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Ngamasana EL, Moxie J. Cash transfer, maternal and child health outcomes: a scoping review in sub-Saharan Africa. Glob Health Action 2024; 17:2309726. [PMID: 38333923 PMCID: PMC10860414 DOI: 10.1080/16549716.2024.2309726] [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: 08/27/2023] [Accepted: 01/19/2024] [Indexed: 02/10/2024] Open
Abstract
BACKGROUND Cash Transfer (CT) programmes can improve maternal and child health outcomes in low- and middle-income countries. However, studies assessing the effectiveness of these programmes on maternal and child health outcomes (MCH), beyond nutritional outcomes and service utilisation, remain inconclusive. OBJECTIVES We synthesized current empirical evidence on the effectiveness of these programmes in improving MCH outcomes and suggested a framework for reporting such outcomes. We focused on sub-Saharan Africa because of substantial operational differences between regions, and the need for MCH advancement in this region. METHODS This review searched PubMed Central and Google Scholar and supplemented it with a backward citation search for studies conducted in sub-Saharan Africa for the period between 2000 and 2021. Only peer-reviewed studies on CT that reported health outcomes beyond nutritional outcomes and service utilisation among women of reproductive age and children below 18 years old were included. RESULTS Twenty-one articles reporting studies conducted in six sub-Saharan African countries were identified. All studies reported health outcome measures, and programmes targeted women of reproductive age and children under 18 years of age. Of the 21 articles, 1 reported measures of mortality, 13 reported measures of functional status; 3 reported subjective measures of well-being, and 4 reported behavioural health outcomes. Across all categories of reported measures, evidence emerges that cash transfer programmes improved some health outcomes (e.g. improved infant and child survival, reduced incidence of illnesses, improved cognitive and motor development, improved general health, delayed sexual debut, lower transactional sex, etc.), while in some of the studies, outcomes such as depression did not show significant improvements. CONCLUSION Cash Transfer programmes are effective and cost-effective, with a real potential to improve maternal and child health outcomes in sub-Saharan African countries. However, further research is needed to address implementation challenges, which include data collection, and programme management.
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Affiliation(s)
- Emery L. Ngamasana
- Department of Public Health Sciences, College of Health and Human Services, University of North Carolina at Charlotte, Charlotte, NC, USA
| | - Jessamyn Moxie
- Department of Public Health Sciences, College of Health and Human Services, University of North Carolina at Charlotte, Charlotte, NC, USA
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Joseph G, Kobi-Jackson S, Birmingham M, Champetier de Ribes G, De Mucio B, Colomar M, Sosa C, Alfred JP, Thermidor R. Changes in reproductive, maternal, and child health in Haiti during the pre- and peri-COVID-19 pandemic. Rev Panam Salud Publica 2024; 48:e57. [PMID: 38859812 PMCID: PMC11164238 DOI: 10.26633/rpsp.2024.57] [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: 01/01/2024] [Accepted: 04/22/2024] [Indexed: 06/12/2024] Open
Abstract
Objective To assess changes in reproductive, maternal, newborn, child, and adolescent health (RMNCAH) in Haiti from August 2018 to September 2021, before and during the COVID-19 pandemic. Methods A retrospective study using surveillance data from the Haitian Unique Health Information System, examining two periods: pre- and peri-COVID-19 pandemic. Health indicators at the national level in the two periods were compared using two-sample t-tests for proportions, and average absolute monthly changes were calculated using variance-weighted regression. Results There was a statistically significant decline in the proportion of most of the indicators assessed from the pre- to the peri-COVID-19 pandemic period. However, the most affected indicators were the proportions of pregnant women with four antenatal care visits, with five antenatal care visits or more, and those who received a second dose of tetanus vaccine, which decreased by over 4 percentage points during the two periods. Likewise, the proportions of children who received diphtheria, tetanus, and pertussis (DTaP), BCG, polio, pentavalent, and rotavirus vaccines also all declined by over 8 percentage points. In contrast, pneumococcal conjugate vaccine increased by over 4 percentage points. A statistically significant decrease was also observed in the average absolute monthly changes of several reproductive and child health indicators assessed. Conclusions The COVID-19 pandemic may have contributed to the decline observed in several RMNCAH indicators in Haiti. However, the role played by the sociopolitical crisis and control exercised by armed groups over the population in the last three years cannot be ruled out.
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Affiliation(s)
- Gary Joseph
- University of GuyanaGeorgetownGuyanaUniversity of Guyana, Georgetown, Guyana
| | - Solange Kobi-Jackson
- Pan American Health OrganizationPort-au-PrinceHaitiPan American Health Organization, Port-au-Prince, Haiti
| | - Maureen Birmingham
- Pan American Health OrganizationPort-au-PrinceHaitiPan American Health Organization, Port-au-Prince, Haiti
| | - Gilles Champetier de Ribes
- Pan American Health OrganizationPort-au-PrinceHaitiPan American Health Organization, Port-au-Prince, Haiti
| | - Bremen De Mucio
- Latin American Center for PerinatologyWomen and Reproductive HealthMontevideoUruguayLatin American Center for Perinatology, Women and Reproductive Health, Montevideo, Uruguay
| | - Mercedes Colomar
- Latin American Center for PerinatologyWomen and Reproductive HealthMontevideoUruguayLatin American Center for Perinatology, Women and Reproductive Health, Montevideo, Uruguay
| | - Claudio Sosa
- Latin American Center for PerinatologyWomen and Reproductive HealthMontevideoUruguayLatin American Center for Perinatology, Women and Reproductive Health, Montevideo, Uruguay
| | - Jean Patrick Alfred
- Ministère de la Santé Publique et de la PopulationPort-au-PrinceHaitiMinistère de la Santé Publique et de la Population, Port-au-Prince, Haiti
| | - Roody Thermidor
- Ministère de la Santé Publique et de la PopulationPort-au-PrinceHaitiMinistère de la Santé Publique et de la Population, Port-au-Prince, Haiti
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Mazzilli S, Paparatto G, Chieti A, Nannavecchia AM, Bisceglia L, Lopalco PL, Martinelli D, Tavoschi L. Comparison of geographical and individual deprivation index to assess the risk of Sars-CoV-2 infection and disease severity: a retrospective cohort study. Int J Health Geogr 2024; 23:8. [PMID: 38575967 PMCID: PMC10993505 DOI: 10.1186/s12942-024-00367-6] [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: 09/28/2023] [Accepted: 03/13/2024] [Indexed: 04/06/2024] Open
Abstract
BACKGROUND It has been shown that COVID-19 affects people at socioeconomic disadvantage more strongly. Previous studies investigating the association between geographical deprivation and COVID-19 outcomes in Italy reported no differences in case-hospitalisation and case-fatality. The objective of this research was to compare the usefulness of the geographic and individual deprivation index (DI) in assessing the associations between individuals' deprivation and risk of Sars-CoV-2 infection and disease severity in the Apulia region from February to December 2020. METHODS This was a retrospective cohort study. Participants included individuals tested for SARS-CoV-2 infection during the study period. The individual DI was calculated employing polychoric principal component analysis on four census variables. Multilevel logistic models were used to test associations between COVID-19 outcomes and individual DI, geographical DI, and their interaction. RESULTS In the study period, 139,807 individuals were tested for COVID-19 and 56,475 (43.5%) tested positive. Among those positive, 7902 (14.0%) have been hospitalised and 2215 (4.2%) died. During the first epidemic wave, according the analysis done with the individual DI, there was a significant inversely proportional trend between the DI and the risk of testing positive. No associations were found between COVID-19 outcomes and geographic DI. During the second wave, associations were found between COVID-19 outcomes and individual DI. No associations were found between the geographic DI and the risk of hospitalisation and death. During both waves, there were no association between COVID-19 outcomes and the interaction between individual and geographical DI. CONCLUSIONS Evidence from this study shows that COVID-19 pandemic has been experienced unequally with a greater burden among the most disadvantaged communities. The results of this study remind us to be cautious about using geographical DI as a proxy of individual social disadvantage because may lead to inaccurate assessments. The geographical DI is often used due to a lack of individual data. However, on the determinants of health and health inequalities, monitoring has to have a central focus. Health inequalities monitoring provides evidence on who is being left behind and informs equity-oriented policies, programmes and practices. Future research and data collection should focus on improving surveillance systems by integrating individual measures of inequalities into national health information systems.
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Affiliation(s)
- Sara Mazzilli
- Scuola Normale Superiore, Pisa, Italy.
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy.
| | - Gianluca Paparatto
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
- Health Science Interdisciplinary Research Centre, Sant'Anna School of Advanced Studies, Pisa, Italy
| | - Antonio Chieti
- Strategic Regional Health and Social Agency of Puglia (AReSS Puglia), Bari, Italy
| | | | - Lucia Bisceglia
- Strategic Regional Health and Social Agency of Puglia (AReSS Puglia), Bari, Italy
| | - Pier Luigi Lopalco
- Department of Biological and Environmental Sciences and Technology, University of Salento, Lecce, Italy
| | - Domenico Martinelli
- Hygiene Unit, Policlinico Foggia Hospital, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Lara Tavoschi
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
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Peléšková Š, Polák J, Janovcová M, Chomik A, Sedláčková K, Frynta D, Landová E. Human emotional evaluation of ancestral and modern threats: fear, disgust, and anger. Front Psychol 2024; 14:1321053. [PMID: 38239483 PMCID: PMC10794497 DOI: 10.3389/fpsyg.2023.1321053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 12/12/2023] [Indexed: 01/22/2024] Open
Abstract
Introduction Animal and human ancestors developed complex physiological and behavioral response systems to cope with two types of threats: immediate physical harm from predators or conspecifics, triggering fear, and the risk of infections from parasites and pathogens leading to the evolution of the behavioral immune system with disgust as the key emotion. Integration of the evolutionary concepts of the fear module and behavioral immune systems has been infrequent, despite the significant survival advantages of disgust in various contexts. Studies comparing attention to ancestral and modern threats accompanied by fear have yielded ambiguous results and what qualifies as salient modern disgusting stimuli remains unclear. We do not know whether disgust or the behavioral immune system, as inherent aspects of human psychology, have adapted to safeguard us from pandemic risks or poisoning by modern toxic substances. Methods To test these effects, we have developed a survey comprised of 60 short vignettes describing threats evoking fear and disgust belonging to one of the three main categories of threats: (1) ancestral (phylogenetic), (2) modern (ontogenetic), and (3) pandemics of airborne disease. Each vignette was evaluated on a 7-point Likert scale based on fear, disgust, and anger. In total, 660 respondents completed the survey. The data were analysed using a factor analysis and general linear model with the respondent as a random factor. Results The results show that the strongest fear is triggered by modern threats (electricity, car accidents), while the highest disgust is evoked by ancient threats (body waste products, worms, etc.). Interestingly, disgust does not respond to modern threat stimuli such as toxic substances or radioactivity as these evoke mainly fear and anger. Finally, a distinct response pattern was found for pandemic threats, in which both fear (e.g., of disease and death) and disgust (e.g., of used face masks) are employed. Discussion Our study offers valuable insights into the emotional responses to ancestral and modern threats and their adaptation to pandemic challenges. Ancestral threats are not always more powerful stimuli than adequate threats of the modern type, but they function specifically. Thus, snakes and heights as fear-inducing ancestral threats form separate factors in a multivariate analysis, whereas all ancestral disgust stimuli group together. The threat of a pandemic forms a specific category and people process it emotionally and cognitively. These insights contribute to our understanding of human psychology and behavior in an ever-changing world.
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Affiliation(s)
- Šárka Peléšková
- Department of Zoology, Faculty of Science, Charles University, Prague, Czechia
| | - Jakub Polák
- Department of Zoology, Faculty of Science, Charles University, Prague, Czechia
- Department of Economy and Management, Ambis University, Prague, Czechia
| | - Markéta Janovcová
- Department of Zoology, Faculty of Science, Charles University, Prague, Czechia
| | - Aleksandra Chomik
- Department of Zoology, Faculty of Science, Charles University, Prague, Czechia
| | | | - Daniel Frynta
- Department of Zoology, Faculty of Science, Charles University, Prague, Czechia
| | - Eva Landová
- Department of Zoology, Faculty of Science, Charles University, Prague, Czechia
- National Institute of Mental Health, Klecany, Czechia
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Shakibfar S, Zhao J, Li H, Nordeng H, Lupattelli A, Pavlovic M, Sandve GK, Nyberg F, Wettermark B, Hajiebrahimi M, Andersen M, Sessa M. Machine learning-driven development of a disease risk score for COVID-19 hospitalization and mortality: a Swedish and Norwegian register-based study. Front Public Health 2023; 11:1258840. [PMID: 38146473 PMCID: PMC10749372 DOI: 10.3389/fpubh.2023.1258840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 11/20/2023] [Indexed: 12/27/2023] Open
Abstract
Aims To develop a disease risk score for COVID-19-related hospitalization and mortality in Sweden and externally validate it in Norway. Method We employed linked data from the national health registries of Sweden and Norway to conduct our study. We focused on individuals in Sweden with confirmed SARS-CoV-2 infection through RT-PCR testing up to August 2022 as our study cohort. Within this group, we identified hospitalized cases as those who were admitted to the hospital within 14 days of testing positive for SARS-CoV-2 and matched them with five controls from the same cohort who were not hospitalized due to SARS-CoV-2. Additionally, we identified individuals who died within 30 days after being hospitalized for COVID-19. To develop our disease risk scores, we considered various factors, including demographics, infectious, somatic, and mental health conditions, recorded diagnoses, and pharmacological treatments. We also conducted age-specific analyses and assessed model performance through 5-fold cross-validation. Finally, we performed external validation using data from the Norwegian population with COVID-19 up to December 2021. Results During the study period, a total of 124,560 individuals in Sweden were hospitalized, and 15,877 individuals died within 30 days following COVID-19 hospitalization. Disease risk scores for both hospitalization and mortality demonstrated predictive capabilities with ROC-AUC values of 0.70 and 0.72, respectively, across the entire study period. Notably, these scores exhibited a positive correlation with the likelihood of hospitalization or death. In the external validation using data from the Norwegian COVID-19 population (consisting of 53,744 individuals), the disease risk score predicted hospitalization with an AUC of 0.47 and death with an AUC of 0.74. Conclusion The disease risk score showed moderately good performance to predict COVID-19-related mortality but performed poorly in predicting hospitalization when externally validated.
