A, Vynnycky E, Woodruff K, Ferguson NM, Toor J, Gaythorpe KAM. Vaccine equity in low and middle income countries: a systematic review and meta-analysis. Int J Equity Health 2022; 21:82. [PMID: 35701823 PMCID: PMC9194352 DOI: 10.1186/s12939-022-01678-5] [Citation(s) in RCA: 39] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 05/17/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Evidence to date has shown that inequality in health, and vaccination coverage in particular, can have ramifications to wider society. However, whilst individual studies have sought to characterise these heterogeneities in immunisation coverage at national level, few have taken a broad and quantitative view of the contributing factors to heterogeneity in immunisation coverage and impact, i.e. the number of cases, deaths, and disability-adjusted life years averted. This systematic review aims to highlight these geographic, demographic, and sociodemographic characteristics through a qualitative and quantitative approach, vital to prioritise and optimise vaccination policies. METHODS A systematic review of two databases (PubMed and Web of Science) was undertaken using search terms and keywords to identify studies examining factors on immunisation inequality and heterogeneity in vaccination coverage. Inclusion criteria were applied independently by two researchers. Studies including data on key characteristics of interest were further analysed through a meta-analysis to produce a pooled estimate of the risk ratio using a random effects model for that characteristic. RESULTS One hundred and eight studies were included in this review. We found that inequalities in wealth, education, and geographic access can affect vaccine impact and vaccination dropout. We estimated those living in rural areas were not significantly different in terms of full vaccination status compared to urban areas but noted considerable heterogeneity between countries. We found that females were 3% (95%CI[1%, 5%]) less likely to be fully vaccinated than males. Additionally, we estimated that children whose mothers had no formal education were 28% (95%CI[18%,47%]) less likely to be fully vaccinated than those whose mother had primary level, or above, education. Finally, we found that individuals in the poorest wealth quintile were 27% (95%CI [16%,37%]) less likely to be fully vaccinated than those in the richest. CONCLUSIONS We found a nuanced picture of inequality in vaccination coverage and access with wealth disparity dominating, and likely driving, other disparities. This review highlights the complex landscape of inequity and further need to design vaccination strategies targeting missed subgroups to improve and recover vaccination coverage following the COVID-19 pandemic. TRIAL REGISTRATION Prospero, CRD42021261927.
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Affiliation(s)
- Huda Ahmed Ali
- grid.7445.20000 0001 2113 8111Imperial College London, Praed Street, London, UK
| | - Anna-Maria Hartner
- grid.7445.20000 0001 2113 8111Imperial College London, Praed Street, London, UK
| | | | - Jeremy Roth
- grid.7445.20000 0001 2113 8111Imperial College London, Praed Street, London, UK
| | - Xiang Li
- grid.7445.20000 0001 2113 8111Imperial College London, Praed Street, London, UK
| | - Kaja Abbas
- grid.8991.90000 0004 0425 469XLondon School of Hygiene and Tropical Medicine, Keppel Street, London, UK
| | - Allison Portnoy
- grid.38142.3c000000041936754XCenter for Health Decision Science, Harvard T H Chan School of Public Health, Cambridge, USA
| | - Emilia Vynnycky
- grid.271308.f0000 0004 5909 016XPublic Health England, London, UK
| | - Kim Woodruff
- grid.7445.20000 0001 2113 8111Imperial College London, Praed Street, London, UK
| | - Neil M Ferguson
- grid.7445.20000 0001 2113 8111Imperial College London, Praed Street, London, UK
| | - Jaspreet Toor
- grid.7445.20000 0001 2113 8111Imperial College London, Praed Street, London, UK
| | - Katy AM Gaythorpe
- grid.7445.20000 0001 2113 8111Imperial College London, Praed Street, London, UK
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Das A, Nanda V, Lauden SM, Behrmann A, González de Rivas MDR, Kurbasic M, Okolo A, Oyerinde K, Smith S, Vides M, Jacobs T, Umoren R. COVID-19 Pandemic Response and Adaptations by International Community Access to Child Health (ICATCH) Projects in Low- and Middle-Income Countries. Glob Pediatr Health 2022; 9:2333794X221097240. [PMID: 35592791 PMCID: PMC9112297 DOI: 10.1177/2333794x221097240] [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: 02/08/2022] [Accepted: 04/11/2022] [Indexed: 11/17/2022] Open
Abstract
Background. The health personnel in low/low and middle-income
countries have faced significant challenges during the COVID-19 pandemic. The
International Community Access to Child Health (ICATCH) grants support locally
initiated projects in those countries. The aim of this study was to highlight
how the challenges countered by grant project teams continuing their projects
and demonstrating their skills to adapt to an increasingly difficult
environment. Methods. This was a mixed methodology study for
which data were obtained from the evaluation of annual reports submitted by the
projects. The annual reports review comprised of answers to questions on whether
project objectives were met, problems or barriers encountered, and reviewer
feedback in the form of specific concerns or recommendations. The reports were
analyzed both quantitatively and qualitatively. Results. A
total of 34 (92%) of annual reports were included with 17 (94%) received in 2020
and 17 (89%) in 2021. Compared to 2020, in 2021 the projects that indicated
meeting objectives increased by more than half from 29% to 58%. Over one third
of the projects encountered barriers in both years. The percentage of projects
with major concerns decreased by almost 2/3 in 2021 while unexpected expenses
decreased by 1/3. Four themes emerged from the qualitative analysis: Concerns
over COVID-19, Barriers to accomplishing project goals, Positivity around
adaptations, and Despair over lack of ability to overcome challenges.
Conclusions. ICATCH funded projects demonstrated resiliency
and adaptations to meet program objectives despite the challenges posed by the
COVID-19 pandemic demonstrating greater success in 2021.
