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Jamal Z, ElKhatib Z, AlBaik S, Horino M, Waleed M, Fawaz F, Loffreda G, Seita A, Witter S, Diaconu K. Social determinants and mental health needs of Palestine refugees and UNRWA responses in Gaza during the COVID-19 pandemic: a qualitative assessment. BMC Public Health 2022; 22:2296. [PMID: 36482403 PMCID: PMC9733234 DOI: 10.1186/s12889-022-14771-9] [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: 05/11/2022] [Accepted: 11/29/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Due to pre-existing difficulties, refugees are especially susceptible to the negative effects of the pandemic; nonetheless, the pandemic's effect on this group is still unclear. The purpose of this study was to determine the effects of the COVID-19 pandemic on the mental health of Palestine refugees in Gaza by identifying the role of social determinants. During the pandemic, the United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) enacted a number of policies and measures. The purpose of this research was to assess their efficacy and acceptability. METHODS This qualitative study took place between August and November 2020. Twenty-nine key-informant interviews were conducted remotely with UNRWA Headquarters, field and clinical staff in Gaza and with community members, aged ≥18 years and residing in Rafah and Jabalia camps. We sought informed consent verbally or via email. Data was coded based on the framework for social determinants of mental health. RESULTS Interview results indicated that the relationship might be unidirectional, with COVID-19 causing the degradation of living conditions and vice versa, with living conditions exacerbating the COVID-19 situation by facilitating virus transmission. In other instances, the association between mental health determinants and COVID-19 might be bidirectional. In terms of experiencing violence and anxieties, women, children, and daily-paid employees were significantly more disadvantaged than other groups in the community. UNRWA modified its service delivery techniques in order to continue providing essential services. In general, UNRWA's strategies throughout the pandemic were deemed beneficial, but insufficient to meet the needs of Gazans. CONCLUSION The pandemic highlights the need to go beyond disease treatment and prevention to address social determinants to improve refugees' health and reduce their susceptibility to future shocks. UNRWA has rapidly implemented telemedicine and mental telehealth services, making it imperative to assess the efficacy of these novel approaches to provide care at a distance. A long-term option may be to employ a hybrid strategy, which combines online and in-person therapy.
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Affiliation(s)
- Zeina Jamal
- grid.104846.fInstitute for Global Health and Development, Queen Margaret University, Musselburgh EH21 6UU Edinburgh, Scotland, UK
| | - Zoheir ElKhatib
- The United Nations for the Relief and Works Agency in the Near East (UNRWA) Field Office, Gaza, Palestine
| | - Shatha AlBaik
- grid.501184.90000 0001 2173 1062The United Nations for the Relief and Works Agency in the Near East (UNRWA) Headquarters, Amman, Jordan
| | - Masako Horino
- grid.501184.90000 0001 2173 1062The United Nations for the Relief and Works Agency in the Near East (UNRWA) Headquarters, Amman, Jordan ,grid.21107.350000 0001 2171 9311Center for Human Nutrition and Sight & Life Global Nutrition Research Institute, Dept of Int’l Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA
| | - Mohammed Waleed
- The United Nations for the Relief and Works Agency in the Near East (UNRWA) Field Office, Gaza, Palestine
| | - Farah Fawaz
- grid.501184.90000 0001 2173 1062The United Nations for the Relief and Works Agency in the Near East (UNRWA) Headquarters, Amman, Jordan
| | - Giulia Loffreda
- grid.104846.fInstitute for Global Health and Development, Queen Margaret University, Musselburgh EH21 6UU Edinburgh, Scotland, UK
| | - Akihiro Seita
- grid.501184.90000 0001 2173 1062The United Nations for the Relief and Works Agency in the Near East (UNRWA) Headquarters, Amman, Jordan
| | - Sophie Witter
- grid.104846.fInstitute for Global Health and Development, Queen Margaret University, Musselburgh EH21 6UU Edinburgh, Scotland, UK
| | - Karin Diaconu
- grid.104846.fInstitute for Global Health and Development, Queen Margaret University, Musselburgh EH21 6UU Edinburgh, Scotland, UK
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Kamberi F, Ndreu V, Sinaj E, Zekja I, Jaho J. Impact of COVID-19 Outbreak in Healthcare of People with Type 2 Diabetes: Evidence from a Cross-Sectional Study. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.10753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Objective
The aim was to assess the impact of the COVID-19 outbreak on the health care of type 2 diabetes patients and identify the correlated factors.
Research Design and Methods
A cross-sectional study was carried out from November 2020 to February 2021. The study enrolled 400 adults with type 2 diabetes aged 40–65 with at least one other chronic illness receiving health services in primary care in Vlore, Albania. A short questionnaire based on literature, taking into account the situation of the COVID-19 pandemic, was used for the data collection. The administration of the questionnaire was done by trained nurses. All participants gave their written informed consent before administering the questionnaire. Two-tailed Pearson correlation and linear regression were used to test the correlations.
