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Vanderlocht J, Møgelmose S, Van Kerckhove K, Beutels P, Hens N. Chronic disease patients have fewer social contacts: A pilot survey with implications for transmission dynamics. Infect Dis Model 2024; 9:926-930. [PMID: 38800113 PMCID: PMC11127182 DOI: 10.1016/j.idm.2024.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 02/26/2024] [Accepted: 05/06/2024] [Indexed: 05/29/2024] Open
Abstract
Non-communicable diseases (NCD) are the most important cause of death in the world. The socio-economic costs associated with NCDs makes it imperative to prevent and control them in the 21st century. The severe toll that the COVID-19 pandemic has taken worldwide is an unfortunate illustration of our limited insight into the infectious risk for the global population. Co-incidence between NCD and infection offers an underexplored opportunity to design preventive policies. In a pilot survey, we observed that the NCD population displays a substantial reduction in their social contacting behavior as compared to the general population. This indicates that existing mathematical models based on contact surveys in the general population are not applicable to the NCD population and that the risk of acquiring an infection following a contact is probably underestimated. Our demonstration of reduced social mixing in several chronic conditions, raises the question to what extent the social mixing is influenced by the burden of disease. We advocate the design of disease-specific contact surveys to address how the burden of disease associates with social contact behavior and the risk of infection. The SARS-CoV-2 pandemic offers an unprecedented opportunity to gain insight into the importance of infection in the NCD population and to find ways to improve healthcare procedures.
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Affiliation(s)
- J. Vanderlocht
- Interuniversity Institute of Biostatistics and Statistical Bioinformatics, Data Science Institute, Hasselt University, Hasselt, Belgium
| | - S. Møgelmose
- Interuniversity Institute of Biostatistics and Statistical Bioinformatics, Data Science Institute, Hasselt University, Hasselt, Belgium
| | - K. Van Kerckhove
- Interuniversity Institute of Biostatistics and Statistical Bioinformatics, Data Science Institute, Hasselt University, Hasselt, Belgium
| | - P. Beutels
- Centre for Health Economic Research and Modelling Infectious Diseases, University of Antwerp, Antwerp, Belgium
| | - N. Hens
- Interuniversity Institute of Biostatistics and Statistical Bioinformatics, Data Science Institute, Hasselt University, Hasselt, Belgium
- Centre for Health Economic Research and Modelling Infectious Diseases, University of Antwerp, Antwerp, Belgium
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Bulamba RM, Nalugoda F, Nkale J, Kigozi G, Ochieng AM, Kyasanku E, Watya S, Olwa VO, Daama A, Nkwanzi V, Kiwanuka D, Mugamba S, Kigozi G, Wagman J, Ekström AM, Nakigozi G, Miller AP. Examining associations between mental health and Chronic Non-Communicable Diseases (C-NCDs) among older adults in Wakiso, Uganda. PLoS One 2024; 19:e0293993. [PMID: 38885211 PMCID: PMC11182548 DOI: 10.1371/journal.pone.0293993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Accepted: 05/29/2024] [Indexed: 06/20/2024] Open
Abstract
BACKGROUND Globally, the prevalence of chronic non-communicable diseases (C-NCDs) and occurrence of multi-morbidity specifically, has been increasing and will continue to rise as life expectancy increases. The burden of mental health disorders has also been rising globally. In sub-Saharan Africa (SSA), literature on these health issues, which are interrelated, is scarce. This study assesses the prevalence of C-NCDs, and depressive and anxiety symptomology and examines the relationship between these issues among a sample of older adults in Uganda. METHODS Between 2021-2022, 604 consenting adults aged 35 years and older were surveyed on a broad range of health issues for the ongoing AMBSO Population Health Surveillance (APHS) cohort study in Wakiso district. Descriptive analyses were performed to characterize the burden of C-NCDs (e.g. diabetes, hypertension), depression (PHQ-9 using a cutoff of <5 scores for minimal/no and 5+ for mild to severe symptomology) and anxiety (GAD-7 using a cutoff of 5+ scores for mild to severe symptomology). Bivariate analysis and multivariable logistic regression models were built using STATA software version 16.0 to examine associations between mental health disorders and having at least one C-NCD. Our exposures of interest were depressive and anxiety symptoms and our outcomes of interest was presence of C-NCDs. RESULTS Majority of participants were females (63.6%), median age was 46 (IQR: 39-54). Any C-NCDs prevalence was 18.7%, while 18.9% and 11.4%, had screening scores indicative of depressive and anxiety symptomology, respectively. Three percent (3.2%) had PHQ-9 scores indicative of moderate to severe depressive symptomology. In models adjusted for sociodemographic characteristics, there was 12% increased odds of suffering from C-NCDs for every unit increase in PHQ-9 score (AOR = 1.12, 95% CI: 1.10-1.20). Participants with any anxiety symptoms had 2.1 greater odds of suffering from C-NCD compared to those who did not have anxiety symptoms (AOR = 2.10, 95% CI: 1.21-3.70). CONCLUSION C-NCDs were prevalent in older adults, particularly among those experiencing mental health symptoms. Screening for C-NCDs and mental health disorders should be integrated into routine health care for older adults in the country. Early screening and identification of these health issues through primary health care could significantly reduce the public health burden attributable to mental health disorders and the incidence of multi-morbidity in Uganda.
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Affiliation(s)
- Robert M. Bulamba
- Africa Medical and Behavioral Sciences Organization (AMBSO), Kampala, Uganda
| | - Fred Nalugoda
- Africa Medical and Behavioral Sciences Organization (AMBSO), Kampala, Uganda
| | - James Nkale
- Africa Medical and Behavioral Sciences Organization (AMBSO), Kampala, Uganda
| | - Godfrey Kigozi
- Africa Medical and Behavioral Sciences Organization (AMBSO), Kampala, Uganda
| | | | - Emmanuel Kyasanku
- Africa Medical and Behavioral Sciences Organization (AMBSO), Kampala, Uganda
| | - Stephen Watya
- Africa Medical and Behavioral Sciences Organization (AMBSO), Kampala, Uganda
| | - Vitalis Ofumbi Olwa
- Africa Medical and Behavioral Sciences Organization (AMBSO), Kampala, Uganda
| | - Alex Daama
- Africa Medical and Behavioral Sciences Organization (AMBSO), Kampala, Uganda
| | - Violet Nkwanzi
- East Tennessee State University, Johnson City, TN, United States of America
| | - Deusdedit Kiwanuka
- Africa Medical and Behavioral Sciences Organization (AMBSO), Kampala, Uganda
| | - Stephen Mugamba
- Africa Medical and Behavioral Sciences Organization (AMBSO), Kampala, Uganda
| | - Grace Kigozi
- Africa Medical and Behavioral Sciences Organization (AMBSO), Kampala, Uganda
| | - Jennifer Wagman
- University of California, Los Angeles, Los Angeles, CA, United States of America
| | | | - Gertrude Nakigozi
- Africa Medical and Behavioral Sciences Organization (AMBSO), Kampala, Uganda
| | - Amanda P. Miller
- San Diego State University, San Diego, CA, United States of America
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Saad RK, Alsouri R, Kruse MH, Kufoof L, Lobanov-Rostovsky S, Richter P, Khader Y. Addressing emerging public health threats: the Noncommunicable Disease Capacity Assessment and Planning (N-CAP) Process. Front Public Health 2024; 12:1384957. [PMID: 38903573 PMCID: PMC11188389 DOI: 10.3389/fpubh.2024.1384957] [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: 02/11/2024] [Accepted: 05/22/2024] [Indexed: 06/22/2024] Open
Abstract
Background The global epidemic of noncommunicable diseases (NCDs) is increasing. Current assessments that monitor capacity to address NCDs are often externally led and do not facilitate country planning. The Noncommunicable Disease Capacity Assessment and Planning (N-CAP) Process assists ministries of health and other governmental and non-governmental stakeholders to assess, prioritize, and plan how to address NCDs and other public health threats. This paper describes the development of this tool. Materials and methods Driven by ministries of health, the N-CAP Process engages new and existing stakeholders in three activities: Stakeholder Mapping; Strengths, Weaknesses, Opportunities, and Threats Workshop; and N-CAP Workshop that uses Discussion Guides to lead in-depth assessment and planning. Standard Operating Procedures, a library of Discussion Guides based on common NCD themes, and an open-access e-learning course are available. Results The N-CAP Process outcome is a prioritized plan of how to improve the country's public health functions. Adaptations to the tool were made after piloting in Jordan and Iraq. Conclusion The N-CAP Process helps countries engage various stakeholders to identify gaps and create collaborative, country-specific strategies to effectively respond to NCDs, a leading public health threat. The pilots sparked interest from other countries and underscored its potential for broader implementation to combat the rising global burden of NCDs.
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Affiliation(s)
- Randa K. Saad
- Research and Policy, Center of Excellence for Applied Epidemiology, Global Health Development | Eastern Mediterranean Public Health Network, Amman, Jordan
| | - Ruba Alsouri
- Workforce Capacity, Center of Excellence for Applied Epidemiology, Global Health Development | Eastern Mediterranean Public Health Network, Amman, Jordan
| | - Meredith H. Kruse
- Global Public Health Systems, Division of Global Health Protection, United States Centers for Disease Control and Prevention, Atlanta, GA, United States
- Alexton Inc., Springfield, VA, United States
| | - Lara Kufoof
- Project Management Office, Global Health Development | Eastern Mediterranean Public Health Network, Amman, Jordan
| | - Sophie Lobanov-Rostovsky
- Global Public Health Systems, Division of Global Health Protection, United States Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Patricia Richter
- Global Public Health Systems, Division of Global Health Protection, United States Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Yousef Khader
- Department of Community Medicine, Public Health, and Family Medicine, Faculty of Medicine, Jordan University of Science & Technology, Irbid, Jordan
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Auderset D, Amiguet M, Clair C, Riou J, Pittet V, Schwarz J, Mueller Y. Gender/Sex Disparities in the COVID-19 Cascade From Testing to Mortality: An Intersectional Analysis of Swiss Surveillance Data. Int J Public Health 2024; 69:1607063. [PMID: 38835806 PMCID: PMC11148283 DOI: 10.3389/ijph.2024.1607063] [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: 01/08/2024] [Accepted: 05/10/2024] [Indexed: 06/06/2024] Open
Abstract
Objectives This study investigates gender and sex disparities in COVID-19 epidemiology in the Canton of Vaud, Switzerland, focusing on the interplay with socioeconomic position (SEP) and age. Methods We analyzed COVID-19 surveillance data from March 2020 to June 2021, using an intersectional approach. Negative binomial regression models assessed disparities between women and men, across SEP quintiles and age groups, in testing, positivity, hospitalizations, ICU admissions, and mortality (Incidence Rate Ratios [IRR], with 95% Confidence Intervals [CI]). Results Women had higher testing and positivity rates than men, while men experienced more hospitalizations, ICU admissions, and deaths. The higher positivity in women under 50 was mitigated when accounting for their higher testing rates. Within SEP quintiles, gender/sex differences in testing and positivity were not significant. In the lowest quintile, women's mortality risk was 68% lower (Q1: IRR 0.32, CI 0.20-0.52), with decreasing disparities with increasing SEP quintiles (Q5: IRR 0.66, CI 0.41-1.06). Conclusion Our findings underscore the complex epidemiological patterns of COVID-19, shaped by the interactions of gender/sex, SEP, and age, highlighting the need for intersectional perspectives in both epidemiological research and public health strategy development.
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Affiliation(s)
- Diane Auderset
- Department of Family Medicine, University Center of General Medicine and Public Health, Lausanne, Switzerland
| | - Michaël Amiguet
- Department of Epidemiology and Health Systems, University Center of General Medicine and Public Health, Lausanne, Switzerland
| | - Carole Clair
- Department of Ambulatory Care, University Center of General Medicine and Public Health, Lausanne, Switzerland
| | - Julien Riou
- Department of Epidemiology and Health Systems, University Center of General Medicine and Public Health, Lausanne, Switzerland
| | - Valérie Pittet
- Department of Epidemiology and Health Systems, University Center of General Medicine and Public Health, Lausanne, Switzerland
| | - Joelle Schwarz
- Department of Ambulatory Care, University Center of General Medicine and Public Health, Lausanne, Switzerland
| | - Yolanda Mueller
- Department of Family Medicine, University Center of General Medicine and Public Health, Lausanne, Switzerland
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Sirili N, Kilonzi M, Kiwango G, Lengai E, Nandala R, Mwakawanga DL, Philipo EG, Thobias JM, Frumence G. Knowledge of non-communicable diseases and access to healthcare services among adults before and during COVID-19 pandemic in rural Tanzania. Front Public Health 2024; 12:1342885. [PMID: 38605870 PMCID: PMC11008714 DOI: 10.3389/fpubh.2024.1342885] [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: 11/22/2023] [Accepted: 03/18/2024] [Indexed: 04/13/2024] Open
Abstract
Background The COVID-19 pandemic significantly affected access to healthcare services, particularly among individuals living with Non-Communicable Diseases (NCDs) who require regular healthcare visits. Studies suggest that knowledge about a specific disease is closely linked to the ability to access services for that condition. In preparation for the future, we conducted the study to assess knowledge of NCDs and access to healthcare services among adults residing in rural areas before and during the COVID-19 pandemic. Methods We conducted a community-based cross-sectional study in rural Tanzania in October 2022, a few months after the end of the third wave of the COVID-19 pandemic. A total of 689 community residents participated in the study. The level of knowledge of NCDs was assessed using an 11-item Likert questionnaire, which was later dichotomized into adequate and inadequate levels of knowledge. In addition, access to healthcare was assessed before and during the pandemic. We summarized the results using descriptive statistics and logistic regression was applied to determine factors associated with adequate levels of knowledge of NCDs. All statistical tests were two-sided; a p-value <0.05 was considered statistically significant. All data analyses were performed using SPSS. Results Among 689 participants, more than half 369 (55%) had adequate knowledge of whether a disease is NCD or not; specifically, 495 (73.8%), 465 (69.3%), and 349 (52%) knew that hypertension, diabetes mellitus, and stroke are NCDs while 424 (63.2%) know that UTI is not NCD. Of the interviewed participants, 75 (11.2%) had at least one NCD. During the COVID-19 pandemic the majority 57 (72.2%) accessed healthcare services from nearby health facilities followed by traditional healers 10 (12.7%) and community drug outlets 8 (10.1%). Residence and education level were found to be significantly associated with knowledge of NCDs among participants. Conclusion The study revealed that the community has a moderate level of knowledge of NCDs, and during the COVID-19 pandemic outbreaks, people living with NCD (s) relied on nearby health facilities to obtain healthcare services. Health system preparedness and response to pandemics should take into account empowering the community members to understand that NCD care is continuously needed even during pandemic times. We further advocate for a qualitative study to explore contextual factors influencing the knowledge of NCDs and access to healthcare services beyond the big domains of education and residence.