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Affiliation(s)
- Anirudha Das
- Cleveland Clinic Children's Hospital, Cleveland, OH, USA
| | - Vishakha Nanda
- John H. Stroger Jr. Hospital of Cook County, Chicago, IL, USA
| | | | - Ann Behrmann
- American Academy of Pediatrics' International Community Access to Child Health (ICATCH) Grants Program, Itasca, IL, USA.,University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | | | | | | | | | - Sherri Smith
- American Academy of Pediatrics' International Community Access to Child Health (ICATCH) Grants Program, Itasca, IL, USA
| | | | - Troy Jacobs
- George Washington University and Children's National Hospital, Washington, DC, USA
| | - Rachel Umoren
- American Academy of Pediatrics' International Community Access to Child Health (ICATCH) Grants Program, Itasca, IL, USA.,University of Washington and Seattle Children's Hospital, Seattle, WA, USA
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Weldetsadik AY, Abayneh M, Abraha M, Sirgu S, Bekele D. Clinical Characteristics and Outcome of Pediatric COVID-19 Patients in Ethiopia During the Early COVID-19 Pandemic: A Prospective Cohort Study. Pediatric Health Med Ther 2022; 13:165-174. [PMID: 35573390 PMCID: PMC9106426 DOI: 10.2147/phmt.s359333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 04/28/2022] [Indexed: 12/15/2022] Open
Abstract
Introduction Setting Methods Results Conclusion
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Affiliation(s)
- Abate Yeshidinber Weldetsadik
- Department of Pediatrics and Child Health, St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
- Correspondence: Abate Yeshidinber Weldetsadik, Department of Pediatrics and Child Health, St Paul’s Hospital Millennium Medical College, PO. Box 1271, Addis Ababa, Ethiopia, Tel +251 911993975, Email
| | - Mahlet Abayneh
- Department of Pediatrics and Child Health, St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Mebratu Abraha
- Research Directorate, St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Sisay Sirgu
- Department of Internal Medicine, St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Delayehu Bekele
- Department of Obstetrics and Gynecology St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
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Majeed A, Wright T, Guo B, Arora RS, Lam CG, Martiniuk AL. The Global Impact of COVID-19 on Childhood Cancer Outcomes and Care Delivery - A Systematic Review. Front Oncol 2022; 12:869752. [PMID: 35463381 PMCID: PMC9023072 DOI: 10.3389/fonc.2022.869752] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 03/14/2022] [Indexed: 11/25/2022] Open
Abstract
Background Childhood cancer represents a leading cause of death and disease burden in high income countries (HICs) and low-and-middle income countries (LMICs). It is postulated that the current COVID-19 pandemic has hampered global development of pediatric oncology care programs. This systematic review aimed to comprehensively review the global impact of COVID-19 on childhood cancer clinical outcomes and care delivery. Methods A systematic search was conducted on PubMed, Embase, Medline, and the African Medical Index from inception to November 3, 2021 following PRISMA guidelines. A manual search was performed to identify additional relevant studies. Articles were selected based on predetermined eligibility criteria. Findings The majority of studies reported patients with cancer and COVID-19 presenting as asymptomatic (HICs: 33.7%, LMICs: 22.0%) or with primary manifestations of fever (HICs: 36.1%, LMICs: 51.4%) and respiratory symptoms (HICs: 29.6%, LMICs: 11.7%). LMICs also reported a high frequency of patients presenting with cough (23.6%) and gastrointestinal symptoms (10.6%). The majority of patients were generally noted to have a good prognosis; however the crude mortality rate was higher in LMICs when compared to HICs (8.0% vs 1.8%). Moreover, the pandemic has resulted in delays and interruptions to cancer therapies and delays in childhood cancer diagnoses in both HICs and LMICs. However, these findings were disproportionately reported in LMICs, with significant staff shortages, supply chain disruptions, and limited access to cancer therapies for patients. Conclusions The COVID-19 pandemic has resulted in delays and interruptions to childhood cancer therapies and delays in childhood cancer diagnoses, and disproportionately so within LMICs. This review provides lessons learned for future system-wide disruptions to care, as well as provides key points for moving forward better with care through the remainder of this pandemic. Systematic Review Registration CRD42021266758, https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=266758
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Affiliation(s)
- Amna Majeed
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Tom Wright
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Biqi Guo
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Ramandeep S Arora
- Department of Medical Oncology, Max Super-Specialty Hospital, New Delhi, India
| | - Catherine G Lam
- Department of Global Pediatric Medicine and Oncology, St. Jude Children's Research Hospital, Memphis, TN, United States
| | - Alexandra L Martiniuk
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
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Sialubanje C, Sitali DC, Mukumbuta N, Liyali L, Sumbwa PI, Kamboyi HK, Ng'andu M, Goma FM. Perspectives on factors influencing transmission of COVID-19 in Zambia: a qualitative study of health workers and community members. BMJ Open 2022; 12:e057589. [PMID: 35383080 PMCID: PMC8983411 DOI: 10.1136/bmjopen-2021-057589] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE To explore the health professionals' and community members' perspectives on the factors influencing transmission of the novel COVID-19 in Zambia. DESIGN An exploratory qualitative study using in-depth interviews as data collection technique. SETTING Four primary healthcare facilities and local communities of Lusaka city and Chirundu international border town under Lusaka province, Zambia. PARTICIPANTS Purposive sampling of 60 study participants comprising health professionals (n=15) and community members (n=45). Health staff were health inspectors and surveillance officers. Community members included public market traders, civic and religious leaders, immigration officers, bus and international truck drivers. RESULTS Both health professionals and community members were aware of the COVID-19 pandemic, the preventive and control measures. Nevertheless, stark differences were observed on the two groups' perspectives on COVID-19 and the factors influencing its transmission. Most health staff expressed high personal risk and susceptibility to the disease and a positive attitude towards the prevention and control measures. Conversely, myths and misconceptions influenced most community members' perspectives on the disease and their attitude towards the COVID-19 guidelines. Participants were unanimous on the low levels of adherence to the COVID-19 preventive and control measures in the community. Reasons for non-adherence included limited information on COVID-19, negative attitude towards COVID-19 guidelines, social movement and travel patterns, networks and interactions, living and work conditions, water and sanitation facilities, and observation of behaviours of important role models such as politicians and other community leaders. These factors were perceived to increase the risk of COVID-19 transmission. CONCLUSION These findings highlight important factors influencing transmission of COVID-19 in Zambia. Future interventions should focus on providing information to mitigate myths and misconceptions, increasing people's risk perception to the disease, and improving attitude towards the prevention and control interventions and mitigating structural and socioeconomic barriers.
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Affiliation(s)
- Cephas Sialubanje
- School of Public Health, Levy Mwanawasa Medical University, Lusaka, Zambia
| | - Doreen C Sitali
- School of Public Health, University of Zambia, Lusaka, Zambia
| | - Nawa Mukumbuta
- School of Public Health, Levy Mwanawasa Medical University, Lusaka, Zambia
| | - Libonda Liyali
- School of Medicine and Health Sciences, Eden University, Lusaka, Zambia
| | | | | | - Mary Ng'andu
- School of Public Health, Levy Mwanawasa Medical University, Lusaka, Zambia
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Distribution and Drug Resistance of Bacterial Pathogens Associated with Lower Respiratory Tract Infection in Children and the Effect of COVID-19 on the Distribution of Pathogens. THE CANADIAN JOURNAL OF INFECTIOUS DISEASES & MEDICAL MICROBIOLOGY = JOURNAL CANADIEN DES MALADIES INFECTIEUSES ET DE LA MICROBIOLOGIE MEDICALE 2022; 2022:1181283. [PMID: 35368516 PMCID: PMC8965734 DOI: 10.1155/2022/1181283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 01/26/2022] [Accepted: 03/01/2022] [Indexed: 11/17/2022]
Abstract