Results
Among 400 patients with type 2 diabetes in the study, 53.0% were female and 47.0% were men. Most of the participants were married (n = 303) with a high level of education (54.3%). Treatment was mainly with oral medications (58.0%). Based on body mass index, 63.0% of participants were overweight. Employment status (p = 003), the type of treatment, oral medication vs insulin (p = 001), body mass index (p = 001), and living alone (p = 008) were the more correlated factors.
Conclusions
Care of type 2 diabetic patients due to the COVID-19 pandemic is closely associated with social determinants of health and the resources of healthcare settings. The need to address innovative approaches to care including self-care, social support, and e-health is recommended.
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Abdou M, Hassan MM, Hassanein SA, Elsebaie EH, Shamma RA. Presentations, Complications, and Challenges Encountered During Management of Type 1 Diabetes in Egyptian Children During COVID-19 Pandemic: A Single-Center Experience. Front Endocrinol (Lausanne) 2022; 13:814991. [PMID: 35360079 PMCID: PMC8963467 DOI: 10.3389/fendo.2022.814991] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Accepted: 01/27/2022] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic has been associated with significant challenges pertaining to the management of children and adolescents with type 1 diabetes (T1D). Issues such as fear of infection and lockdown measures have resulted in delayed and more severe clinical presentations of this disease. OBJECTIVES This study aimed at reporting the frequency and severity of diabetic ketoacidosis (DKA) and the rate of DKA complications in children with diabetes who presented to the emergency unit during COVID-19 pandemic. Furthermore, the purpose of this study was to compare the data collected from the first and second COVID-19 waves with that of the pre-COVID-19 period and describe the challenges encountered during disease management. METHODS This cross-sectional study included all children and adolescents with T1D who presented to the emergency department at Abo El Rish Children's Hospital, Cairo University, during the first and second COVID-19 waves. It also included data collected from the pre-COVID-19 period. Demographic and clinical data, investigations, and management details were collected from the patients' medical records. RESULTS Three hundred twenty-four Egyptian children and adolescents diagnosed with T1D were recruited. One hundred forty patients (43.2%) presented with severe DKA, and approximately 66% were newly diagnosed with T1D. The participants presented with manifestations suggestive of COVID-19, such as fever (29.5%), respiratory manifestations (7.2%), and gastrointestinal symptoms (14.7%). Thirty-seven patients were tested for severe acute respiratory syndrome coronavirus 2 infection using nasopharyngeal swabs, and four patients tested positive. Around 18% of patients developed hypokalemia during disease management. A comparison between these data and the data from previous years revealed that there was a significant increase in the number of newly diagnosed cases with more severe DKA at presentation and a higher frequency of development of hypokalemia during both COVID-19 waves. CONCLUSION An increase in the frequency of newly diagnosed cases was identified during the first and the second COVID-19 waves compared with the pre-COVID-19 period. The patients presented with more severe DKA, probably due to a more delayed presentation. The frequency of hypokalemia development was also significantly higher, and the severity of DKA was associated with a longer ICU admission. Further studies are required to establish a definitive link between the COVID-19 pandemic and the severity of presentation.
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Affiliation(s)
- Marise Abdou
- The Diabetes, Endocrine and Metabolism Pediatric Unit, Pediatric Department, Cairo University, Cairo, Egypt
- *Correspondence: Marise Abdou,
| | - Mona M. Hassan
- The Diabetes, Endocrine and Metabolism Pediatric Unit, Pediatric Department, Cairo University, Cairo, Egypt
| | - Samah A. Hassanein
- The Diabetes, Endocrine and Metabolism Pediatric Unit, Pediatric Department, Cairo University, Cairo, Egypt
| | - Eman H. Elsebaie
- Public Health and Community Medicine Department, Cairo University, Cairo, Egypt
| | - Radwa A. Shamma
- The Diabetes, Endocrine and Metabolism Pediatric Unit, Pediatric Department, Cairo University, Cairo, Egypt
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Farooqi MH, Abdelmannan DK, Al buflasa MM, Abbas Hamed MA, Xavier M, Santos Cadiz TJ, Nawaz FA. The Impact of Telemonitoring on Improving Glycemic and Metabolic Control in Previously Lost-to-Follow-Up Patients with Type 2 Diabetes Mellitus: A Single-Center Interventional Study in the United Arab Emirates. Int J Clin Pract 2022; 2022:6286574. [PMID: 35685530 PMCID: PMC9159213 DOI: 10.1155/2022/6286574] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Revised: 01/28/2022] [Accepted: 03/24/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Telemonitoring (TM), mobile-phone technology for health, and bluetooth-enabled self-monitoring devices represent innovative solutions for proper glycemic control, compliance and monitoring, and access to providers. OBJECTIVE In this study, we evaluated the impact of TM devices on glycemic control and the compliance of 38 previously lost-to-follow-up (LTFU) patients with type 2 diabetes mellitus (T2DM). METHODS This was an interventional single-center study that randomly recruited LTFU patients from the Dubai Diabetes Center (DDC), UAE. After contact and recruitment by phone, patients had an initial visit at which they were provided with home-based TM devices. A follow-up visit was conducted three months later. RESULTS The mean HbA1c decreased significantly from 10.3 ± 1.9% at baseline to 7.4 ± 1.5% at the end of follow-up, with a mean difference (MD) of -2.9% [95% CI: -3.6 to -2.2]. The percentage of patients with HbA1c <7% was 50% after three months. Home-based blood sugar monitor devices showed a significant reduction in fasting blood glucose (FBG) after three months (MD = -40.1 mg/dL, 95% CI: -70.8 to -9.3). A significant reduction was observed in terms of body weight after three months (MD = -1.3 kg, 95% CI: -2.5 to -0.08). The mean number of days the participants used a device was the highest for portable pill dispensers (86.5 ± 22.8 days), followed by a OneTouch® blood glucose monitor (72.9 ± 23.5 days). CONCLUSIONS TM led to significant improvements in overall diabetes outcomes, including glycemic control and body weight, indicating its effectiveness in a challenging population of T2DM patients who had previously been lost to follow-up.