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Affiliation(s)
- Nathanael Sirili
- School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Manase Kilonzi
- School of Pharmacy, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - George Kiwango
- School of Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | | | | | - Dorkasi L. Mwakawanga
- School of Nursing, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Erick G. Philipo
- School of Pharmacy, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Joseph Matobo Thobias
- School of Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Gasto Frumence
- School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
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Mohamed SF, Kisia L, Mashiashi I, Mair F, Wisdom JP, Bunn C, Gray C, Kibe PM, Sanya RE, Karugu CH, Mtenga SM, Binyaruka P, Asiki G. Policies for type 2 diabetes and non-communicable disease management during the COVID-19 pandemic in Kenya and Tanzania: a desk review and views of decision-makers. BMJ Open 2024; 14:e073261. [PMID: 38531573 PMCID: PMC10966805 DOI: 10.1136/bmjopen-2023-073261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 02/20/2024] [Indexed: 03/28/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic caused disruptions in care that adversely affected the management of non-communicable diseases (NCDs) globally. Countries have responded in various ways to support people with NCDs during the pandemic. This study aimed to identify policy gaps, if any, in the management of NCDs, particularly diabetes, during COVID-19 in Kenya and Tanzania to inform recommendations for priority actions for NCD management during any future similar crises. METHODS We undertook a desk review of pre-existing and newly developed national frameworks, policy models and guidelines for addressing NCDs including type 2 diabetes. This was followed by 13 key informant interviews with stakeholders involved in NCD decision-making: six in Kenya and seven in Tanzania. Thematic analysis was used to analyse the documents. RESULTS Seventeen guidance documents were identified (Kenya=10; Tanzania=7). These included pre-existing and/or updated policies/strategic plans, guidelines, a letter, a policy brief and a report. Neither country had comprehensive policies/guidelines to ensure continuity of NCD care before the COVID-19 pandemic. However, efforts were made to update pre-existing documents and several more were developed during the pandemic to guide NCD care. Some measures were put in place during the COVID-19 period to ensure continuity of care for patients with NCDs such as longer supply of medicines. Inadequate attention was given to monitoring and evaluation and implementation issues. CONCLUSION Kenya and Tanzania developed and updated some policies/guidelines to include continuity of care in emergencies. However, there were gaps in the documents and between policy/guideline documents and practice. Health systems need to establish disaster preparedness plans that integrate attention to NCD care to enable them to better handle severe disruptions caused by emergencies such as pandemics. Such guidance needs to include contingency planning to enable adequate resources for NCD care and must also address evaluation of implementation effectiveness.
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Affiliation(s)
- Shukri F Mohamed
- Chronic Disease Management Unit, African Population and Health Research Center, Nairobi, Kenya
| | - Lyagamula Kisia
- Chronic Disease Management Unit, African Population and Health Research Center, Nairobi, Kenya
| | - Irene Mashiashi
- Department of Health System, Impact Evaluation and Policy, Ifakara Health Institute, Dar es Salaam, Tanzania
| | - Frances Mair
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | | | - Christopher Bunn
- School of Social and Political Sciences, University of Glasgow, Glasgow, UK
| | - Cindy Gray
- School of Social and Political Sciences, University of Glasgow, Glasgow, UK
| | - Peter M Kibe
- Chronic Disease Management Unit, African Population and Health Research Center, Nairobi, Kenya
| | - Richard E Sanya
- Chronic Disease Management Unit, African Population and Health Research Center, Nairobi, Kenya
| | - Caroline H Karugu
- Chronic Disease Management Unit, African Population and Health Research Center, Nairobi, Kenya
| | - Sally M Mtenga
- Department of Health System, Impact Evaluation and Policy, Ifakara Health Institute, Dar es Salaam, Tanzania
| | - Peter Binyaruka
- Department of Health System, Impact Evaluation and Policy, Ifakara Health Institute, Dar es Salaam, Tanzania
| | - Gershim Asiki
- Chronic Disease Management Unit, African Population and Health Research Center, Nairobi, Kenya
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Matovelle P, Oliván-Blázquez B, Fraile-Peñaranda I, Turón-Lanuza A, Gallego-Royo A, Casado-Vicente V, Magallón-Botaya R. Polypharmacy in Older Patients: A Three-Year Longitudinal Analysis in Primary Care Settings of Aragón, Spain. Ann Geriatr Med Res 2024; 28:36-45. [PMID: 37994020 PMCID: PMC10982450 DOI: 10.4235/agmr.23.0137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 11/14/2023] [Accepted: 11/16/2023] [Indexed: 11/24/2023] Open
Abstract
BACKGROUND Challenges of polypharmacy and the impact of coronavirus disease 2019 (COVID-19) pandemic in older patients require further investigation. This retrospective study analyzed the progression of polypharmacy and anticholinergic burden in older patients in a primary care setting before, during, and after the COVID-19 pandemic. METHODS This 3-year cross-sectional study (2019, 2020, and 2021) comprised a dynamic cohort of individuals aged ≥75 years, who attended the Arrabal Primary Care Center in Zaragoza, Spain. Older patients with polypharmacy (≥5 medications) were identified according to their electronic health records. We collected demographic and clinical data, including medication prescriptions, diagnoses, and anticholinergic risks, and performed descriptive and statistical analyses. RESULTS This study included a total of 1,928 patients with a mean age of 83.52±0.30 years. Over the 3-year study period, the mean number of medications prescribed increased, from 9.4 in 2019 to 10.4 in 2021. The prevalence of excessive polypharmacy (≥10 medications) increased from 39% in 2019 to 45% in 2021. The most commonly prescribed drugs were anilides, proton pump inhibitors, benzodiazepine derivatives, and platelet aggregation inhibitors. Women had a higher prevalence of illnesses and anticholinergic drug prescriptions than men. CONCLUSION The results of this study highlighted an upward trend in polypharmacy and excessive polypharmacy among older patients in primary care settings. Future research should focus on optimizing medication management and deprescribing strategies and minimizing the adverse effects of polypharmacy in this population.
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Affiliation(s)
- Priscila Matovelle
- Department of Geriatrics, San Juan de Dios Hospital, Zaragoza, Spain
- Department of Medicine, Psychiatry and Dermatology, Faculty of Medicine, University of Zaragoza, Zaragoza, Spain
| | - Bárbara Oliván-Blázquez
- Group B21-20R, Health Research Institute of Aragon (IISA), Zaragoza, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS, RD21/0016/0001), Zaragoza, Spain
- Department of Psychology and Sociology, University of Zaragoza, Zaragoza, Spain
| | - Irene Fraile-Peñaranda
- Department of Preventive Medicine Unit, Lozano Blesa University Clinical Hospital, Zaragoza, Spain
| | | | - Alba Gallego-Royo
- Aragonese Healthcare Service (SALUD), Zaragoza, Spain
- Aragon Health Research Institute, Zaragoza, Spain
| | - Verónica Casado-Vicente
- Family and Community Medicine, University Health Centre Parquesol, Valladolid, Spain
- Department of Medicine, University of Valladolid, Valladolid, Spain
| | - Rosa Magallón-Botaya
- Department of Medicine, Psychiatry and Dermatology, Faculty of Medicine, University of Zaragoza, Zaragoza, Spain
- Group B21-20R, Health Research Institute of Aragon (IISA), Zaragoza, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS, RD21/0016/0001), Zaragoza, Spain
- Aragonese Healthcare Service (SALUD), Zaragoza, Spain
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Mehrizi R, Golestani A, Malekpour MR, Karami H, Nasehi MM, Effatpanah M, Rezaee M, Shahali Z, Akbari Sari A, Daroudi R. Patterns of case fatality and hospitalization duration among nearly 1 million hospitalized COVID-19 patients covered by Iran Health Insurance Organization (IHIO) over two years of pandemic: An analysis of associated factors. PLoS One 2024; 19:e0298604. [PMID: 38394118 PMCID: PMC10889889 DOI: 10.1371/journal.pone.0298604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 01/26/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND Different populations and areas of the world experienced diverse COVID-19 hospitalization and mortality rates. Claims data is a systematically recorded source of hospitalized patients' information that could be used to evaluate the disease management course and outcomes. We aimed to investigate the hospitalization and mortality patterns and associated factors in a huge sample of hospitalized patients. METHODS In this retrospective registry-based study, we utilized claim data from the Iran Health Insurance Organization (IHIO) consisting of approximately one million hospitalized patients across various hospitals in Iran over a 26-month period. All records in the hospitalization dataset with ICD-10 codes U07.1/U07.2 for clinically/laboratory confirmed COVID-19 were included. In this study, a case referred to one instance of a patient being hospitalized. If a patient experienced multiple hospitalizations within 30 days, those were aggregated into a single case. However, if hospitalizations had longer intervals, they were considered independent cases. The primary outcomes of study were general and intensive care unit (ICU) hospitalization periods and case fatality rate (CFR) at the hospital. Besides, various demographic and hospitalization-associated factors were analyzed to derive the associations with study outcomes using accelerated failure time (AFT) and logistic regression models. RESULTS A total number of 1 113 678 admissions with COVID-19 diagnosis were recorded by IHIO during the study period, defined as 917 198 cases, including 51.9% females and 48.1% males. The 61-70 age group had the highest number of cases for both sexes. Among defined cases, CFR was 10.36% (95% CI: 10.29-10.42). The >80 age group had the highest CFR (26.01% [95% CI: 25.75-26.27]). The median of overall hospitalization and ICU days were 4 (IQR: 3-7) and 5 (IQR: 2-8), respectively. Male patients had a significantly higher risk for mortality both generally (odds ratio (OR) = 1.36 [1.34-1.37]) and among ICU admitted patients (1.12 [1.09-1.12]). Among various insurance funds, Foreign Citizens had the highest risk of death both generally (adjusted OR = 2.06 [1.91-2.22]) and in ICU (aOR = 1.71 [1.51-1.92]). Increasing age groups was a risk of longer hospitalization, and the >80 age group had the highest risk for overall hospitalization period (median ratio = 1.52 [1.51-1.54]) and at ICU (median ratio = 1.17 [1.16-1.18]). Considering Tehran as the reference province, Sistan and Balcuchestan (aOR = 1.4 [1.32-1.48]), Alborz (aOR = 1.28 [1.22-1.35]), and Khorasan Razavi (aOR = 1.24 [1.20-1.28]) were the provinces with the highest risk of mortality in hospitalized patients. CONCLUSION Hospitalization data unveiled mortality and duration associations with variables, highlighting provincial outcome disparities in Iran. Using enhanced registry systems in conjunction with other studies, empowers policymakers with evidence for optimizing resource allocation and fortifying healthcare system resilience against future health challenges.
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Affiliation(s)
- Reza Mehrizi
- National Center for Health Insurance Research, Tehran, Iran
| | - Ali Golestani
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad-Reza Malekpour
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Karami
- National Center for Health Insurance Research, Tehran, Iran
| | - Mohammad Mahdi Nasehi
- National Center for Health Insurance Research, Tehran, Iran
- Pediatric Neurology Research Center, Research Institute for Children Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Effatpanah
- National Center for Health Insurance Research, Tehran, Iran
- School of Medicine, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehdi Rezaee
- National Center for Health Insurance Research, Tehran, Iran
- Department of Orthopedics, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Shahali
- National Center for Health Insurance Research, Tehran, Iran
| | - Ali Akbari Sari
- Department of Health Management, Policy and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Rajabali Daroudi
- Department of Health Management, Policy and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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Sun L, Zhang Y, Chen Y, Chen L, Lei M. Validation of phenomenon and cross-sectional investigation of predictors for a post-COVID-19 surge of osteoporosis outpatients in China. Sci Rep 2024; 14:4230. [PMID: 38378764 PMCID: PMC10879099 DOI: 10.1038/s41598-024-54858-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 02/17/2024] [Indexed: 02/22/2024] Open
Abstract
An unexpected surge of osteoporosis outpatients occurred after COVID-19 lockdown was lifted in China. To confirm the observation and identify possible reasons driving patients care seeking behaviors post-pandemic, we compared the outpatient volumes at the osteoporosis clinic in January through May, 2019-2022 and surveyed seven osteoporosis specialists across China to validate the phenomenon before devising an online questionnaire to collect patients' characters and physical activity levels. Univariate and binary logistic regression analyses were calculated to identify predictors of post-lockdown care-seeking. We received 480 valid responses, including 397 (82.7%) patients having visited the clinic after lockdown and 83 (17.3%) having not. Four significant predictors were identified, including being female, experiencing pain, aggravating symptoms, and heightened anxiety during lockdown (P < 0.05). Both groups experienced lower physical activity levels during lockdown, which however was not a significant predictor (P = 0.317). The surge in osteoporosis outpatient visits after COVID-19 lockdown suggests vast latent demand for osteoporosis care accumulated during the pandemic. Four significant factors predict post-lockdown outpatient care-seeking, including being female, experiencing pain and aggravating symptoms, and heightened anxiety levels. Though physical activity levels decreased during lockdown, it failed to predict care-seeking. This demonstrates resilience of osteoporosis patients to resume regular care despite disruption and stress the substantial backlog of unmet healthcare needs.
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Affiliation(s)
- Lei Sun
- Department of Osteoporosis, Non-Communicable Diseases Research Center, West China-PUMC C.C. Chen Institute of Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, 610041, Sichuan, People's Republic of China
| | - Yuehua Zhang
- Department of Osteoporosis, Non-Communicable Diseases Research Center, West China-PUMC C.C. Chen Institute of Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, 610041, Sichuan, People's Republic of China
| | - Yao Chen
- Department of Osteoporosis, Non-Communicable Diseases Research Center, West China-PUMC C.C. Chen Institute of Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, 610041, Sichuan, People's Republic of China
| | - Li Chen
- Department of Medical Records, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, 610041, Sichuan, People's Republic of China
| | - Mei Lei
- Department of Orthopaedics Medical Center, West China School of Public Health and West China Fourth Hospital, Sichuan University, #18 3Rd Section, Renmin Nan Road, Chengdu, 610041, Sichuan, People's Republic of China.
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10
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Malijan GMB, Besa JJV, Mendoza J, Uy EJB, Yan LL, Østbye T, Palileo-Villanueva L. Assessing COVID-19 pandemic's impact on essential diabetes care in Manila, the Philippines: A mixed methods study. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0002333. [PMID: 38261582 PMCID: PMC10805280 DOI: 10.1371/journal.pgph.0002333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Accepted: 01/02/2024] [Indexed: 01/25/2024]
Abstract
The COVID-19 pandemic directly increased mortality and morbidity globally. In addition, it has had extensive indirect ill effects on healthcare service delivery across health systems worldwide. We aimed to describe how patient access to diabetes care was affected by the pandemic in Manila, the Philippines. We used an explanatory, sequential mixed method approach including a cross-sectional survey (n = 150) and in-depth interviews of patients (n = 19), focus group discussions of healthcare workers (n = 22), and key informant interviews of health facility administrators (n = 3) from October 2021 to January 2022. Larger proportions of patients reported absence of livelihood (67.3%), being in the lowest average monthly household income group (17.3%), and disruptions in diabetes care (54.0%) during the pandemic. They identified the imposition of lockdowns, covidization of the healthcare system, and financial instability as contributors to the reduced availability, accessibility, and affordability of diabetes-related consultations, medications, and diagnostics. At least a quarter of the patients experienced catastrophic health expenditures across all areas of diabetes care during the pandemic. Most healthcare workers and administrators identified telemedicine as a potential but incomplete tool for reaching more patients, especially those deemed lost to follow-up. In the Philippines, the pandemic negatively impacted access to essential diabetes care.