By studying the distribution and drug resistance of bacterial pathogens associated with lower respiratory tract infection (LRTI) in children in Chengdu and the effect of the COVID-19 on the distribution of pathogens and by analyzing the epidemic trend and drug resistance changes of the main pathogens of LRTI, this research is supposed to provide a useful basis for the prevention of LRTI in children and the rational use of drugs in clinical practice. Hospitalized children clinically diagnosed with LRTI in Chengdu Women and Children's Central Hospital from 2011 to 2020 were selected as the study subjects. The pathogens of LRTI in children and the distribution of pathogens in different ages, genders, seasons, years, and departments and before and after the pandemic situation of COVID-19 were counted. The drug resistance distribution of the top six pathogens with the highest infection rate in the past three years and the trend of drug resistance in the past decade were analyzed. A total of 26,469 pathogens were isolated. Among them, 6240 strains (23.6%) were Gram-positive bacteria, 20152 strains (76.1%) were Gram-negative bacteria, and 73 strains (0.3%) were fungi. Klebsiella pneumoniae, Escherichia coli, Enterobacter cloacae, and Staphylococcus aureus were highly isolated in the group of infants aged 0-1 (P < 0.01), Moraxella catarrhalis and Streptococcus pneumoniae were highly isolated in children aged 1–6 (P < 0.01), and Haemophilus influenzae was highly isolated in children over 1 (P < 0.01). The isolation rates of Enterobacteriaceae, Acinetobacter baumannii, Pseudomonas aeruginosa, Stenotrophomonas maltophilia, Staphylococcus aureus, and Candida albicans in the lower respiratory tract of 0-1 year-old male infants were higher than those of female infants (p < 0.05). Haemophilus influenzae was highly isolated in spring and summer, and Moraxella catarrhalis was highly isolated in autumn and winter, while the infection of Streptococcus pneumoniae was mainly concentrated in winter. This difference was statistically significant (P < 0.01). Affected by the COVID-19 pandemic, the isolation rates of Haemophilus influenzae and Streptococcus pneumoniae were significantly lower than those before the pandemic, and the isolation rate of Moraxella catarrhalis was significantly higher. The difference was statistically significant (P < 0.01). The proportion of isolated negative bacteria in NICU and PICU was higher than that in positive bacteria, and the infection rates of Klebsiella pneumoniae, Escherichia coli, Enterobacter cloacae, and Acinetobacter baumannii were higher than those in other departments. The differences were statistically significant (P < 0.01). The results of drug sensitivity test showed that the drug resistance of Haemophilus influenzae and Moraxella catarrhalis was mainly concentrated in Ampicillin, First- and Second-generation cephalosporins, and Cotrimoxazole, with stable sensitivity to Third-generation cephalosporins, while the drug resistance of Streptococcus pneumoniae was concentrated in Macrolides, Sulfonamides, and Tetracyclines, with stable sensitivity to Penicillin. Staphylococcus aureus is highly resistant to penicillins and macrolides and susceptible to vancomycin. Enterobacteriaceae resistance is concentrated in cephalosporins, with a low rate of carbapenem resistance. From 2018 to 2020, 1557 strains of Staphylococcus aureus were isolated, of which 416 strains were MRSA, accounting for 27% of the isolates; 1064 strains of Escherichia coli were isolated, of which 423 strains were ESBL and 23 strains were CRE, accounting for 40% and 2% of the isolates, respectively; and 1400 strains of Klebsiella pneumoniae were isolated, of which 385 strains were ESBL and 402 strains were CRE, accounting for 28% and 29% of the isolates, respectively. Since 2011, the resistance of Escherichia coli and Klebsiella pneumoniae to Third-generation cephalosporins has increased, peaking in 2017, and has decreased after 2018, years after which carbapenem resistance has increased significantly, corresponding to an increase in the detection rate of Carbapenem-resistant Enterobacteriaceae CRE. Findings from this study revealed that there are significant differences in community-associated infectious pathogens before and after the COVID-19 pandemic, and there are significant age differences, seasonal epidemic trends, and high departmental correlation of pathogens related to lower respiratory tract disease infection in children. There was a significant gender difference in the isolation rate of pathogens associated with LRTI in infants under one year. Vaccination, implementation of isolation measures and social distance, strengthening of personal protective measures, aseptic operation of invasive medical treatment, hand hygiene, and environmental disinfection are beneficial to reducing community-associated pathogen infection, opportunistic pathogen infection, and an increase in resistant bacteria. The strengthening of bacterial culture of lower respiratory tract samples by pediatricians is conducive to the diagnosis of respiratory tract infections caused by different pathogens, contributing to the selection of effective drugs for treatment according to drug susceptibility results, which is important for the rational use of antibiotics and curbing bacterial resistance.
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32
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Carr OG, Jilani-Hyler N, Murray GR. Identifying factors related to school closures due to COVID-19 in the Middle East and North Africa region. INTERNATIONAL JOURNAL OF EDUCATIONAL DEVELOPMENT 2022; 90:102560. [PMID: 35125638 PMCID: PMC8802155 DOI: 10.1016/j.ijedudev.2022.102560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 01/25/2022] [Accepted: 01/25/2022] [Indexed: 06/14/2023]
Abstract
The COVID-19 pandemic has had devastating effects on the Middle East and North Africa (MENA) region, and MENA states have taken dramatic steps in response. This study focuses on school closures, an intervention that all MENA states adopted, some much earlier than others. It seeks to identify policy factors related to MENA governments' decisions to close schools during the first wave of the pandemic. Results suggest external issues regarding temporal and geographic diffusion played the largest role. They also indicate that factors related to disease risk, the economy, political institutions, and women's position in society mattered as well, all of which suggest the decisions were complex.
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Affiliation(s)
- Olivia G Carr
- Education Research Alliance for New Orleans, Tulane University, USA
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33
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Haffejee S, Vostanis P, O'Reilly M, Law E, Eruyar S, Fleury J, Hassan S, Getanda E. Disruptions, adjustments and hopes: The impact of the COVID-19 pandemic on child well-being in five Majority World Countries. CHILDREN & SOCIETY 2022; 37:CHSO12563. [PMID: 35602421 PMCID: PMC9111791 DOI: 10.1111/chso.12563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 12/20/2021] [Accepted: 02/22/2022] [Indexed: 06/15/2023]
Abstract
Drawing on integrated data from focus groups and diary entries, we explored the impact of the COVID-19 pandemic on child well-being for children from five Majority World Countries. We focus on the disruptions the pandemic caused, the adjustments made in response to these, and children's vision of a post-pandemic world. Underlying children's experiences of loss, boredom and concerns about educational progress, was an awareness of systemic inequalities that disadvantaged them or others in their community. Findings have implications on capturing children's voices through introspective and dialogical approaches that transcend cultures and for the development of preventive and responsive interventions during crises.
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Affiliation(s)
- Sadiyya Haffejee
- Centre for Social Development in AfricaUniversity of JohannesburgJohannesburgSouth Africa
| | - Panos Vostanis
- School of Media, Communication and SociologyUniversity of LeicesterLeicesterUK
| | - Michelle O'Reilly
- School of Media, Communication and SociologyUniversity of LeicesterLeicesterUK
| | - Effie Law
- Department of Computer ScienceDurham UniversityDurhamUK
| | - Seyda Eruyar
- Faculty of Social Sciences and HumanitiesNecmettin Erbakan UniversityKonyaTurkey
| | | | - Sajida Hassan
- Child and Adolescent Development Programme CADPKarachiPakistan
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34
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Sinha B, Dudeja N, Mazumder S, Kumar T, Adhikary P, Roy N, Rongsen Chandola T, Mehta R, Raina N, Bhandari N. Estimating the Impact of COVID-19 Pandemic Related Lockdown on Utilization of Maternal and Perinatal Health Services in an Urban Neighborhood in Delhi, India. Front Glob Womens Health 2022; 3:816969. [PMID: 35425937 PMCID: PMC9002136 DOI: 10.3389/fgwh.2022.816969] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 02/17/2022] [Indexed: 11/13/2022] Open
Abstract
Objective To estimate utilization of maternal, perinatal healthcare services after the lockdown was implemented in response to the COVID-19 pandemic compared to the period before. Methods This study conducted in Dakshinpuri, an urban neighborhood in Delhi, reports data over a 13-month period which includes the period “before lockdown” i.e., October 1, 2019 to March 21, 2020 and “after lockdown” i.e., March 22 to November 5, 2020. The period “after lockdown” included the lockdown phase (March 22 to May 31, 2020) and unlock phase (June 1 to November 5, 2020). Mothers delivered during this period in the study area were interviewed using semi-structured questionnaires. In-depth interviews (IDIs) were conducted in a subsample to understand the experiences, challenges, and factors for underutilization of healthcare services. Findings The survey covered a total population of 21,025 in 4,762 households; 199 eligible mothers (mean age 27.4 years) were interviewed. In women who delivered after lockdown against before lockdown, adjusted odds of having >2 antenatal care visits in the third trimester was 80% lower (aOR 0.2, 95% CI 0.1–0.5); proportion of institutional deliveries was lower (93 vs. 97%); exclusive breastfeeding during first 6 months of birth (64.5 vs. 75.7%) and health worker home visitation within 6 weeks of birth (median, 1 vs. 3 visits) were substantially lower. Fear of contracting COVID-19, poor quality of services, lack of transportation and financial constraints were key issues faced by mothers in accessing health care. More than three-fourth (81%) of the mothers reported feeling down, depressed or hopeless after lockdown. The major factors for stress during lockdown was financial reasons (70%), followed by health-related concerns. Conclusion COVID-19 pandemic-related lockdown substantially affected maternal and perinatal healthcare utilization and service delivery.
