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Orfão NH, Andrade RLDP, Ruffino-Netto A, da Silva LWF, Villa TCS, Seifert ML, Zilly A, Arcoverde MAM, Hoare I, Izurieta R, da Silva-Sobrinho RA. Influence of COVID-19 on the notification of drug-resistant pulmonary tuberculosis cases. BMC Infect Dis 2023; 23:497. [PMID: 37507668 PMCID: PMC10375729 DOI: 10.1186/s12879-023-08463-x] [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: 01/26/2023] [Accepted: 07/15/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND To analyze the influence of the COVID-19 pandemic on the process of diagnosis and monitoring of drug-resistant pulmonary tuberculosis (TB) cases reported in the state of Paraná, Brazil, from 2015 to 2020. METHODS Ecological study with quantitative approach. This study was based on diagnosed cases of pulmonary TB reported in the Notifiable Disease Information System in residents of Paraná; as well as through the number of confirmed cases of COVID-19 in the state epidemiological bulletin for the year 2020. The study data were analyzed using descriptive statistics. RESULTS It was found that, although the number of reported pulmonary TB cases (drug-resistant and general) increased between 2015 and 2019, there was a drop in notification in 2020, the first year of the COVID-19 pandemic. The notification of TB cases was also influenced monthly during the year according to the increase in the number of COVID-19 cases. For cases of drug-resistant pulmonary TB, the provision of diagnostic tests and Directly Observed Treatment decreased by more than half in 2020, especially when compared to 2019. CONCLUSIONS In view of these findings, the influence of COVID-19 on the diagnosis and monitoring of drug-resistant and general pulmonary TB cases is evident, showing that the pandemic has compromised the advances of recent decades in achieving the goals established for its eradication by 2035.
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Affiliation(s)
| | | | | | | | | | | | - Adriana Zilly
- Universidade Estadual do Oeste do Paraná, Foz do Iguaçu, Brazil
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Puig-García M, Rivadeneira MF, Peralta A, Chilet-Rosell E, Benazizi-Dahbi I, Hernández-Enríquez M, Lucía Torres-Castillo A, Caicedo-Montaño C, Parker LA. Access to health services for chronic disease care during the COVID-19 pandemic in Ecuador: A qualitative analysis using a Social Determinants of Health approach. Glob Public Health 2023; 18:2224859. [PMID: 37344363 PMCID: PMC7616628 DOI: 10.1080/17441692.2023.2224859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 06/07/2023] [Indexed: 06/23/2023]
Abstract
This qualitative study aims to explore how the COVID-19 pandemic impacted healthcare access for patients with chronic conditions in Ecuador from the patient's perspective. We interviewed 19 patients diagnosed with arterial hypertension or type 2 diabetes in rural and urban areas of Ecuador during August and September 2020. We used the Framework Method to analyse the interview transcripts with ATLAS.Ti 8.4 and organised the ideas discussed using categories from the World Health Organization Commission on the Social Determinants of Health conceptual framework. Reorganization of health services during the pandemic meant that patients with arterial hypertension or diabetes could no longer attend face-to-face appointments for disease follow-up. System failures related to medication supply led to increased out-of-pocket payments, which, together with reduced or absent earnings, and in a context with limited social protection policies, meant that patients frequently went for prolonged periods without medication. Rural health initiatives, support from family and use of traditional medicine were reported as ways to manage their chronic condition during this time. Barriers to disease management disproportionately affected individuals with low socioeconomic positions. Stock shortages, lack of protective labour policies and limited reach of anticipatory policies for health emergencies likely worsened pre-existing health inequities in Ecuador.