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Affiliation(s)
- Greco Mark B. Malijan
- San Lazaro Hospital–Nagasaki University Collaborative Research Office, Manila, Philippines
| | - John Jefferson V. Besa
- College of Medicine, University of the Philippines Manila, Manila, Philippines
- Department of Medicine, Philippine General Hospital, University of the Philippines Manila, Manila, Philippines
| | - Jhaki Mendoza
- College of Medicine, University of the Philippines Manila, Manila, Philippines
| | | | - Lijing L. Yan
- Global Health Research Center, Duke Kunshan University, Jiangsu Province, China
- School of Public Health, Wuhan University, Wuhan, China
| | - Truls Østbye
- Global Health Research Center, Duke Kunshan University, Jiangsu Province, China
- Department of Family Medicine and Community Health, Duke University, Durham, North Carolina, United States of America
| | - Lia Palileo-Villanueva
- College of Medicine, University of the Philippines Manila, Manila, Philippines
- Department of Medicine, Philippine General Hospital, University of the Philippines Manila, Manila, Philippines
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11
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Balasubramani K, Ravichandran V, Prasad KA, Ramkumar M, Shekhar S, James MM, Kodali NK, Behera SK, Gopalan N, Sharma RK, Sarma DK, Santosh M, Dash AP, Balabaskaran Nina P. Spatio-temporal epidemiology and associated indicators of COVID-19 (wave-I and II) in India. Sci Rep 2024; 14:220. [PMID: 38167962 PMCID: PMC10761923 DOI: 10.1038/s41598-023-50363-2] [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: 08/13/2022] [Accepted: 12/19/2023] [Indexed: 01/05/2024] Open
Abstract
The spatio-temporal distribution of COVID-19 across India's states and union territories is not uniform, and the reasons for the heterogeneous spread are unclear. Identifying the space-time trends and underlying indicators influencing COVID-19 epidemiology at micro-administrative units (districts) will help guide public health strategies. The district-wise daily COVID-19 data of cases and deaths from February 2020 to August 2021 (COVID-19 waves-I and II) for the entire country were downloaded and curated from public databases. The COVID-19 data normalized with the projected population (2020) and used for space-time trend analysis shows the states/districts in southern India are the worst hit. Coastal districts and districts adjoining large urban regions of Mumbai, Chennai, Bengaluru, Goa, and New Delhi experienced > 50,001 cases per million population. Negative binomial regression analysis with 21 independent variables (identified through multicollinearity analysis, with VIF < 10) covering demography, socio-economic status, environment, and health was carried out for wave-I, wave-II, and total (wave-I and wave-II) cases and deaths. It shows wealth index, derived from household amenities datasets, has a high positive risk ratio (RR) with COVID-19 cases (RR: 3.577; 95% CI: 2.062-6.205) and deaths (RR: 2.477; 95% CI: 1.361-4.506) across the districts. Furthermore, socio-economic factors such as literacy rate, health services, other workers' rate, alcohol use in men, tobacco use in women, overweight/obese women, and rainfall have a positive RR and are significantly associated with COVID-19 cases/deaths at the district level. These positively associated variables are highly interconnected in COVID-19 hotspot districts. Among these, the wealth index, literacy rate, and health services, the key indices of socio-economic development within a state, are some of the significant indicators associated with COVID-19 epidemiology in India. The identification of district-level space-time trends and indicators associated with COVID-19 would help policymakers devise strategies and guidelines during public health emergencies.
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Affiliation(s)
- Karuppusamy Balasubramani
- Department of Geography, School of Earth Sciences, Central University of Tamil Nadu, Thiruvarur, 610005, India
| | - Venkatesh Ravichandran
- Department of Civil Engineering, Indian Institute of Technology Guwahati, Guwahati, 781039, India
| | - Kumar Arun Prasad
- Department of Geography, School of Earth Sciences, Central University of Tamil Nadu, Thiruvarur, 610005, India
| | - Mu Ramkumar
- Department of Geology, Periyar University, Salem, India
| | - Sulochana Shekhar
- Department of Geography, School of Earth Sciences, Central University of Tamil Nadu, Thiruvarur, 610005, India
| | - Meenu Mariya James
- Department of Epidemiology and Public Health, School of Life Sciences, Central University of Tamil Nadu, Thiruvarur, 610005, India
| | - Naveen Kumar Kodali
- Department of Epidemiology and Public Health, School of Life Sciences, Central University of Tamil Nadu, Thiruvarur, 610005, India
| | - Sujit Kumar Behera
- Department of Epidemiology and Public Health, School of Life Sciences, Central University of Tamil Nadu, Thiruvarur, 610005, India
| | - Natarajan Gopalan
- Department of Epidemiology and Public Health, School of Life Sciences, Central University of Tamil Nadu, Thiruvarur, 610005, India
| | - Rakesh Kumar Sharma
- Shree Guru Gobind Singh Tricentenary University, Gurugram, New-Delhi-NCR, 122505, India
| | - Devojit Kumar Sarma
- ICMR- National Institute for Research in Environmental Health, Bhopal Bypass Road, Bhouri, Bhopal, Madhya Pradesh, India
| | - M Santosh
- School of Earth Sciences and Resources, China University of Geosciences, Beijing, People's Republic of China
- Department of Earth Sciences, University of Adelaide, Adelaide, SA, Australia
| | - Aditya Prasad Dash
- Asian Institute of Public Health University, Phulnakhara, Cuttack, Odisha, 754001, India
| | - Praveen Balabaskaran Nina
- Department of Public Health and Community Medicine, Central University of Kerala, Kasaragod, Kerala, 671316, India.
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12
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Mpinda B, Kabongo CD, Yoko JLM, Tumbo J. Knowledge, attitudes, and practices of chronic disease patients in Bojanala towards COVID-19. S Afr Fam Pract (2004) 2023; 65:e1-e8. [PMID: 37916699 PMCID: PMC10623641 DOI: 10.4102/safp.v65i1.5763] [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: 04/18/2023] [Revised: 07/31/2023] [Accepted: 08/03/2023] [Indexed: 11/03/2023] Open
Abstract
BACKGROUND COVID-19 is an acute respiratory disease. Its morbidity and mortality in patients with comorbidities have been established. This study evaluated the knowledge, attitude and practices regarding COVID-19 of patients with comorbidities attending primary health care services. METHODS An analytical cross-sectional study was conducted, with data collected from patients using a self-administered questionnaire. Knowledge, attitude and practice scores were calculated. Descriptive and inferential statistical analyses were used, and the level of significance was set at 5%. RESULTS This study enrolled 469 participants aged 18-84 years, and the majority were women. The mean knowledge score was 7.09 ± 1.73 out of 9, the mean attitude score was 2.33 ± 0.86 out of 3, and the mean practices score was 3.79 ± 0.56 out of 4. There was a positive linear relationship between knowledge and attitude scores and between attitude and practices scores; as one score increased, the other also increased significantly. CONCLUSION The level of knowledge was good in general, with optimistic attitudes and good practices by the patients. Those aged 70 years and above need special attention because older persons have poorer knowledge of and practices towards COVID-19, which could lead to higher hospitalisation and mortality rates.Contribution: This study found that patients with chronic diseases had good COVID-19 knowledge, attitudes and practices, while interventions targeting patients aged 70 years and above are needed to improve their COVID-19 awareness and practices.
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Affiliation(s)
- Beya Mpinda
- Department of Family Medicine, Sefako Magkatho Health Sciences University, Pretoria.
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13
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Tannor EK, Quentin W, Busse R, Opoku D, Amuasi J. Impact of COVID-19 on health service utilisation in sub-Saharan Africa: protocol for a scoping review. BMJ Open 2023; 13:e074769. [PMID: 37751950 PMCID: PMC10533669 DOI: 10.1136/bmjopen-2023-074769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Accepted: 08/30/2023] [Indexed: 09/30/2023] Open
Abstract
INTRODUCTION The COVID-19 pandemic has exposed weaknesses in health systems of many countries, including those in sub-Saharan Africa. Despite comparatively low rates of COVID-19 admissions and deaths in sub-Saharan Africa, the pandemic still had a significant impact by disrupting health service utilisation (HSU). The aim of this scoping review is to synthesise the available evidence on HSU in sub-Saharan Africa during the COVID-19 pandemic, especially focusing on (1) changes in HSU compared with the prepandemic period, (2) changes in HSU among particular patient groups studied and (3) identifying factors determining changes in HSU as a result of the COVID-19 pandemic. METHOD AND ANALYSIS The scoping review will be guided by the methodological framework for conducting scoping reviews developed by Arskey and O'Malley. We will identify relevant studies on HSU in sub-Saharan Africa during the COVID-19 pandemic using PubMed (MEDLINE), Embase, Scopus and Web of Science databases from 1 December, 2019 to 31 March 2023. We will search grey literature, government and organisational websites for reports and conference proceedings. Included studies will be restricted to those reported in English or French. Two reviewers will independently screen articles at the title and abstract stage for inclusion into full text screening. We will provide a general descriptive overview, tabular summaries and content analysis for the extracted data. ETHICS AND DISSEMINATION Ethical approval is not required for the conduct of the scoping review. We will disseminate our findings via open access peer-reviewed journals and scientific presentations. Our scoping review findings will help to determine the feasibility of a subsequent systematic review (and meta-analysis) on HSU during the COVID-19 pandemic.
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Affiliation(s)
- Elliot Koranteng Tannor
- School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- Department of Global Health, German-West African Center for Global Health and Pandemic Preparedness, Kumasi, Ghana
| | - Wilm Quentin
- Department of Health Care Management, Technische Universität Berlin, Berlin, Germany
- Department of Health Care Management, German-West African Center for Global Health and Pandemic Preparedness, Berlin, Germany
| | - Reinhard Busse
- Department of Health Care Management, Technische Universität Berlin, Berlin, Germany
- Department of Health Care Management, German-West African Center for Global Health and Pandemic Preparedness, Berlin, Germany
| | - Daniel Opoku
- School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- Department of Global Health, German-West African Center for Global Health and Pandemic Preparedness, Kumasi, Ghana
- Department of Health Care Management, Technische Universität Berlin, Berlin, Germany
| | - John Amuasi
- School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- Department of Global Health, German-West African Center for Global Health and Pandemic Preparedness, Kumasi, Ghana
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14
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Shu J, Jin W. Prioritizing non-communicable diseases in the post-pandemic era based on a comprehensive analysis of the GBD 2019 from 1990 to 2019. Sci Rep 2023; 13:13325. [PMID: 37587173 PMCID: PMC10432467 DOI: 10.1038/s41598-023-40595-7] [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: 03/22/2023] [Accepted: 08/14/2023] [Indexed: 08/18/2023] Open
Abstract
This study aimed to assess the burden of communicable diseases (CDs) and non-communicable diseases (NCDs) globally, regionally, and nationally from 1990 to 2019, and propose global strategies to transform the public health policy. Using data from the Global Burden of Disease Study (GBD) 2019, we analyzed CDs and NCDs across various factors such as sex, age, year, and location, and evaluate the temporal trends of these diseases with joinpoint analysis. We also examined the differences between regions based on their socio-demographic index (SDI). In 2019, there were 7,862,907 (95% uncertainty interval [UI], 7,183,475 to 8,654,104) deaths from CDs and 42,034,124 (40,081,323 to 43,942,475) deaths from NCDs recorded worldwide. The low SDI region had markedly high age-standardized death and DALY rates of CDs. Although the age-standardized incidence rate of CDs has decreased in about half of the regions since 1990, NCDs have been on the rise in most regions. Over the past 30 years, the global burden of CDs has decreased significantly, while the burden of NCDs has aggrandized to an extent. In the post-pandemic era, effective interventions and cooperation among countries should be promoted to allocate medical resources more reasonably and improve healthcare for NCD patients.
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Affiliation(s)
- Jianhao Shu
- The Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, 310053, China
| | - Weifeng Jin
- College of Pharmaceutical Science, Zhejiang Chinese Medical University, Hangzhou, 310053, China.
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15
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Baquerizo-Sedano L, Goni L, Sayón-Orea C, González-Muniesa P. A U-shaped protection of altitude against mortality and infection of COVID-19 in Peru: an ecological study. BMC Public Health 2023; 23:1054. [PMID: 37264338 DOI: 10.1186/s12889-023-15537-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Accepted: 03/27/2023] [Indexed: 06/03/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has affected the world in multiple ways and has been a challenge for the health systems of each country. From the beginning, risk factors for the severity and mortality of the disease were considered, as the spread of the virus was related to the living conditions of each population. METHODS In this ecological study we have evaluated the role of geography, precisely the altitude above sea level in the incidence and mortality of COVID-19 in Peru. Incidence and mortality data were taken from the open-access database of the government of Peru until March 2021. COVID-19 cases and COVID-19 mortality were treated as cases/density population and 1000 x cases/inhabitants while altitude was treated as continuous and as a categorical variable divided in 7 categories. The relationship between COVID-19 cases or deaths for COVID-19 and altitude as continuous variable was determined using Spearman correlation test. Meanwhile when altitude was considered as a categorical variable, Poisson regression or negative binomial analyses were applied. RESULTS A significant inverse correlation was found between COVID-19 cases by population density and altitude (r=-0.37 p < 0.001). By altitude categories, the lowest risk for infection was observed between 3,000 and 3,500 m (IRR 0.08; 95% CI 0.05,0.12). Moreover, we found an inverse correlation between altitude and COVID-19 mortality (r=-0.39 p < 0.001). Also, the lowest risk for mortality was observed between 3,000 and 3,500 m (IRR 0.12; 95%CI 0.08; 0.18). Similar results were found when analyses were adjusted for inhabitants and stratified by sex. CONCLUSION This study reports an inverse relationship between COVID-19 incidence and mortality with respect to the altitude of residence, particularly, a u-shaped protection is shown, with a highest benefit between 3000 and 3500 m. The possibility of using hypoxia as an alternative treatment requires more complex studies that should allow knowing the physiological and environmental mechanisms of the protective role.
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Affiliation(s)
- L Baquerizo-Sedano
- Facultad de Ciencias de la Salud, Universidad Privada del Norte, Lima, Peru
- Faculty of Pharmacy and Nutrition, Department of Food Sciences and Physiology, University of Navarra, Pamplona, Spain
- Center for Nutrition Research, University of Navarra, Pamplona, Spain
| | - L Goni
- Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain
- IDISNA - Navarra Institute for Health Research, Pamplona, Spain
- CIBER Physiopathology of Obesity and Nutrition (CIBERobn), Carlos III Health Institute (ISCIII), Madrid, Spain
| | - C Sayón-Orea
- Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain
- IDISNA - Navarra Institute for Health Research, Pamplona, Spain
- CIBER Physiopathology of Obesity and Nutrition (CIBERobn), Carlos III Health Institute (ISCIII), Madrid, Spain
- Navarra Public Health Institute, Pamplona, Spain
| | - P González-Muniesa
- Faculty of Pharmacy and Nutrition, Department of Food Sciences and Physiology, University of Navarra, Pamplona, Spain.
- Center for Nutrition Research, University of Navarra, Pamplona, Spain.
- IDISNA - Navarra Institute for Health Research, Pamplona, Spain.
- CIBER Physiopathology of Obesity and Nutrition (CIBERobn), Carlos III Health Institute (ISCIII), Madrid, Spain.