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Affiliation(s)
- Saeed Shakibfar
- Department of Drug Design and Pharmacology, Pharmacovigilance Research Center, University of Copenhagen, Copenhagen, Denmark
- Department of Drug Design and Pharmacology, Drug Safety Group, University of Copenhagen, Copenhagen, Denmark
| | - Jing Zhao
- Department of Pharmacy, Pharmacoepidemiology and Drug Safety Research Group, Faculty of Mathematics and Natural Sciences, University of Oslo, Oslo, Norway
- UiO: RealArt Convergence Environment, University of Oslo, Oslo, Norway
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Huiqi Li
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Hedvig Nordeng
- Department of Pharmacy, Pharmacoepidemiology and Drug Safety Research Group, Faculty of Mathematics and Natural Sciences, University of Oslo, Oslo, Norway
- UiO: RealArt Convergence Environment, University of Oslo, Oslo, Norway
| | - Angela Lupattelli
- Department of Pharmacy, Pharmacoepidemiology and Drug Safety Research Group, Faculty of Mathematics and Natural Sciences, University of Oslo, Oslo, Norway
- UiO: RealArt Convergence Environment, University of Oslo, Oslo, Norway
| | - Milena Pavlovic
- UiO: RealArt Convergence Environment, University of Oslo, Oslo, Norway
- Department of Informatics, Faculty of Mathematics and Natural Sciences, University of Oslo, Oslo, Norway
| | - Geir Kjetil Sandve
- UiO: RealArt Convergence Environment, University of Oslo, Oslo, Norway
- Department of Informatics, Faculty of Mathematics and Natural Sciences, University of Oslo, Oslo, Norway
| | - Fredrik Nyberg
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Björn Wettermark
- Department of Pharmacy, Pharmacoepidemiology and Social Pharmacy, Uppsala University, Uppsala, Sweden
| | | | - Morten Andersen
- Department of Drug Design and Pharmacology, Pharmacovigilance Research Center, University of Copenhagen, Copenhagen, Denmark
| | - Maurizio Sessa
- Department of Drug Design and Pharmacology, Drug Safety Group, University of Copenhagen, Copenhagen, Denmark
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Desai S, Rashid SF. Group think? Questioning the individual global health expert. Lancet Glob Health 2023; 11:e1853-e1854. [PMID: 37973332 DOI: 10.1016/s2214-109x(23)00434-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 09/07/2023] [Indexed: 11/19/2023]
Affiliation(s)
- Sapna Desai
- Population Council Institute, New Delhi, India; BRAC James P Grant School of Public Health, BRAC University, Dhaka 1212, Bangladesh
| | - Sabina F Rashid
- BRAC James P Grant School of Public Health, BRAC University, Dhaka 1212, Bangladesh.
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Sahoo S, Patra S. A Rapid Systematic Review of the Prevalence of Suicide and Self-Harm Behaviors in Adolescents During the COVID-19 Pandemic. CRISIS 2023; 44:497-505. [PMID: 37194641 DOI: 10.1027/0227-5910/a000906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
Background: COVID-19 has caused psychological, social, and physical isolation in adolescents resulting in varying rates of suicidal behavior and self-harm. Aims: We investigated the pandemic's impact on adolescent suicidal behavior and self-harm by reviewing the existing literature. Methods: We searched PubMed using keywords: adolescent, suicide, suicidal behavior, self-harm, prevalence, and COVID-19 and included studies reporting primary data only. Results: Of the 551 studies identified, we included 39 studies in the final analysis. Two of the six high-quality population-based suicide registry studies reported increased suicide rates during the pandemic. Seven of fifteen emergency department-based studies out of which four were of high quality and three high-quality population-based health registry studies reported increased self-harm. A few school and community-based surveys and national helpline data also reported an increase in suicidal behavior or self-harm. Limitations: Methodological heterogeneity of the included studies. Conclusions: There is wide variation in study methodology, population, settings, and age groups in the included studies. Suicidal behavior and self-harm were increased in specific study settings and adolescent populations during the pandemic. More methodologically rigorous research is needed to evaluate the impact of COVID-19 on adolescent suicidal behavior and self-harm.
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Affiliation(s)
- Swapnajeet Sahoo
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Suravi Patra
- Department of Psychiatry, All India Institute of Medical Sciences Bhubaneswar, India
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Jovanović V, Lazić M. Vaccination Attitudes Examination (VAX) Scale: a Bifactor-ESEM approach in a youth sample (15-24 years). BMC Psychol 2023; 11:351. [PMID: 37872642 PMCID: PMC10594745 DOI: 10.1186/s40359-023-01388-9] [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: 03/14/2023] [Accepted: 10/10/2023] [Indexed: 10/25/2023] Open
Abstract
BACKGROUND The Vaccination Attitudes Examination (VAX) Scale is a widely used scale designed to measure general attitudes toward vaccinations. However, evidence for the VAX's structural, convergent, and discriminant validity is still limited, especially in youth samples. METHODS The present study examined the psychometric multidimensionality and evidence of convergent and discriminant validity of the VAX using the bifactor-exploratory structural equation modeling approach (bifactor-ESEM). Using a sample of 803 Serbian adolescents and young adults (Mage = 18.23, SDage = 2.66, age range = 15-24 years, 59.2% female), we contrasted the original four-factor model of the VAX with alternative solutions (ESEM, bifactor-CFA, and bifactor-ESEM), and investigated associations between vaccination attitudes and a variety of external criteria. RESULTS The results supported the bifactor-ESEM solution with one general factor of vaccination attitudes and four specific factors (Mistrust of vaccine benefit, Worries about unforeseen future effects, Concerns about commercial profiteering, and Preference for natural immunity) as the best representation of the data. The general factor was well-defined, and three specific factors showed good validity and specificity after the general factor was taken into account. The results of convergent validity analyses showed that the general factor of vaccine attitudes and one specific factor (Mistrust of vaccine benefit) were good predictors of vaccine conspiracy beliefs, attitudes towards COVID-19 vaccination, intention to get vaccinated against COVID-19, and trust in healthcare. The remaining three specific factors' contributions to external criteria were generally weak and nonsignificant. Evidence of the discriminant validity of the VAX scores was supported by weak positive associations of the general factor with medical fears and paranoid worry. CONCLUSIONS The present findings indicate that distinguishing general and specific components of vaccination attitudes offers a more nuanced assessment and understanding of vaccination attitudes.
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Affiliation(s)
- Veljko Jovanović
- Department of Psychology, Faculty of Philosophy, University of Novi Sad, Dr Zorana Đinđića 2, Novi Sad, Novi Sad, 21 000, Serbia.
| | - Milica Lazić
- Department of Psychology, Faculty of Philosophy, University of Novi Sad, Dr Zorana Đinđića 2, Novi Sad, Novi Sad, 21 000, Serbia
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Xiao H, Liu F, Unger JM. Dynamic zero-COVID policy and healthcare utilization patterns in China during the Shanghai COVID-19 Omicron outbreak. COMMUNICATIONS MEDICINE 2023; 3:143. [PMID: 37821531 PMCID: PMC10567791 DOI: 10.1038/s43856-023-00375-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 09/29/2023] [Indexed: 10/13/2023] Open
Abstract
BACKGROUND In April 2022, an outbreak of the SARS-CoV-2 virus Omicron variant in Shanghai precipitated an extensive lockdown. We assessed changes in healthcare utilization during this outbreak and investigated the relationship between the stringency of mitigation strategies and disruptions in healthcare utilization. METHODS Using provincial-level data from routine health information systems covering all hospitals across Mainland China, we conducted an interrupted time series analysis to examine changes in healthcare utilization during the Shanghai outbreak. Linear regression was used to evaluate the direction and magnitude of the association between the relative changes in the move-out movement index, a proxy for the stringency in population-level mitigation strategies, and the estimated relative changes in healthcare utilization. RESULTS Overall, there were 22.9 billion outpatient visits and 1.2 billion discharged inpatients during the study period from January 2016 to May 2022, including 9.1 billion (39.7%) and 0.46 billion (38.2%) in the post-COVID-19 period (January 2020-May 2022), respectively. From March through May 2022, the outbreak resulted in an accumulative loss of 23.5 million (47%) outpatient visits and 0.6 million (55%) discharged inpatients in Shanghai, and a loss of 150.3 million (14%) outpatient visits and 3.6 million (7%) discharged inpatients in other regions. We find that for every 10-percentage point reduction in the relative change of move-out index, a 2.7 (95% CI: 2.0-3.4) percentage point decline in the relative change of outpatient visits, and a 4.3 (95% CI: 3.5-5.2) percentage points decline in the relative change of inpatient discharges. CONCLUSIONS The Shanghai COVID-19 Omicron outbreak associates with a substantial reduction in outpatient visits and inpatient discharges within Shanghai and other regions in China. The stringency of the COVID-19 lockdown policies associates with more profound reductions in healthcare utilization.
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Affiliation(s)
- Hong Xiao
- Public Health Sciences Division, Fred Hutchinson Cancer Center, Seattle, WA, USA.
| | - Fang Liu
- Independent Researcher, Beijing, China
| | - Joseph M Unger
- Public Health Sciences Division, Fred Hutchinson Cancer Center, Seattle, WA, USA.
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Ali J. Mapping scientific knowledge discovery on COVID-19 pandemic and agriculture: a bibliometric analysis and future research directions. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:95155-95171. [PMID: 37597148 DOI: 10.1007/s11356-023-29238-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 08/04/2023] [Indexed: 08/21/2023]
Abstract
This paper aims at analyzing the research productivity and scientific knowledge discovery of the COVID-19 pandemic in agriculture using a bibliometric analysis approach. A total of 1514 research papers indexed in the Scopus database, covering a period of 2020 to 2022, are processed using VOSviewer and R-Studio software. The analysis of research productivity indicates that the number of research publications on COVID-19 and agriculture has exponentially increased globally, and about 80% of the research papers have been published in the top 10 countries led by the USA, India, and China. The countries are increasingly collaborating in undertaking research on COVID-19 and agriculture. Furthermore, major journals and articles with citations have been extracted to analyze the leading publication avenues and focused areas of research. The science mapping is done using co-occurrence and thematic map. With the help of co-occurrence analysis, six clusters are identified depicting major research themes, i.e., COVID-19 and agricultural supply chain disruption, COVID-19 and human health issues and coping strategies, COVID-19 and non-human and animal health, COVID-19 pandemic and environment and pollution, COVID-19 and healthcare and treatment, and COVID-19 and food nutrition from dairy and meat products. The thematic map analysis identifies potential research areas such as mental health, anxiety, and depression in the agricultural system, which may help in setting future research agenda and help devising policy supports for managing the agriculture sector better during crisis. The paper also highlights the theoretical and practical implications.
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Affiliation(s)
- Jabir Ali
- Economics & Business Environment Area , Indian Institute of Management Jammu, 180 016, Jammu, India.
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Trentin M, Rubini E, Bahattab A, Loddo M, Della Corte F, Ragazzoni L, Valente M. Vulnerability of migrant women during disasters: a scoping review of the literature. Int J Equity Health 2023; 22:135. [PMID: 37481546 PMCID: PMC10362632 DOI: 10.1186/s12939-023-01951-1] [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: 10/24/2022] [Accepted: 07/06/2023] [Indexed: 07/24/2023] Open
Abstract
BACKGROUND Disasters have an unequal impact on the population because of differences in conditions of vulnerability, exposure, and capacity. Migrants and women are among the groups that are at greater risk for and disproportionately affected by disasters. However, despite the large body of evidence that analyzes their vulnerability separately, disaster research that targets migrant women is scant. The aim of this scoping review was to analyze the published scientific literature concerning the vulnerability of migrant women and the consequent negative impact they experience during disasters. METHODS A literature search was conducted on December 15th, 2021 on Pubmed, Scopus, and Web of Science databases. No time filter was applied to the search. Information regarding the article's main characteristics and design, migrant women and their migration experience, as well as about the type of disaster was collected. The factors responsible for the vulnerability of migrant women and the negative outcomes experienced during a disaster were extracted and inductively clustered in main themes reflecting several vulnerability pathways. The review followed the Joanna Briggs Institute methodology for scoping reviews and relied on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). RESULTS After full text review, 14 articles met the inclusion criteria. All of them adopted a qualitative methodology and focused on COVID-19. The pandemic negatively affected migrant women, by triggering numerous drivers that increased their level of exposure and vulnerability. Overall, six vulnerability factors have been identified: legal status, poverty conditions, pre-existing health conditions, limited agency, gender inequality and language and cultural barriers. These resulted in nine impacts: worsening of mental health status, poor access to care, worsening of physical health conditions, fraud, exacerbation of poverty, gender-based violence, jeopardization of educational path, and unfulfillment of their religious needs. CONCLUSIONS This review provided an analysis of the vulnerability factors of migrant women and the pathways leading to negative outcomes during a disaster. Overall, the COVID-19 pandemic demonstrated that health equity is a goal that is still far to reach. The post-pandemic era should constitute the momentum for thoroughly addressing the social determinants of health that systematically marginalize the most vulnerable groups.
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Affiliation(s)
- Monica Trentin
- CRIMEDIM - Center for Research and Training in Disaster Medicine, Humanitarian Aid and Global Health, Università del Piemonte Orientale, 28100, Novara, Italy.
| | - Elena Rubini
- CRIMEDIM - Center for Research and Training in Disaster Medicine, Humanitarian Aid and Global Health, Università del Piemonte Orientale, 28100, Novara, Italy
| | - Awsan Bahattab
- CRIMEDIM - Center for Research and Training in Disaster Medicine, Humanitarian Aid and Global Health, Università del Piemonte Orientale, 28100, Novara, Italy
| | | | - Francesco Della Corte
- CRIMEDIM - Center for Research and Training in Disaster Medicine, Humanitarian Aid and Global Health, Università del Piemonte Orientale, 28100, Novara, Italy
| | - Luca Ragazzoni
- CRIMEDIM - Center for Research and Training in Disaster Medicine, Humanitarian Aid and Global Health, Università del Piemonte Orientale, 28100, Novara, Italy
| | - Martina Valente
- CRIMEDIM - Center for Research and Training in Disaster Medicine, Humanitarian Aid and Global Health, Università del Piemonte Orientale, 28100, Novara, Italy
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12
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Kelabi HM, Alharbi AS, Alshamrani AS, Baqais K, Alenazi AM, Alqwaiee MM. Impact of COVID-19 Pandemic on Respiratory Syncytial Virus (RSV) Prophylaxis Program: A Tertiary-Care Center Experience. Cureus 2023; 15:e42563. [PMID: 37637610 PMCID: PMC10460243 DOI: 10.7759/cureus.42563] [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] [Accepted: 07/27/2023] [Indexed: 08/29/2023] Open
Abstract
OBJECTIVES The purpose of this investigation was to evaluate the effects of the COVID-19 pandemic on the respiratory syncytial virus (RSV) prevention program at our institution across three time frames: 2019-2020, 2020-2021, and 2021-2022. METHODS We carried out a descriptive, single-site observational study spanning four years, from June 2019 to June 2022. Our study included patients in our institution's RSV program who met our enrollment criteria. We collected information about the number of children receiving immunoprophylaxis, immunoprophylaxis doses, and RSV risk factors. RESULTS The number of patients receiving immunoprophylaxis dropped across the three periods, from 315 patients in the first period (2019-2020) to 176 in the second period (2020-2021), and further decreased to 128 in the third period (2021-2022). Following the COVID-19 pandemic, there was a 50% reduction in the number of patients receiving immunoprophylaxis. The proportion of RSV-infected patients remained relatively similar in the first and second periods (2.86% and 2.27%, respectively) but increased in the third period (5.47%). In the first period, most patients (60.32%) received seven doses, 11.75% got four to six doses, and 27.95% received three doses or fewer. The second period saw 59.66% of patients receiving four to six doses and 40.34% receiving three doses or fewer. In the third period, a mere 9.38% received four to five doses, while 90.63% got three doses or fewer. CONCLUSIONS While preventative measures associated with COVID-19 may have helped reduce the number of RSV cases, the pandemic seems to have caused a significant decrease in the number of children receiving immunoprophylaxis and the doses of immunoprophylaxis. More extensive, multicenter research is needed to understand the impact of the COVID-19 pandemic on RSV immunoprophylaxis, its activity, and seasonal patterns fully.