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Affiliation(s)
- Bireshwar Sinha
- Centre for Health Research and Development, Society for Applied Studies, New Delhi, India
- Department of Biotechnology (DBT)/Wellcome India Alliance, Hyderabad, India
| | - Nonita Dudeja
- Centre for Health Research and Development, Society for Applied Studies, New Delhi, India
| | - Sarmila Mazumder
- Centre for Health Research and Development, Society for Applied Studies, New Delhi, India
- *Correspondence: Sarmila Mazumder
| | - Tivendra Kumar
- Centre for Health Research and Development, Society for Applied Studies, New Delhi, India
| | - Priyanka Adhikary
- Centre for Health Research and Development, Society for Applied Studies, New Delhi, India
| | - Nivedita Roy
- Centre for Health Research and Development, Society for Applied Studies, New Delhi, India
| | | | - Rajesh Mehta
- Regional Office for South-East Asia, World Health Organization, New Delhi, India
| | - Neena Raina
- Regional Office for South-East Asia, World Health Organization, New Delhi, India
| | - Nita Bhandari
- Knowledge Integration and Translational Platform at Centre for Health Research and Development, Society for Applied Studies, New Delhi, India
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35
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Mercado-Reyes MM, Daza M, Pacheco A, Meneses-Gil MX, Galindo M, Catama J, Botero LS, Muñoz L, Quinche G, Ospina ML. Seroprevalence of SARS-CoV-2 Antibodies in Children and Adolescents: Results From a Population-Based Survey in 10 Colombian Cities. Glob Pediatr Health 2022; 9:2333794X221085385. [PMID: 35342777 PMCID: PMC8941708 DOI: 10.1177/2333794x221085385] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 02/16/2022] [Indexed: 12/23/2022] Open
Abstract
Background. Understanding COVID-19 dynamics in Colombia during
the first pandemic year (2020) gives important insights surrounding population’s
exposure risk and specific susceptibilities. Seroprevalence studies can aid in
having a broader understanding of the disease, offering a more inclusive view of
the pandemic’s impact across the population. Methods. A
population-based cross-sectional study to assess antibodies against SARS-CoV-2
in 10 Colombian cities was developed between September and December 2020. Cities
were grouped according development typology (Robust (RD), Intermediate (ID) and
Incipient (InD)). Detection of total antibodies (IgM + IgG) against SARS-CoV-2
was employed. Univariate Odds Ratios (OR) were estimated for antibody results
and selected variables. Results. About 3124 children aged
between 5 and 17 years were included. Factors related to lower seropositive
results were affiliation to the employer-based health insurance in RD and ID
cities (OR: 0.579, 95% CI 0.477-0.703, OR: 0.648, 95%CI 0.480-0.874
respectively) and living in a household with adequate access to public services
only for ID cities (OR: 0.679. 95% CI 0.491-0.939). Higher seropositivity rates
in RD and ID cities were seen in children belonging to the low socioeconomic
stratum (RD: OR: 1.758, 95% CI 1.427-2.165; ID: OR: 2.288, 95% CI 1.599-3.275)
and living in an overcrowded household (RD: OR: 1.846, 95% CI 1.467-2.323; ID:
OR: 2.379, 95% CI 1.769-3.199). Conclusions. Children and
adolescents showed substantial impact from the COVID-19 pandemic.
Disadvantageous living conditions were found to be significantly related to
having a positive SARS-CoV-2 antibody test. These results highlight the need to
prioritize vulnerable populations in the context of health emergencies.
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Affiliation(s)
| | | | | | | | | | | | | | - Lyda Muñoz
- Instituto Nacional de Salud, Bogotá, Colombia
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36
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Singh K, Lima G, Cha M, Cha C, Kulshrestha J, Ahn YY, Varol O. Misinformation, believability, and vaccine acceptance over 40 countries: Takeaways from the initial phase of the COVID-19 infodemic. PLoS One 2022; 17:e0263381. [PMID: 35139117 PMCID: PMC8827463 DOI: 10.1371/journal.pone.0263381] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 01/18/2022] [Indexed: 11/19/2022] Open
Abstract
The COVID-19 pandemic has been damaging to the lives of people all around the world. Accompanied by the pandemic is an infodemic, an abundant and uncontrolled spread of potentially harmful misinformation. The infodemic may severely change the pandemic’s course by interfering with public health interventions such as wearing masks, social distancing, and vaccination. In particular, the impact of the infodemic on vaccination is critical because it holds the key to reverting to pre-pandemic normalcy. This paper presents findings from a global survey on the extent of worldwide exposure to the COVID-19 infodemic, assesses different populations’ susceptibility to false claims, and analyzes its association with vaccine acceptance. Based on responses gathered from over 18,400 individuals from 40 countries, we find a strong association between perceived believability of COVID-19 misinformation and vaccination hesitancy. Our study shows that only half of the online users exposed to rumors might have seen corresponding fact-checked information. Moreover, depending on the country, between 6% and 37% of individuals considered these rumors believable. A key finding of this research is that poorer regions were more susceptible to encountering and believing COVID-19 misinformation; countries with lower gross domestic product (GDP) per capita showed a substantially higher prevalence of misinformation. We discuss implications of our findings to public campaigns that proactively spread accurate information to countries that are more susceptible to the infodemic. We also defend that fact-checking platforms should prioritize claims that not only have wide exposure but are also perceived to be believable. Our findings give insights into how to successfully handle risk communication during the initial phase of a future pandemic.