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16
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Acharya SD, Mukhtar Q, Richter P. Advancing Cardiovascular Disease Prevention, Management, and Control Through Field Epidemiology Training Programs in Noncommunicable Diseases in Low- and Middle-Income Countries. Prev Chronic Dis 2023; 20:E31. [PMID: 37115107 PMCID: PMC10159332 DOI: 10.5888/pcd20.220215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023] Open
Affiliation(s)
- Sushama D Acharya
- Program Implementation and Capacity Building Team, Office of Global Noncommunicable Diseases, Division of Global Health Protection, Centers for Disease Control and Prevention, 1600 Clifton Rd NE, MS H21-7, Atlanta, GA 30329
- Graham Technologies, LLC, Upper Marlboro, Maryland
| | - Qaiser Mukhtar
- Office of Global Noncommunicable Diseases, Division of Global Health Protection, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Patricia Richter
- Office of Global Noncommunicable Diseases, Division of Global Health Protection, Centers for Disease Control and Prevention, Atlanta, Georgia
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17
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Pitayarangsarit S, Bhagaman N, Yodmai K, Thangsirikul N, Tipayamongkholgul M. The resiliency of noncommunicable diseases services during the public health crisis: a lesson from Bangkok, Thailand. BMC Health Serv Res 2023; 23:409. [PMID: 37101168 PMCID: PMC10132400 DOI: 10.1186/s12913-023-09400-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 04/13/2023] [Indexed: 04/28/2023] Open
Abstract
BACKGROUND The healthcare services for non-communicable diseases (NCD) are commonly affected by public health crises like the COVID-19 pandemic. During the pandemic, all healthcare facilities in Bangkok had been overwhelmed by the extreme caseload of COVID-19. Health service resiliency is crucial for the continued service of healthcare facilities post pandemic. This study aims to explore the impacts of COVID-19 on NCD service disruption and addressed the resilience of healthcare services at the operational level. METHODS Healthcare facility-based surveys and in-depth interviews were conducted among representatives of the facilities in Bangkok from April 2021 to July 2021. The web-based, self-administered questionnaire, was sent to directors or authorities of all healthcare facilities in Bangkok Thailand (n = 169). Two healthcare facilities from three levels of health services were purposively selected. The directors or medical doctors and nurses who are in charge of the NCD service, and working at the six selected health facilities, were invited to participate in the in-depth interviews. Descriptive statistics were used to analyze the survey data, and thematic analysis was used to analyze the data from the in-depth interviews. RESULTS The impact of COVID-19 on NCD service disruption in the second wave (2021) was more severe than in the first wave (2020). The main reasons for NCD service disruptions are insufficient staff, and the closure of some services offered by the healthcare facilities. Surprisingly, both the budget and medical supply for healthcare facilities in Bangkok are less affected by the COVID-19 pandemic. Our study revealed resilience capability i.e. absorptive, adaptive, and transformative capabilityamong the healthcare facilities that provide a continuum of care by increasing availability and accessibility to healthcare services for chronic illness as DM. The service disruption in Bangkok may alter from other provinces because of variations in COVID-19 incidence and health services contexts. CONCLUSION During the public health crisis, using affordable and common digital technologies to ensure DM patients can access a continuum of care and providing alternative services such as mobile medical laboratories, medication delivery, and medical refill at drug stores can increase consistent monitoring of glycemic levels and use of prescribed medication.
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Affiliation(s)
- Siriwan Pitayarangsarit
- Division of Non-communicable Diseases, Department of Disease Control, Ministry of Public Health, Nonthaburi, Thailand
- International Health Policy Program, Ministry of Public Health, Nonthaburi, Thailand
| | - Nanapas Bhagaman
- Department of Epidemiology, Faculty of Public Health, Mahidol University, 420/1 Ratchawithi Road, Ratchathewi, Bangkok, 10400, Thailand
| | - Korravarn Yodmai
- Department of Family Health, Faculty of Public Health, Korravarn Yodmai, Mahidol University, 420/1 Ratchawithi Road, Ratchathewi, Bangkok, 10400, Thailand
| | - Nattaya Thangsirikul
- Division of Non-communicable Diseases, Department of Disease Control, Ministry of Public Health, Nonthaburi, Thailand
| | - Mathuros Tipayamongkholgul
- Department of Epidemiology, Faculty of Public Health, Mahidol University, 420/1 Ratchawithi Road, Ratchathewi, Bangkok, 10400, Thailand.
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18
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Fornasini M, Sisa I, Baldeon ME. Increased Cardiovascular Mortality in Ecuador during COVID-19 Pandemic. Ann Glob Health 2023; 89:21. [PMID: 37034452 PMCID: PMC10077983 DOI: 10.5334/aogh.4021] [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: 11/17/2022] [Accepted: 02/18/2023] [Indexed: 04/08/2023] Open
Abstract
Before the COVID-19 pandemic, chronic noncommunicable diseases (NCDs), represented a high burden for low and middle-income countries. Patients with NCDs are at higher risk of COVID-19 and suffer worse clinical outcomes. We present mortality trends for myocardial infarction (AMI), stroke, hypertension (HT), and type-2 diabetes mellitus (T2DM) from 2005 to 2021 in Ecuador. The greatest increase in mortality observed in the pandemic was in AMI, T2DM, and HT. Factors related to COVID-19, health services, and patients with NCDs could contribute to these important increases in mortality.
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Affiliation(s)
- Marco Fornasini
- Facultad de Ciencias de la Salud y de la Vida, Universidad Internacional del Ecuador (UIDE), Quito, Ecuador
| | - Ivan Sisa
- Escuela de Medicina, Universidad San Francisco de Quito USFQ, Quito, Ecuador
| | - Manuel E. Baldeon
- Facultad de Ciencias de la Salud y de la Vida, Universidad Internacional del Ecuador (UIDE), Quito, Ecuador
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Daga A, Bjornstad EC, McCarthy F, Bonilla-Felix M. World Kidney Day 2023: preparing for the unexpected, supporting the vulnerable! Pediatr Nephrol 2023; 38:1697-1699. [PMID: 36941486 PMCID: PMC10027260 DOI: 10.1007/s00467-023-05945-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 03/09/2023] [Accepted: 03/09/2023] [Indexed: 03/23/2023]
Affiliation(s)
- Ankana Daga
- Division of Nephrology, Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
| | - Erica C Bjornstad
- Division of Nephrology, Department of Pediatrics, Children's of Alabama, University of Alabama Birmingham, Birmingham, AL, USA
| | | | - Melvin Bonilla-Felix
- Department of Pediatrics, Medical Sciences Campus, University of Puerto Rico, PO Box 365067, San Juan, 00936-5067, Puerto Rico
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Flexner N, Ng AP, Ahmed M, Khandpur N, Acton RB, Lee JJ, L’Abbe MR. Estimating the dietary and health impact of implementing front-of-pack nutrition labeling in Canada: A macrosimulation modeling study. Front Nutr 2023; 10:1098231. [PMID: 37006927 PMCID: PMC10065472 DOI: 10.3389/fnut.2023.1098231] [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: 11/14/2022] [Accepted: 03/01/2023] [Indexed: 03/19/2023] Open
Abstract
Background Front-of-pack labeling (FOPL) has been identified as a cost-effective policy to promote healthy diets. Health Canada has recently published FOPL regulations that will require food and beverages that meet or exceed set thresholds for sodium, sugars, or saturated fat to display a 'high in' symbol on the front of the package. Although a promising measure, its potential impact on dietary intakes and health have not yet been estimated in Canada. Objective This study aims to estimate (1) the potential dietary impact of implementing a mandatory FOPL among Canadian adults; and (2) the number of diet-related non-communicable disease (NCD) deaths that could be averted or delayed due to these estimated dietary changes. Methods Baseline and counterfactual usual intakes of sodium, total sugars, saturated fats, and calories were estimated among Canadian adults (n = 11,992) using both available days of 24 h recalls from the 2015 Canadian Community Health Survey-Nutrition. The National Cancer Institute method was used to estimate usual intakes, and adjusted for age, sex, misreporting status, weekend/weekday, and sequence of recall. Estimated counterfactual dietary intakes were modeled from reductions observed in experimental and observational studies that examined changes in sodium, sugars, saturated fat, and calorie content of food purchases in the presence of a 'high in' FOPL (four counterfactual scenarios). The Preventable Risk Integrated ModEl was used to estimate potential health impacts. Results Estimated mean dietary reductions were between 31 and 212 mg/day of sodium, 2.3 and 8.7 g/day of total sugars, 0.8 and 3.7 g/day of saturated fats, and 16 and 59 kcal/day of calories. Between 2,183 (95% UI 2,008-2,361) and 8,907 (95% UI 8,095-9,667) deaths due to diet-related NCDs, mostly from cardiovascular diseases (~70%), could potentially be averted or delayed by implementing a 'high in' FOPL in Canada. This estimation represents between 2.4 and 9.6% of the total number of diet-related NCD deaths in Canada. Conclusion Results suggest that implementing a FOPL could significantly reduce sodium, total sugar, and saturated fat intakes among Canadian adults and subsequently prevent or postpone a substantial number of diet-related NCD deaths in Canada. These results provide critical evidence to inform policy decisions related to implementing FOPL in Canada.
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Affiliation(s)
- Nadia Flexner
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Alena P. Ng
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Mavra Ahmed
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Joannah and Brian Lawson Centre for Child Nutrition, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Neha Khandpur
- Department of Human Nutrition and Health, Wageningen University, Wageningen, Netherlands
- Center for Epidemiological Research in Nutrition and Health, School of Public Health, University of São Paulo, São Paulo, Brazil
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Harvard University, Boston, MA, United States
| | - Rachel B. Acton
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada
| | - Jennifer J. Lee
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Mary R. L’Abbe
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
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Gonçalves RL, Pagano AS, Reis ZSN, Brackstone K, Lopes TCP, Cordeiro SA, Nunes JM, Afagbedzi SK, Head M, Meira W, Batchelor J, Ribeiro ALP. Usability of Telehealth Systems for Noncommunicable Diseases in Primary Care From the COVID-19 Pandemic Onward: Systematic Review. J Med Internet Res 2023; 25:e44209. [PMID: 36787223 PMCID: PMC10022651 DOI: 10.2196/44209] [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: 11/10/2022] [Revised: 01/25/2023] [Accepted: 02/06/2023] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND During the COVID-19 pandemic, telehealth was expanded without the opportunity to extensively evaluate the adopted technology's usability. OBJECTIVE We aimed to synthesize evidence on health professionals' perceptions regarding the usability of telehealth systems in the primary care of individuals with noncommunicable diseases (NCDs; hypertension and diabetes) from the COVID-19 pandemic onward. METHODS A systematic review was performed of clinical trials, prospective cohort studies, retrospective observational studies, and studies that used qualitative data collection and analysis methods published in English, Spanish, and Portuguese from March 2020 onward. The databases queried were MEDLINE, Embase, BIREME, IEEE Xplore, BVS, Google Scholar, and grey literature. Studies involving health professionals who used telehealth systems in primary care and managed patients with NCDs from the COVID-19 pandemic onward were considered eligible. Titles, abstracts, and full texts were reviewed. Data were extracted to provide a narrative qualitative evidence synthesis of the included articles. The risk of bias and methodological quality of the included studies were analyzed. The primary outcome was the usability of telehealth systems, while the secondary outcomes were satisfaction and the contexts in which the telehealth system was used. RESULTS We included 11 of 417 retrieved studies, which had data from 248 health care professionals. These health care professionals were mostly doctors and nurses with prior experience in telehealth in high- and middle-income countries. Overall, 9 studies (82%) were qualitative studies and 2 (18%) were quasiexperimental or multisite trial studies. Moreover, 7 studies (64%) addressed diabetes, 1 (9%) addressed diabetes and hypertension, and 3 (27%) addressed chronic diseases. Most studies used a survey to assess usability. With a moderate confidence level, we concluded that health professionals considered the usability of telehealth systems to be good and felt comfortable and satisfied. Patients felt satisfied using telehealth. The most important predictor for using digital health technologies was ease of use. The main barriers were technological challenges, connectivity issues, low computer literacy, inability to perform complete physical examination, and lack of training. Although the usability of telehealth systems was considered good, there is a need for research that investigates factors that may influence the perceptions of telehealth usability, such as differences between private and public services; differences in the level of experience of professionals, including professional experience and experience with digital tools; and differences in gender, age groups, occupations, and settings. CONCLUSIONS The COVID-19 pandemic has generated incredible demand for virtual care. Professionals' favorable perceptions of the usability of telehealth indicate that it can facilitate access to quality care. Although there are still challenges to telehealth, more than infrastructure challenges, the most reported challenges were related to empowering people for digital health. TRIAL REGISTRATION PROSPERO International Prospective Register of Systematic Reviews CRD42021296887; https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=296887. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.21801/ppcrj.2022.82.6.
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Affiliation(s)
- Roberta Lins Gonçalves
- Hospital das Clínicas da Universidade Federal de Minas Gerais, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
- Universidade Federal do Amazonas, Faculdade de Educação Física e Fisioterapia, Manaus, Brazil
| | | | | | | | | | - Sarah Almeida Cordeiro
- Universidade Federal do Amazonas, Faculdade de Educação Física e Fisioterapia, Manaus, Brazil
| | - Julia Macedo Nunes
- Department of Linguistics, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Michael Head
- University of Southampton, Southampton, United Kingdom
| | - Wagner Meira
- Department of Linguistics, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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22
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Hsiao LL, Shah KM, Liew A, Abdellatif D, Balducci A, Haris Á, Kumaraswami LA, Liakopoulos V, Lui SF, Ulasi I, Langham RG. Kidney health for all: preparedness for the unexpected in supporting the vulnerable. Kidney Int 2023; 103:436-443. [PMID: 36822747 DOI: 10.1016/j.kint.2022.12.013] [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: 11/04/2022] [Revised: 12/19/2022] [Accepted: 12/20/2022] [Indexed: 02/23/2023]
Abstract
As the rate of natural disasters and other devastating events caused by human activities increases, the burden on the health and well-being of those affected by kidney disease has been immeasurable. Health system preparedness, which involves creating a resilient system that is able to deal with the health needs of the entire community during times of unexpected disruptions to usual care, has become globally important. In the wake of the COVID-19 pandemic, there is a heightened awareness of the amplification of negative effects on the renal community. Paradoxically, the complex medical needs of those who have kidney diseases are not met by systems handling crises, often compounded by an acute increase in burden via new patients as a result of the crisis itself. Disruptions in kidney care as a result of unexpected events are becoming more prevalent and likely to increase in the years to come. It is therefore only appropriate that the theme for this year's World Kidney Day will focus on Kidney Health for All: preparedness for the unexpected in supporting the vulnerable.
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Affiliation(s)
- Li-Li Hsiao
- Renal Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
| | - Kavya M Shah
- Renal Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Adrian Liew
- Department of Renal Medicine, Mount Elizabeth Novena Hospital, Singapore
| | - Dina Abdellatif
- Department of Nephrology, Cairo University Hospital, Cairo, Egypt
| | | | - Ágnes Haris
- Nephrology Department, Péterfy Hospital, Budapest, Hungary
| | - Latha A Kumaraswami
- Tamilnad Kidney Research (TANKER) Foundation, The International Federation of Kidney Foundations-World Kidney Alliance (IFKF-WKA), Chennai, India
| | - Vassilios Liakopoulos
- Division of Nephrology and Hypertension, 1st Department of Internal Medicine, AHEPA Hospital Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Siu-Fai Lui
- International Federation of Kidney Foundations-World Kidney Alliance, Hong Kong, China; The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Ifeoma Ulasi
- Department of Medicine, College of Medicine, University of Nigeria/University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, Nigeria
| | - Robyn G Langham
- Department of Medicine, St. Vincent's Hospital, University of Melbourne, Melbourne, Victoria, Australia
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23
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Shrivastav R, Rawal T, Kataria I, Mehrotra R, Bassi S, Arora M. Accelerating policy response to curb non-communicable diseases: an imperative to mitigate the dual public health crises of non-communicable diseases and COVID-19 in India. THE LANCET REGIONAL HEALTH. SOUTHEAST ASIA 2023; 10:100132. [PMID: 36570060 PMCID: PMC9763206 DOI: 10.1016/j.lansea.2022.100132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 12/04/2022] [Accepted: 12/09/2022] [Indexed: 12/24/2022]
Abstract
Non-communicable Diseases (NCDs) are a threat to public health and sustainable development. NCDs were equated to being a 'pandemic' before COVID-19 originated. Globally, NCDs caused approximately 74% of deaths (2019). India accounted for nearly 14.5% of these deaths. NCDs and COVID-19 have a lethal bi-directional relationship with both exacerbating each other's impact. Health systems and populations, particularly in Low- and Middle-Income Countries (LMICs) like India have among the highest burden of COVID-19. This narrative review tracks key policy and programmatic developments on NCD prevention and control in India, with a focus on commercially-driven risk factors (tobacco and alcohol use, unhealthy diet, physical inactivity, and air pollution), and the corresponding NCD targets. It identifies lacunae and recommends urgent policy-focussed multi-dimensional action, to ameliorate the dual impact of NCDs and COVID-19. India's comprehensive response to NCDs can steer national, regional and global progress towards time-bound NCD targets and NCD-related Sustainable Development Goals (SDGs). Funding This work is supported by the Commonwealth Foundation. None of the authors were paid to write this article by a pharmaceutical company or other agency. The authors were not precluded from accessing data and accept responsibility to submit for publication.