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Affiliation(s)
- Hamza M Kelabi
- Department of Pediatrics, Prince Sultan Military Medical City, Ministry of Defense, Riyadh, SAU
| | - Adel S Alharbi
- Department of Pediatrics, Prince Sultan Military Medical City, Ministry of Defense, Riyadh, SAU
| | - Abdullah S Alshamrani
- Department of Pediatrics, Prince Sultan Military Medical City, Ministry of Defense, Riyadh, SAU
| | - Khaled Baqais
- Department of Pediatrics, Prince Sultan Military Medical City, Ministry of Defense, Riyadh, SAU
| | - Ayed M Alenazi
- Department of Pediatrics, Prince Sultan Military Medical City, Ministry of Defense, Riyadh, SAU
| | - Mansour M Alqwaiee
- Department of Pediatrics, Prince Sultan Military Medical City, Ministry of Defense, Riyadh, SAU
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13
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Wang B, Yuan S, Ruan S, Ning X, Li H, Liu Y, Li X. Associations between underlying diseases with COVID-19 and its symptoms among adults: a cross-sectional study. Front Public Health 2023; 11:1210800. [PMID: 37383271 PMCID: PMC10298173 DOI: 10.3389/fpubh.2023.1210800] [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: 04/23/2023] [Accepted: 05/22/2023] [Indexed: 06/30/2023] Open
Abstract
Background Specific underlying diseases were reported to be associated with severe COVID-19 outcomes, but little is known about their combined associations. The study was aimed to assess the relations of number of and specific underlying diseases to COVID-19, severe symptoms, loss of smell, and loss of taste. Methods A total of 28,204 adult participants in the National Health Interview Survey 2021 were included. Underlying diseases (including cardiovascular diseases, cancer, endocrine diseases, respiratory diseases, neuropsychiatric diseases, liver and kidney diseases, fatigue syndrome, and sensory impairments), the history of COVID-19, and its symptoms were self-reported by structured questionnaires. Multivariable logistic regression models were used to assess the combined relation of total number of underlying diseases to COVID-19 and its symptoms, while mutually adjusted logistic models were used to examine their independent associations. Results Among the 28,204 participants (mean ± standard deviation: 48.2 ± 18.5 years), each additional underlying disease was related to 33, 20, 37, and 39% higher odds of COVID-19 (odds ratio [OR]: 1.33, 95% confidence interval [CI]: 1.29-1.37), severe symptoms (OR: 1.20, 95% CI: 1.12-1.29), loss of smell (OR: 1.37, 95% CI: 1.29-1.46), and loss of taste (OR: 1.39, 95% CI: 1.31-1.49). In addition, independent associations of sensory impairments with COVID-19 (OR: 3.73, 95% CI: 3.44-4.05), severe symptoms (OR: 1.37, 95% CI: 1.13-1.67), loss of smell (OR: 8.17, 95% CI: 6.86-9.76), and loss of taste (OR: 6.13, 95% CI: 5.19-7.25), cardiovascular diseases with COVID-19 (OR: 1.13, 95% CI: 1.03-1.24), neuropsychiatric diseases with severe symptoms (OR: 1.41, 95% CI: 1.15-1.74), and endocrine diseases with loss of taste (OR: 1.28, 95% CI: 1.05-1.56) were observed. Conclusion A larger number of underlying diseases were related to higher odds of COVID-19, severe symptoms, loss of smell, and loss of taste in a dose-response manner. Specific underlying diseases might be individually associated with COVID-19 and its symptoms.
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Affiliation(s)
- Binghan Wang
- Department of Big Data in Health Science, and Center for Clinical Big Data and Statistics, the Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
- School of Public Health, Zhejiang University School of Medicine, Hangzhou, China
| | - Shuyan Yuan
- School of Public Health, Zhejiang University School of Medicine, Hangzhou, China
| | - Shuke Ruan
- School of Public Health, Zhejiang University School of Medicine, Hangzhou, China
| | - Xiuyuan Ning
- School of Public Health, Zhejiang University School of Medicine, Hangzhou, China
| | - Hanrui Li
- School of Public Health, Zhejiang University School of Medicine, Hangzhou, China
| | - Yuanhao Liu
- School of Public Health, Zhejiang University School of Medicine, Hangzhou, China
| | - Xiuyang Li
- Department of Big Data in Health Science, and Center for Clinical Big Data and Statistics, the Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
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14
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Seljemo C, Wiig S, Røise O, Ree E. The role of local context for managers' strategies when adapting to the COVID-19 pandemic in Norwegian homecare services: a multiple case study. BMC Health Serv Res 2023; 23:492. [PMID: 37194101 DOI: 10.1186/s12913-023-09444-1] [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: 11/25/2022] [Accepted: 04/25/2023] [Indexed: 05/18/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic had a major impact on healthcare systems around the world, and lack of resources, lack of adequate preparedness and infection control equipment have been highlighted as common challenges. Healthcare managers' capacity to adapt to the challenges brought by the COVID-19 pandemic is crucial to ensure safe and high-quality care during a crisis. There is a lack of research on how these adaptations are made at different levels of the homecare services system and how the local context influences the managerial strategies applied in response to a healthcare crisis. This study explores the role of local context for managers' experiences and strategies in homecare services during the COVID-19 pandemic. METHODS A qualitative multiple case study in four municipalities with different geographic locations (centralized and decentralized) across Norway. A review of contingency plans was performed, and 21 managers were interviewed individually during the period March to September 2021. All interviews were conducted digitally using a semi-structured interview guide, and data was subjected to inductive thematic analysis. RESULTS The analysis revealed variations in managers' strategies related to the size and geographical location of the homecare services. The opportunities to apply different strategies varied among the municipalities. To ensure adequate staffing, managers collaborated, reorganized, and reallocated resources within their local health system. New guidelines, routines and infection control measures were developed and implemented in the absence of adequate preparedness plans and modified according to the local context. Supportive and present leadership in addition to collaboration and coordination across national, regional, and local levels were highlighted as key factors in all municipalities. CONCLUSION Managers who designed new and adaptive strategies to respond to the COVID-19 pandemic were central in ensuring high-quality Norwegian homecare services. To ensure transferability, national guidelines and measures must be context-dependent or -sensitive and must accommodate flexibility at all levels in a local healthcare service system.
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Affiliation(s)
- Camilla Seljemo
- SHARE - Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway.
| | - Siri Wiig
- SHARE - Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - Olav Røise
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Division of Orthopedic Surgery, Oslo University Hospital, Oslo, Norway
| | - Eline Ree
- SHARE - Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
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15
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Carroll JJ, Rossi SL, Vetrova MV, Blokhina E, Sereda Y, Lioznov D, Luoma J, Kiriazova T, Lunze K. The impacts of COVID-19 on structural inequities faced by people living with HIV who inject drugs: A qualitative study in St. Petersburg, Russia. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2023; 117:104060. [PMID: 37210965 DOI: 10.1016/j.drugpo.2023.104060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 05/06/2023] [Accepted: 05/08/2023] [Indexed: 05/23/2023]
Abstract
BACKGROUND People who inject drugs (PWID) living with HIV may be disproportionately impacted by pandemic restrictions. This study qualitatively explored the impacts of the SARS-CoV-2 pandemic on PWID with HIV in St. Petersburg, Russia. METHODS In March and April 2021, we conducted remote, semi-structured interviews with PWID with HIV, health care providers, and harm reductionists. RESULTS We interviewed 25 PWID with HIV (aged 28-56 years, 46% female) and 11 providers. The pandemic exacerbated economic and psychological challenges experienced by PWID with HIV. Simultaneously, barriers to HIV care access, ART prescription refill and dispensing and police violence, which hindered the health and safety of PWID with HIV, were themselves hindered from normal operations by the pandemic, significantly reducing these burdens. CONCLUSION Pandemic responses should account for the unique vulnerabilities of PWID with HIV to avoid worsening the structural violence they already experience. Wherever the pandemic decreased structural barriers, such as institutional, administrative, and bureaucratic challenges and state violence enacted by police and other elements of the criminal justice system, such changes should be protected.
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Affiliation(s)
- Jennifer J Carroll
- Department of Sociology and Anthropology, North Carolina State University, 10 Current Drive, Raleigh, NC, 27695, USA; Warren Alpert School of Medicine at Brown University, 222 Richmond St, Providence, RI, 02903 USA.
| | - Sarah L Rossi
- Department of Medicine, Boston Medical Center, 801 Massachusetts Ave, 2nd Floor, Boston, MA, 02118, USA
| | - Marina V Vetrova
- Pavlov University, 11 Komendantsky pr., office 45N, St. Petersburg, 197227, Russia
| | - Elena Blokhina
- Pavlov University, 11 Komendantsky pr., office 45N, St. Petersburg, 197227, Russia
| | - Yuliia Sereda
- Ukrainian Institute on Public Health Policy, 10 B. Khmelnytskoho St., Apt. 60, Kyiv, 01054, Ukraine; Smorodintsev Research Institute of Influenza, 15/17 Popov St., St. Petersburg, 197376, Russia
| | - Dmitry Lioznov
- Pavlov University, 11 Komendantsky pr., office 45N, St. Petersburg, 197227, Russia
| | - Jason Luoma
- Portland Psychotherapy Clinic, Training, and Research Center, 3700N Williams Ave, Portland, OR, 97227, USA
| | - Tetiana Kiriazova
- Ukrainian Institute on Public Health Policy, 10 B. Khmelnytskoho St., Apt. 60, Kyiv, 01054, Ukraine
| | - Karsten Lunze
- Department of Medicine, Boston Medical Center, 801 Massachusetts Ave, 2nd Floor, Boston, MA, 02118, USA; School of Medicine, Boston University, 72 E Concord St, Boston, MA, 02118, USA
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16
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Bhattacharya J. Revitalizing primary care is the key to people's health in the post-COVID era. J Family Med Prim Care 2023; 12:807-811. [PMID: 37448935 PMCID: PMC10336947 DOI: 10.4103/jfmpc.jfmpc_621_23] [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: 04/10/2023] [Accepted: 04/27/2023] [Indexed: 07/18/2023] Open
Abstract
Growing evidence shows that primary care-oriented systems achieve better health outcomes, more health equity, and lower costs. Despite this strong evidence, such care has been chronically underfunded. If a council focused on primary care had existed during the height of the coronavirus disease 2019 (COVID-19) pandemic, it could have helped rapidly mobilize primary care to address vaccine equity and shore up public health, particularly in rural and historically marginalized urban communities. We believe an infrastructure investment plan should include oversight, tools, and resources for rebuilding primary care. Researchers have tried to compare the number of deaths due to "neglected tropical diseases" and that due to COVID - total deaths in the former cases are greater than COVID deaths. We should take into consideration a few issues: (a) distinction between health (as a human right) and health care (as commodity), (b) "clinical health" and "public health," (3) primary health care (as the backbone of public health) as well as community-based horizontal program NOT to be replaced by selective primary health care or GOBI or any disease-centered vertical program.
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Affiliation(s)
- Jayanta Bhattacharya
- Family Practitioner, Independent Researcher on Public Health and History of Medicine, Uttar Dinajpur, West Bengal, India
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17
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Reddy T, Kapoor NR, Kubota S, Doubova SV, Asai D, Mariam DH, Ayele W, Mebratie AD, Thermidor R, Sapag JC, Bedregal P, Passi-Solar Á, Gordon-Strachan G, Dulal M, Gadeka DD, Mehata S, Margozzini P, Leerapan B, Rittiphairoj T, Kaewkamjornchai P, Nega A, Awoonor-Williams JK, Kruk ME, Arsenault C. Associations between the stringency of COVID-19 containment policies and health service disruptions in 10 countries. BMC Health Serv Res 2023; 23:363. [PMID: 37046260 PMCID: PMC10096103 DOI: 10.1186/s12913-023-09363-1] [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] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 04/03/2023] [Indexed: 04/14/2023] Open
Abstract
BACKGROUND Disruptions in essential health services during the COVID-19 pandemic have been reported in several countries. Yet, patterns in health service disruption according to country responses remain unclear. In this paper, we investigate associations between the stringency of COVID-19 containment policies and disruptions in 31 health services in 10 low- middle- and high-income countries in 2020. METHODS Using routine health information systems and administrative data from 10 countries (Chile, Ethiopia, Ghana, Haiti, Lao People's Democratic Republic, Mexico, Nepal, South Africa, South Korea, and Thailand) we estimated health service disruptions for the period of April to December 2020 by dividing monthly service provision at national levels by the average service provision in the 15 months pre-COVID (January 2019-March 2020). We used the Oxford COVID-19 Government Response Tracker (OxCGRT) index and multi-level linear regression analyses to assess associations between the stringency of restrictions and health service disruptions over nine months. We extended the analysis by examining associations between 11 individual containment or closure policies and health service disruptions. Models were adjusted for COVID caseload, health service category and country GDP and included robust standard errors. FINDINGS Chronic disease care was among the most affected services. Regression analyses revealed that a 10% increase in the mean stringency index was associated with a 3.3 percentage-point (95% CI -3.9, -2.7) reduction in relative service volumes. Among individual policies, curfews, and the presence of a state of emergency, had the largest coefficients and were associated with 14.1 (95% CI -19.6, 8.7) and 10.7 (95% CI -12.7, -8.7) percentage-point lower relative service volumes, respectively. In contrast, number of COVID-19 cases in 2020 was not associated with health service disruptions in any model. CONCLUSIONS Although containment policies were crucial in reducing COVID-19 mortality in many contexts, it is important to consider the indirect effects of these restrictions. Strategies to improve the resilience of health systems should be designed to ensure that populations can continue accessing essential health care despite the presence of containment policies during future infectious disease outbreaks.
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Affiliation(s)
- Tarylee Reddy
- Biostatistics Research Unit, South African Medical Research Council, Durban, South Africa
- School of Mathematics, Statistics and Computer Science, University of KwaZulu Natal, Durban, South Africa
| | - Neena R Kapoor
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, USA
| | - Shogo Kubota
- World Health Organization, Vientiane, Lao People's Democratic Republic, Vientiane, Laos
| | - Svetlana V Doubova
- Epidemiology and Health Services Research Unit CMN Siglo XXI, Mexican Institute of Social Security, Mexico City, Mexico
| | - Daisuke Asai
- World Health Organization, Vientiane, Lao People's Democratic Republic, Vientiane, Laos
| | - Damen Haile Mariam
- School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Wondimu Ayele
- School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Anagaw Derseh Mebratie
- School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Roody Thermidor
- Studies and Planning Unit, Ministry of Public Health and Population, Port-Au-Prince, Haiti
| | - Jaime C Sapag
- Public Health Department, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Paula Bedregal
- Public Health Department, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Álvaro Passi-Solar
- Public Health Department, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | | | - Mahesh Dulal
- Office of the Member of Federal Parliament Gagan Kumar Thapa, Kathmandu, Nepal
| | | | - Suresh Mehata
- Ministry of Health, Koshi Province, Biratnagar, Nepal
| | - Paula Margozzini
- Public Health Department, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Borwornsom Leerapan
- Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | | | | | - Adiam Nega
- School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | | | - Margaret E Kruk
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, USA
| | - Catherine Arsenault
- Department of Global Health, The George Washington University Milken Institute School of Public Health, Washington, USA.