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Affiliation(s)
| | - Gabriel Lima
- Institute for Basic Science, Daejeon, South Korea
- School of Computing, KAIST, Daejeon, South Korea
| | - Meeyoung Cha
- Institute for Basic Science, Daejeon, South Korea
- School of Computing, KAIST, Daejeon, South Korea
- * E-mail: (MC); (CC)
| | - Chiyoung Cha
- College of Nursing, Graduate Program in System Health Science and Engineering, Ewha Womans University, Seoul, South Korea
- * E-mail: (MC); (CC)
| | - Juhi Kulshrestha
- Department of Politics and Public Administration, University of Konstanz, Konstanz, Germany
| | - Yong-Yeol Ahn
- Center for Complex Networks and Systems Research, Luddy School of Informatics, Computing, and Engineering, Indiana University, Bloomington, IN, United States of America
- Indiana University Network Science Institute, Indiana University, Bloomington, IN, United States of America
- Connection Science, Massachusetts Institute of Technology, Cambridge, MA, United States of America
| | - Onur Varol
- Faculty of Engineering and Natural Sciences, Sabanci University, Istanbul, Turkey
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Abstract
Health promotion has long aspired for a world where all people can live to their full potential. Yet, COVID-19 illuminates dramatically different consequences for populations bearing heavy burdens of systemic disadvantage within countries and between the Global South and Global North. Many months of pandemic is entrenching inequities that reveal themselves in the vastly differential distribution of hospitalization and mortality, for example, among racialized groups in the USA. Amplified awareness of the intimate relationship between health, social structures, and economy opens a window of opportunity to act on decades of global commitments to prioritize health equity. Choices to act (or not act) are likely to accelerate already vast inequities within and between countries as rapidly as the COVID-19 pandemic itself. Recognizing the inherently global nature of this pandemic, this article explores how determinants of equity are embedded in global responses to it, arguing that these determinants will critically shape our global futures. This article aims to stimulate dialogue about equity-centered health promoting action during a pandemic, using the Canadian Coalition for Global Health Research (CCGHR) Principles for Global Health Research to examine equity considerations at a time of pandemic. Attentiveness to power and the relationship between political economy and health are argued as central to identifying and examining issues of equity. This article invites dialogue about how equity-centered planning, decision-making and action could leverage this massive disruption to society to spark a more hopeful, just, and humane collective future.
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Affiliation(s)
- Katrina M Plamondon
- School of Nursing, Faculty of Health & Social Development, University of British Columbia, 1147 Research Road, Kelowna, BC V1V 1V7, Canada
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Bliznashka L, Ahun MN, Velthausz D, Donco R, Karuskina-Drivdale S, Pinto J, Yousafzai AK, Jeong J. Effects of COVID-19 on Child Health Services Utilisation and Delivery in Rural Mozambique: A Qualitative Study. Health Policy Plan 2022; 37:737-746. [PMID: 35077547 PMCID: PMC8807260 DOI: 10.1093/heapol/czac009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 12/01/2021] [Accepted: 01/24/2022] [Indexed: 11/24/2022] Open
Abstract
Little is known about the COVID-19 pandemic-related disruptions in health services and the resilience of the health system response in rural low-resource settings. We conducted a phenomenological qualitative study (October-November 2020) to understand COVID-19-related influences on the utilisation and delivery of child health services in Monapo district, rural Mozambique. We interviewed 36 caregivers with children <2.5 years, 21 health providers, and 4 district health services staff using in-person in-depth interviews. Data were analysed using inductive thematic content analysis. Our findings showed that caregivers, providers, and district health services staff unanimously reported a decrease in child consultations at the start of the pandemic. Administrative data from health facilities confirmed persisting declines in monthly consultations. Respondents explained reductions due to miscommunication about health facility operations, fear of COVID-19, reduced consultation schedules, and reduced household incomes. Providers reported several challenges in delivering services including lack of caregiver compliance with risk mitigation measures, caregivers’ fear of risk mitigation measures, perceived lack of caregiver knowledge about COVID-19, and lack of supplies and protective equipment. All respondents described how COVID-19 had increased food insecurity and food prices, and reduced incomes and livelihoods. These negative economic consequences were perceived as the main reason for reported increases in cases of child malnutrition. Despite reductions, child health service utilisation and delivery has largely continued throughout the COVID-19 pandemic, indicating an adaptive and resilient primary health system response in Monapo district. Our findings highlighted the persistent difficulties providers and caregivers face adhering to COVID-19 prevention and risk mitigation measures. A coordinated multi-sectoral response is needed to address the persistent negative economic impacts of the pandemic for young children and their families in rural areas.
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Affiliation(s)
- Lilia Bliznashka
- Corresponding author: Lilia Bliznashka, 665 Huntington Avenue, Building 1, 11th Floor, Boston, MA 02115, USA. ; Phone: 617-432-1232
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Understanding Household Water-Use Behavior and Consumption Patterns during COVID-19 Lockdown in Saudi Arabia. WATER 2022. [DOI: 10.3390/w14030314] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
With the COVID-19 lockdown impacting the livelihood of people globally, changes in household behaviors, water consumption patterns, etc., have implications on sanitation, hygiene, and disease control. An online questionnaire survey was conducted, and officials were interviewed to assess the impact of the lockdown on water consumption patterns in the Dammam Metropolitan Area, Saudi Arabia. The multiple regression analysis on responses from the survey indicates that water consumption increased by 50% in 86% of the respondents, leading to higher utility bills. Socioeconomic factors also influenced water consumption. The officials interviewed emphasized the need for integrating water policies with disaster management actions. This study contributes to the prospering empirical literature on the pandemic COVID-19 and water consumption/usage behavioral practices by exploring the behavior of household water during COVID-19 in Saudi Arabia. This study can help decision-makers in Saudi Arabia and other developing countries in boosting awareness related to water management in crisis time.
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Impact of the Coronavirus Disease (COVID-19) Pandemic on Neonatal Nutrition: Focus on Low- and Middle-Income Countries. CURRENT TROPICAL MEDICINE REPORTS 2022; 9:218-224. [PMID: 36415223 PMCID: PMC9672601 DOI: 10.1007/s40475-022-00272-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/22/2022] [Indexed: 11/19/2022]
Abstract
Purpose of Review This review serves to account for the published literature regarding the changing impact of the COVID-19 pandemic with a focus on neonatal nutrition in low- and middle-income countries. Recent Findings Initial national and international guidelines regarding breastfeeding were often contradictory. Lack of clear guidelines resulted in separation of mother-neonate dyads and the reliance on non-human sources of milk at institutional levels. Mothers and families were less likely to initiate and/or continue breastfeed during the pandemic due to confusion regarding guidelines, lack of support for lactation, and concern for infection transmission to their neonates. Continued research in neonatal nutrition, however, continues to support the use of breastmilk as the optimal nutritional source for neonates. Summary Despite concerns for increased risk of COVID-19 transmission with breastfeeding, the use of breastmilk with preserved and combined mother-baby care is associated with improved neonatal nutrition.