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Affiliation(s)
- Radhika Shrivastav
- HRIDAY (Health Related Information Dissemination Amongst Youth), New Delhi, India
| | - Tina Rawal
- HRIDAY (Health Related Information Dissemination Amongst Youth), New Delhi, India,Public Health Foundation of India, Gurugram, Haryana, India
| | - Ishu Kataria
- Center for Global Noncommunicable Diseases, RTI International, New Delhi, India
| | - Ravi Mehrotra
- Centre for Health Innovation and Policy (CHIP) Foundation, Noida, Uttar Pradesh, India
| | - Shalini Bassi
- HRIDAY (Health Related Information Dissemination Amongst Youth), New Delhi, India,Public Health Foundation of India, Gurugram, Haryana, India
| | - Monika Arora
- HRIDAY (Health Related Information Dissemination Amongst Youth), New Delhi, India,Public Health Foundation of India, Gurugram, Haryana, India,Corresponing author. HRIDAY, N-25, Second Floor, Green Park Extension, New Delhi, 110016, India
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24
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Revu J, Anand MP, Aadil R, Mini GK. Non-communicable disease management: Access to healthcare during COVID-19 pandemic in rural Kerala, India. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2023; 20:101231. [PMID: 36691659 PMCID: PMC9850649 DOI: 10.1016/j.cegh.2023.101231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Revised: 01/12/2023] [Accepted: 01/16/2023] [Indexed: 01/20/2023] Open
Abstract
Background Globally, data on the coronavirus disease (COVID-19) pandemic showed a higher risk of infection and complications in people with non-communicable diseases (NCDs). In India, the prevalence of NCDs and their risk factors vary significantly between states. Compared to other states, Kerala has the highest prevalence of non-communicable diseases in the country, along with the highest proportion of the elderly population. The study evaluates the disease management patterns and changes in healthcare behaviors among adults with NCDs in Kerala during the COVID-19 pandemic. Methods A cross-sectional study was conducted among 410 adult NCD patients in rural Thiruvananthapuram district, Kerala. Using a semi-structured interview schedule, the present study gathered information on socio-demographic characteristics, disease patterns, healthcare utilization, and behavioral change during the pandemic. Results Mean age of the participants was 62 years (range: 37-88; women: 64%). The most prevalent NCD was hypertension (74%) and diabetes (65%) followed by chronic respiratory disease (12%), cardiovascular disease (11%), and cancer (2%). Nearly 76% had difficulty in obtaining consultation/medical follow-up. Around 10% relied on telecommunication and 32% reported increased stress during the pandemic. Those with low socio-economic status and with a single NCD were more vulnerable to the challenges faced during the pandemic. Conclusion A higher proportion of adults with NCDs faced difficulties in healthcare access and had negative healthcare behaviors during the pandemic. The findings highlight the need to ensure better healthcare for people living with NCDs during the times of pandemic.
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Affiliation(s)
- J Revu
- Global Institute of Public Health, Ananthapuri Hospitals and Research Institute, Thiruvananthapuram, Kerala, India
| | - Marthada Pillai Anand
- Global Institute of Public Health, Ananthapuri Hospitals and Research Institute, Thiruvananthapuram, Kerala, India
- Department of Cardiology, Ananthapuri Hospitals and Research Institute, Thiruvananthapuram, Kerala, India
| | - Rafi Aadil
- Department of Cardiology, Ananthapuri Hospitals and Research Institute, Thiruvananthapuram, Kerala, India
| | - G K Mini
- Global Institute of Public Health, Ananthapuri Hospitals and Research Institute, Thiruvananthapuram, Kerala, India
- Department of Public Health Dentistry, Saveetha Dental Colleges & Hospitals, Saveetha Institute of Medical and Technical Sciences, Chennai, India
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25
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Lee LZ, Cheng SH. Impact of COVID-19 on dietary intake, sleeping patterns and physical activity levels among Malaysian University students. Int J Adolesc Med Health 2023; 35:209-217. [PMID: 36803949 DOI: 10.1515/ijamh-2022-0119] [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: 12/15/2022] [Accepted: 02/06/2023] [Indexed: 02/23/2023]
Abstract
OBJECTIVES The COVID-19 pandemic has brought a significant impact on people's behaviour and lifestyles. Limited research has been conducted on the impact of COVID-19 on Malaysian university students' lifestyle modifications. This study aims to identify the impact of COVID-19 on dietary intake, sleeping patterns and physical activity levels among Malaysian university students. METHODS A total of 261 university students were recruited. Sociodemographic and anthropometric data were collected. Dietary intake was assessed using PLifeCOVID-19 questionnaire, sleep quality was assessed using Pittsburgh Sleep Quality Index Questionnaire (PSQI) while physical activity level was assessed using International Physical Activity Questionnaire-Short Forms (IPAQ-SF). SPSS was used to perform statistical analysis. RESULTS 30.7% of the participants adhered to the unhealthy dietary pattern, 48.7% had poor quality of sleep and 59.4% engaged in low physical activity levels during the pandemic. Unhealthy dietary pattern was significantly associated with a lower IPAQ category (p=0.013), and increased time spent sitting (p=0.027) during the pandemic. Participants being underweight before the pandemic (aOR=2.472, 95% CI=1.358-4.499), increased takeaway meal consumption (aOR=1.899, 95% CI=1.042-3.461), increased snacking between meals consumption (aOR=2.989, 95% CI=1.653-5.404) and engaged in a low level of physical activity during pandemic (aOR=1.935, 95% CI=1.028-3.643) were the predictors of unhealthy dietary pattern. CONCLUSIONS The university students' dietary intake, sleeping patterns, and physical activity levels were impacted in different ways during the pandemic. Strategies and interventions should be developed and implemented to improve the dietary intake and lifestyle of the students.
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Affiliation(s)
- Le Zhen Lee
- School of Biosciences, Faculty of Science and Engineering, University of Nottingham Malaysia, Selangor, Malaysia
| | - Shi-Hui Cheng
- School of Biosciences, Faculty of Science and Engineering, University of Nottingham Malaysia, Selangor, Malaysia
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26
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Al‐Qudimat AR, Al Darwish MB, Elaarag M, Al‐Zoubi RM, Rejeb MA, Ojha LK, Nashwan AJ, Alshunag T, Adawi K, Omri AE, Aboumarzouk OM, Yassin A, Al‐Ansari AA. COVID‐19 effect on patients with noncommunicable diseases: A narrative review. Health Sci Rep 2023; 6:e995. [DOI: 10.1002/hsr2.995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 11/28/2022] [Accepted: 12/05/2022] [Indexed: 12/16/2022] Open
Affiliation(s)
- Ahmad R. Al‐Qudimat
- Department of Surgery, Surgical Research Section Hamad Medical Corporation Doha Qatar
- Department of Public Health Qatar University Doha Qatar
| | - Mohamed B. Al Darwish
- Department of Surgery, Surgical Research Section Hamad Medical Corporation Doha Qatar
| | - Mai Elaarag
- Department of Surgery, Surgical Research Section Hamad Medical Corporation Doha Qatar
| | - Raed M. Al‐Zoubi
- Department of Surgery, Surgical Research Section Hamad Medical Corporation Doha Qatar
- Department of Biomedical Sciences, QU‐Health, College of Health Sciences Qatar University Doha Qatar
- Department of Chemistry Jordan University of Science and Technology Irbid Jordan
| | - Mohamed Amine Rejeb
- Department of Surgery, Surgical Research Section Hamad Medical Corporation Doha Qatar
| | - Laxmi K. Ojha
- Department of Surgery, Surgical Research Section Hamad Medical Corporation Doha Qatar
| | | | | | - Karam Adawi
- Department of Public Health Qatar University Doha Qatar
| | - Abdelfettah El Omri
- Department of Surgery, Surgical Research Section Hamad Medical Corporation Doha Qatar
| | - Omar M. Aboumarzouk
- Department of Surgery, Surgical Research Section Hamad Medical Corporation Doha Qatar
- College of Medicine Qatar University Doha Qatar
- School of Medicine, Dentistry and Nursing The University of Glasgow Glasgow UK
| | - Aksam Yassin
- Department of Surgery, Surgical Research Section Hamad Medical Corporation Doha Qatar
- Center of Medicine and Health Sciences Dresden International University Dresden Germany
| | - Abdulla A. Al‐Ansari
- Department of Surgery, Surgical Research Section Hamad Medical Corporation Doha Qatar
- Hamad General Hospital Hamad Medical Corporation Doha Qatar
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Ayenigbara IO. Diabetes Prevention and Measures to Ensuring a Healthy Lifestyle during COVID-19 Pandemic and after. Korean J Fam Med 2023; 44:11-20. [PMID: 36709956 PMCID: PMC9887446 DOI: 10.4082/kjfm.21.0216] [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: 10/27/2021] [Accepted: 01/03/2022] [Indexed: 01/20/2023] Open
Abstract
The incidence of diabetes mellitus (DM) is increasing exponentially globally, with 90% of the confirmed cases being type 2 DM. The global incidence of DM is expected to increase by 48% during 2017-2045. The coronavirus disease 2019 (COVID-19) pandemic continues to have a massive impact on human health, causing sudden lifestyle changes through quarantine measures, such as lockdown, social distancing, various curfews, and isolation at home. This in turn might increase the risk of developing numerous chronic diseases, such as DM, obesity, and cardiovascular diseases, which increase the severity of COVID-19. To this end, we performed a comprehensive review to determine viable measures for the prevention of DM and its subsequent upsurge globally. Additionally, we have determined strategies that should be adopted globally to ensure a healthy lifestyle during the COVID-19 pandemic and later.
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Affiliation(s)
- Israel Oluwasegun Ayenigbara
- School and Community Health Promotion Unit, Department of Health Education, University of Ibadan, Ibadan, Nigeria,Corresponding Author: Israel Oluwasegun Ayenigbara https://orcid.org/0000-0002-0085-5493 Tel: +234-8139177538, Fax: +234-8098103043, E-mail:
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28
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Legesse E, Nigussie T, Girma D, Adugna Geleta L, Dejene H, Senbeta Deriba B, Abeya Geleta T, Hailu D, Teshome F, Midaksa G, Worku A, Tessema M, Negash D. Does knowledge of non-communicable diseases risk factors influence screening service utilization? The finding from North Shewa Zone, Central Ethiopia. Prev Med Rep 2022; 30:102040. [DOI: 10.1016/j.pmedr.2022.102040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 10/18/2022] [Accepted: 10/30/2022] [Indexed: 11/07/2022] Open
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Sandoval RC, Malik S, Roche M, Belausteguigoitia I, Morales-Zamora G. Lessons learned from fostering tobacco taxes in the Americas and implications for other health taxes. Rev Panam Salud Publica 2022; 46:e188. [PMID: 36339943 PMCID: PMC9621300 DOI: 10.26633/rpsp.2022.188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 05/13/2022] [Indexed: 11/05/2022] Open
Abstract
During the past decade progress has been made from a public health perspective in advancing tobacco taxation policies in the World Health Organization’s Region of the Americas, and there are important lessons to be learned from this experience. This report aims to systematize and distill the key lessons learned, both by documenting progress and paving the way toward a comprehensive approach to taxing other health-harming products, particularly those considered to be drivers of the noncommunicable disease epidemic, such as alcohol and sugar-sweetened beverages. A thorough review of publications and institutional documents was undertaken and discussions were held with experts about the experiences of the past decade. Broadly, the lessons can be characterized according to the main mechanisms that have fostered progress. These are the robust, consistent and standardized monitoring of tobacco taxes that has enabled comparisons between countries and across time; the setting of tax policy within a framework of multisectoral policy coherence; and the development of guidelines and the generation of independent evidence to support tobacco taxes and tackle harmful industry interference. Currently, progress in these areas is lagging for taxes on alcohol and sugar-sweetened beverages. Applying the lessons learned from the extensive experience with tobacco taxation can help advance progress in taxes on alcohol and sugar-sweetened beverages and capture the potential synergies to be gained from building a comprehensive approach. Although more work is needed in developing and implementing taxation policies across all three products, the findings from this report can assist in strengthening their public health objectives to tackle noncommunicable diseases and improve population health.
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Affiliation(s)
| | - Sehr Malik
- Pan American Health Organization, Washington D.C., United States of America
| | - Maxime Roche
- Imperial College Business School, Imperial College London, London, United Kingdom
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Napalai P, Seangpraw K, Boonyathee S, Ong-Artborirak P. COVID-19-related knowledge influences mental health, self-care behaviors, and quality of life among elderly with non-communicable diseases in Northern Thailand. Front Public Health 2022; 10:993531. [PMID: 36388338 PMCID: PMC9650286 DOI: 10.3389/fpubh.2022.993531] [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: 07/13/2022] [Accepted: 10/14/2022] [Indexed: 01/26/2023] Open
Abstract
Background A growing body of research shows that individuals with non-communicable diseases (NCDs), such as hypertension, diabetes, hypercholesterolemia, and heart disease, are more likely to suffer from severe COVID-19 and, subsequently, death. The purpose of this study was to assess the influence of COVID-19-related knowledge on mental health, healthcare behaviors, and quality of life among the elderly with NCDs in Northern Thailand. Methods In this cross-sectional study, the participants were 450 elderly people with NCDs, living in the Chiang Rai province, Northern Thailand. Random sampling was applied to select the subjects. Data collection included demographic information, COVID-19-related knowledge, healthcare behaviors, the Suanprung Stress Test-20, the Thai General Health Questionnaire (GHQ-28) for the assessment of mental health, and the Thai version of the World Health Organization Quality of Life-BREF. Results Almost half of the participants (45.6%) had poor knowledge about COVID-19. More than half of the sample had high stress (52.0%) and a low score in healthcare behaviors (64.9%), while approximately one-third of the participants had mental health problems (34.0%). The overall quality of life during the COVID-19 pandemic was moderate (70.7%). The score of COVID-19-related knowledge was significantly correlated with scores of stress (r = -0.85), mental health (r = -0.74), healthcare behaviors (r = 0.50), and quality of life (r = 0.33). Multiple linear regression found that history of COVID-19 detection and COVID-19-related knowledge were associated with scores of stress and quality of life (p < 0.05). Multiple logistic regression showed that history of COVID-19 detection (OR = 4.48, 95% CI = 1.45-13.84) and COVID-19-related knowledge (OR = 0.23, 95% CI = 0.17-0.31) were associated with mental health problem (p < 0.05). Discussion The findings emphasize the importance of COVID-19-related knowledge concerning the improvement of self-care behaviors and quality of life in the elderly population with NCDs during the pandemic, especially due to the high rate of stress and mental health problems documented in our sample. Health education interventions for this vulnerable population should be organized.