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18
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Lindinger R, Richter H, Reuter TC, Fischer T. Effect of the COVID-19 Pandemic on Paediatric Check-Ups and Vaccinations in Germany. Vaccines (Basel) 2023; 11:vaccines11040720. [PMID: 37112632 PMCID: PMC10145570 DOI: 10.3390/vaccines11040720] [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: 02/08/2023] [Revised: 03/16/2023] [Accepted: 03/21/2023] [Indexed: 04/29/2023] Open
Abstract
Paediatric check-ups and vaccinations are provided and free of charge in Germany. Despite being hitherto generally well-received and adhered to, it is possible that the lockdown implemented due to the COVID-19 pandemic resulted in delays or even cancellations of critical paediatric visits with healthcare providers. This study attempts to quantify the rate and time to follow-up for check-ups in Germany using the retrospective IQVIATM Disease Analyzer database. Additionally, timely administration of 4 vaccines (Hexavalent, pneumococcal, MMR-V, Rotavirus) was analysed to examine the impact of pandemic restrictions on vaccine uptake. The timeframes which were compared to determine the effects of COVID-19 were June 2018-December 2019 and March 2020-September 2021. The follow-up rates for paediatric check-ups were consistently lower in the COVID-19 phase, but generally ~90%. Follow-up rates for the vaccinations were distinctly higher during COVID-19. The time between events was almost unchanged for check-ups during the pandemic. For check-ups, age at initial event differed by less than a week between the phases. For vaccinations, the age differences were slightly higher, but exceeded one week in only two cases. The results show that the COVID-19 pandemic had little effect on paediatric check-ups and vaccinations in Germany.
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Affiliation(s)
- Rudolf Lindinger
- Medical Affairs Department, MSD Sharp & Dohme GmbH, 81673 Munich, Germany
| | | | | | - Tim Fischer
- Medical Affairs Department, MSD Sharp & Dohme GmbH, 81673 Munich, Germany
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19
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Zbiri S, Fauconnier A, Milcent C. Care for uterine fibroids: another casualty of the COVID pandemic. BJOG 2023; 130:321-322. [PMID: 36151919 DOI: 10.1111/1471-0528.17293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 09/04/2022] [Accepted: 09/12/2022] [Indexed: 01/12/2023]
Affiliation(s)
- Saad Zbiri
- Research Unit 7285 'Risk and Safety in Clinical Medicine for Women and Perinatal Health' (RISCQ), UVSQ, Paris-Saclay University, Montigny-le-Bretonneux, France
| | - Arnaud Fauconnier
- Research Unit 7285 'Risk and Safety in Clinical Medicine for Women and Perinatal Health' (RISCQ), UVSQ, Paris-Saclay University, Montigny-le-Bretonneux, France.,Department of Gynaecology and Obstetrics, Poissy Saint-Germain Hospital, Poissy, France
| | - Carine Milcent
- Paris-Jourdan Sciences Economiques, French National Center for Scientific Research (CNRS), Paris, France.,Paris School of Economics (PSE), Paris, France
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20
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Ersoy Dursun F, Çağ Y, İğneci E, Işık Gören B, Arslan F, Akarsu Ayazoğlu T, İşman FK, Vahaboğlu MH. Adaptive immune system in severe COVID-19 patients in the first week of illness: A pilot study. Eur J Microbiol Immunol (Bp) 2023; 12:100-106. [PMID: 36645664 PMCID: PMC9869865 DOI: 10.1556/1886.2022.00022] [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: 11/05/2022] [Accepted: 11/29/2022] [Indexed: 01/17/2023] Open
Abstract
Introduction The presentation of the course of COVID-19-related T-cell responses in the first week of the disease may be a more specific period for adaptive immune response assessment. This study aimed to clarify the relationship between changes in peripheral blood lymphocyte counts and death in patients with COVID-19 pneumonia. Methods Thirty-three patients (14 females and 19 males) admitted for severe and desaturated COVID-19 pneumonia confirmed by polymerase chain reaction were included. Lymphocyte subsets and CD4+/CD8+ and CD16+/CD56+ rates were measured using flow cytometry from peripheral blood at admission and on the day of death or hospital discharge. Results Twenty-eight patients survived and five died. On the day of admission, the CD4+ cell count was significantly higher and the saturation of O2 was significantly lower in the deceased patients compared to the survivors (P < 0.05). The CD16+/CD56+ rate was significantly lower on the day of death in the deceased patients than in discharge day for the survivors (P = 0.013). Conclusion CD4+ lymphocyte percentages and O2 saturation in samples taken on the day of admission to the hospital and CD16+/CD56+ ratios taken at the time of discharge from the hospital were found to be associated with the mortality in patients with severe COVID-19.
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Affiliation(s)
- Fadime Ersoy Dursun
- Department of Hematology, Prof. Dr. Süleyman Yalçın City Hospital, Istanbul, Turkey,Corresponding author. Department of Hematology, Prof. Dr. Süleyman Yalçın City Hospital, Kadıköy, Istanbul, Turkey. Tel.: +90 5368385101. E-mail:
| | - Yasemin Çağ
- Department of Infectious Disease, Prof. Dr. Süleyman Yalçın City Hospital, Istanbul, Turkey
| | - Ender İğneci
- Department of Internal Medicine, Prof. Dr. Süleyman Yalçın City Hospital, Istanbul, Turkey
| | - Burcu Işık Gören
- Department of Infectious Disease, Prof. Dr. Süleyman Yalçın City Hospital, Istanbul, Turkey
| | - Ferhat Arslan
- Department of Infectious Disease, Prof. Dr. Süleyman Yalçın City Hospital, Istanbul, Turkey
| | - Tülin Akarsu Ayazoğlu
- Department of Intensive Care Unit, Prof. Dr. Süleyman Yalçın City Hospital, Istanbul, Turkey,Department of Intensive Care Unit, Faculty of Medicine, Alaaddin Keykubat University, Alanya-Antalya, Turkey
| | - Ferruh Kemal İşman
- Department of Biochemistry, Prof. Dr. Süleyman Yalçın City Hospital, Istanbul, Turkey
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21
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Alsabeeha NHM, Atieh MA, Balakrishnan MS. Older Adults' Satisfaction with Telemedicine During the COVID-19 Pandemic: A Systematic Review. Telemed J E Health 2023; 29:38-49. [PMID: 35613380 DOI: 10.1089/tmj.2022.0045] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Aims: This systematic review aimed to evaluate the satisfaction of older adults with telemedicine during the COVID-19 pandemic, assess preferences to telemedicine or in-person visits, and identify factors of influence on the satisfaction with telemedicine. Methods: The review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Statement. A search through key electronic databases identified 228 citations. After duplicate record removal, and title and abstract screening, 43 articles were eligible for full-text review. Of these, 10 studies meeting the inclusion criteria of the review were finally included. Results: Older adults were satisfied with telemedicine during the COVID-19 pandemic. Patients were in favor of telemedicine compared to in-person visits, but the evidence support for this preference was limited. Factors influencing satisfaction were identified and categorized under four main categories: system-related factors, patient-related factors, socioeconomic factors, and factors related to the nature of the medical intervention. Conclusions: Older adults were satisfied with telemedicine during the COVID-19 pandemic. A positive trend of preference toward telemedicine was observed, but not well established due to the lack of an objective measure of assessment. Technical issues related to the telemedicine delivery system were the main challenges. The socioeconomic status and level of education of older adults can relatively influence the level of satisfaction with telemedicine. The experience of older adults with telemedicine is still evolving and advanced technologies specifically designed to address their needs must be explored to increase the telemedicine uptake among the older adult population during and beyond the COVID-19 pandemic.
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Affiliation(s)
| | - Momen A Atieh
- Department of Periodontology, Hamdan Bin Mohammed College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates.,Faculty of Dentistry, Sir John Walsh Research Institute, University of Otago, Dunedin, New Zealand
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22
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Madia JE, Moscone F, Nicodemo C. Informal care, older people, and COVID-19: Evidence from the UK. JOURNAL OF ECONOMIC BEHAVIOR & ORGANIZATION 2023; 205:468-488. [PMID: 36447784 PMCID: PMC9684107 DOI: 10.1016/j.jebo.2022.11.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 11/08/2022] [Accepted: 11/15/2022] [Indexed: 06/16/2023]
Abstract
The negative health effects and mortality caused by the COVID-19 pandemic disproportionately fell upon older and disabled people. Protecting these vulnerable groups has been a key policy priority throughout the pandemic and related vaccination campaigns. Using data from the latest survey of the UK Household Longitudinal Study on COVID-19 we found that people who receive informal care have higher probability of being infected when compared to those not receiving informal care. Further, we found that care recipients who are in the lowest income groups have a higher probability of catching the virus when compared to those in the highest income groups. We also estimated the likelihood of being infected for informal carers versus those who did not provide any care during the pandemic and found no significant differences between these two groups. Our empirical findings suggest that the standard measures introduced with the aim of protecting vulnerable groups, such as closing care homes or prioritising the vaccination of their staff, were not sufficient to avoid the spread of the virus amongst disabled and older people. Informal carers play an important role in the social care sector. As such, protecting vulnerable people by investing in the informal care sector should be a priority for future health policy.
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Affiliation(s)
- Joan E Madia
- Nuffield College and Nuffield Department of Primary Care Health Sciences, University of Oxford and FBK-IRVAPP, New Rd, Oxford OX1 1NF, United Kingdom
| | - Francesco Moscone
- Brunel University London, United Kingdom
- Università Ca' Foscari Venezia, Italy
| | - Catia Nicodemo
- University of Oxford, Nuffield Department of Primary Care Health Sciences, United Kingdom
- University of Verona, Department of Economics, Italy
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23
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Radhuber IM, Fiske A, Galasso I, Gessl N, Hill MD, Morales ER, Olarte-Sánchez LE, Pelfini A, Saxinger G, Spahl W. Toward global citizenship? People (de)bordering their lives during COVID-19 in Latin America and Europe. Glob Public Health 2023; 18:2285880. [PMID: 38010427 DOI: 10.1080/17441692.2023.2285880] [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: 07/06/2023] [Accepted: 11/13/2023] [Indexed: 11/29/2023]
Abstract
The COVID-19 pandemic highlighted global interdependencies, accompanied by widespread calls for worldwide cooperation against a virus that knows no borders, but responses were led largely separately by national governments. In this tension between aspiration and reality, people began to grapple with how their own lives were affected by the global nature of the pandemic. In this article, based on 493 qualitative interviews conducted between 2020 and 2021, we explore how people in Argentina, Austria, Bolivia, Ecuador, Ireland, Italy and Mexico experienced, coped with and navigated the global nature of the pandemic. In dialogue with debates about the parameters of the 'global' in global health, we focus on what we call people's everyday (de)bordering practices to examine how they negotiated (dis)connections between 'us' and 'them' during the pandemic. Our interviewees' reactions moved from national containment to an increasing focus on people's unequal socio-spatial situatedness. Eventually, they began to (de)border their lives beyond national lines of division and to describe a new normal: a growing awareness of global connectedness and a desire for global citizenship. This newfound sense of global interrelatedness could signal support for and encourage transnational political action in times of crises.
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Affiliation(s)
| | - Amelia Fiske
- Department of Clinical Medicine, TUM School of Medicine and Health, Institute of History and Ethics in Medicine, Technical University of Munich, Munchen, Germany
| | - Ilaria Galasso
- Department of Clinical Medicine, TUM School of Medicine and Health, Institute of History and Ethics in Medicine, Technical University of Munich, Munchen, Germany
- University College Dublin, Dublin, Ireland
| | - Nicolai Gessl
- Department of Political Science, University of Vienna, Wien, Austria
| | - Michael D Hill
- Department of Anthropology, Universidad San Francisco de Quito USFQ, Quito, Ecuador
| | - Emma R Morales
- Department of Habitat and Urban Development, ITESO, Universidad Jesuita de Guadalajara, Tlaquepaque, Mexico
| | | | - Alejandro Pelfini
- Faculty of Social Sciences, Universidad del Salvador, Buenos Aires, Argentina
- Global Studies Programme, Facultad Latinoamericana de Ciencias Sociales FLACSO-Argentina, Buenos Aires, Argentina
| | - Gertrude Saxinger
- Department of Political Science, University of Vienna, Wien, Austria
| | - Wanda Spahl
- Department of Political Science, University of Vienna, Wien, Austria
- Division Biomedical and Public Health Ethics, Karl Landsteiner University of Health Sciences, Krems an der Donau, Austria
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24
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Kapoor NR, Aryal A, Mehata S, Dulal M, Kruk ME, Bauhoff S, Arsenault C. Effect of lifting COVID-19 restrictions on utilisation of primary care services in Nepal: a difference-in-differences analysis. BMJ Open 2022; 12:e061849. [PMID: 36446449 PMCID: PMC9709811 DOI: 10.1136/bmjopen-2022-061849] [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] [Indexed: 12/02/2022] Open
Abstract
INTRODUCTION An increasing number of studies have reported disruptions in health service utilisation due to the COVID-19 pandemic and its associated restrictions. However, little is known about the effect of lifting COVID-19 restrictions on health service utilisation. The objective of this study was to estimate the effect of lifting COVID-19 restrictions on primary care service utilisation in Nepal. METHODS Data on utilisation of 10 primary care services were extracted from the Health Management Information System across all health facilities in Nepal. We used a difference-in-differences design and linear fixed effects regressions to estimate the effect of lifting COVID-19 restrictions. The treatment group included palikas that had lifted restrictions in place from 17 August 2020 to 16 September 2020 (Bhadra 2077) and the control group included palikas that had maintained restrictions during that period. The pre-period included the 4 months of national lockdown from 24 March 2020 to 22 July 2020 (Chaitra 2076 to Ashar 2077). Models included month and palika fixed effects and controlled for COVID-19 incidence. RESULTS We found that lifting COVID-19 restrictions was associated with an average increase per palika of 57.5 contraceptive users (95% CI 14.6 to 100.5), 15.6 antenatal care visits (95% CI 5.3 to 25.9) and 1.6 child pneumonia visits (95% CI 0.2 to 2.9). This corresponded to a 9.4% increase in contraceptive users, 34.2% increase in antenatal care visits and 15.6% increase in child pneumonia visits. Utilisation of most other primary care services also increased after lifting restrictions, but coefficients were not statistically significant. CONCLUSIONS Despite the ongoing pandemic, lifting restrictions can lead to an increase in some primary care services. Our results point to a causal link between restrictions and health service utilisation and call for policy makers in low- and middle-income countries to carefully consider the trade-offs of strict lockdowns during future COVID-19 waves or future pandemics.
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Affiliation(s)
- Neena R Kapoor
- Department of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Amit Aryal
- Swiss TPH, University of Basel, Basel, Switzerland
| | - Suresh Mehata
- Ministry of Health, Government of Nepal, Biratnagar, Province 1, Nepal
| | - Mahesh Dulal
- Office of the Member of Federal Parliament Nepal, Gagan Kumar Thapa, Kathmandu, Nepal
| | - Margaret E Kruk
- Department of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Sebastian Bauhoff
- Department of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Catherine Arsenault
- Department of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
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25
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Lyimo E, Fougeroux C, Malabeja A, Mbwana J, Hayuma PM, Liheluka E, Turner L, Gesase S, Lavstsen T, Lusingu JPA, Minja DTR, Wang CW. Seroprevalence of SARS-CoV-2 antibodies among children and adolescents recruited in a malariometric survey in north-eastern Tanzania July 2021. BMC Infect Dis 2022; 22:846. [PMCID: PMC9652923 DOI: 10.1186/s12879-022-07820-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 10/29/2022] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background
African countries stand out globally as the region seemingly least affected by the COVID-19 pandemic, caused by the virus SARS-CoV-2. Besides a younger population and potential pre-existing immunity to a SARS-CoV-2-like virus, it has been hypothesized that co-infection or recent history of Plasmodium falciparum malaria may be protective of COVID-19 severity and mortality. The number of COVID-19 cases and deaths, however, may be vastly undercounted. Very little is known about the extent to which the Tanzanian population has been exposed to SARS-CoV-2. Here, we investigated the seroprevalence of IgG to SARS-CoV-2 spike protein in two Tanzanian rural communities 1½ years into the pandemic and the association of coinciding malaria infection and exposure.