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Zhu PH, Mhango SN, Vinnakota A, Mansour M, Coss-Bu JA. Effects of COVID-19 Pandemic on Nutritional Status, Feeding Practices, and Access to Food Among Infants and Children in Lower and Middle-Income Countries: a Narrative Review. CURRENT TROPICAL MEDICINE REPORTS 2022; 9:197-206. [PMID: 36249489 PMCID: PMC9549037 DOI: 10.1007/s40475-022-00271-8] [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] [Accepted: 09/22/2022] [Indexed: 01/11/2023]
Abstract
Purpose of Review The COVID-19 pandemic has affected children across the planet and the consequences on their health, nutritional status, and social structure have been more pronounced in low- and middle-income countries (LMICs). This review will focus on the effects of the COVID-19 pandemic on infant growth and feeding practices and access to food and obesity prevalence among children in LMICs. An electronic search was performed on MEDLINE and Embase to identify relevant articles in the English language. Recent Findings A higher prevalence of infections by the SARS-CoV-2 virus and a lower mortality rate were found in children in LMICs compared to western countries. In 2020, 22% and 52% of the wasting and deaths in children under 5 years of age in LMICS came from the sub-Saharan Africa region, respectively. Despite the decrease in stunting from 40% in 1990 to 24.2% in 2019, the prevalence remains above 30% in LMICs. Regarding breastfeeding practices in LMICs, many organizations recommend breastfeeding for infants and children born to infected mothers with SARS-CoV-2. This pandemic has resulted in higher food insecurity and disruption to access to health care and nutrition-related programs from schools; this situation has been more detrimental for younger children from LMICs. Summary Given the devastating effects of the COVID-19 pandemic on the nutritional status, higher food insecurity, and lack of access to health care for infants and children in LMICs, efforts from government, world organizations, and non-for-profit institutions should be implemented to ameliorate the effects of this pandemic.
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Affiliation(s)
- Paola Hong Zhu
- Division of Critical Care Medicine, Baylor College of Medicine, Texas Children’s Hospital, Houston, TX USA ,Department of Pediatrics, Baylor College of Medicine, Texas Children’s Hospital, Houston, TX USA
| | - Susan Nita Mhango
- Baylor College of Medicine Children’s Foundation Malawi, Lilongwe, Malawi
| | - Anirudh Vinnakota
- Department of Pediatrics, Baylor College of Medicine, Texas Children’s Hospital, Houston, TX USA
| | - Marwa Mansour
- Division of Critical Care Medicine, Baylor College of Medicine, Texas Children’s Hospital, Houston, TX USA ,Department of Pediatrics, Baylor College of Medicine, Texas Children’s Hospital, Houston, TX USA
| | - Jorge A. Coss-Bu
- Division of Critical Care Medicine, Baylor College of Medicine, Texas Children’s Hospital, Houston, TX USA ,Department of Pediatrics, Baylor College of Medicine, Texas Children’s Hospital, Houston, TX USA
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Anabwani-Richter F, Swanson T, Dlamini S, Katulege K, Daire C, Singhal G. The Silent Pandemic: the Impact of COVID-19 on the Mental Health of Adolescents Living with HIV. CURRENT TROPICAL MEDICINE REPORTS 2022; 9:207-217. [PMID: 36277680 PMCID: PMC9579544 DOI: 10.1007/s40475-022-00270-9] [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] [Accepted: 09/22/2022] [Indexed: 01/11/2023]
Abstract
Purpose of Review The pandemic caused by the coronavirus disease (COVID-19) has resulted in millions of confirmed cases and likely more than six million deaths globally Worldometer (2022). We sought to understand secondary mental effects in adolescents living with HIV (ALHIV) on the African continent caused by lockdowns, school closures, and other restriction measures for infection control. We reviewed the broader literature and conducted 86 retrospective chart reviews of mental health disorders of ALHIV and interventions utilized at a pediatric clinic in Eswatini. Recent Findings ALHIVs are disproportionately affected by mental health disorders. The COVID-19 pandemic has exacerbated adverse mental health outcomes of adolescents on the African continent, especially for ALHIV. There have been many calls for researchers, clinicians, and governments to prioritize mental health in adolescents going forward. Summary In pediatric clinics in Eswatini, Malawi, and Uganda, there were psychosocial measures in place prior to the COVID-19 pandemic for ALHIV. After looking closely at a pediatric clinic in Eswatini, we found that many interventions were paused and new psychosocial interventions compatible with social distancing were instead utilized by clinicians. Even so, after multidisciplinary management comprising of interventions such as psychotherapy, pharmacotherapy, referral to psychologists/psychiatrists, and enrollment in peer support groups, the PHQ-9 depressions scores of ALHIV during the COVID-19 significantly improved. We found that there is a need for age-specific standardized tools to measure depression in ALHIV. Furthermore, more research is needed on the effectiveness and scope of psychosocial interventions for ALHIV post-COVID-19 throughout Eswatini and the African continent.
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Affiliation(s)
| | - Trina Swanson
- Baylor College of Medicine Children’s Foundation - Eswatini, Mbabane, Eswatini
| | - Sandile Dlamini
- Baylor College of Medicine Children’s Foundation - Eswatini, Mbabane, Eswatini ,grid.39382.330000 0001 2160 926XBaylor College of Medicine, Houston, TX USA
| | - Kizito Katulege
- grid.423308.e0000 0004 0397 2008Baylor College of Medicine Children’s Foundation - Uganda, Kampala, Uganda
| | - Chikabachi Daire
- Baylor College of Medicine Children’s Foundation - Malawi, Lilongwe, Malawi
| | - Geeta Singhal
- grid.416975.80000 0001 2200 2638Texas Children’s Hospital, Houston, TX USA
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Rudan I, Adeloye D, Katikireddi SV, Murray J, Simpson C, Shah SA, Robertson C, Sheikh A. The COVID-19 pandemic in children and young people during 2020-2021: Learning about clinical presentation, patterns of spread, viral load, diagnosis and treatment. J Glob Health 2021; 11:01010. [PMID: 35047182 PMCID: PMC8763336 DOI: 10.7189/jogh.11.01010] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Igor Rudan
- Centre for Global Health, Usher Institute, The University of Edinburgh, Edinburgh, UK
| | - Davies Adeloye
- Centre for Global Health, Usher Institute, The University of Edinburgh, Edinburgh, UK
| | | | - Josie Murray
- COVID-19 Surveillance Lead, Public Health Scotland, Fife, UK
| | - Colin Simpson
- School of Health, Wellington Faculty of Health, Victoria University of Wellington, New Zealand
- Usher Institute, The University of Edinburgh, Edinburgh, UK
| | | | - Chris Robertson
- Department of Mathematics and Statistics, University of Strathclyde, Glasgow, UK and Public Health Scotland, Glasgow, UK
| | - Aziz Sheikh
- Usher Institute, The University of Edinburgh, Edinburgh, UK
| | - EAVE II collaboration
- Centre for Global Health, Usher Institute, The University of Edinburgh, Edinburgh, UK
- MRC/CSO Social & Public Health Sciences Unit, Glasgow, UK
- COVID-19 Surveillance Lead, Public Health Scotland, Fife, UK
- School of Health, Wellington Faculty of Health, Victoria University of Wellington, New Zealand
- Usher Institute, The University of Edinburgh, Edinburgh, UK
- Department of Mathematics and Statistics, University of Strathclyde, Glasgow, UK and Public Health Scotland, Glasgow, UK
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Hearst MO, Hughey L, Magoon J, Mubukwanu E, Ndonji M, Ngulube E, Makhoul Z. Rapid health impact assessment of COVID-19 on families with children with disabilities living in low-income communities in Lusaka, Zambia. PLoS One 2021; 16:e0260486. [PMID: 34910762 PMCID: PMC8673599 DOI: 10.1371/journal.pone.0260486] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Accepted: 11/10/2021] [Indexed: 11/23/2022] Open
Abstract
Introduction Worldwide, children with disabilities are a vulnerable population and at high risk for COVID-19 morbidity and mortality. There is little information on the impact that COVID-19 had on children with disabilities and their families, particularly in low-income settings. This assessment describes the extent to which the pandemic impacted seven indicators of well-being in three low-income communities in Lusaka, Zambia. Methods Interviews were conducted with a random selection of families participating in an existing program (n = 39), community health workers (n = 6), healthcare workers (n = 7) and government officials (n = 2). Descriptive data was summarized and qualitative responses reviewed for themes. Results Most families reported a major loss of income resulting in food insecurity (79%), housing instability (67%), stress (36%), and increased risk of child separation and neglect (18%). Most families did not report receiving governmental financial assistance and reported loss of access to health services for their child such as physiotherapy (33%). Stakeholders interviewed reported that COVID-19 information was widely available although few specific interventions for children. Families were seen to have greater food insecurity, more poverty, more crowding, less healthcare services and children left alone or on the streets to beg. Discussion COVID-19 and related containment measures have impacted the lives of children with disabilities and their families to a great extent. There is an urgent need for disability-inclusive responses that deliberately address the needs of children with disabilities and their families, notably uninterrupted access to adequate food, inclusive education, rehabilitation therapy, and income-generating activities.