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Affiliation(s)
- Marta Puig-García
- Department of Public Health, Universidad Miguel Hernández (UMH), Alicante, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - María Fernanda Rivadeneira
- Institute of Public Health, Faculty of Medicine, Pontificia Universidad Católica del Ecuador (PUCE), Quito, Ecuador
| | - Andrés Peralta
- Institute of Public Health, Faculty of Medicine, Pontificia Universidad Católica del Ecuador (PUCE), Quito, Ecuador
| | - Elisa Chilet-Rosell
- Department of Public Health, Universidad Miguel Hernández (UMH), Alicante, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Ikram Benazizi-Dahbi
- Department of Public Health, Universidad Miguel Hernández (UMH), Alicante, Spain
| | - María Hernández-Enríquez
- Institute of Public Health, Faculty of Medicine, Pontificia Universidad Católica del Ecuador (PUCE), Quito, Ecuador
| | - Ana Lucía Torres-Castillo
- Institute of Public Health, Faculty of Medicine, Pontificia Universidad Católica del Ecuador (PUCE), Quito, Ecuador
| | | | - Lucy Anne Parker
- Department of Public Health, Universidad Miguel Hernández (UMH), Alicante, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
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Bello K, De Lepeleire J, Agossou C, Apers L, Zannou DM, Criel B. Lessons Learnt From the Experiences of Primary Care Physicians Facing COVID-19 in Benin: A Mixed-Methods Study. FRONTIERS IN HEALTH SERVICES 2022; 2:843058. [PMID: 36925823 PMCID: PMC10012796 DOI: 10.3389/frhs.2022.843058] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Accepted: 03/08/2022] [Indexed: 11/13/2022]
Abstract
Introduction In sub-Saharan Africa, there is a need to better understand and guide the practice of primary care physicians (PCPs), especially in a crisis context like the COVID-19 pandemic. This study analyses the experiences of PCPs facing COVID-19 in Benin and draws policy lessons. Methods The study followed a fully mixed sequential dominant status design. Data were collected between April and August 2020 from a sample of PCPs in Benin. We performed descriptive analyses on the quantitative data. We also performed bivariate analyses for testing associations between various outcomes and the public/private status of the PCPs, their localization within or outside the cordon sanitaire put in place at the beginning of COVID-19, and their practice' category. A thematic content analysis was done on qualitative data. Results from both analyses were triangulated. Results Ninety PCPs participated in the quantitative strand, and 14 in the qualitative. The median percentage of the COVID-19 control measures implemented in the health facilities, as reported by the PCPs, was 77.8% (interquartile range = 16.7%), with no difference between the various groups. While 29.4% of the PCPs reported being poorly/not capable of helping the communities to deal with COVID-19, 45.3% felt poorly/not confident in dealing with an actual case. These percentages were bigger in the private sector. The PCP's experiences were marked by anxiety and fear, with 80.2% reporting stress. Many PCPs (74.1%) reported not receiving support from local health authorities, and 75.3% felt their concerns were not adequately addressed. Both percentages were higher in the private sector. The PCPs especially complained of insufficient training, insufficient coordination, and less support to private providers than the public ones. For 72.4 and 79.3% of the PCPs, respectively, the pandemic impacted services utilization and daily work. There were negative impacts (like a decrease in the services utilization or the quality of care), but also positive ones (like improved compliance to hygiene measures and new opportunities). Conclusion Our study highlighted the need for more structured support to PCPs for optimizing their contribution to epidemics control and good primary healthcare in Benin. Efforts in this direction can build on several good practices and opportunities.
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Affiliation(s)
- Kéfilath Bello
- Centre de Recherche en Reproduction Humaine et en Démographie, Cotonou, Benin.,Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium.,Department of Public Health and Primary Care, General Practice, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Jan De Lepeleire
- Department of Public Health and Primary Care, General Practice, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Christian Agossou
- Centre de Recherche en Reproduction Humaine et en Démographie, Cotonou, Benin
| | - Ludwig Apers
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | | | - Bart Criel
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
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Lakoh S, Firima E, Williams CEE, Conteh SK, Jalloh MB, Sheku MG, Adekanmbi O, Sevalie S, Kamara SA, Kamara MAS, Barrie U, Kamara GN, Yi L, Guo X, Haffner C, Kamara MN, Jiba DF, Namanaga ES, Maruta A, Kallon C, Kanu JS, Deen GF, Samai M, Okeibunor JC, Russell JBW. An Intra-COVID-19 Assessment of Hand Hygiene Facility, Policy and Staff Compliance in Two Hospitals in Sierra Leone: Is There a Difference between Regional and Capital City Hospitals? Trop Med Infect Dis 2021; 6:tropicalmed6040204. [PMID: 34941660 PMCID: PMC8705290 DOI: 10.3390/tropicalmed6040204] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 11/21/2021] [Accepted: 11/26/2021] [Indexed: 12/12/2022] Open
Abstract
Although hand hygiene (HH) is the most effective intervention to reduce the spread of infections, there are limited data on HH facilities, policy, and compliance in sub-Saharan Africa. This cross-sectional study is aimed at assessing HH using the WHO HH self-assessment framework, HH technical reference manual, and a modified infection control self-assessment tool in two hospitals in Sierra Leone. Only 10% and 9% of regional and capital city hospitals had running tap water, respectively. Veronica buckets were the resources for HH in 89% of units in the regional hospital and 92% of units in capital city hospital. Constant supply of soap and alcohol-based hand rub was available in 82% and 68%; and 74% and 79% of units in the capital city and regional hospitals, respectively. Only 10% of the units in both hospitals had hand-drying facilities and functional sinks. Overall HH compliance for the two hospitals was 18.6% and was higher in the regional (20.8%) than the capital city (17.0%) hospitals. The HH levels for the capital city and regional hospitals were 277.5 and 262.5 respectively. Despite the COVID-19 pandemic, there are still challenges with HH compliance in Sierra Leone. It is, therefore, necessary to strengthen the HH multi-modal strategy.