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Bai Y, Zhang Y, Zotova O, Pineo H, Siri J, Liang L, Luo X, Kwan MP, Ji J, Jiang X, Chu C, Cong N, Lin V, Summerskill W, Luo Y, Yu H, Wu T, Yang C, Li J, Xiao Y, Zhou J, Dou D, Xiong H, Zhang LL, Wang L, Tao S, Fu B, Zhang Y, Xu B, Yang J, Gong P. Healthy cities initiative in China: Progress, challenges, and the way forward. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2022; 27:100539. [PMID: 35854811 PMCID: PMC9286727 DOI: 10.1016/j.lanwpc.2022.100539] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
UNLABELLED China implemented the first phase of its National Healthy Cities pilot program from 2016-20. Along with related urban health governmental initiatives, the program has helped put health on the agenda of local governments while raising public awareness. Healthy City actions taken at the municipal scale also prepared cities to deal with the COVID-19 pandemic. However, after intermittent trials spanning the past two decades, the Healthy Cities initiative in China has reached a crucial juncture. It risks becoming inconsequential given its overlap with other health promotion efforts, changing public health priorities in response to the pandemic, and the partial adoption of the Healthy Cities approach advanced by the World Health Organization (WHO). We recommend aligning the Healthy Cities initiative in China with strategic national and global level agendas such as Healthy China 2030 and the Sustainable Development Goals (SDGs) by providing an integrative governance framework to facilitate a coherent intersectoral program to systemically improve population health. Achieving this alignment will require leveraging the full spectrum of best practices in Healthy Cities actions and expanding assessment efforts. FUNDING Tsinghua-Toyota Joint Research Fund "Healthy city systems for smart cities" program.
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Affiliation(s)
- Yuqi Bai
- Department of Earth System Science, Institute for Global Change Studies, Ministry of Education Key Laboratory for Earth System Modelling, Tsinghua University, Beijing, China
| | - Yutong Zhang
- Department of Earth System Science, Institute for Global Change Studies, Ministry of Education Key Laboratory for Earth System Modelling, Tsinghua University, Beijing, China
| | - Olena Zotova
- Faculty of Health and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain
| | - Helen Pineo
- Institute for Environmental Design and Engineering, University College London, WC1H 0NN London, UK
| | - José Siri
- Independent Consultant, Urban Health, Philadelphia, PA 19103, United States of America
| | - Lu Liang
- Department of Geography and the Environment, University of North Texas, 1155 Union Circle, Denton, TX 76203, United States of America
| | - Xiangyu Luo
- Department of Earth System Science, Institute for Global Change Studies, Ministry of Education Key Laboratory for Earth System Modelling, Tsinghua University, Beijing, China
| | - Mei-Po Kwan
- Department of Geography and Resource Management and Institute of Space and Earth Information Science, The Chinese University of Hong Kong, Shatin, Hong Kong, China
| | - John Ji
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Xiaopeng Jiang
- Office of the WHO Representative in People's Republic of China, WHO, Beijing, China
| | - Cordia Chu
- Centre for Environment and Population Health, School of Medicine and Dentistry, Griffith University, Nathan, QLD 4111, Australia
| | - Na Cong
- Department of Earth System Science, Institute for Global Change Studies, Ministry of Education Key Laboratory for Earth System Modelling, Tsinghua University, Beijing, China
| | - Vivian Lin
- LKS Faculty of Medicine, University of Hong Kong, Hong Kong Special Administrative Region, China
| | - William Summerskill
- Consulting Editor, The Lancet, 125 London Wall, London EC2Y 5AS, United Kingdom
| | - Yong Luo
- Department of Earth System Science, Institute for Global Change Studies, Ministry of Education Key Laboratory for Earth System Modelling, Tsinghua University, Beijing, China
| | - Hongjun Yu
- Department of Physical Education, Tsinghua University, Beijing, China
| | - Tinghai Wu
- School of Architecture, Tsinghua University, Beijing, China
| | - Changhong Yang
- Division for Business Management and Quality Control of Sichuan Centre for Diseases Control and Prevention, Chengdu 610041, China
| | - Jing Li
- Fuwai Hospital, Chinese Academy of Medical Sciences, Shenzhen; National Clinical Research Centre for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Centre for Cardiovascular Diseases, Beijing, China
| | - Yixiong Xiao
- Business Intelligence Lab, Baidu Research, Beijing, China
| | - Jingbo Zhou
- Business Intelligence Lab, Baidu Research, Beijing, China
| | - Dejing Dou
- Business Intelligence Lab, Baidu Research, Beijing, China
| | - Hui Xiong
- Artificial Intelligence Thrust, The Hong Kong University of Science and Technology (Guangzhou), Guangzhou, China and The Department of Computer Science and Engineering, The Hong Kong University of Science and Technology, Hong Kong SAR, China
| | | | - Lan Wang
- College of Architecture and Urban Planning, Tongji University, Shanghai, China
| | - Shu Tao
- School of Environmental Science and Engineering, Southern University of Science and Technology, Shenzhen, China
| | - Bojie Fu
- State Key Laboratory of Urban and Regional Ecology, Research Centre for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing, China
| | - Yong Zhang
- Cancer Hospital Chinese Academy of Medical Science, Beijing, China
| | - Bing Xu
- Department of Earth System Science, Institute for Global Change Studies, Ministry of Education Key Laboratory for Earth System Modelling, Tsinghua University, Beijing, China
| | - Jun Yang
- Department of Earth System Science, Institute for Global Change Studies, Ministry of Education Key Laboratory for Earth System Modelling, Tsinghua University, Beijing, China
| | - Peng Gong
- Department of Earth Sciences and Geography, University of Hong Kong, Hong Kong Special Administrative Region, China
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Sidebottom R, Wassie SB, Cerami C, Jallow MW, Fennell S, Dalzell S. A longitudinal investigation of dietary diversity during the COVID-19 pandemic in Mandinka households in Kanifing, Brikama, and the West Kiang region in The Gambia. Front Nutr 2022; 9:907969. [PMID: 36245476 PMCID: PMC9562626 DOI: 10.3389/fnut.2022.907969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 08/24/2022] [Indexed: 11/21/2022] Open
Abstract
The Covid pandemic has exposed fissures of inequality through heightened food insecurity and nutritional deficiency for vulnerable social cohorts with limited coping mechanisms. Given the multi-dimensional pathways through which its effects have been felt, several researchers have highlighted the need to analyse the pandemic in specific contexts. Using random and fixed effect regression models, this study analyzed longitudinal survey data collected from 103 Mandinka households in rural and urban Gambia. The study employed convenience and snowball sampling and involved the monthly collection of detailed income, food consumption, expenditure, sourcing, migration, health, and coping mechanism data through mobile phone interviews which yielded 676 observations. Food insecurity was manifest in terms of quality, not quantity, and spread unevenly across food types and households. Dietary outcomes and sourcing strategies were associated with location, improved sanitation, household size, changes in monthly income, Covid policy stringency, and Covid cases but these associations varied by food group. Staples were the most frequently consumed food group, and dark green vegetables were the least. Rural communities were more likely to eat more healthy millets but much less likely to consume dairy products or roots and tubers. Access to own production was also important for Vitamin A-rich foods but higher incomes and markets were key for protein and heme-iron-rich foods. Tighter Covid policy stringency was negatively associated with dietary diversity and, along with fear of market hoarding, was positively associated with reliance on a range of consumption and production coping mechanisms. Resilience was higher in larger households and those with improved water and sanitation. The number of Covid cases was associated with higher consumption of protein-rich foods and greater reliance on own produced iron-rich foods. Very few households received Government aid and those that did already had access to other income sources. Our findings suggest that the nature of food insecurity may have evolved over time during the pandemic. They also reiterate not only the importance of access to markets and employment but also that the capacity to absorb affordability shocks and maintain food choices through switching between sources for specific nutritious food groups varied by household and location.
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Affiliation(s)
- Richard Sidebottom
- Department of Land Economy, University of Cambridge, Cambridge, United Kingdom
- *Correspondence: Richard Sidebottom ;
| | | | - Carla Cerami
- Nutrition Unit, MRC Gambia at London School of Hygiene and Tropical Medicine, Banjul, Gambia
| | - Momodou W. Jallow
- Nutrition Unit, MRC Gambia at London School of Hygiene and Tropical Medicine, Banjul, Gambia
| | - Shailaja Fennell
- Department of Land Economy, University of Cambridge, Cambridge, United Kingdom
| | - Sarah Dalzell
- MRC Nutrition and Bone Health Research Group, University of Cambridge, Cambridge, United Kingdom
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Sente C, Onyuth H, Matovu G, Namara BG, Mugoya GJ. Provision of Travel Health Advice Through Local Tourist Handlers: Perspectives of Safari Tour Operators in Uganda. Travel Med Infect Dis 2022; 49:102407. [PMID: 35961490 DOI: 10.1016/j.tmaid.2022.102407] [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: 07/20/2021] [Revised: 05/10/2022] [Accepted: 07/25/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND The public health burden of travel related diseases (TRDs) remains significant despite the fact that most can be avoided, particularly with the assistance of local tourist handlers such as Safari Tour Operators' (STOs). The STO's are the immediate close contact with tourist groups, and yet their perspectives regarding provision of travel health advice are unknown in Uganda. This study was conducted to determine the level of knowledge, attitude, and practices of STOs regarding TRDs in Uganda. METHODS A cross sectional study was carried out among selected STOs in Kampala and Wakiso Districts using self-administered questionnaires. RESULTS The overall level of knowledge about travel health information was inadequate. Although 77.5% of the STOs were aware of some TRDs, the availability of travel health information or database in their organisations was not observed. Knowledge of the current TRDs in Uganda among the STOs was very low, with a few individuals mentioning yellow fever (9.7%), malaria (9.2%), cholera (9.2%), and HIV/AIDs (8.9%). Knowledge related to the sources of the travel health information was also low, with STOs (19.1%) and travel health clinics (14.9%) being mentioned as the main sources. The STOs had mostly positive attitude towards provision of travel health advice related to travellers, and all agreed that STOs should play a big role in the provision of travel health advice. First Aid and simple treatment options were mentioned as practices that STOs conducted to keep the travellers safe. CONCLUSIONS While the STOs are motivated to do the right thing and provide their clients with sound travel health advice, they have a limited awareness of the actual TRDs in Uganda. The STOs must be educated on pertinent travel health advice, and intra-travel disease and injury management. The responsible government and non-governmental entities in Uganda need to develop educational materials emphasising the relevance of travel health advice.
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Affiliation(s)
- Celsus Sente
- Department of Wildlife and Aquatic Animal Resources (WAAR), School of Veterinary Medicine and Animal Resources (SVAR), College of Veterinary Medicine, Animal Resources and Biosecurity (COVAB), Makerere University, P.O. Box 7062, Kampala, Uganda.
| | - Howard Onyuth
- Department of Wildlife and Aquatic Animal Resources (WAAR), School of Veterinary Medicine and Animal Resources (SVAR), College of Veterinary Medicine, Animal Resources and Biosecurity (COVAB), Makerere University, P.O. Box 7062, Kampala, Uganda
| | | | - Benigna Gabriela Namara
- Department of Microbiology, School of Biomedical Sciences (SBS), College of Health Sciences (CHS), Makerere University, P.O. Box 7062, Kampala, Uganda
| | - Gizamba Jacob Mugoya
- School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town Observatory, 7925, South Africa
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Wattanapisit A, Sottiyotin T, Thongruch J, Wattanapisit S, Yongpraderm S, Kowaseattapon P. Self-Care Practices of Patients with Non-Communicable Diseases during the COVID-19 Pandemic: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:9727. [PMID: 35955084 PMCID: PMC9368016 DOI: 10.3390/ijerph19159727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 08/05/2022] [Accepted: 08/06/2022] [Indexed: 06/15/2023]
Abstract
Individuals with chronic non-communicable diseases (NCDs) have a higher risk of morbidity and mortality. This study explores the lived experience of patients with NCDs during the COVID-19 pandemic and the impact of COVID-19 on their self-care. An interpretive phenomenological analysis approach was used that involved in-depth interviews with patients who received medical services from a family medicine clinic, along with caregivers who responded on their behalf. An inductive thematic approach was utilized to analyze the data. Interview respondents included 17 patients with NCDs and four caregivers. The patients had a mean age of 65.7 ± 11.3 years and were diagnosed with an NCD, a mean of 4.8 ± 1.1 years previously. Self-care practices used during the pandemic were classified as therapeutic or preventive. Patients responded to changes in healthcare services by seeking in-person services for their acute illnesses and accepting remote services for underlying chronic conditions. The COVID-19 pandemic influenced the self-care practices of patients with NCDs. Most patients paid more attention to self-care during this time, while some became more concerned with other aspects of their life.
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Affiliation(s)
- Apichai Wattanapisit
- School of Medicine, Walailak University, Thasala, Nakhon Si Thammarat 80160, Thailand
- Family Medicine Clinic, Walailak University Hospital, Thasala, Nakhon Si Thammarat 80160, Thailand
| | - Tida Sottiyotin
- School of Pharmacy, Walailak University, Thasala, Nakhon Si Thammarat 80160, Thailand
| | - Jaruporn Thongruch
- Family Medicine Clinic, Walailak University Hospital, Thasala, Nakhon Si Thammarat 80160, Thailand
| | | | - Siranee Yongpraderm
- School of Pharmacy, Walailak University, Thasala, Nakhon Si Thammarat 80160, Thailand
| | - Pichawee Kowaseattapon
- Family Medicine Clinic, Walailak University Hospital, Thasala, Nakhon Si Thammarat 80160, Thailand
- School of Pharmacy, Walailak University, Thasala, Nakhon Si Thammarat 80160, Thailand
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Harris P, Kirkland R, Masanja S, Le Feuvre P, Montgomery S, Ansbro É, Woodman M, Harris M. Strengthening the primary care workforce to deliver high-quality care for non-communicable diseases in refugee settings: lessons learnt from a UNHCR partnership. BMJ Glob Health 2022; 7:bmjgh-2021-007334. [PMID: 35798443 PMCID: PMC9272076 DOI: 10.1136/bmjgh-2021-007334] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 01/27/2022] [Indexed: 12/21/2022] Open
Abstract
Non-communicable disease (NCD) prevention and care in humanitarian contexts has been a long-neglected issue. Healthcare systems in humanitarian settings have focused heavily on communicable diseases and immediate life-saving health needs. NCDs are a significant cause of morbidity and mortality in refugee settings, however, in many situations NCD care is not well integrated into primary healthcare services. Increased risk of poorer outcomes from COVID-19 for people living with NCDs has heightened the urgency of responding to NCDs and shone a spotlight on their relative neglect in these settings. Partnering with the United Nations Refugee Agency (UNHCR) since 2014, Primary Care International has provided clinical guidance and Training of Trainer (ToT) courses on NCDs to 649 health professionals working in primary care in refugee settings in 13 countries. Approximately 2300 healthcare workers (HCW) have been reached through cascade trainings over the last 6 years. Our experience has shown that, despite fragile health services, high staff turnover and competing clinical priorities, it is possible to improve NCD knowledge, skills and practice. ToT programmes are a feasible and practical format to deliver NCD training to mixed groups of HCW (doctors, nurses, technical officers, pharmacy technicians and community health workers). Clinical guidance must be adapted to local settings while co-creating an enabling environment for health workers is essential to deliver accessible, high-quality continuity of care for NCDs. On-going support for non-clinical systems change is equally critical for sustained impact. A shared responsibility for cascade training—and commitment from local health partners—is necessary to raise NCD awareness, influence local and national policy and to meet the UNHCR’s objective of facilitating access to integrated prevention and control of NCDs.
