Challenges Facing Women Survivors of Self-Immolation in the Kurdish Regions of Iran: A Qualitative Study

The epidemiology of self-immolation in Iraq: A systematic review

BACKGROUND

Self-immolation is one of the most brutal suicide methods and is a significant social and medical problem throughout the world. Self-immolation is more common in low-income countries than in high-income countries.

AIM

The aim is to evaluate the trends in self-immolation and examine its frequency in Iraq.

METHODS

The PRISMA guideline was used to conduct this systematic review study. We searched for publications in English, Arabic and Kurdish in PubMed and Google Scholar. A total of 105 publications were identified through the search; however, 92 were eliminated due to duplication and irrelevant content. Finally, 13 full articles were included for data extraction. The inclusion criteria were articles that investigated self-immolation. However, letters to editors and media reports on self-immolation were excluded. The retrieved studies were selected, reviewed and then quality assessed.

RESULTS

This study included 13 articles. According to the findings, self-immolation accounted for 26.38% of all burn admissions in the Iraqi provinces and the Kurdistan region, with 16.02% of those occurring in the middle and southern provinces of Iraq and 36.75% in the Kurdistan region. It is more common in women than in men, especially among young, married, illiterate, or poorly educated people. Sulaymaniyah had a higher percentage of self-immolation than other governorates in Iraq, accounting for 38.3% of burn admissions. Cultural and social norms, domestic violence, mental health problems, family conflicts and financial problems were identified as the most common causes of self-immolation.

CONCLUSION

The prevalence of self-immolation is high among the Iraqi population, compared to other countries, particularly among the Kurdish population and in Sulaymaniyah. Self-immolation is relatively common among women. There are sociocultural factors that could contribute to this problem. Families must be restricted from having easy access to kerosene, and high-risk individuals should have access to psychological consultation to reduce the risk of self-immolation.

Exploring the coping strategies of women after self-immolation: A qualitative study

BACKGROUND

Women confront a slew of issues following self-immolation, and it is crucial to examine how women react after self-immolation and live with their scars. Therefore, this study was conducted with the aim of exploring the coping strategies of Kurdish women following self-immolation using a qualitative methodology.

METHODS

The conventional content analysis approach was used in this qualitative investigation. Semi-structured face-to-face and phone interviews were conducted with 26 Kurdish women who had self-immolated and were chosen using purposeful sampling and snowballing for this study. To reinforce the research, Guba and Lincoln's trustworthiness criteria were fulfilled.

RESULTS

The data analysis yielded 2 categories, 11 subcategories, and 85 initial codes. Positive coping is one of the categories and subcategories (spirituality, rebuilding their body, psychological rehabilitation, hiding the scars, restoring self-confidence, changing the lifestyle, forming a new life) 2- Negative coping (separation from society, neglecting the body and mind, violence and aggression, staying in the past).

CONCLUSION

Using the capacity of religious organizations to help victims of self-immolation, providing appropriate conditions and facilities to heal the scars caused by self-immolation, and facilitating access to counseling services can provide the conditions for women to better adapt after self-immolation.

Stigma as a barrier to suicide prevention efforts in Iran

Suicide and suicide attempt affect a considerable part of the general population, and in spite of their prevalence, the stigma associated with suicide remains an unsolved problem surrounding this important public health problem, especially in lower-income countries such as Iran. Evidence shows that help-seeking from formal mental health services for suicidal people is low in countries like Iran. Previous studies on Iranian survivors of suicide attempts have shown that these people experience fear of stigma due to labels such as loss of faith in God, having forms of severe mental illnesses ("madness"), and being involved in unaccepted sexual relationships. The associated stigma prevents them from seeking appropriate health and social services. Although both self-stigma and public stigma contribute to an unwillingness to seek mental health care and suicide prevention efforts in Iran, public stigma may be of greater consequence, significantly impeding an individual's likelihood of accessing care for their suicidal thoughts or attempts. In such circumstances, many people with suicidal thoughts miss out on social and formal support programs offered by social and healthcare providers. In this perspective article, focusing on the public stigma regarding suicide in Iranian society, we address the challenges and barriers to seeking suicide prevention efforts in Iran and discuss culturally appropriate strategies to improve the current situation.