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Affiliation(s)
- Mary O. Hearst
- Public Health Department, Henrietta Schmoll School of Health, St. Catherine University, St. Paul, Minnesota, United States of America
- * E-mail:
| | | | - Jamie Magoon
- Public Health Department, Henrietta Schmoll School of Health, St. Catherine University, St. Paul, Minnesota, United States of America
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45
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Kalam A, Shano S, Khan MA, Islam A, Warren N, Hassan MM, Davis M. Understanding the social drivers of antibiotic use during COVID-19 in Bangladesh: Implications for reduction of antimicrobial resistance. PLoS One 2021; 16:e0261368. [PMID: 34905563 PMCID: PMC8670684 DOI: 10.1371/journal.pone.0261368] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 11/29/2021] [Indexed: 12/13/2022] Open
Abstract
Antimicrobial resistance (AMR) is a global public health crisis that is now impacted by the COVID-19 pandemic. Little is known how COVID-19 risks influence people to consume antibiotics, particularly in contexts like Bangladesh where these pharmaceuticals can be purchased without a prescription. This paper identifies the social drivers of antibiotics use among home-based patients who have tested positive with SARS-CoV-2 or have COVID-19-like symptoms. Using qualitative telephone interviews, the research was conducted in two Bangladesh cities with 40 participants who reported that they had tested positive for coronavirus (n = 20) or had COVID-19-like symptoms (n = 20). Our analysis identified five themes in antibiotic use narratives: antibiotics as 'big' medicine; managing anxiety; dealing with social repercussions of COVID-19 infection; lack of access to COVID-19 testing and healthcare services; and informal sources of treatment advice. Antibiotics were seen to solve physical and social aspects of COVID-19 infection, with urgent ramifications for AMR in Bangladesh and more general implications for global efforts to mitigate AMR.
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Affiliation(s)
- Abul Kalam
- Bangladesh Country Office, Helen Keller International, Dhaka, Bangladesh
| | - Shahanaj Shano
- Institute of Epidemiology, Disease Control and Research (IEDCR), Dhaka, Bangladesh
- EcoHealth Alliance, New York, New York, United States of America
| | | | - Ariful Islam
- EcoHealth Alliance, New York, New York, United States of America
| | - Narelle Warren
- School of Social and Political Sciences, Monash University, Melbourne, Victoria, Australia
| | | | - Mark Davis
- School of Social and Political Sciences, Monash University, Melbourne, Victoria, Australia
- Centre to Impact Antimicrobial Resistance, Monash University, Melbourne, Victoria, Australia
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Gothwal VK, Kodavati K, Subramanian A. Life in lockdown: impact of COVID-19 lockdown measures on the lives of visually impaired school-age children and their families in India. Ophthalmic Physiol Opt 2021; 42:301-310. [PMID: 34873715 DOI: 10.1111/opo.12928] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Revised: 10/26/2021] [Accepted: 10/28/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE The COVID-19 outbreak has adversely impacted all societal domains including education. Home confinement, school closures and distance learning impacted children's, teachers' and parents' lives worldwide. In this study, we aimed to examine the impact of the COVID-19 lockdown on the lives, including education, of school-age children with vision impairment (VI) and their parents in India. METHODS Primary and secondary school children with VI were recruited from the Institute for Vision Rehabilitation, L V Prasad Eye Institute, Hyderabad, India. A qualitative research methodology, utilising a self-constructed questionnaire with open and closed questions and stem and leaf design, was employed to explore the experiences of school closure and its impact on education and attending online classes during the COVID-19 lockdown. Textual data from responses to the questions were analysed using content analysis to identify themes pertinent to the cohort studied. RESULTS Forty eight child-parent dyads were included. The median age of children was 10 years (range, 7-19 years) and 60% were male. Inherited retinal disorders were the major cause of VI (40%). Best spectacle corrected visual acuity (better eye) ranged from 0.30 to 2.09 logMAR (6/12 to 6/750). Six major themes were identified: (1) accessibility of technology (online learning and technology); (2) parental beliefs/concerns (harmful effects of technology, prioritisation of normally sighted children, online classes considered a distraction); (3) support (peers, parents, teachers, private tuition); (4) socialisation and physical activity; (5) socioeconomic status and (6) near vision. CONCLUSIONS This study provides an understanding of the adverse impact of lockdown on the lives of children with VI and their parents, especially related to education in India. The study identified critical factors that affect online learning and the participation of children with VI in these sessions. Policymakers and educators should implement effective measures for supporting online classes.
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Affiliation(s)
- Vijaya K Gothwal
- Meera and L B Deshpande Centre for Sight Enhancement, Institute for Vision Rehabilitation, Hyderabad, India.,Brien Holden Eye Research Centre - Patient Reported Outcomes Unit, L V Prasad Eye Institute, Hyderabad, India
| | - KrishnaPriya Kodavati
- Meera and L B Deshpande Centre for Sight Enhancement, Institute for Vision Rehabilitation, Hyderabad, India
| | - Ahalya Subramanian
- Centre for Applied Vision Research, School of Health Sciences, City, University of London, London, UK
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Abstract
Antibodies to seasonal human-coronaviruses (sHCoV) may cross-protect against SARS-CoV-2. We investigated antibody responses in biobanked serum obtained before the pandemic from infants with polymerase chain reaction-confirmed sHCoV. Among 141 samples with antibodies to sHCoV, 4 (2.8%) were positive for SARS-CoV-2-S1 and 8 (5.7%) for SARS-CoV-2-S2. Antibodies to sHCoV rarely cross-react with SARS-CoV-2 antigens and are unlikely to account for mild pediatric illness.