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Affiliation(s)
| | | | - Saimon Masanja
- School of Public Health, Catholic University of Health and Allied Sciences (CUHAS), Bugando Medical Centre, Mwanza, Tanzania
| | | | | | - Éimhín Ansbro
- Centre for Global Chronic Conditions, London School of Hygiene & Tropical Medicine, London, UK
| | - Michael Woodman
- The Office of the United Nations High Commissioner for Refugees, Geneva, Switzerland
| | - Matthew Harris
- Department of Primary Care and Public Health, Imperial College London, London, UK
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Vellakkal S, Khan Z, Alavani H, Fledderjohann J, Stuckler D. Effects of public policies in the prevention of cardiovascular diseases: a systematic review of global literature. Public Health 2022; 207:73-81. [PMID: 35567826 DOI: 10.1016/j.puhe.2022.03.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 01/28/2022] [Accepted: 03/30/2022] [Indexed: 02/07/2023]
Abstract
OBJECTIVES Given the growing interest worldwide in applying public policies to improve human health, we undertook a systematic review of studies investigating whether public policies targeting unhealthy products could reduce cardiovascular diseases. STUDY DESIGN This study was a systematic review of the literature. METHODS We searched research studies published in 2000-2020 from major databases, including MEDLINE and Embase. We followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and narratively synthesized the studies based on vote counting and direction of the intervention effect. RESULTS Ninety-eight studies, mostly from high-income countries, met the inclusion criteria. Most studies were on public policies targeting sugar-sweetened beverages and tobacco, followed by alcohol, sugar, salt, and junk foods. Overall, many reported that several fiscal, regulatory, and educational policies generated beneficial effects of reducing the diseases. Those studies that reported no or limited effects highlighted several sociodemographic and health risk characteristics and design and implementation aspects of the policy interventions as factors limiting the policy effects; most of these are modifiable with appropriate policy interventions. For instance, low magnitude of tax, substitution with other unhealthy products, firms' competitive response strategies, pre-existence of smoking bans, incremental enactment of smoking regulations, degree of enforcement, and various sociocultural factors minimized the effects of the policies. CONCLUSION The literature supports a growing consensus on the beneficial effects of public policy for improving human health. The design and implementation of public policies must address various impeding factors and incorporate appropriate remedial measures. Further research is needed from low- and middle-income countries and on whether and how multiple policy instruments work in tandem.
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Affiliation(s)
- S Vellakkal
- Department of Economic Sciences, Indian Institute of Technology Kanpur, Kalyanpur, Uttar Pradesh, India.
| | - Z Khan
- IIPH Bhubaneshwar, Bhubaneshwar, Odisha, India
| | - H Alavani
- Department of Economics and Finance, BITS Pilani, KK Birla Goa Campus, Zuarinagar, Goa, India
| | - J Fledderjohann
- Department of Sociology, Lancaster University, Lancaster, UK
| | - D Stuckler
- Department of Social and Political Sciences, Bocconi University, Milan, Italy
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Stepien M, Keller I, Takki M, Caldeira S. European public health best practice portal - process and criteria for best practice assessment. Arch Public Health 2022; 80:131. [PMID: 35524289 PMCID: PMC9073824 DOI: 10.1186/s13690-022-00892-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 05/02/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Non-communicable diseases (NCDs) are major and growing burden on population health and the use and cost of healthcare in EU Member States and beyond. Different countries face many common challenges in public health and can learn from each other. The exchange of 'best practices' is one way to tackle the observed disparities in health sector. To address the United Nations Sustainable Development Goals, the European Commission developed the EU Public Health Best Practice Portal to facilitate the exchange of best practices and facilitate their implementation in other EU countries or regions. The ultimate aim of the portal is to reduce NCDs burden and the prevalence of their risk factors by promoting implementation and scale up of evidence-based effective interventions in the areas of health promotion, disease prevention and management of NCDs. RESULTS This article presents the rationale and the process, ranging from best practice assessment to their transfer to interested Member States, applied in the EU Public Health Best Practice Portal. The portal selects best practices using rigorously defined criteria for best practice assessment. This article further provides an overview of other similar initiatives in Europe and internationally that collect and disseminate information on interventions and actions to combat NCDs. CONCLUSION Exchange of best practices is a promising tool in tackling NCDs. Transfer and scaling up of policies and interventions between countries may contribute to tackle disparities observed between countries in regards to the prevalence of risk factors and associated diseases.
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Affiliation(s)
- Magdalena Stepien
- Joint Research Centre, European Commission, Via E. Fermi, 2749, I-21027, Ispra (VA), Italy.
| | - Ingrid Keller
- Health Security Unit, Directorate-General for Health and Food, European Commission, 11, rue Eugène Ruppert, L-2453, Luxembourg, Luxembourg
| | - Marianne Takki
- Health promotion, disease prevention, financial instruments Unit, Directorate-General for Health and Food Safety, European Commission, 11, rue Eugène Ruppert, L-2453, Luxembourg, Luxembourg
| | - Sandra Caldeira
- Joint Research Centre, European Commission, Via E. Fermi, 2749, I-21027, Ispra (VA), Italy
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Al-Qudah M, Al-Shaikh A, Haddad H, Alolayyan M, Zawaneh Y, Matalka M, Matalka I. Impact of COVID-19 Exclusive Allocation Strategy on Quality of Healthcare: A Study from Jordan, 2020. Health Secur 2022; 20:193-202. [PMID: 35486857 DOI: 10.1089/hs.2021.0146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The COVID-19 pandemic has brought uncertainty to everyday medical practice. Deciding how to ration limited healthcare resources is difficult and requires the involvement of higher authorities in each country. In this article we focus on the Jordanian strategy of allocating tertiary healthcare centers exclusively for COVID-19 patients and postponing all other treatments and healthcare provision. We collected secondary data on admissions, occupancy of hospital beds, and length of stay at emergency departments and outpatient clinics, as well as surgeries conducted, between March and May 2020 at King Abdullah University Hospital in Irbid, Jordan. We also conducted a literature review to explore health resource utilization and allocation in terms of health service quality. Our findings showed a major decrease in the demand for health services at the hospital including admissions, emergency department visits, outpatient clinic visits, surgeries, and radiology during the study period. These findings indicate the enormous impact of the pandemic on the largest segment of patients in Jordan-those who depend on government health insurance-to manage their routine healthcare needs, which may affect the health status of patients. Authorities should address the COVID-19 pandemic holistically by prioritizing both COVID-19 cases and non-COVID-19 cases and should draft a framework for managing future pandemics. Moreover, planning a strategy to accommodate the number of people waiting for elective surgeries and routine healthcare should be in place to minimize the burden of this pandemic.
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Affiliation(s)
- Mohammad Al-Qudah
- Mohammad Al-Qudah, MD, is an Associate Professor, Department of Pathology and Microbiology, Jordan University of Science and Technology, Irbid, Jordan
| | - Ala'a Al-Shaikh
- Ala'a Al-Shaikh, MD, MPH, is an Immunization Officer, Ministry of Health, Amman, Jordan
| | - Husam Haddad
- Husam Haddad, MD, is a Pathology Specialist, Ministry of Health, Amman, Jordan
| | - Main Alolayyan
- Main Alolayyan, MSc, PhD, is an Assistant Professor, Department of Health Management and Policy, Jordan University of Science and Technology, Irbid, Jordan
| | - Yousef Zawaneh
- Yousef Zawaneh, MD, MSc, is a Researcher, Certara UK Ltd., London, UK
| | - Mohammad Matalka
- Mohammad Matalka, MD, is an Internship Doctor, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Ismail Matalka
- Ismail Matalka, MD, FRCPath, is a Professor, Department of Pathology and Microbiology, Jordan University of Science and Technology, Irbid, Jordan
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Using an Intervention Mapping Approach to Develop a Program for Preventing High Blood Pressure in a Marginalized Afro-Colombian Population: A Community-Based Participatory Research. JOURNAL OF PREVENTION 2022; 43:209-224. [PMID: 35445375 PMCID: PMC8800401 DOI: 10.1007/s10935-022-00668-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 01/11/2022] [Indexed: 11/04/2022]
Abstract
The prevention of high blood pressure (HBP) is an important public health initiative worldwide, since HBP is the main risk factor for cardiovascular diseases and increases the damage caused by coronavirus disease 2019 (COVID-19). We designed, implemented, and evaluated a program to identify effective and sustainable interventions for preventing HBP in a marginalized black population. Our study was conducted in Quibdó, a city in Colombia with the highest poverty rate and located in the Pacific coast, a subregion in Colombia with the highest prevalence of HBP. We followed an intervention mapping framework using a community-based participatory research approach. Focus groups, photovoice, literature reviews, and cross-sectional quantitative surveys were used for data collection. The community chose the time, place, and type of physical activity; led the physical activities; and strengthened their skills in seeking resources in their community to sustain the program. The evaluation was aimed at determining whether the interventions were able to achieve the program’s primary aim. We used a before (September 2016) and after (December 2017) design for the evaluation. To decrease the selection bias and allow comparisons between homogeneous groups, we used a propensity score matching technique. The steps required to create a self-sustaining physical activity program were provided in detail. The pre-post test showed a decrease of the HBP (systolic, 13.4% points; p = 0.018; diastolic, 6.5% points; p = 0.002). The program may be an effective and self-sustaining intervention, and it can be replicated by policymakers and implemented in other population groups.
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Wang F, Ma Y, Xu S, Liu H, Chen Y, Yang H, Shao M, Xu W, Kong J, Chen L, Xu S, Shuai Z, Pan F. Prevalence and risk of COVID-19 in patients with rheumatic diseases: a systematic review and meta-analysis. Clin Rheumatol 2022; 41:2213-2223. [PMID: 35352217 PMCID: PMC8964246 DOI: 10.1007/s10067-022-06087-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 01/03/2022] [Accepted: 01/29/2022] [Indexed: 02/06/2023]
Abstract
Objectives COVID-19 pandemic has already had a tremendous impact on the process of human society; the survival of mankind and the healthy living environment deterioration with the influence will last for many years. This meta-analysis aims to assess the risk of COVID-19 in patients with rheumatic diseases. Methods PubMed, Web of Science, Embase, China National Knowledge Infrastructure (CNKI), and Chinese Biomedical Database (CBM) were systematically searched with no language restriction up to July 5, 2021. The pooled rates were synthesized by fixed effect model or random effect model depending on heterogeneity. Results A total of 83 articles were included in this meta-analysis. The incidence of COVID-19 in patient with rheumatic diseases was 0.0190 (95% CI: 0.0136-0.0252), and the hospitalization rate, intensive care unit admission rate, mechanical ventilation rate, and case fatality rate of patients with rheumatic diseases infected with COVID-19 were 0.4396 (95% CI: 0.3899-0.4898), 0.0635 (95% CI: 0.0453-0.0836), 0.0461 (95% CI: 0.0330-0.0609), and 0.0346 (95% CI: 0.0218-0.0493), respectively. Conclusions Our research shows that patients with rheumatic diseases have great risk of COVID-19. Differences in COVID-19 incidence, hospitalization rates, and mortality rates in regions were statistically significant. We still need to pay attention to the risk of COVID-19 in patients with rheumatic diseases. Key Points • Although the risk of COVID-19 in patients with rheumatic diseases has been discussed in previous meta-analysis, their research directions were inconsistent, and few studies focus on prevalence or serious outcomes of COVID-19 in patient with rheumatic diseases, while the quality of these articles was variable. • The incidence of COVID-19 and serious clinical outcomes in patients with rheumatic diseases were still high along with differential risks in most regions. • The use of glucocorticoids and conventional synthetic disease-modifying antirheumatic drugs did not affect the hospitalization rate and mortality in rheumatism patients with COVID-19. Supplementary Information The online version contains supplementary material available at 10.1007/s10067-022-06087-1.
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Affiliation(s)
- Feier Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China.,The Key Laboratory of Major Autoimmune Diseases, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Yubo Ma
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China.,The Key Laboratory of Major Autoimmune Diseases, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Shanshan Xu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China.,The Key Laboratory of Major Autoimmune Diseases, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Huanhuan Liu
- Department of Clinical Laboratory, the Second Hospital of Anhui Medical University, 678 Furong Road, Hefei, Anhui, China
| | - Yuting Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China.,The Key Laboratory of Major Autoimmune Diseases, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Hui Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China.,The Key Laboratory of Major Autoimmune Diseases, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Ming Shao
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China.,The Key Laboratory of Major Autoimmune Diseases, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Wei Xu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China.,The Key Laboratory of Major Autoimmune Diseases, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Jiangping Kong
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China.,The Key Laboratory of Major Autoimmune Diseases, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Liwen Chen
- Department of Clinical Laboratory, the Second Hospital of Anhui Medical University, 678 Furong Road, Hefei, Anhui, China
| | - Shengqian Xu
- Department of Rheumatism and Immunity, the First Affiliated Hospital of Anhui Medical University, Hefei, 230022, Anhui, China
| | - Zongwen Shuai
- Department of Rheumatism and Immunity, the First Affiliated Hospital of Anhui Medical University, Hefei, 230022, Anhui, China
| | - Faming Pan
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China. .,The Key Laboratory of Major Autoimmune Diseases, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China.
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Pounder P. Intersection of health protection policy and sport during COVID-19: identifying and analyzing behavioral issues. MANAGING SPORT AND LEISURE 2022. [DOI: 10.1080/23750472.2022.2046491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Paul Pounder
- Department of Business and Management, St. George’s University, True Blue, Grenada
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Pharmacological Adherence Behavior Changes during COVID-19 Outbreak in a Portugal Patient Cohort. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031135. [PMID: 35162159 PMCID: PMC8835016 DOI: 10.3390/ijerph19031135] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 01/17/2022] [Accepted: 01/18/2022] [Indexed: 02/07/2023]
Abstract
Concerns, behaviours, and beliefs influence how people deal with COVID-19. Understanding the factors influencing adherence behaviour is of utmost importance to develop tailored interventions to increase adherence within this context. Hence, we aimed to understand how COVID-19 affected adherence behaviour in Portugal. A cross-sectional online survey was conducted between 1 March and 3 April 2021. Descriptive statistics were performed, as well as univariable and multivariable regression models. Of the 1202 participants, 476 who were taking at least one medication prescribed by the doctor were selected. Of these, 78.2% were female, and the mean age was 40.3 ± 17.9 years old. About 74.2% were classified as being highly adherent. During the pandemic, 8.2% of participants reported that their adherence improved, while 5.9% had worsened adherence results. Compared with being single, widowers were 3 times more prone to be less adherent (OR:3.390 [1.106–10.390], p = 0.033). Comorbid patients were 1.8 times (OR:1.824 [1.155–2.881], p = 0.010) more prone to be less adherent. Participants who reported that COVID-19 negatively impacted their adherence were 5.6 times more prone to be less adherent, compared with those who reported no changes (OR:5.576 [2.420–12.847], p < 0.001). None of the other variables showed to be significantly associated with pharmacological adherence.