Self-immolation in the Arab world: A systematic review

Self-immolation is the act of setting fire to oneself. Recent spikes in self-immolation events have been noticed in the Arab world, specifically in the aftermath of the Arab Spring in 2011. We aimed to examine the literature assessing the characteristics and patterns of suicide by self-immolation in the Arab world. We registered our systematic review in Prospero. We searched PubMed, Medline, PsycInfo, Embase, and Scopus databases from inception until 9 July 2022, along with other sources, following the PRISMA 2020 guidelines. We collected relevant articles tackling suicide by self-immolation in the Arab world via title and abstract screening followed by full-text screening. We then conducted a narrative synthesis of the results. Out of 326 records from databases and 17 additional records identified through other sources, 31 articles (27 quantitative and 4 qualitative) were included. The studies came from Iraq (n = 16), Tunisia (n = 6), Kingdom of Saudi Arabia (n = 3), Jordan (n = 2), Libya (n = 2), Bahrain (n = 1), and Egypt (n = 1). The quantitative studies had a sample size ranging from 22 to 600 self-inflicted burn victims. Studies showed that self-immolators were mostly married women with low educational level and low socioeconomic status. Self-immolation was more likely to happen at home, usually following marital conflicts. Kerosene was the accelerant used the most. Depression was the most comorbid mental health diagnosis. Studies highlighted that self-immolation was being increasignly used as a form of protest. Self-immolation is not uncommon in the Arab world. Specific interventions directed at the population at risk are warranted.

Exploring Iraqi people’s perception about early marriage: a qualitative study

Background and objective

Early marriage is prevalent in Iraq, but the factors related to this behavior, especially people's attitudes about it, have not been well studied. It has been proven that early marriage seriously threatens young girls' lives and health. This study aimed to explore the perception of people about early marriage in the Iraqi Kurdistan region.

Methods

A qualitative method was employed to carry out this study in 2020. Data were collected through 16 focus group discussions in different health centers in Erbil, Iraq. Each focus group included 8–12 participants who had the experience of early marriage. The transcripts of the focus groups were analyzed through the six methodological activities of Van Manen. The trustworthiness of the data was confirmed by using qualitative data evaluation criteria.

Results

Different themes and subthemes regarding the ideal age of marriage, attitudes toward marriage, reasons for early marriage, advantages and disadvantages of early marriage, and practice of early marriage in the community emerged from focus group discussions. Most participants identified early marriage as inappropriate social behavior that should not be practiced. Reasons for early marriage included poor economic status, protection of girls and boys, low educational level, and respect for old traditions of the community. Divorce and violence against women were the main disadvantages of early marriage.

Conclusion

There is a generally negative attitude towards early marriage, and the practice's disadvantages and health and psychological consequences are well recognized in Iraqi Kurdistan Region. However, different social, traditional, economic, educational, and religious factors encourage early marriage in the region. Further research is recommended in other governorates in the area to have a more precise and representative idea about the topic.

Policy Intervention and Financial Sustainability in an Emerging Economy: A Structural Vector Auto Regression Analysis

The purpose of the study is to observe the impact of policy intervention on financial sustainability using the structural vector autoregression (SVAR) analysis. The population of the study is the manufacturing sector of Pakistan, which is an emerging economy. Data for 249 firms operating in the manufacturing sector are taken, collected from Datastream from 2005 to 2019, with total observations of 2,400. To conduct the analysis, R software is used for its better visualization. Results show that firm performance, corporate governance, and sectoral policies have a positive and long-term impact on financial sustainability, whereas earning management and financialization not only have a negative impact, but this impact affects the operations of the corporate for a longer period. This study would be helpful for policymakers as it gives a framework for financial sustainability based on the policies and strategies developed by the sector.