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Affiliation(s)
- Sulaiman Lakoh
- College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone; (M.B.J.); (S.S.); (M.N.K.); (J.S.K.); (G.F.D.); (M.S.); (J.B.W.R.)
- Ministry of Health and Sanitation, Government of Sierra Leone, Freetown, Sierra Leone; (C.E.E.W.); (S.K.C.); (M.G.S.); (C.H.); (D.F.J.); (E.S.N.); (C.K.)
- Correspondence: (S.L.); (E.F.)
| | - Emmanuel Firima
- Clinical Research Unit, Department of Medicine, Swiss Tropical and Public Health Institute, CH-4051 Basel, Switzerland
- University of Basel, CH-4001 Basel, Switzerland
- SolidarMed, Christie House 3rd Floor, Orpen Road, Old Europa, P.O. Box 0254, Maseru West 105, Lesotho
- Correspondence: (S.L.); (E.F.)
| | - Christine Ellen Elleanor Williams
- Ministry of Health and Sanitation, Government of Sierra Leone, Freetown, Sierra Leone; (C.E.E.W.); (S.K.C.); (M.G.S.); (C.H.); (D.F.J.); (E.S.N.); (C.K.)
| | - Sarah K. Conteh
- Ministry of Health and Sanitation, Government of Sierra Leone, Freetown, Sierra Leone; (C.E.E.W.); (S.K.C.); (M.G.S.); (C.H.); (D.F.J.); (E.S.N.); (C.K.)
| | - Mohamed Boie Jalloh
- College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone; (M.B.J.); (S.S.); (M.N.K.); (J.S.K.); (G.F.D.); (M.S.); (J.B.W.R.)
- 34 Military Hospital, Freetown, Sierra Leone; (S.A.K.); (M.A.S.K.); (G.N.K.)
| | - Mohamed Gbeshay Sheku
- Ministry of Health and Sanitation, Government of Sierra Leone, Freetown, Sierra Leone; (C.E.E.W.); (S.K.C.); (M.G.S.); (C.H.); (D.F.J.); (E.S.N.); (C.K.)
| | - Olukemi Adekanmbi
- Department of Medicine, College of Medicine, University of Ibadan, Ibadan 200005, Nigeria;
- Department of Medicine, University College Hospital, Ibadan 200005, Nigeria
| | - Stephen Sevalie
- College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone; (M.B.J.); (S.S.); (M.N.K.); (J.S.K.); (G.F.D.); (M.S.); (J.B.W.R.)
- 34 Military Hospital, Freetown, Sierra Leone; (S.A.K.); (M.A.S.K.); (G.N.K.)
| | - Sylvia Adama Kamara
- 34 Military Hospital, Freetown, Sierra Leone; (S.A.K.); (M.A.S.K.); (G.N.K.)
| | | | - Umu Barrie
- Infectious Disease Research Network, Freetown, Sierra Leone;
| | | | - Le Yi
- Changchun Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Changchun 130122, China; (L.Y.); (X.G.)
| | - Xuejun Guo
- Changchun Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Changchun 130122, China; (L.Y.); (X.G.)
| | - Chukwuemeka Haffner
- Ministry of Health and Sanitation, Government of Sierra Leone, Freetown, Sierra Leone; (C.E.E.W.); (S.K.C.); (M.G.S.); (C.H.); (D.F.J.); (E.S.N.); (C.K.)
| | - Matilda N. Kamara
- College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone; (M.B.J.); (S.S.); (M.N.K.); (J.S.K.); (G.F.D.); (M.S.); (J.B.W.R.)
| | - Darlinda F. Jiba
- Ministry of Health and Sanitation, Government of Sierra Leone, Freetown, Sierra Leone; (C.E.E.W.); (S.K.C.); (M.G.S.); (C.H.); (D.F.J.); (E.S.N.); (C.K.)