Methods
During a malariometric survey in July 2021 in two villages in north-eastern Tanzania, blood samples were taken from 501 participants (0–19 years old). Malaria was detected by mRDT and microscopy. Levels of IgG against the spike protein of SARS-CoV-2 were measured by ELISA as well as IgG against five different antigens of P. falciparum; CIDRα1.1, CIDRα1.4 and CIDRα1.5 of PfEMP1 and GLURP and MSP3.
Results
The seroprevalence of SARS-CoV-2 IgG was 39.7% (106/267) in Kwamasimba and 32.5% (76/234) in Mkokola. In both villages the odds of being seropositive increased significantly with age (AOR = 1.12, 95% CI 1.07–1.17, p < 0.001). P. falciparum malaria prevalence by blood smear microscopy was 7.9% in Kwamasimba and 2.1% in Mkokola. 81.3% and 70.5% in Kwamasimba and Mkokola, respectively, showed recognition of minimum one malaria antigen. Residing in Kwamasimba was associated with a broader recognition (AOR = 1.91, 95% CI 1.34–2.71, p < 0.001). The recognition of malaria antigens increased significantly with age in both villages (AOR = 1.12; 95% CI 1.08–1.16, p < 0.001). Being SARS-CoV-2 seropositive did not associate with the breadth of malaria antigen recognition when adjusting for age (AOR = 0.99; 95% CI 0.83–1.18; p = 0.91).
Conclusion
More than a third of the children and adolescents in two rural communities in Tanzania had antibodies to SARS-CoV-2. In particular, the adolescents were seropositive but being seropositive did not associate with the status of coinciding malaria infections or previous exposure. In Tanzania, natural immunity may have developed fast, potentially protecting a substantial part of the population from later variants.
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Pushpalata Zanwar P, Perianayagam A, Zazdravnykh E, Omar Z, Vinod Joseph KJ, Santos FH, Negm AM, Reistetter TA, Heyn PC, Kelekar U. Examining the Impacts of Coronavirus Disease 2019 Mitigation Policies on Health Outcomes of Older Adults: Lessons Learned From Six High-Income or Middle-Income Countries. THE PUBLIC POLICY AND AGING REPORT 2022; 32:121-130. [PMID: 36349280 PMCID: PMC9619694 DOI: 10.1093/ppar/prac023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Indexed: 11/16/2022]
Affiliation(s)
- Preeti Pushpalata Zanwar
- Address correspondence to: Preeti Zanwar, PhD, MPH, MS, Jefferson College of Population Health, Thomas Jefferson University, 901 Walnut Street, 10th Floor, Philadelphia, Pennsylvania, 19107, USA.
| | - Arokiasamy Perianayagam
- International Institute for Population Sciences, Mumbai, India,National Council of Applied Economic Research (NCAER), Delhi, India
| | - Evguenii Zazdravnykh
- Department of Management, International Centre of Health Economics, Policy, and Management, HSE University, St. Petersburg, Russia
| | - Zaliha Omar
- Department of Rehabilitation Medicine, Fujita Health University, Toyoake, Aichi, Japan,Department of Rehabilitation Medicine, University Malaya, Kuala Lumpur, Malaysia
| | - K J Vinod Joseph
- Department of Public Health and Mortality Studies, International Institute for Population Sciences, Mumbai, India
| | - Flavia H Santos
- Centre for Disability Studies, University College Dublin, Ireland
| | - Ahmed M Negm
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada,School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Timothy A Reistetter
- Department of Occupational Therapy, School of Health Professions, University of Texas Health Science Center, San Antonio, Texas, USA
| | - Patricia C Heyn
- Marymount Center for Optimal Aging, Marymount University, Arlington, Virginia, USA
| | - Uma Kelekar
- Marymount Center for Optimal Aging, Marymount University, Arlington, Virginia, USA,School of Business, Innovation, Leadership and Technology, Marymount University, Arlington, Virginia, USA
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27
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Nemat A, Sediqi MF, Elhadi YAM, Raufi N, Essar MY, Asady A. Self-reported adherence to preventive practices during the third wave of COVID-19 in Afghanistan. SAGE Open Med 2022; 10:20503121221122399. [PMID: 36093422 PMCID: PMC9459448 DOI: 10.1177/20503121221122399] [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: 02/15/2022] [Accepted: 08/10/2022] [Indexed: 11/15/2022] Open
Abstract
Objective: The study objectives were aimed to highlight the areas where public awareness
is needed to enhance preventive practices among the public. Hence, to avoid
the spread of virus in public settings. In addition, the study has provided
compelling data and evidence on the coronavirus disease-2019 trend for
health policymakers to make strategic decisions. Introduction: The coronavirus disease-2019 is a highly contagious respiratory disease
caused by severe acute respiratory syndrome coronavirus type-2. The disease
has spread across the globe. In Afghanistan, thousands of confirmed cases
with hundreds of deaths have been reported. In addition, due to insufficient
healthcare workforce, insecurity, fragile healthcare infrastructure, low
coronavirus disease-2019 vaccination and low testing capacity, the true
nature of the pandemic is unlcear. Method: An online survey of the general population in Afghanistan was conducted from
April-May 2021. Convenience sampling technique was used to recruit the
respondents. Social media platforms were used (WhatsApp, Twitter and
Facebook Messenger) to disseminate the electronic survey instrument. Written
informed consent was taken from the participants before the filling
questionnaires. Data collection was guided through a self-administered
questionnaire developed by the researchers according to the World Health
Organization guidelines. The sample size was calculated using EPI software.
The inclusion criteria were being 18 years or older and having access to the
Internet to fill out the online questionnaire. IBM SPSS Statistics version
25.0 was used for analysis. Descriptive statistics (frequencies,
percentages) and bi-variable (chi-square) analyses were done. A p value of
<0.05 was considered significant at a 95% confidence interval. Results: From 1094 respondents, 78% were male. The majority of respondents were aged
⩽30 years and had an undergraduate education. Nearly 1 in 3 participants
were healthcare workers, and 70% lived in households with five or more
family members. Overall, 70% of the respondents reported good preventive
practices. The majority of the participants reported covering their mouth
and nose while coughing and sneezing and cleaning their hands regularly and
using alcohol. Meanwhile, 80% of the participants wore a mask when going
outside. Moreover, people with post-graduate education had a higher level of
preventive practices than those with an undergraduate education. The results of logistic regression revealed participants residence in Kabul,
healthcare workers, family size less than 5, avoid meeting people outside,
gender, and avoiding 3Cs, were the significant determinants of adhering to
good preventive practices. Conclusion: Generally, the public in Afghanistan followed infection prevention rules.
However, certain areas require further improvement, such as observing social
distance and avoiding shaking hands when meeting others. Negligence of these
prevention practices can lead to an increase in infection transmission among
people. Public awareness should be continued to keep the people supportive
of the government policies.
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Affiliation(s)
- Arash Nemat
- Department of Microbiology, Kabul University of Medical Sciences, Kabul, Afghanistan.,Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Mohammad Faiq Sediqi
- Department of Histology, Kabul University of Medical Sciences, Kabul, Afghanistan
| | - Yasir Ahmed Mohammed Elhadi
- Department of Health Administration and Behavioral Sciences, High Institute of Public Health, Alexandria University, Alexandria, Egypt
| | - Nahid Raufi
- Department of Dermatology, Kabul University of Medical Sciences, Kabul, Afghanistan
| | | | - Abdullah Asady
- Department of Microbiology, Kabul University of Medical Sciences, Kabul, Afghanistan
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Sidibé ML, Yonaba R, Tazen F, Karoui H, Koanda O, Lèye B, Andrianisa HA, Karambiri H. Understanding the COVID-19 pandemic prevalence in Africa through optimal feature selection and clustering: evidence from a statistical perspective. ENVIRONMENT, DEVELOPMENT AND SUSTAINABILITY 2022; 25:1-29. [PMID: 36061268 PMCID: PMC9424840 DOI: 10.1007/s10668-022-02646-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 08/18/2022] [Indexed: 06/15/2023]
Abstract
The COVID-19 pandemic, which outbroke in Wuhan (China) in December 2019, severely hit almost all sectors of activity in the world as a consequence of the restrictive measures imposed. Two years later, Africa still emerges as the least affected continent by the pandemic. This study analyzed COVID-19 prevalence across African countries through country-level variables prior to clustering. Using Spearman-rank correlation, multicollinearity analysis and univariate filtering, 9 country-level variables were identified from an initial set of 34 variables. These variables relate to socioeconomic status, population structure, healthcare system and environment and the climatic setting. A clustering of the 54 African countries is further carried out through the use of agglomerative hierarchical clustering (AHC) method, which generated 3 distinctive clusters. Cluster 1 (11 countries) is the most affected by COVID-19 (median of 63,508.6 confirmed cases and 946.5 deaths per million) and is composed of countries with the highest socioeconomic status. Cluster 2 (27 countries) is the least affected (median of 4473.7 confirmed cases and 81.2 deaths per million), and mainly features countries with the least socioeconomic features and international exposure. Cluster 3 (16 countries) is intermediate in terms of COVID-19 prevalence (median of 2569.3 confirmed cases and 35.7 deaths per million) and features countries the least urbanized and geographically close to the equator, with intermediate international exposure and socioeconomic features. These findings shed light on the main features of COVID-19 prevalence in Africa and might help refine effectively coping management strategies of the ongoing pandemic. Supplementary Information The online version contains supplementary material available at 10.1007/s10668-022-02646-3.
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Affiliation(s)
- Mohamed Lamine Sidibé
- Laboratoire Eaux, Hydro-Systèmes Et Agriculture (LEHSA), Institut International d’Ingénierie de l’Eau Et de l’Environnement (2iE), 1 Rue de la Science, 01 BP 594, Ouagadougou 01, Burkina Faso
| | - Roland Yonaba
- Laboratoire Eaux, Hydro-Systèmes Et Agriculture (LEHSA), Institut International d’Ingénierie de l’Eau Et de l’Environnement (2iE), 1 Rue de la Science, 01 BP 594, Ouagadougou 01, Burkina Faso
| | - Fowé Tazen
- Laboratoire Eaux, Hydro-Systèmes Et Agriculture (LEHSA), Institut International d’Ingénierie de l’Eau Et de l’Environnement (2iE), 1 Rue de la Science, 01 BP 594, Ouagadougou 01, Burkina Faso
| | - Héla Karoui
- Laboratoire Eaux, Hydro-Systèmes Et Agriculture (LEHSA), Institut International d’Ingénierie de l’Eau Et de l’Environnement (2iE), 1 Rue de la Science, 01 BP 594, Ouagadougou 01, Burkina Faso
| | - Ousmane Koanda
- Laboratoire Eaux, Hydro-Systèmes Et Agriculture (LEHSA), Institut International d’Ingénierie de l’Eau Et de l’Environnement (2iE), 1 Rue de la Science, 01 BP 594, Ouagadougou 01, Burkina Faso
| | - Babacar Lèye
- Laboratoire Eaux, Hydro-Systèmes Et Agriculture (LEHSA), Institut International d’Ingénierie de l’Eau Et de l’Environnement (2iE), 1 Rue de la Science, 01 BP 594, Ouagadougou 01, Burkina Faso
| | - Harinaivo Anderson Andrianisa
- Laboratoire Eaux, Hydro-Systèmes Et Agriculture (LEHSA), Institut International d’Ingénierie de l’Eau Et de l’Environnement (2iE), 1 Rue de la Science, 01 BP 594, Ouagadougou 01, Burkina Faso
| | - Harouna Karambiri
- Laboratoire Eaux, Hydro-Systèmes Et Agriculture (LEHSA), Institut International d’Ingénierie de l’Eau Et de l’Environnement (2iE), 1 Rue de la Science, 01 BP 594, Ouagadougou 01, Burkina Faso
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Boro E, Stoll B. Barriers to COVID-19 Health Products in Low-and Middle-Income Countries During the COVID-19 Pandemic: A Rapid Systematic Review and Evidence Synthesis. Front Public Health 2022; 10:928065. [PMID: 35937225 PMCID: PMC9354133 DOI: 10.3389/fpubh.2022.928065] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 06/13/2022] [Indexed: 12/15/2022] Open
Abstract
Introduction The coronavirus disease 2019 (COVID-19) pandemic has intensified the urgency in addressing pressing global health access challenges and has also laid bare the pervasive structural and systemic inequities that make certain segments of society more vulnerable to the tragic consequences of the disease. This rapid systematic review analyses the barriers to COVID-19 health products in low-and middle-income countries (LMICs). It does so from the canon of global health equity and access to medicines by proposing an access to health products in low-and middle-income countries framework and typology adapted to underscore the complex interactive and multiplicative nature and effects of barriers to health products and their root cause as they coexist across different levels of society in LMICs. Methods Modified versions of the Joanna Briggs Institute (JBI) reviewers' manual for evidence synthesis of systematic reviews and the PRISMA-ScR framework were used to guide the search strategy, identification, and screening of biomedical, social science, and gray literature published in English between 1 January 2020 and 30 April 2021. Results The initial search resulted in 5,956 articles, with 72 articles included in this review after screening protocol and inclusion criteria were applied. Thirty one percent of the articles focused on Africa. The review revealed that barriers to COVID-19 health products were commonly caused by market forces (64%), the unavailability (53%), inaccessibility (42%), and unaffordability (35%), of the products, incongruent donors' agenda and funding (33%) and unreliable health and supply systems (28%). They commonly existed at the international and regional (79%), health sectoral (46%), and national cross-sectoral [public policy] (19%) levels. The historical heritage of colonialism in LMICs was a commonly attributed root cause of the barriers to COVID-19 health products in developing countries. Conclusion This review has outlined and elaborated on the various barriers to health products that must be comprehensively addressed to mount a successful global, regional, national and subnational response to present and future epidemics and pandemics in LMICs.
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Affiliation(s)
- Ezekiel Boro
- Faculty of Medicine, Institute of Global Health, University of Geneva, Geneva, Switzerland
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30
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Singh S, Cadigan RJ, Moodley K. Challenges to biobanking in LMICs during COVID-19: time to reconceptualise research ethics guidance for pandemics and public health emergencies? JOURNAL OF MEDICAL ETHICS 2022; 48:466-471. [PMID: 33980656 PMCID: PMC8117471 DOI: 10.1136/medethics-2020-106858] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Revised: 03/20/2021] [Accepted: 04/20/2021] [Indexed: 06/12/2023]
Abstract
Biobanking can promote valuable health research that may lead to significant societal benefits. However, collecting, storing and sharing human samples and data for research purposes present numerous ethical challenges. These challenges are exacerbated when the biobanking efforts aim to facilitate research on public health emergencies and include the sharing of samples and data between low/middle-income countries (LMICs) and high-income countries (HICs). In this article, we explore ethical challenges for COVID-19 biobanking, offering examples from two past infectious disease outbreaks in LMICs where biobanking activities contributed to the perpetuation of global inequities. We focus on how the ethical imperative to promote the common good during public health emergencies can conflict with protecting the interests of biobank participants. We discuss how conducting biobank research under a waiver of informed consent during public health emergencies is ethically permissible, provided guidance is in place to prevent biopiracy and exploitation of vulnerable communities. We also highlight the need for biobank collaborations between LMICs and HICs to promote capacity building and benefit sharing. Finally, we offer guidance to promote the ethical oversight of biobanks and biobank research during the COVID-19 pandemic or other future public health emergencies.