Comparison of Students' Mental Wellbeing, Anxiety, Depression, and Quality of Life During COVID-19's Full and Partial (Smart) Lockdowns: A Follow-Up Study at a 5-Month Interval

Objective

Scholars have debated the COVID-19's full and partial lockdowns' effectivity to control the transmission of the new case. They emphasized the provision of required economic and social resources worldwide. Past literature related to COVID-19 has contributed little evidence to examine the efficacy of full and partial lockdown measures with experimental perspectives at different intervals. This study bridges this literature gap and explores the full and smart lockdowns' impacts on Pakistani students' mental health, depression, quality of life, and anxiety symptoms, during the various waves of the COVID-19 pandemic.

Method

This pretest and posttest experimental designed web-based survey recruited 40 students from March 23 to August 23, 2020, and recorded their responses. The study incorporated four standardized psychological instruments to receive the desired datasets related to students' mental health, quality of life, anxiety, and depression. Researchers shared data links with the participants via social media, WhatsApp. The study applied one-way and multivariate ANOVA tests (analysis of variance) to draw the desired results.

Results

This study's findings suggest that both full and partial COVID-19 lockdowns effectively improve students' mental health and quality of life. These measures help reduce anxiety and depressive symptoms among university students. The study results exhibit that partial lockdown (PL) is more effective in improving quality of life. Besides, PL helps reduce anxiety symptoms than complete lockdown among Pakistani students.

Conclusion

The present study's findings suggest that students are vulnerable. They need particular interventions and preventive measures to protect and improve their mental health and quality of life during a global pandemic. As the stressful experience of the epidemic persists in Pakistan. It will also be interesting to examine the psychological impact of the successive waves of the COVID-19 pandemic.

Tourists' Health Risk Threats Amid COVID-19 Era: Role of Technology Innovation, Transformation, and Recovery Implications for Sustainable Tourism

Technology innovation has changed the patterns with its advanced features for travel and tourism industry during the outbreak of COVID-19 pandemic, which massively hit tourism and travel worldwide. The profound adverse effects of the coronavirus disease resulted in a steep decline in the demand for travel and tourism activities worldwide. This study focused on the literature based on travel and tourism in the wake global crisis due to infectious virus. The study aims to review the emerging literature critically to help researchers better understand the situation. It valorizes transformational affordance, tourism, and travel industries impacts posed by the virus COVID-19. The study proposed a research model on reviving the international tourism activities post COVID-19 pandemic to gain sustainable development and recovery. The scholars have debated seeking the best possible ways to predict a sustainable recovery of travel, tourism, and leisure sectors from the devastating consequences of coronavirus COVID-19. In the first phase, the study describes how the current pandemic can become transformational opportunities. It debates the situation and questions related to the emergence of the COVID-19 outbreak. The present research focuses on identifying fundamental values, organizations, and pre-assumptions related to travel and tourism revival and help academia and researchers to a breakthrough in initiating the frontiers based on research and practice. This study aims at exploring the role of technological innovation in the crisis management of COVID-19 tourism impacts, tourists' behavior, and experiences. The travel and tourism industry's main stakeholders include tourism demand and organizations that manage tourists' destinations and policymakers. They have already experienced the stages of responses, recovery, and resetting tourism recovery strategies. The study provides valuable insight into the coronavirus consequences on travel and tourism and practical implications for global tourism and academic research revitalization.

Women's Entrepreneurial Contribution to Family Income: Innovative Technologies Promote Females' Entrepreneurship Amid COVID-19 Crisis