| | - Enanga Sonia Namanaga
- Ministry of Health and Sanitation, Government of Sierra Leone, Freetown, Sierra Leone; (C.E.E.W.); (S.K.C.); (M.G.S.); (C.H.); (D.F.J.); (E.S.N.); (C.K.)
| | - Anna Maruta
- World Health Organization Country Office, Freetown, Sierra Leone;
| | - Christiana Kallon
- Ministry of Health and Sanitation, Government of Sierra Leone, Freetown, Sierra Leone; (C.E.E.W.); (S.K.C.); (M.G.S.); (C.H.); (D.F.J.); (E.S.N.); (C.K.)
| | - Joseph Sam Kanu
- College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone; (M.B.J.); (S.S.); (M.N.K.); (J.S.K.); (G.F.D.); (M.S.); (J.B.W.R.)
- Ministry of Health and Sanitation, Government of Sierra Leone, Freetown, Sierra Leone; (C.E.E.W.); (S.K.C.); (M.G.S.); (C.H.); (D.F.J.); (E.S.N.); (C.K.)
| | - Gibrilla F. Deen
- College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone; (M.B.J.); (S.S.); (M.N.K.); (J.S.K.); (G.F.D.); (M.S.); (J.B.W.R.)
- Ministry of Health and Sanitation, Government of Sierra Leone, Freetown, Sierra Leone; (C.E.E.W.); (S.K.C.); (M.G.S.); (C.H.); (D.F.J.); (E.S.N.); (C.K.)
| | - Mohamed Samai
- College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone; (M.B.J.); (S.S.); (M.N.K.); (J.S.K.); (G.F.D.); (M.S.); (J.B.W.R.)
- Ministry of Health and Sanitation, Government of Sierra Leone, Freetown, Sierra Leone; (C.E.E.W.); (S.K.C.); (M.G.S.); (C.H.); (D.F.J.); (E.S.N.); (C.K.)
| | | | - James B. W. Russell
- College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone; (M.B.J.); (S.S.); (M.N.K.); (J.S.K.); (G.F.D.); (M.S.); (J.B.W.R.)
- Ministry of Health and Sanitation, Government of Sierra Leone, Freetown, Sierra Leone; (C.E.E.W.); (S.K.C.); (M.G.S.); (C.H.); (D.F.J.); (E.S.N.); (C.K.)
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Gandhi PA, Rehman T, Ilanchoorian D, Kathirvel S. Community Preparedness and Practices for Prevention and Control of COVID-19 (COP-COVID): An Assessment from Rural Northern India. Disaster Med Public Health Prep 2021; 17:e29. [PMID: 34344491 PMCID: PMC8523966 DOI: 10.1017/dmp.2021.255] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 07/04/2021] [Accepted: 07/20/2021] [Indexed: 02/02/2023]
Abstract
OBJECTIVES The study assessed the community preparedness to manage the coronavirus disease 2019 (COVID-19) and access to health-care services during the lockdown of 2020 in a rural health block of northern India. METHODS A cross-sectional study was conducted during June-July, 2020, in 25 villages and 5 wards of a rural administrative block of Haryana. A pretested, semi-structured investigator-administered checklist was used to assess the community preparedness and practices for COVID-19 prevention/control and health-care access through direct observations and interviewing community health workers and beneficiaries. RESULTS Active surveillance for influenza-like illness was carried out in 86.7% of the study units, although the frequency was once a month. There was poor adherence (adherence: 0-3%) to COVID-19 infection prevention and control (IPC) measures such as physical distancing and use of face masks. Rural beneficiaries reported difficulty in accessing essential health-care services than their urban counterparts. CONCLUSIONS A qualitative study to understand the facilitators and barriers for the non-adherence to IPC measures by the study population and formulating behavior change communication strategies for improving the IPC measures is needed. Repeat, cross-sectional surveys at regular intervals may be planned to gauge the change and effect of the interventions on the community preparedness and practices.
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Affiliation(s)
- P. Aravind Gandhi
- Department of Community Medicine & School of Public Health, PGIMER, Chandigarh, India
| | - Tanveer Rehman
- Department of Community Medicine & School of Public Health, PGIMER, Chandigarh, India
| | - Divya Ilanchoorian
- Department of Community Medicine & School of Public Health, PGIMER, Chandigarh, India
| | - Soundappan Kathirvel
- Department of Community Medicine & School of Public Health, PGIMER, Chandigarh, India
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