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Affiliation(s)
- Shenuka Singh
- Faculty of Medicine and Health Sciences, Centre for Medical Ethics and Law, Stellenbosch University, Cape Town, South Africa
| | - Rosemary Jean Cadigan
- Social Medicine, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA
| | - Keymanthri Moodley
- Faculty of Medicine and Health Sciences, Centre for Medical Ethics and Law, University of Stellenbosch, Stellenbosch, Western Cape, South Africa
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Lamberti-Castronuovo A, Valente M, Cretu A, Dal Molin A. Decentralization of healthcare during crises: Riding the wave of post-pandemic health system reforms to rethink health workforce. INTERNATIONAL JOURNAL OF DISASTER RISK REDUCTION : IJDRR 2022; 76:103040. [PMID: 35601395 PMCID: PMC9107381 DOI: 10.1016/j.ijdrr.2022.103040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 05/09/2022] [Indexed: 06/15/2023]
Affiliation(s)
- A Lamberti-Castronuovo
- CRIMEDIM-Center for Research and Training in Disaster Medicine, Humanitarian Aid and Global Health, Università del Piemonte Orientale, Via Lanino 1, 28100, Novara, Italy
| | - M Valente
- CRIMEDIM-Center for Research and Training in Disaster Medicine, Humanitarian Aid and Global Health, Università del Piemonte Orientale, Via Lanino 1, 28100, Novara, Italy
| | - A Cretu
- International Committee of the Red Cross - ICRC 19, Avenue de la paix 1202, Geneva, Switzerland
| | - A Dal Molin
- Department of Translational Medicine, University of Piemonte Orientale, Direzione delle Professioni Sanitarie - A.O.U. Maggiore della Carità di Novara, Via P. Solaroli, 17, 28100, Novara, Italy
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Arya V, Page A, Spittal MJ, Dandona R, Vijayakumar L, Munasinghe S, John A, Gunnell D, Pirkis J, Armstrong G. Suicide in India during the first year of the COVID-19 pandemic. J Affect Disord 2022; 307:215-220. [PMID: 35395323 PMCID: PMC8983610 DOI: 10.1016/j.jad.2022.03.066] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 03/24/2022] [Accepted: 03/28/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND There has been substantial discussion as to whether the mental health and socio-economic consequences of the COVID-19 pandemic might impact suicide rates. Although India accounts for the largest proportion of global suicides, the early impacts of the COVID-19 pandemic on suicide rates in this country are unknown. METHODS National Crime Records Bureau (NCRB) data were used to calculate annual suicide rates for the period 2010-2020, stratified by sex and state. Rate Ratios (RRs) stratified by sex and state were calculated to estimate the extent of change in suicide rates. RESULTS Suicide rates in India generally showed a decreasing trend from 2010 until 2017, with the trend reversing after this period, particularly for males. Among males and females, the highest increase post 2017 was noted in 2020 (compared to 2017) (males: RR = 1.18 95% UI 1.17-1.19; females: RR = 1.05 95% UI 1.03-1.06). LIMITATION Suicide rates based on the NCRB data might be an underestimation of the true suicide rates. CONCLUSION Suicide rates in India increased during the first year of the COVID-19 pandemic, and although the increase in suicide rates, especially among males, predates the pandemic, the increase in suicide rates was highest in 2020, compared to increases in previous years. Further research is warranted to understand the potential ongoing impact of the COVID-19 pandemic on suicide in India.
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Affiliation(s)
- Vikas Arya
- Melbourne School of Population and Global Health, University of Melbourne, Australia.
| | - Andrew Page
- Translational Health Research Institute, Western Sydney University, Australia
| | - Matthew J Spittal
- Melbourne School of Population and Global Health, University of Melbourne, Australia
| | - Rakhi Dandona
- Public Health Foundation of India, India; Institute for Health Metrics and Evaluation, University of Washington, USA
| | - Lakshmi Vijayakumar
- SNEHA, - Suicide Prevention Centre, Voluntary Health Services, Chennai, India
| | - Sithum Munasinghe
- Translational Health Research Institute, Western Sydney University, Australia
| | - Ann John
- Swansea University Medical School, UK
| | - David Gunnell
- Population Health Sciences, Bristol Medical School, National Institute of Health Research Biomedical Research Centre at the University Hospitals, Bristol and Weston NHS Foundation Trust and the University of Bristol, UK
| | - Jane Pirkis
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Australia
| | - Gregory Armstrong
- Nossal Institute for Global Health, Melbourne School of Population and Global Health, The University of Melbourne, Australia
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Knipe D, John A, Padmanathan P, Eyles E, Dekel D, Higgins JPT, Bantjes J, Dandona R, Macleod-Hall C, McGuinness LA, Schmidt L, Webb RT, Gunnell D. Suicide and self-harm in low- and middle- income countries during the COVID-19 pandemic: A systematic review. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000282. [PMID: 36962383 PMCID: PMC10021274 DOI: 10.1371/journal.pgph.0000282] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 04/05/2022] [Indexed: 04/12/2023]
Abstract
There is widespread concern over the potential impact of the COVID-19 pandemic on suicide and self-harm globally, particularly in low- and middle-income countries (LMIC) where the burden of these behaviours is greatest. We synthesised the evidence from the published literature on the impact of the pandemic on suicide and self-harm in LMIC. This review is nested within a living systematic review (PROSPERO ID CRD42020183326) that continuously identifies published evidence (all languages) through a comprehensive automated search of multiple databases (PubMed; Scopus; medRxiv, PsyArXiv; SocArXiv; bioRxiv; the WHO COVID-19 database; and the COVID-19 Open Research Dataset by Semantic Scholar (up to 11/2020), including data from Microsoft Academic, Elsevier, arXiv and PubMed Central.) All articles identified by the 4th August 2021 were screened. Papers reporting on data from a LMIC and presenting evidence on the impact of the pandemic on suicide or self-harm were included. Methodological quality was assessed using an appropriate tool, and a narrative synthesis presented. A total of 22 studies from LMIC were identified representing data from 12 countries. There was an absence of data from Africa, the Pacific, and the Caribbean. The reviewed studies mostly report on the early months of COVID-19 and were generally methodologically poor. Few studies directly assessed the impact of the pandemic. The most robust evidence, from time-series studies, indicate either a reduction or no change in suicide and self-harm behaviour. As LMIC continue to experience repeated waves of the virus and increased associated mortality, against a backdrop of vaccine inaccessibility and limited welfare support, continued efforts are needed to track the indirect impact of the pandemic on suicide and self-harm in these countries.
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Affiliation(s)
- Duleeka Knipe
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- South Asian Clinical Toxicology Research Collaboration, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
| | - Ann John
- Population Data Science, Swansea University Medical School, Swansea, United Kingdom
| | - Prianka Padmanathan
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Emily Eyles
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Dana Dekel
- Population Data Science, Swansea University Medical School, Swansea, United Kingdom
| | - Julian P. T. Higgins
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- National Institute of Health Research Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, United Kingdom
| | - Jason Bantjes
- Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, Cape Town, South Africa
- Institute for Life Course Health Research, Department of Global Health, Stellenbosch University, Stellenbosch, South Africa
| | - Rakhi Dandona
- Public Health Foundation of India, Gurugram, India
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, United States of America
| | - Catherine Macleod-Hall
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Luke A. McGuinness
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Lena Schmidt
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- Sciome LLC, Research Triangle Park, Durham, NC, United States of America
| | - Roger T. Webb
- Division of Psychology & Mental Health, University of Manchester, Manchester, United Kingdom
- National Institute of Health Research Greater Manchester Patient Safety Translational Research Centre, Manchester, United Kingdom
| | - David Gunnell
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- National Institute of Health Research Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, United Kingdom
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Malécot N, Chrusciel J, Sanchez S, Sellès P, Goetz C, Lévêque HP, Parizel E, Pradel J, Almhana M, Bouvier E, Uyttenhove F, Bonnefoy E, Vazquez G, Adib O, Calvo P, Antoine C, Jullien V, Cirille S, Dumas A, Defasque A, Ben Ghorbal Y, Elkadri M, Schertz M, Cavet M. Chest CT Characteristics are Strongly Predictive of Mortality in Patients with COVID-19 Pneumonia: A Multicentric Cohort Study. Acad Radiol 2022; 29:851-860. [PMID: 35282991 PMCID: PMC8769941 DOI: 10.1016/j.acra.2022.01.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 12/09/2021] [Accepted: 01/13/2022] [Indexed: 12/11/2022]
Abstract
Rationale and Objectives The novel coronavirus (COVID-19) has presented a significant and urgent threat to global health and there has been a need to identify prognostic factors in COVID-19 patients. The aim of this study was to determine whether chest computed tomography (CT) characteristics had any prognostic value in patients with COVID-19. Materials and Methods A retrospective analysis of COVID-19 patients who underwent a chest CT-scan was performed in four medical centers. The prognostic value of chest CT results was assessed using a multivariable survival analysis with the Cox model. The characteristics included in the model were the degree of lung involvement, ground glass opacities, nodular consolidations, linear consolidations, a peripheral topography, a predominantly inferior lung involvement, pleural effusion, and crazy paving. The model was also adjusted on age, sex, and the center in which the patient was hospitalized. The primary endpoint was 30-day in-hospital mortality. A second model used a composite endpoint of admission to an intensive care unit or 30-day in-hospital mortality. Results A total of 515 patients with available follow-up information were included. Advanced age, a degree of pulmonary involvement ≥50% (Hazard Ratio 2.25 [95% CI: 1.378-3.671], p = 0.001), nodular consolidations and pleural effusions were associated with lower 30-day in-hospital survival rates. An exploratory subgroup analysis showed a 60.6% mortality rate in patients over 75 with ≥50% lung involvement on a CT-scan. Conclusion Chest CT findings such as the percentage of pulmonary involvement ≥50%, pleural effusion and nodular consolidation were strongly associated with 30-day mortality in COVID-19 patients. CT examinations are essential for the assessment of severe COVID-19 patients and their results must be considered when making care management decisions.
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Arsenault C, Gage A, Kim MK, Kapoor NR, Akweongo P, Amponsah F, Aryal A, Asai D, Awoonor-Williams JK, Ayele W, Bedregal P, Doubova SV, Dulal M, Gadeka DD, Gordon-Strachan G, Mariam DH, Hensman D, Joseph JP, Kaewkamjornchai P, Eshetu MK, Gelaw SK, Kubota S, Leerapan B, Margozzini P, Mebratie AD, Mehata S, Moshabela M, Mthethwa L, Nega A, Oh J, Park S, Passi-Solar Á, Pérez-Cuevas R, Phengsavanh A, Reddy T, Rittiphairoj T, Sapag JC, Thermidor R, Tlou B, Valenzuela Guiñez F, Bauhoff S, Kruk ME. COVID-19 and resilience of healthcare systems in ten countries. Nat Med 2022; 28:1314-1324. [PMID: 35288697 PMCID: PMC9205770 DOI: 10.1038/s41591-022-01750-1] [Citation(s) in RCA: 132] [Impact Index Per Article: 66.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 02/17/2022] [Indexed: 02/07/2023]
Abstract
Declines in health service use during the Coronavirus Disease 2019 (COVID-19) pandemic could have important effects on population health. In this study, we used an interrupted time series design to assess the immediate effect of the pandemic on 31 health services in two low-income (Ethiopia and Haiti), six middle-income (Ghana, Lao People's Democratic Republic, Mexico, Nepal, South Africa and Thailand) and high-income (Chile and South Korea) countries. Despite efforts to maintain health services, disruptions of varying magnitude and duration were found in every country, with no clear patterns by country income group or pandemic intensity. Disruptions in health services often preceded COVID-19 waves. Cancer screenings, TB screening and detection and HIV testing were most affected (26-96% declines). Total outpatient visits declined by 9-40% at national levels and remained lower than predicted by the end of 2020. Maternal health services were disrupted in approximately half of the countries, with declines ranging from 5% to 33%. Child vaccinations were disrupted for shorter periods, but we estimate that catch-up campaigns might not have reached all children missed. By contrast, provision of antiretrovirals for HIV was not affected. By the end of 2020, substantial disruptions remained in half of the countries. Preliminary data for 2021 indicate that disruptions likely persisted. Although a portion of the declines observed might result from decreased needs during lockdowns (from fewer infectious illnesses or injuries), a larger share likely reflects a shortfall of health system resilience. Countries must plan to compensate for missed healthcare during the current pandemic and invest in strategies for better health system resilience for future emergencies.
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Affiliation(s)
- Catherine Arsenault
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston MA, USA.
| | - Anna Gage
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston MA, USA
| | - Min Kyung Kim
- Seoul National University College of Medicine, Seoul, South Korea
| | - Neena R Kapoor
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston MA, USA
| | | | - Freddie Amponsah
- Policy, Planning, Monitoring and Evaluation, Ghana Health Services, Accra, Ghana
| | - Amit Aryal
- Office of the Member of Federal Parliament Gagan Kumar Thapa, Kathmandu, Nepal
| | - Daisuke Asai
- World Health Organization, Vientiane, Lao People's Democratic Republic, Vientiane, Laos
| | | | - Wondimu Ayele
- School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | - Paula Bedregal
- Public Health Department, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Svetlana V Doubova
- Epidemiology and Health Services Research Unit CMN Siglo XXI, Mexican Institute of Social Security, Mexico City, Mexico
| | - Mahesh Dulal
- Office of the Member of Federal Parliament Gagan Kumar Thapa, Kathmandu, Nepal
| | | | | | | | - Dilipkumar Hensman
- World Health Organization, Vientiane, Lao People's Democratic Republic, Vientiane, Laos
| | - Jean Paul Joseph
- Hôpital Universitaire de Mirebalais, Zanmi Lasante, Arrondissement de Mirebalais, Mirebalais, Haïti
| | | | | | | | - Shogo Kubota
- World Health Organization, Vientiane, Lao People's Democratic Republic, Vientiane, Laos
| | - Borwornsom Leerapan
- Faculty of Medicine Ramathibodi Hospital, Madidol University, Bangkok, Thailand
| | - Paula Margozzini
- Public Health Department, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | | | - Suresh Mehata
- Ministry of Health and Population, Government of Nepal, Kathmandu, Nepal
| | - Mosa Moshabela
- School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
| | - Londiwe Mthethwa
- School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
| | - Adiam Nega
- School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | - Juhwan Oh
- Seoul National University College of Medicine, Seoul, South Korea
| | - Sookyung Park
- Korea National Health Insurance Services, Health Insurance Research Institute, Gangwon-do, South Korea
| | - Álvaro Passi-Solar
- Public Health Department, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Ricardo Pérez-Cuevas
- Division of Social Protection and Health, Inter-American Development Bank, Kingston, Jamaica
| | - Alongkhone Phengsavanh
- Faculty of Medicine, University of Health Sciences, Vientiane, Lao People's Democratic Republic, Vientiane, Laos
| | - Tarylee Reddy
- Biostatistics Unit, South African Medical Research Council, Durban, South Africa
| | | | - Jaime C Sapag
- Public Health Department, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Roody Thermidor
- Studies and Planning Unit, Ministry of Public Health and Population, Port-au-Prince, Haiti
| | - Boikhutso Tlou
- School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
| | | | - Sebastian Bauhoff
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston MA, USA
| | - Margaret E Kruk
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston MA, USA
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Sathyamala C. COVID-19: The Political Economy of a Global Pandemic. DEVELOPMENT AND CHANGE 2022:DECH12711. [PMID: 35942175 PMCID: PMC9348391 DOI: 10.1111/dech.12711] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
It is two years since a microbe, SARS-CoV-2, a 'novel' coronavirus, travelled through the world to wreak havoc on the lives of humans across the globe. Although the total number of global COVID-19 deaths, currently estimated at 6 million, comes nowhere near the 50 million deaths of the Spanish flu pandemic of 1918‒19 to which it has been compared, the impact of COVID-19 and the measures to control it have been far more devastating to humans and economies. This virtual issue gleans insights from selected papers in previous issues of Development and Change to contribute to the ongoing debate on the COVID-19 pandemic by touching upon its political economy aspects. The articles put together in this virtual issue try to demonstrate that pandemics are not a 'fact of life'. They are very much rooted in the processes of capital accumulation and the ensuing destruction of the global ecosystems that makes zoonoses a recurring imminent threat. In the context of a hyper-connected globalized world, regional and global pandemics could well become the norm. Meanwhile, neoliberal reforms and restructuring have left the health sector unable to handle the public health crisis caused by COVID-19. At the same time, with the waiving and dilution of well-established norms of regulation for testing and marketing of vaccines and drugs, the pandemic has created opportunities for accumulation in the healthcare technology industry, specifically the pharmaceutical sector. It is hoped that this virtual issue will contribute to the ongoing debate on the emergence of 'novel' diseases and pandemics by shifting the current focus from the disease agent (the virus) and broadening the concern to include the larger social determinants which are rooted in the global political economy.