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Nogales Vasconcelos AM, Ishitani L, Abreu DMX, França E. Covid Adult Mortality in Brazil: An Analysis of Multiple Causes of Death. Front Public Health 2022; 9:788932. [PMID: 35111718 PMCID: PMC8801696 DOI: 10.3389/fpubh.2021.788932] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Accepted: 12/14/2021] [Indexed: 12/20/2022] Open
Abstract
Objective This study aimed to analyze the chain of events and contributing causes associated with COVID-19 adult mortality (30–69 years old), based on qualified data on CoD from three Brazilian capitals cities, Belo Horizonte, Salvador, and Natal, in 2020. Methods Data of all deaths among residents in the three capitals in 2020 were provided by these municipalities' routine Mortality Information System (SIM). Mentions B34.2 with the markers U07.1 and U07.2 in the death certificate identified COVID-19 deaths. We used a multiple-cause-of-death approach better to understand the complexity of the morbid process of COVID-19. Conditions that appeared more frequently in the same line or above the COVID-19 mentions in the death certificate were considered a chain-of-event. Conditions that occurred more often after the codes for COVID-19 were considered as contributing. Results In 2020, 7,029 records from COVID-19 as the underlying cause of death were registered in SIM in the three capitals. Among these, 2,921 (41.6%) were deceased between 30 and 69 years old, representing 17.0% of deaths in this age group. As chain-of-events, the most frequent conditions mentioned were sepsis (33.4%), SARS (32.0%), acute respiratory failure (31.9%), unspecified lower respiratory infections (unspecified pneumonia) (20.1%), and other specified respiratory disorders (14.1%). Hypertension (33.3%), diabetes unspecified type (21.7%), renal failure (12.7%), obesity (9.8%), other chronic kidney diseases (4.9%), and diabetes mellitus type 2 (4.7%) were the most frequent contributing conditions. On average, 3.04 conditions were mentioned in the death certificate besides COVID-19. This average varied according to age, place of death, and capital. Conclusion The multiple-cause analysis is a powerful tool to better understand the morbid process due to COVID-19 and highlight the importance of chronic non-communicable diseases as contributing conditions.
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Affiliation(s)
| | - Lenice Ishitani
- Epidemiology and Health Assessment Research Group (GPEAS), Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Daisy Maria Xavier Abreu
- Epidemiology and Health Assessment Research Group (GPEAS), Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Elisabeth França
- Graduate Program in Public Health, School of Medicine and Epidemiology and Health Assessment Research Group (GPEAS), Federal University of Minas Gerais, Belo Horizonte, Brazil
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COVID-19 pandemic: The fears and hopes for SDG 3, with focus on prevention and control of noncommunicable diseases (SDG 3.4) and universal health coverage (SDG 3.8). COVID-19 AND THE SUSTAINABLE DEVELOPMENT GOALS 2022. [PMCID: PMC9334993 DOI: 10.1016/b978-0-323-91307-2.00014-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The 17 Sustainable Development Goals (SDGs) were adopted by the United Nations (UN) General Assembly in 2015 to set the world on the path to peace, prosperity, and sustainable development. As a result of the global focus on SDGs, in particular SDG 3—ensuring a healthy life and promoting well-being for all—and its 13 targets, significant progress has been made in global health. The Global Action Plan for the Prevention and Control of Noncommunicable Diseases (NCDs) was officially placed on the World Health Organization (WHO) agenda in 2013. Subsequently, the UNs’ SDGs incorporated SDG 3.4, based on which many countries have been developing national strategies to reduce burden of NCDs. Besides, building upon WHO’s efforts to promote universal health coverage (UHC) since 2010, SDG 3.8 with a focus on UHC was adopted, following which 75% of national health policies were developed with the aim of moving toward UHC. Almost through one-third of SDG’s pathway, the COVID-19 pandemic has been hampering global efforts to achieve the 2030 agenda. The ongoing COVID-19 pandemic has affected all aspects of social, political, environmental, and economic life worldwide. The crisis has made SDGs almost unlikely to reach. It has unprecedentedly interrupted the provision of and access to essential healthcare services in all settings. The situation worsened particularly in low- and middle-income countries, where preexisting health inequalities and weak health systems jeopardized control and mitigation. The disruption in the provision of healthcare services may have long-term consequences for people with NCDs, especially the most vulnerable and in need of regular long-term care. Worse still, patients with NCDs have been reported to be at higher risk for serious illness or death from COVID-19. The pandemic also reinforces the importance of UHC, the need to prioritize universal health preparedness and accelerate global efforts to build back stronger and more resilient health systems to make progress toward UHC. COVID-19 has demonstrated the fact that the health systems of many countries are not fully prepared to protect the health of their populations and reaffirmed the fact that a strong and resilient health system based on primary healthcare is the basis for effective response to the crises and a reliable platform for advances in health safety and UHC. In this chapter, we will discuss the consequences of the COVID-19 pandemic on achieving SDG 3 targets—with a special focus on SDG 3.4 (NCDs) and SDG 3.8 (UHC).
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Reeve E, Thow AM, Huse O, Bell C, Peeters A, Sacks G. Policy-makers' perspectives on implementation of cross-sectoral nutrition policies, Western Pacific Region. Bull World Health Organ 2021; 99:865-873. [PMID: 34866682 PMCID: PMC8640684 DOI: 10.2471/blt.20.283366] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Revised: 08/24/2021] [Accepted: 08/25/2021] [Indexed: 02/07/2023] Open
Abstract
Implementation of effective cross-sectoral nutrition policies remains a challenge worldwide. By reviewing reports from World Health Organization meetings and consultations - convened for policy-makers representing Member States of the Western Pacific Region - we provide an insight into how national policy-makers and external actors can support different dimensions of nutrition policy implementation. Key insights of policy-makers attending food and nutrition-centred meetings include that country-level implementation of nutrition policy relies on strong policy design, organizational planning and governance mechanisms that promote collective responsibility across multiple sectors. Policy-makers responsible for implementing nutrition policies face major challenges resulting from limited capacity, both within and external to government, particularly in relation to monitoring and enforcement activities. Successful implementation of nutrition policy measures will require greater political will to provide the requisite resources and institutional structures to ensure sustained policy effectiveness. Nongovernmental partners, including international agencies and researchers, have an opportunity to support policy implementation by providing technical support to Member States to frame action on nutrition in a more compelling way. They can also help policy-makers to build the organizational and structural capacity to coordinate cross-sectoral policy. Improved policy design, planning and governance and strategic capacity-building, supported by external partners, can strengthen the sustained implementation of cross-sectoral nutrition policy and improve nutrition outcomes.
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Affiliation(s)
- Erica Reeve
- Institute for Health Transformation, Deakin University, 221 Burwood Highway, Burwood, VIC 3125, Australia
| | - Anne-Marie Thow
- Menzies Centre for Health Policy, University of Sydney, Sydney, Australia
| | - Oliver Huse
- Institute for Health Transformation, Deakin University, 221 Burwood Highway, Burwood, VIC 3125, Australia
| | - Colin Bell
- Institute for Health Transformation, Deakin University, 221 Burwood Highway, Burwood, VIC 3125, Australia
| | - Anna Peeters
- Institute for Health Transformation, Deakin University, 221 Burwood Highway, Burwood, VIC 3125, Australia
| | - Gary Sacks
- Institute for Health Transformation, Deakin University, 221 Burwood Highway, Burwood, VIC 3125, Australia
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Wood S, Harrison SE, Judd N, Bellis MA, Hughes K, Jones A. The impact of behavioural risk factors on communicable diseases: a systematic review of reviews. BMC Public Health 2021; 21:2110. [PMID: 34789209 PMCID: PMC8596356 DOI: 10.1186/s12889-021-12148-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 10/22/2021] [Indexed: 12/24/2022] Open
Abstract
Background The coronavirus (COVID-19) pandemic has highlighted that individuals with behavioural risk factors commonly associated with non-communicable diseases (NCDs), such as smoking, harmful alcohol use, obesity, and physical inactivity, are more likely to experience severe symptoms from COVID-19. These risk factors have been shown to increase the risk of NCDs, but less is known about their broader influence on communicable diseases. Taking a wide focus on a range of common communicable diseases, this review aimed to synthesise research examining the impact of behavioural risk factors commonly associated with NCDs on risks of contracting, or having more severe outcomes from, communicable diseases. Methods Literature searches identified systematic reviews and meta-analyses that examined the association between behavioural risk factors (alcohol, smoking, illicit drug use, physical inactivity, obesity and poor diet) and the contraction/severity of common communicable diseases, including infection or associated pathogens. An a priori, prospectively registered protocol was followed (PROSPERO; registration number CRD42020223890). Results Fifty-three systematic reviews were included, of which 36 were also meta-analyses. Reviews focused on: tuberculosis, human immunodeficiency virus, hepatitis C virus, hepatitis B virus, invasive bacterial diseases, pneumonia, influenza, and COVID-19. Twenty-one reviews examined the association between behavioural risk factors and communicable disease contraction and 35 examined their association with communicable disease outcomes (three examined their association with both contraction and outcomes). Fifty out of 53 reviews (94%) concluded that at least one of the behavioural risk factors studied increased the risk of contracting or experiencing worse health outcomes from a communicable disease. Across all reviews, effect sizes, where calculated, ranged from 0.83 to 8.22. Conclusions Behavioural risk factors play a significant role in the risk of contracting and experiencing more severe outcomes from communicable diseases. Prevention of communicable diseases is likely to be most successful if it involves the prevention of behavioural risk factors commonly associated with NCDs. These findings are important for understanding risks associated with communicable disease, and timely, given the COVID-19 pandemic and the need for improvements in future pandemic preparedness. Addressing behavioural risk factors should be an important part of work to build resilience against any emerging and future epidemics and pandemics. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-12148-y.
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Affiliation(s)
- Sara Wood
- Policy and International Health, World Health Organization Collaborating Centre on Investment for Health and Well-being, Public Health Wales, Wrexham, UK
| | - Sophie E Harrison
- Public Health Collaborating Unit, School of Medical and Health Sciences, Bangor University, Wrexham, UK.,Institute for Applied Human Physiology, School of Human and Behavioural Sciences, Bangor University, Bangor, UK
| | - Natasha Judd
- Policy and International Health, World Health Organization Collaborating Centre on Investment for Health and Well-being, Public Health Wales, Wrexham, UK.,Public Health Collaborating Unit, School of Medical and Health Sciences, Bangor University, Wrexham, UK
| | - Mark A Bellis
- Policy and International Health, World Health Organization Collaborating Centre on Investment for Health and Well-being, Public Health Wales, Wrexham, UK. .,Public Health Collaborating Unit, School of Medical and Health Sciences, Bangor University, Wrexham, UK.
| | - Karen Hughes
- Policy and International Health, World Health Organization Collaborating Centre on Investment for Health and Well-being, Public Health Wales, Wrexham, UK.,Public Health Collaborating Unit, School of Medical and Health Sciences, Bangor University, Wrexham, UK
| | - Andrew Jones
- Health Protection and Screening Services, Public Health Wales, Cardiff, UK
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Dietert RR. Microbiome First Approaches to Rescue Public Health and Reduce Human Suffering. Biomedicines 2021; 9:biomedicines9111581. [PMID: 34829809 PMCID: PMC8615664 DOI: 10.3390/biomedicines9111581] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 10/27/2021] [Indexed: 01/03/2023] Open
Abstract
The is a sequential article to an initial review suggesting that Microbiome First medical approaches to human health and wellness could both aid the fight against noncommunicable diseases and conditions (NCDs) and help to usher in sustainable healthcare. This current review article specifically focuses on public health programs and initiatives and what has been termed by medical journals as a catastrophic record of recent failures. Included in the review is a discussion of the four priority behavioral modifications (food choices, cessation of two drugs of abuse, and exercise) advocated by the World Health Organization as the way to stop the ongoing NCD epidemic. The lack of public health focus on the majority of cells and genes in the human superorganism, the microbiome, is highlighted as is the "regulatory gap" failure to protect humans, particularly the young, from a series of mass population toxic exposures (e.g., asbestos, trichloroethylene, dioxin, polychlorinated biphenyls, triclosan, bisphenol A and other plasticizers, polyfluorinated compounds, herbicides, food emulsifiers, high fructose corn syrup, certain nanoparticles, endocrine disruptors, and obesogens). The combination of early life toxicity for the microbiome and connected human physiological systems (e.g., immune, neurological), plus a lack of attention to the importance of microbial rebiosis has facilitated rather than suppressed, the NCD epidemic. This review article concludes with a call to place the microbiome first and foremost in public health initiatives as a way to both rescue public health effectiveness and reduce the human suffering connected to comorbid NCDs.
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Affiliation(s)
- Rodney R Dietert
- Department of Microbiology and Immunology, Cornell University, Ithaca, NY 14853, USA
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Yasmin F, Najeeb H, Asghar MS, Ullah I, Islam SMS. Increased COVID-19 infection risk, COVID-19 vaccine inaccessibility, and unacceptability: Worrisome trio for patients with substance abuse disorders. J Glob Health 2021; 11:03106. [PMID: 34671459 PMCID: PMC8501395 DOI: 10.7189/jogh.11.03106] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Affiliation(s)
- Farah Yasmin
- Department of Internal Medicine, Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan
| | - Hala Najeeb
- Department of Internal Medicine, Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan
| | - Muhammad Sohaib Asghar
- Department of Internal Medicine, Dow University Hospital - Ojha Campus, Dow University of Health Sciences, Karachi, Pakistan
| | - Irfan Ullah
- Department of Internal Medicine, Kabir Medical College, Gandhara University, Peshawar, Pakistan
| | - Sheikh Mohammed Shariful Islam
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Faculty of Health, Deakin University, Burwood, Australia
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Carter C, Mukonka PS, Sitwala LJ, Mulawisha G, Notter J. The 'sleeping elephant': The role of mentorship of critical care nurses in Zambia. Int Nurs Rev 2021; 68:543-550. [PMID: 34587285 DOI: 10.1111/inr.12717] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 08/23/2021] [Indexed: 01/13/2023]
Abstract
AIM To develop and evaluate a Zambian context-specific mentorship model that supports registered nurses completing emergency, trauma and critical care programmes in Zambia. BACKGROUND In Zambia, emergency and trauma and critical care nursing are relatively new specialties, with education and training programmes less than a decade old. A train the trainer mentorship programme was developed and delivered at two colleges of nursing. Ethics approval was gained in both Zambia and the UK. SOURCES OF EVIDENCE Documentary data analysis and focus groups were used. Focus groups included stakeholders and nurses in practice who had completed the train the trainer programme and were using the mentorship model. DISCUSSION The critical review of the literature revealed there was a paucity of evidence on the role of mentors in critical care. However, national documentation identified that most post basic education programmes are at Diploma Level with limited content that focuses on bedside teaching, mentorship and assessment content. CONCLUSION Feedback from representatives attending the stakeholder workshops and focus groups which included participants who had completed the training programme enabled the mentorship model and workshop to be developed and evaluated. IMPLICATIONS FOR NURSING PRACTICE Nurses are the backbone of healthcare systems in Africa and the world. Mentorship and assessment in practice enables nurses to develop the competence and skills to lead practice, support peers and junior colleagues. IMPLICATIONS FOR NURSING POLICY This paper has identified the need for a context-specific formalised mentorship model to support specialist practice and this project has provided the foundations for mentorship of emergency, trauma and critical care nurses in Zambia.
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Affiliation(s)
- Chris Carter
- Faculty of Health, Education & Life Sciences, Birmingham City University, UK
| | | | - Lilian Jere Sitwala
- Department of Critical Care Nursing, Lusaka College of Nursing & Midwifery, Lusaka, Zambia
| | - Godwin Mulawisha
- Department of Critical Care Nursing, Ndola College of Nursing & Midwifery, Ndola, Zambia
| | - Joy Notter
- Community Healthcare Studies, Faculty of Health, Education & Life Sciences, Birmingham City University, Birmingham, UK
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