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Affiliation(s)
| | | | | | | | - Maxon Xavier
- Dubai Diabetes Center, Dubai Health Authority, Dubai, UAE
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Axenhus M, Schedin-Weiss S, Winblad B, Wimo A. Changes in mortality trends amongst common diseases during the COVID-19 pandemic in Sweden. Scand J Public Health 2021; 50:748-755. [PMID: 34933630 PMCID: PMC9361422 DOI: 10.1177/14034948211064656] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE It has been found that COVID-19 increases deaths within common diseases in countries that have implemented strict lockdowns. In order to elucidate the proper national response to a pandemic, the mortality rates within COVID-19 and various diseases need to be studied in countries whose pandemic response differ. Sweden represents a country with lax pandemic restrictions, and we aimed to study the effects of COVID-19 on historical mortality rates within common diseases during 2020. METHODS Regression models and moving averages were used to predict expected premature mortality per the ICD-10 during 2020 using historical data sets. Predicted values were then compared to recorded premature mortality to identify changes in mortality trends. RESULTS Seasonal increased mortality was found within neurological diseases. Infectious diseases, tumours and cardiac disease mortality rates decreased compared to expected outcome. CONCLUSIONS Changes in mortality trends were observed for several common diseases during the COVID-19 pandemic. Neurological and cardiac conditions, infections and tumours are examples of diseases that were heavily affected by the pandemic. The indirect effects of COVID-19 on certain patient populations should be considered when determining pandemic impact.
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Affiliation(s)
- Michael Axenhus
- Division of Neurogeriatrics, Centre for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Sweden.,Theme Inflammation and Aging, Karolinska University Hospital, Sweden
| | - Sophia Schedin-Weiss
- Division of Neurogeriatrics, Centre for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Sweden
| | - Bengt Winblad
- Division of Neurogeriatrics, Centre for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Sweden.,Theme Inflammation and Aging, Karolinska University Hospital, Sweden
| | - Anders Wimo
- Division of Neurogeriatrics, Centre for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Sweden.,Primary Care, Hudiksvall-Nordanstig, Sweden
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KARAGOZ E, KİZİLGUL M. Interference of high dose intravenous vitamin C with blood glucose testing in a patient with COVID-19 infection. JOURNAL OF HEALTH SCIENCES AND MEDICINE 2021. [DOI: 10.32322/jhsm.888191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
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Bielka W, Przezak A, Pawlik A. Therapy of Type 2 Diabetes in Patients with SARS-CoV-2 Infection. Int J Mol Sci 2021; 22:ijms22147605. [PMID: 34299225 PMCID: PMC8306903 DOI: 10.3390/ijms22147605] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 07/12/2021] [Accepted: 07/13/2021] [Indexed: 12/15/2022] Open
Abstract
COVID-19 infection poses an important clinical therapeutic problem, especially in patients with coexistent diseases such as type 2 diabetes. Potential pathogenetic links between COVID-19 and diabetes include inflammation, effects on glucose homeostasis, haemoglobin deoxygenation, altered immune status and activation of the renin-angiotensin-aldosterone system (RAAS). Moreover, drugs often used in the clinical care of diabetes (dipeptidyl peptidase 4 inhibitors, glucagon-like peptide 1 receptor agonists, sodium-glucose cotransporter 2 inhibitors, metformin and insulin) may influence the course of SARS-CoV-2 infection, so it is very important to verify their effectiveness and safety. This review summarises the new advances in diabetes therapy and COVID-19 and provides clinical recommendations that are essential for medical doctors and for patients suffering from type 2 diabetes.
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