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Stein DJ, Wessely S. Mental disorders and COVID-19: Towards a precision public mental health approach. Eur Neuropsychopharmacol 2022; 58:42-43. [PMID: 35219179 PMCID: PMC8841148 DOI: 10.1016/j.euroneuro.2022.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 02/05/2022] [Accepted: 02/08/2022] [Indexed: 11/26/2022]
Affiliation(s)
- Dan J Stein
- SA MRC Unit on Risk & Resilience in Mental Disorders, Dept of Psychiatry & Neuroscience Institute, University of Cape Town, South Africa
| | - Simon Wessely
- Dept of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, United Kingdom
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Az Khan M, Mahmood T, Konje JC. Covid-19 and its implications for the provision of gynecological services globally. Eur J Obstet Gynecol Reprod Biol 2022; 272:58-63. [PMID: 35286919 PMCID: PMC8881888 DOI: 10.1016/j.ejogrb.2022.02.176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 02/20/2022] [Accepted: 02/24/2022] [Indexed: 12/15/2022]
Abstract
Covid-19 took the world by surprise and has completely changed the way humans live and work. There is hardly an aspect of life that has not been affected. Whether social, economic, physical, psychological, cultural or religious, this pandemic has revolutionized every aspect of our lives and some of these changes are here to stay for the unforeseeable time. Although much has been written about the negative effects of Covid-19 on our social lives, some technological advances on COVID-19 have profoundly affected various aspects of our lives. These are mostly to do with how we communicate, deliver health services, innovate and investigate new preventative measures and treatments, travel and indeed influenced the carbon footprint of the planet. Although most of gynaecology is elective and was therefore not considered a priority in the early phases of COVI-19, there are considerable consequences of delaying treatment for some of these elective conditions. Of particular importance are infertility, pre-malignant conditions, chronic pelvic pain, sexual disorders and those affecting the psychological and social aspects of women and families. The pandemic forced a rethink of how healthcare is delivered with wide adoption of remote/virtual consultation and triaging of clinical presentations. The rapid development of immunization and drugs against the virus was met with doubts by a large proportion of the population with reluctance to accept these. Consequently, there remains unvaccinated portions of both low and high-risk populations, some of whom may be denied access to gynaecological care. On the other hand, some pregnant women who are frightened of the impact of vaccination on pregnancy put their own lives at risk. While significant progress has been made to combat the pandemic, lessons about healthcare delivery (face-to-face versus virtual), education of the end users and introduction of new technologies into the development of drugs and vaccines must be evaluated and improved moving forward not only during the ongoing epidemic but with future outbreaks.
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Affiliation(s)
- Mohammed Az Khan
- Consultant Reproductive Medicine, Department of Obstetrics & Gynaecology, Sidra Medicine, Qatar and Assistant Professor of Clinical Obstetrics & Gynaecology, Weill Cornell Medicine Qatar, 26999 Doha, Qatar
| | - Tahir Mahmood
- Spire Murray Field Hospital, Edinburgh and School of Medicine St Andrews, Scotland
| | - Justin C Konje
- Emeritus Professor, Department of Health Sciences, University of Leicester, UK and Professor of Obstetrics and Gynaecology, Weill Cornell Medicine Qatar and Fetomaternal Centre Al Markhiya Doha, Qatar.
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Pandey G, Moghal S, Barodia R, Carey W. COVID-19 and Its Effects on the Mental Health of People Living in Urban Slums in India. JOURNAL OF INFORMATION & KNOWLEDGE MANAGEMENT 2022. [DOI: 10.1142/s0219649222400032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The COVID-19 pandemic has had a devastating effect on the mental health of people from different backgrounds; these effects have been particularly acute among the lower-income households and in slums. There has been a steep rise in mental illness and behaviours associated with it since 2020, especially in the slums characterised by poverty, poor housing, high density and unhealthy environments. This paper aims to examine the effect of COVID-19 on the mental health of people living in the slums of Vijayawada and Visakhapatnam in the state of Andhra Pradesh in India. The results of the study confirm that more than three-fourth of people suffer from mental stress due to the spread of COVID-19 and the lockdown imposed by the government. Also, 80% of those surveyed stated that stress affected their decision-making. The study also confirms that the number of dependents, monthly income, number of living rooms, maintenance of physical distancing norms, avoidance of social gatherings, government support, health insurance and living in a rented house are significantly related to the mental stress of people living in the slums in Andhra Pradesh in India.
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Affiliation(s)
- Ghanshyam Pandey
- Department of Economics, School of Liberal Arts and Social Sciences (SLASS), SRM University, Mangalagiri, Guntur 522240, Andhra Pradesh, India
| | - Sheeba Moghal
- Department of Economics, School of Liberal Arts and Social Sciences (SLASS), SRM University, Mangalagiri, Guntur 522240, Andhra Pradesh, India
| | - Rakshit Barodia
- Department of Economics, School of Liberal Arts and Social Sciences (SLASS), SRM University, Mangalagiri, Guntur 522240, Andhra Pradesh, India
| | - William Carey
- Department of Economics, School of Liberal Arts and Social Sciences (SLASS), SRM University, Mangalagiri, Guntur 522240, Andhra Pradesh, India
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Public Transport COVID-19-Safe: New Barriers and Policies to Implement Effective Countermeasures under User’s Safety Perspective. SUSTAINABILITY 2022. [DOI: 10.3390/su14052945] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The COVID-19 emergency forced cities worldwide to adopt measures to restrict travel and implement new urban public transport solutions. The discontinuity and reduction of services made users recognize public transport systems as contamination vectors, and the decrease in the number of passengers can already be seen in several places. Thus, this study assessed the impact of the COVID-19 pandemic on urban public transport. We used hybrid choice models (HCMs) to identify the new barriers and potential solutions to increase users’ perception of safety, considering preexistent perceptions of public transportation quality. We used data from an online survey with users of public transportation in a metropolitan area in southern Brazil. We identified that the main barriers to using public transport during virus transmission are related to the system characteristics that force constant interaction with other passengers. Crowded vehicles and crowded stops/stations were considered the most detrimental factor in feeling safe while riding in the COVID-19 outbreak. Countermeasures that reduce the contact with other passengers—directly (limit the number of passengers in vehicles) or indirectly (operate with large vehicles)—and increase offers are possible solutions to make users feel safe while riding. The results of this research might help reduce passenger evasion and migration to more unsustainable transport modes.
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Jain R, Dupas P. The effects of India's COVID-19 lockdown on critical non-COVID health care and outcomes: Evidence from dialysis patients. Soc Sci Med 2022; 296:114762. [PMID: 35151150 PMCID: PMC8816957 DOI: 10.1016/j.socscimed.2022.114762] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 11/16/2021] [Accepted: 01/28/2022] [Indexed: 12/16/2022]
Abstract
India's COVID-19 lockdown, one of the most severe in the world, is widely believed to have disrupted critical non-COVID health services. However, linking these disruptions to effects on health outcomes has been difficult due to the lack of reliable, up-to-date health outcomes data. We identified all dialysis patients under a statewide health insurance program in Rajasthan, India (N = 2110), and conducted surveys to examine the effects of the lockdown on non-COVID care access and health outcomes. Post-lockdown mortality was our primary outcome and morbidity and hospitalization were secondary outcomes. 63% of patients experienced a disruption to their care. Transport barriers, hospital service disruptions, and difficulty obtaining medicines were the most common causes. We compared monthly mortality in the four months after the lockdown with pre-lockdown mortality trends, as well as with mortality trends for a similar cohort in the previous year. Mortality in May 2020, after a month of exposure to the lockdown, was 1.70 percentage points (95% CI 0.01–0.03) or 64% higher than in March 2020 and total excess mortality between April and July was estimated to be 22%. A 1SD increase in an index of care disruptions was associated with a 0.17SD (95% CI 0.13–0.22) increase in a morbidity index, a 3.1 percentage point (95% CI 0.012–0.051) increase in hospitalization, and a 2.1 percentage point (95% CI 0.00–0.04) increase in probability of death between May and July. Females, socioeconomically disadvantaged groups, and patients living far from the health system faced worse outcomes. The results highlight the unintended consequences of the lockdown on critical, life-saving non-COVID health services that must be taken into account in the implementation of future policy efforts to control the spread of pandemics. India's nationwide COVID-19 lockdown severely disrupted critical chronic care. Non-COVID-19 morbidity and mortality increased sharply in the subsequent months. Socioeconomically disadvantaged patients were worst affected. Indirect health effects increase the toll of pandemics and worsen health inequality. Pandemic control policies must ensure critical health services continue.
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Affiliation(s)
- Radhika Jain
- Shorenstein APARC, Stanford University, Stanford, CA, 94305-6055, USA.
| | - Pascaline Dupas
- Department of Economics, Stanford University, Stanford, CA, 94305-6055, USA.
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Kyeremateng R, Oguda L, Asemota O. COVID-19 pandemic: health inequities in children and youth. Arch Dis Child 2022; 107:297-299. [PMID: 33574027 DOI: 10.1136/archdischild-2020-320170] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 01/03/2021] [Accepted: 01/08/2021] [Indexed: 11/03/2022]
Affiliation(s)
- Rosina Kyeremateng
- Africa Regional Coordinator, International Society of Social Pediatrics and Child Health, (UK) .,Department of Community Paediatrics, Sirona Care & Health CIC, Bristol, UK
| | - Lulu Oguda
- Physician and Global Health Specialist, The Nairobi Hospital, Nairobi, Kenya
| | - Osamagbe Asemota
- Department of Paediatrics, University of Calabar Teaching Hospital, Calabar, Cross River, Nigeria
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Sharma AK, Gupta R, Baig VN, Singh VT, Chakraborty S, Sunda JP, Dhakar P, Sharma SP, Panwar RB, Katoch VM. Educational status and COVID-19 related outcomes in India: hospital-based cross-sectional study. BMJ Open 2022; 12:e055403. [PMID: 35217540 PMCID: PMC8882634 DOI: 10.1136/bmjopen-2021-055403] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE Association of educational status, as marker of socioeconomic status, with COVID-19 outcomes has not been well studied. We performed a hospital-based cross-sectional study to determine its association with outcomes. METHODS Successive patients of COVID-19 presenting at government hospital were recruited. Demographic and clinical details were obtained at admission, and in-hospital outcomes were assessed. Cohort was classified according to self-reported educational status into group 1: illiterate or ≤primary; group 2: higher secondary; and group 3: some college. To compare intergroup outcomes, we performed logistic regression. RESULTS 4645 patients (men 3386, women 1259) with confirmed COVID-19 were recruited. Mean age was 46±18 years, most lived in large households and 30.5% had low educational status. Smoking or tobacco use was in 29.5%, comorbidities in 28.6% and low oxygen concentration (SpO2 <95%) at admission in 30%. Average length of hospital stay was 6.8±3.7 days, supplemental oxygen was provided in 18.4%, high flow oxygen or non-invasive ventilation 7.1% and mechanical ventilation 3.6%, 340 patients (7.3%) died. Group 1 patients had more tobacco use, hypoxia at admission, lymphocytopaenia, and liver and kidney dysfunction. In group 1 versus groups 2 and 3, requirement of oxygen (21.6% vs 16.7% and 17.0%), non-invasive ventilation (8.0% vs 5.9% and 7.1%), invasive ventilation (4.6% vs 3.5% and 3.1%) and deaths (10.0% vs 6.8% and 5.5%) were significantly greater (p<0.05). OR for deaths were higher in group 1 (1.91, 95% CI 1.46 to 2.51) and group 2 (1.24, 95% CI 0.93 to 1.66) compared with group 3. Adjustment for demographic and comorbidities led to some attenuation in groups 1 (1.44, 95% CI 1.07 to 1.93) and 2 (1.38, 95% CI 1.02 to 1.85); this persisted with adjustments for clinical parameters and oxygen support in groups 1 (1.38, 95% CI 0.99 to 1.93) and 2 (1.52, 95% CI 1.01 to 2.11). CONCLUSION Low educational status patients with COVID-19 in India have significantly greater adverse in-hospital outcomes and mortality. TRIAL REGISTRATION NUMBER REF/2020/06/034036.
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Affiliation(s)
- Arvind K Sharma
- Department of Community Medicine, RUHS College of Medical Sciences, Jaipur, India
| | - Rajeev Gupta
- Academic Research Development Unit, Rajasthan University of Health Sciences, Jaipur, Rajasthan, India
- Department of Medicine, Eternal Heart Care Centre and Research Institute, Jaipur, Rajasthan, India
| | - Vaseem Naheed Baig
- Department of Community Medicine, RUHS College of Medical Sciences, Jaipur, India
| | - Veer Teja Singh
- Department of Community Medicine, RUHS College of Medical Sciences, Jaipur, India
| | - Surabhi Chakraborty
- Department of Community Medicine, RUHS College of Medical Sciences, Jaipur, India
| | - Jagdish P Sunda
- Department of Community Medicine, RUHS College of Medical Sciences, Jaipur, India
| | - Prahalad Dhakar
- Department of Medicine, RUHS College of Medical Sciences, Jaipur, Rajasthan, India
| | - Shiv Prakash Sharma
- Department of Community Medicine, RUHS College of Medical Sciences, Jaipur, India
| | - Raja Babu Panwar
- Academic Research Development Unit, Rajasthan University of Health Sciences, Jaipur, Rajasthan, India
| | - Vishwa Mohan Katoch
- ICMR NASI Chair in Public Health Research, Rajasthan University of Health Sciences, Jaipur, Rajasthan, India
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SeyedAlinaghi S, Karimi A, Mojdeganlou H, Alilou S, Mirghaderi SP, Noori T, Shamsabadi A, Dadras O, Vahedi F, Mohammadi P, Shojaei A, Mahdiabadi S, Janfaza N, Keshavarzpoor Lonbar A, Mehraeen E, Sabatier J. Impact of
COVID
‐19 pandemic on routine vaccination coverage of children and adolescents: A systematic review. Health Sci Rep 2022; 5:e00516. [PMID: 35224217 PMCID: PMC8855492 DOI: 10.1002/hsr2.516] [Citation(s) in RCA: 70] [Impact Index Per Article: 35.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 01/12/2022] [Accepted: 01/23/2022] [Indexed: 02/05/2023] Open
Abstract
Background and Aims Scientists and healthcare workers have expressed their concerns on the impacts of the COVID‐19 pandemic on vaccination coverage in children and adolescents. Therefore, we aimed to systematically review the studies addressing this issue worldwide. Methods We conducted a systematic search of relevant studies using the keywords on databases of PubMed, Web of Science, and Cochrane on May 22, 2021. The identified records were imported into EndNote software and underwent a two‐phase screening process consisting of title/abstract and full‐text screenings against inclusion criteria. The data of the included studies were summarized into a table and the findings were analyzed in a systematic approach. Results From 26 eligible studies, 21 studies demonstrated decreased vaccination rates in the children during the COVID‐19 pandemic, while three studies found increased or no significant changes only in influenza vaccination. The two remaining studies from Brazil and Sweden also showed no significant changes in vaccination rates in the children during the pandemic. Conclusion Most of the reports worldwide reported a decline or delay in vaccination at the time of the COVID‐19 pandemic. A sustained catch‐up program seems to be necessary, especially in low‐income countries, to avoid any vaccine dose missing. Facilitating the vaccination process is recommended, such as decreasing the waiting time for vaccination at the health center, addressing the fear and concerns related to COVID infection for parents, and enhancing vaccine availability, and promoting access in remote areas. Countries should ensure proper vaccination to prevent future pandemics related to vaccine‐preventable diseases.