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Oluoch-Aridi J, Chelagat T, Nyikuri MM, Onyango J, Guzman D, Makanga C, Miller-Graff L, Dowd R. COVID-19 Effect on Access to Maternal Health Services in Kenya. Front Glob Womens Health 2021; 1:599267. [PMID: 34816169 PMCID: PMC8593959 DOI: 10.3389/fgwh.2020.599267] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 11/02/2020] [Indexed: 11/13/2022] Open
Abstract
Introduction: Maternal mortality continues to be one of the biggest challenges of the health system in Kenya. Informal settlements in Kenya have been known to have higher rates of maternal mortality and also receive maternity services of varied quality. Data assessing progress on key maternal health indicators within informal settlements are also often scarce. The COVID-19 pandemic hit Kenya in March this year and so far, the impact of the pandemic on access to maternal health has not been established. This study aims to add to the body of knowledge by investigating the effects of the COVID-19 pandemic and mitigation strategies on access to health care services in informal settlements. Methods: Qualitative methods using in-depth interviews were used to assess women's experiences of maternity care during the COVID-19 era and the impact of proposed mitigation strategies such as the lockdown and the curfew. Other aspects of the maternity experience such as women's knowledge of COVID-19, their perceived risk of infection, access to health facilities, perceived quality of care were assessed. Challenges that women facing as a result of the lockdown and curfew with respect to maternal health access and quality were also assessed. Results: Our findings illustrate that there was a high awareness of the symptoms and preventative measures for COVID-19 amongst women in informal settlements. Our findings also show that women's perception of risk to themselves was high, whereas risk to family and friends, and in their neighborhood was perceived as low. Less than half of women reported reduced access due to fear of contracting Coronavirus, Deprioritization of health services, economic constraints, and psychosocial effects were reported due to the imposed lockdown and curfew. Most respondents perceived improvements in quality of care due to short-waiting times, hygiene measures, and responsive health personnel. However, this was only reported for the outpatient services and not in-patient services. Conclusion: The most important recommendation was for the Government to provide food followed by financial support and other basic amenities. This has implications for the Government's mitigation measures that are focused on public health measures and lack social safety-net approaches for the most vulnerable communities.
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Affiliation(s)
- Jackline Oluoch-Aridi
- The Ford Family Program in Human Development Studies and Solidarity, Kellogg Institute for International Studies, University of Notre Dame, Notre Dame, IN, United States.,Strathmore Business School, Institute of Healthcare Management, Strathmore University, Nairobi, Kenya
| | - Tecla Chelagat
- Strathmore Business School, Institute of Healthcare Management, Strathmore University, Nairobi, Kenya
| | - Mary M Nyikuri
- Strathmore Business School, Institute of Healthcare Management, Strathmore University, Nairobi, Kenya
| | - Joseph Onyango
- Strathmore Business School, Institute of Healthcare Management, Strathmore University, Nairobi, Kenya
| | - Danice Guzman
- The Ford Family Program in Human Development Studies and Solidarity, Kellogg Institute for International Studies, University of Notre Dame, Notre Dame, IN, United States
| | - Cindy Makanga
- The Ford Family Program in Human Development Studies and Solidarity, Kellogg Institute for International Studies, University of Notre Dame, Notre Dame, IN, United States
| | - Laura Miller-Graff
- The Ford Family Program in Human Development Studies and Solidarity, Kellogg Institute for International Studies, University of Notre Dame, Notre Dame, IN, United States.,Department of Psychology, The Kroc Institute of Peace Studies, University of Notre Dame, Notre Dame, IN, United States
| | - Robert Dowd
- The Ford Family Program in Human Development Studies and Solidarity, Kellogg Institute for International Studies, University of Notre Dame, Notre Dame, IN, United States
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Gudina EK, Siebeck M, Eshete MT. Evidence Gaps and Challenges in the Fight Against COVID-19 in Africa: Scoping Review of the Ethiopian Experience. Risk Manag Healthc Policy 2021; 14:4511-4521. [PMID: 34764709 PMCID: PMC8575488 DOI: 10.2147/rmhp.s333545] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 10/14/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Ethiopia, like many African countries, took immediate actions to contain the coronavirus disease (COVID-19) outbreak and its impacts. However, the pandemic control measures were not guided by robust local evidence and not tailored to national contexts. In this review, we aimed to evaluate the evidence gaps and challenges of COVID-19 control measures in Ethiopia during the early months of the pandemic. DESIGN Scoping Review. DATA SOURCE Searches were conducted in PubMed, LitCovid, Web of Sciences, Embase, MedRx, ChemRxiv, BioRx, and Google Scholar. ELIGIBILITY CRITERIA Peer-reviewed or pre-print original research articles on COVID-19 from Ethiopia during a period of January 1, 2020 and October 10, 2020 were included in this review. RESULTS Of 573 articles found, 64 were eligible for inclusion. However, only 25 of them were peer-reviewed; 78% (50/64) were based on cross-sectional descriptive studies. Most of the studies focused on human behavior and healthcare system; only 13 articles addressed epidemiology and clinical spectrum of COVID-19. The studies have revealed a good level of awareness and a favorable attitude by community and healthcare workers (HCWs) towards COVID-19 and its control. However, the practices of infection prevention were found to be low among HCWs and the community. The outbreak unfolded at a slower rate than initially feared but the impact of the counter measures against COVID-19 on the delivery of essential healthcare services was felt more than the direct impact of the pandemic. Moreover, the actions taken by the country did not appear to be tailored to the pattern of the outbreak and existing local evidence. The overall number of published COVID-19-related scientific articles from Ethiopia during the review period was found to be limited. CONCLUSION COVID-19 control in Ethiopia was challenged by lack of robust local scientific evidence, and the pandemic control measures were not adapted to local context and the outbreak patterns. Thus, Ethiopia and other African countries should design culturally sensitive and locally acceptable public health interventions for COVID-19 and potential future outbreaks based on locally generated scientific evidence.
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Affiliation(s)
- Esayas Kebede Gudina
- Department of Internal Medicine, Institute of Health, Jimma University, Jimma, Ethiopia
- Center for International Health at LMU, University Hospital, LMU, Munich, Germany
| | - Matthias Siebeck
- Center for International Health at LMU, University Hospital, LMU, Munich, Germany
- Institute of Medical Education, University Hospital, LMU, Munich, Germany
| | - Million Tesfaye Eshete
- Center for International Health at LMU, University Hospital, LMU, Munich, Germany
- Department of Anesthesiology, Institute of Health, Jimma University, Jimma, Ethiopia
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Caffo E, Asta L, Scandroglio F. Predictors of mental health worsening among children and adolescents during the coronavirus disease 2019 pandemic. Curr Opin Psychiatry 2021; 34:624-630. [PMID: 34494973 PMCID: PMC8500206 DOI: 10.1097/yco.0000000000000747] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
PURPOSE OF REVIEW Restrictions put in place to contain the spread of coronavirus disease 2019 (COVID-19) have significantly affected the lives of children and adolescents worldwide. School closure, home confinement and social distancing have the potential to negatively impact the mental health of this population. Several risk factors seem to contribute to worsening mental health of children and adolescents, with an increase of anxiety and depression symptoms. This review aims at exploring research available on risk factors that may worsen the mental health among children and adolescents during the pandemic. RECENT FINDINGS Some of these predictors in worsening the effects are social isolation, screen time and excessive social media use, parental stress and poor parent-child relationship, low socioeconomic status, preexisting mental health conditions and/or disabilities. SUMMARY Further research is needed in order to understand mental health effects of the COVID-19 pandemic, as well as risk factors associated with negative consequences. New findings will help in targeting evidence-based interventions to prevent and mitigate the negative effects of COVID-19 on the mental health of children and adolescents.
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Affiliation(s)
- Ernesto Caffo
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
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