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Affiliation(s)
- SeyedAhmad SeyedAlinaghi
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High‐Risk Behaviors Tehran University of Medical Sciences Tehran Iran
| | - Amirali Karimi
- School of Medicine, Tehran University of Medical Sciences Tehran Iran
| | | | - Sanam Alilou
- School of Medicine, Tehran University of Medical Sciences Tehran Iran
| | | | - Tayebeh Noori
- Department of Health Information Technology Zabol University of Medical Sciences Zabol Iran
| | - Ahmadreza Shamsabadi
- Department of Health Information Technology Esfarayen Faculty of Medical Sciences Esfarayen Iran
| | - Omid Dadras
- School of Public Health Walailak University Nakhon Si Thammarat Thailand
| | - Farzin Vahedi
- School of Medicine, Tehran University of Medical Sciences Tehran Iran
| | - Parsa Mohammadi
- School of Medicine, Tehran University of Medical Sciences Tehran Iran
| | - Alireza Shojaei
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High‐Risk Behaviors Tehran University of Medical Sciences Tehran Iran
| | - Sara Mahdiabadi
- School of Medicine, Tehran University of Medical Sciences Tehran Iran
| | - Nazanin Janfaza
- Internal Medicine Department, Imam Khomeini Hospital Complex, School of Medicine Tehran University of Medical Sciences Tehran Iran
| | | | - Esmaeil Mehraeen
- Department of Health Information Technology Khalkhal University of Medical Sciences Khalkhal Iran
| | - Jean‐Marc Sabatier
- Université Aix‐Marseille, Institut de Neuro‐physiopathologie (INP) Marseille Cedex France
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45
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Shapiro GK, Gottfredson N, Leask J, Wiley K, Ganter-Restrepo FE, Jones SP, Menning L, Brewer NT. COVID-19 and missed or delayed vaccination in 26 middle- and high-income countries: An observational survey. Vaccine 2022; 40:945-952. [PMID: 35039193 PMCID: PMC8687753 DOI: 10.1016/j.vaccine.2021.12.041] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 12/14/2021] [Accepted: 12/15/2021] [Indexed: 01/17/2023]
Abstract
BACKGROUND The COVID-19 pandemic has disrupted vaccination services and raised the risk of a global resurgence of preventable diseases. We assessed the extent of and reasons for missed or delayed vaccinations (hereafter 'missed') in middle- and high-income countries in the early months of the pandemic. METHODS From May to June 2020, participants completed an online survey on missed vaccination. Analyses separated missed childhood and adult vaccination in middle-and high-income countries. RESULTS Respondents were 28,429 adults from 26 middle- and high-income countries. Overall, 9% of households had missed a vaccine, and 13% were unsure. More households in middle- than high-income countries reported missed childhood vaccination (7.6% vs. 3.0%) and missed adult vaccination (9.6% vs. 3.4%, both p < .05). Correlates of missed childhood vaccination in middle-income countries included COVID-19 risk factors (respiratory and cardiovascular diseases), younger age, male sex, employment, psychological distress, larger household size, and more children. In high-income countries, correlates of missed childhood vaccination also included immunosuppressive conditions, but did not include sex or household size. Fewer correlates were associated with missed adult vaccination other than COVID-19 risk factors and psychological distress. Common reasons for missed vaccinations were worry about getting COVID-19 at the vaccination clinic (15%) or when leaving the house (11%). Other reasons included no healthcare provider recommendation, clinic closure, and wanting to save services for others. INTERPRETATION Missed vaccination was common and more prevalent in middle- than high-income countries. Missed vaccination could be mitigated by emphasizing COVID-19 safety measures in vaccination clinics, ensuring free and accessible immunization, and clear healthcare provider recommendations.
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Affiliation(s)
- Gilla K. Shapiro
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada,Corresponding author
| | - Nisha Gottfredson
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Julie Leask
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia,Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Kerrie Wiley
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | | | - Sarah P. Jones
- Institute of Global Health Innovation, Imperial College London, St Mary’s Hospital, London, United Kingdom
| | - Lisa Menning
- Department of Immunization, Vaccines and Biologicals, World Health Organization, Geneva, Switzerland
| | - Noel T. Brewer
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA,Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, United States
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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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Faria CGF, de Matos UMA, Llado-Medina L, Pereira-Sanchez V, Freire R, Nardi AE. Understanding and addressing COVID-19 vaccine hesitancy in low and middle income countries and in people with severe mental illness: Overview and recommendations for Latin America and the Caribbean. Front Psychiatry 2022; 13:910410. [PMID: 36177216 PMCID: PMC9513790 DOI: 10.3389/fpsyt.2022.910410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 08/22/2022] [Indexed: 11/22/2022] Open
Abstract
Despite the speedy development of vaccines for COVID-19, their rollout has posed a major public health challenge, as vaccine hesitancy (VH) and refusal are high. Addressing vaccine hesitancy is a multifactorial and context-dependent challenge. This perspective focuses on VH in the world region of Latin America and the Caribbean (LAC) and includes people suffering from severe mental illness, therefore covering populations and subpopulations often neglected in scientific literature. We present an overview of VH in LAC countries, discussing its global and historical context. Vaccine uptake has shown to widely vary across different subregions of LAC. Current data points to a possible correlation between societal polarization and vaccination, especially in countries going through political crises such as Brazil, Colombia, and Venezuela. Poor accessibility remains an additional important factor decreasing vaccination rollout in LAC countries and even further, in the whole Global South. Regarding patients with severe mental illness in LAC, and worldwide, it is paramount to include them in priority groups for immunization and monitor their vaccination coverage through public health indicators.
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Affiliation(s)
- Clara Gitahy Falcão Faria
- Laboratory of Panic and Respiration, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | | | | | - Victor Pereira-Sanchez
- Department of Psychiatry, Columbia University, New York, NY, United States.,Division of Translational Epidemiology and Mental Health Equity, New York State Psychiatric Institute, New York, NY, United States.,Department of Child and Adolescent Psychiatry, New York University Grossman School of Medicine, New York, NY, United States.,Department of Psychiatry, Amoud University, Borama, Somalia
| | - Rafael Freire
- Laboratory of Panic and Respiration, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil.,Department of Psychiatry and Center for Neuroscience Studies, Queen's University, Kingston, ON, Canada
| | - Antonio Egidio Nardi
- Laboratory of Panic and Respiration, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
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48
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Akhter S, Kumkum FA, Bashar F, Rahman A. Exploring the lived experiences of pregnant women and community health care providers during the pandemic of COVID-19 in Bangladesh through a phenomenological analysis. BMC Pregnancy Childbirth 2021; 21:810. [PMID: 34865620 PMCID: PMC8643626 DOI: 10.1186/s12884-021-04284-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 11/16/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Like many countries, the government of Bangladesh also imposed stay-at-home orders to restrict the spread of severe acute respiratory syndrome coronavirus-2 (COVID-19) in March, 2020. Epidemiological studies were undertaken to estimate the early possible unforeseen effects on maternal mortality due to the disruption of services during the lockdown. Little is known about the constraints faced by the pregnant women and community health workers in accessing and providing basic obstetric services during the pandemic in the country. This study was conducted to explore the lived experience of pregnant women and community health care providers from two southern districts of Bangladesh during the pandemic of COVID-19. METHODS The study participants were recruited through purposive sampling and non-structured in-depth interviews were conducted. Data was collected over the telephone from April to June, 2020. The data collected was analyzed through a phenomenological approach. RESULTS Our analysis shows that community health care providers are working under tremendous strains of work load, fear of getting infected and physical and mental fatigue in a widely disrupted health system. Despite the fear of getting infected, the health workers are reluctant to wear personal protective suits because of gender norms. Similarly, the lived experience of pregnant women shows that they are feeling helpless; the joyful event of pregnancy has suddenly turned into a constant fear and stress. They are living in a limbo of hope and despair with a belief that only God could save their lives. CONCLUSION The results of the study present the vulnerability of pregnant women and health workers during the pandemic. It recognizes the challenges and constraints, emphasizing the crucial need for government and non-government organizations to improve maternal and newborn health services to protect the pregnant women and health workers as they face predicted waves of the pandemic in the future.
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Affiliation(s)
- Sadika Akhter
- International Centre for Diarrhoeal Disease Research, 68, Shahid Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212, Bangladesh.
| | - Feroza Akhter Kumkum
- International Centre for Diarrhoeal Disease Research, 68, Shahid Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212, Bangladesh
| | - Farzana Bashar
- International Centre for Diarrhoeal Disease Research, 68, Shahid Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212, Bangladesh
| | - Aminur Rahman
- International Centre for Diarrhoeal Disease Research, 68, Shahid Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212, Bangladesh
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Desborough J, Dykgraaf SH, Phillips C, Wright M, Maddox R, Davis S, Kidd M. Lessons for the global primary care response to COVID-19: a rapid review of evidence from past epidemics. Fam Pract 2021; 38:811-825. [PMID: 33586769 PMCID: PMC7928916 DOI: 10.1093/fampra/cmaa142] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND COVID-19 is the fifth and most significant infectious disease epidemic this century. Primary health care providers, which include those working in primary care and public health roles, have critical responsibilities in the management of health emergencies. OBJECTIVE To synthesize accounts of primary care lessons learnt from past epidemics and their relevance to COVID-19. METHODS We conducted a review of lessons learnt from previous infectious disease epidemics for primary care, and their relevance to COVID-19. We searched PubMed/MEDLINE, PROQUEST and Google Scholar, hand-searched reference lists of included studies, and included research identified through professional contacts. RESULTS Of 173 publications identified, 31 publications describing experiences of four epidemics in 11 countries were included. Synthesis of findings identified six key lessons: (i) improve collaboration, communication and integration between public health and primary care; (ii) strengthen the primary health care system; (iii) provide consistent, coordinated and reliable information emanating from a trusted source; (iv) define the role of primary care during pandemics; (v) protect the primary care workforce and the community and (vi) evaluate the effectiveness of interventions. CONCLUSIONS Evidence highlights distinct challenges to integrating and supporting primary care in response to infectious disease epidemics that have persisted over time, emerging again during COVID-19. These insights provide an opportunity for strengthening, and improved preparedness, that cannot be ignored in a world where the frequency, virility and global reach of infectious disease outbreaks are increasing. It is not too soon to plan for the next pandemic, which may already be on the horizon.
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Affiliation(s)
- Jane Desborough
- Department of Health Services Research and Policy, Research School of Population Health, College of Health and Medicine, Australian National University, Canberra Australia
- Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, Australia
| | - Sally Hall Dykgraaf
- Australian National University Rural Clinical School, College of Health and Medicine, Australian National University, Canberra, Australia
| | - Christine Phillips
- Australian National University Medical School, College of Health and Medicine Australian National University, Canberra, Australia
| | - Michael Wright
- Centre for Health Economics Research and Evaluation (CHERE), University Technology Sydney, Sydney, Australia
| | - Raglan Maddox
- COVID-19 Primary Care Response Group, Australian Department of Health, Canberra, Australia
- National Centre for Epidemiology and Public Health, Research School of Population Health, College of Health and Medicine, Australian National University, Canberra, Australia
| | - Stephanie Davis
- COVID-19 Primary Care Response Group, Australian Department of Health, Canberra, Australia
- National Centre for Epidemiology and Public Health, Research School of Population Health, College of Health and Medicine, Australian National University, Canberra, Australia
| | - Michael Kidd
- Australian Government Department of Health, Canberra, Australia
- College of Health and Medicine, Australian National University, Canberra, Australia
- Department of Family & Community Medicine, University of Toronto, Toronto, Canada
- World Health Organization Collaborating Centre on Family Medicine and Primary Care, Geneva, Switzerland
- Murdoch Children’s Research Institute, The Royal Children’s Hospital, Melbourne, Australia
- Southgate Institute for Health, Society and Equity, Flinders University, Adelaide, Australia
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50
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Vitorino LM, Sousa LMM, Trzesniak C, de Sousa Valentim OM, Yoshinari Júnior GH, José HMG, Lucchetti G. Mental health, quality of life and optimism during the covid-19 pandemic: a comparison between Brazil and Portugal. Qual Life Res 2021; 31:1775-1787. [PMID: 34750723 PMCID: PMC8574942 DOI: 10.1007/s11136-021-03031-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/31/2021] [Indexed: 02/02/2023]
Abstract
PURPOSE Although there have been numerous studies investigating the mental health of individuals during the pandemic, a comparison between countries is still scarce in the literature. To explore this gap, the present study aimed to compare the mental health (i.e., anxiety and depression), quality of life (QoL), and optimism/pessimism among individuals from Brazil and Portugal during the COVID-19 pandemic and the associated factors. METHOD A cross-sectional population-based study was conducted during the COVID-19 pandemic in Brazil and Portugal. Data collection was carried out between May and June 2020, using an online form which was sent through social networks. A total of 2069 participants (1156 from Brazil and 913 from Portugal) were included. Depressive symptoms (PHQ-9), Anxiety (GAD-7), optimism/pessimism (Revised Life Orientation Test - LOT), QoL (WHOQOL-Bref), and sociodemographic, health, and social distancing variables were assessed. Data was analyzed using univariate and multivariate models. RESULTS There were remarkable differences between Brazil and Portugal in all outcomes during the COVID-19 pandemic, including higher levels of depressive symptoms, anxiety, and optimism for the Brazilian individuals and higher levels of QoL and pessimism for the Portuguese individuals. The following factors were associated with the mental health and QoL in both Brazilian and Portuguese populations: gender, age, being a healthcare professional, and days in social distancing. CONCLUSION Despite the fact that Brazilians were more optimistic during the COVID-19 pandemic, they had lower levels of mental health and QoL as compared to the Portuguese individuals.
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Affiliation(s)
| | - Luís Manuel Mota Sousa
- Nursing Department, Comprehensive Health Research Centre, University of Évora, Évora, Portugal
| | - Clarissa Trzesniak
- Faculty of Medicine of Itajubá-Afya Group, Rennó Júnior avenue, 368, Itajubá, Minas Gerais, Brazil
| | - Olga Maria de Sousa Valentim
- Instituto Politécnico de Leiria, ESSLei Escola Superior de Saúde, Centro de Investigação Em Tecnologias E Serviços de Saúde (CINTESIS, Grupo NursID), Leiria, Portugal
| | | | | | - Giancarlo Lucchetti
- School of Medicine, Federal University of Juiz de Fora, Juiz de Fora, Brazil
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