Women entrepreneurs innovate, initiate, engage, and run business enterprises to contribute the domestic development. Women entrepreneurs think and start taking risks of operating enterprises and combine various factors involved in production to deal with the uncertain business environment. Entrepreneurship and technological innovation play a crucial role in developing the economy by creating job opportunities, improving skills, and executing new ideas. It has a significant impact on the income of the household. The study focused on investigating the role of women's entrepreneurship and innovation technologies in contributing to household income in the challenging situation of the pandemic COVID-19. The paper emphasized identifying the determinants of female entrepreneurial contribution toward household income. This study collected data from selected rural and urban areas of district Faisalabad through a self-administered questionnaire. Investigators interviewed female entrepreneurs and chose them through the snowball sampling technique from a population of purposively selected female-run businesses. Interviews were conducted with women entrepreneurs to gather relevant information for the survey investigation at their workplaces and home. The effects of various factors, including age, education, family size, income from other sources, time allocated to entrepreneurial activity, firm size, and location (rural/urban) were estimated empirically using an ordered logit model. The study findings exhibited a positive and significant role of respondents' education, family size, time allocated to entrepreneurial activities, and firm size. The survey outcomes also indicated that the contribution of entrepreneurial income to household income in the rural areas is significantly higher than that in urban areas. This study signifies that regulations against gender discrimination in public and private institutions are helpful. Besides, encouraging an environment for entrepreneurial culture among women in the country would increase family income. The study's findings and policy implications directly link to Sustainable Development Goal (SDGs) 5 of Gender Equality (GE) and SDG 8 related to decent work and economic growth.

Product Market Competition and Firm Performance: Business Survival Through Innovation and Entrepreneurial Orientation Amid COVID-19 Financial Crisis

The product market competition has become a global challenge for business organizations in the challenging and competitive market environment in the influx of the COVID-19 outbreak. The influence of products competition on organizational performance in developed economies has gained scholars' attention, and numerous studies explored its impacts on business profitability. The existing studies designate mixed findings between the linkage of CSR practices and Chinese business firms' healthier performance in emerging economies; however, the current global crisis due to the coronavirus has made product market completion fierce, which ultimately affects business firms' performance. This study focuses on this logical global challenge, investigates the rationale, and examines product-market completion impact on firms' performance operating in the Chinese markets. The study collected data from the annual reports of Chinese business organizations with A-share listing and registered with the database of China Stock Markets and Accounting Research (CSMAR). The study employed a Generalized Method of Moment technique and investigated the connection between product market competition and Chinese firm performance. The empirical analysis of this study highlights the conclusion that market competition positively and significantly affected business firms' performance. This study specified that product market competition play a dynamic and indispensable role in achieving healthier firm performance in the Chinese markets. This study provides valuable insights on practical implications and future research directions for the scholars to draw interesting results with new study models.

Nexus between integrating technology readiness 2.0 index and students' e-library services adoption amid the COVID-19 challenges: Implications based on the theory of planned behavior

BACKGROUND

The advent of the pandemic COVID-19 has resulted in a global crisis that resulted in the closure of universities and educational institutions worldwide. This study aims to explore the determinants of students' intention towards e-library services usage amid the challenging time of the COVID-19 pandemic. This paper reviews the technology-oriented individual attitude based on four dimensions of the technology readiness 2.0 index factors, which affect medical students' perspectives.

MATERIALS AND METHODS

The authors provided a self-administered questionnaire to medical students to investigate their e-library adoption attitude during the COVID-19 crisis. The authors distributed 542 questionnaires, received 361 complete responses and analyzed the data through path modeling/partial least squares structural equations modeling technique (PLS-SEM) with the smart PLS software version 3.3.3. The structural equation-modelling tool permits the estimation of results.

RESULTS

The main finding revealed that medical students have a positive and explicit approach to use the services available at the e-library. Technology use and online services helped students continue their educational needs in the advent of the current pandemic COVID-19. Attitude and subjective norms have significant influence and are strong predictors of intention. However, due to inadequate support for the government side, the perceived behavioural control has an insignificant impact on intention. This paper indicated one of the pioneers investigating the determinants of e-library adoption among medical students based on technology-oriented personality traits, employing the four dimensions of the technology readiness 2.0 index during the challenges of the COVID-19 outbreak.

CONCLUSION

The study's findings provide useful insight that offers valuable insights to implement specific strategies from the government officials to address medical students' uncertainties and increase the technology adoption amid the COVID-19 pandemic in medical education for developing nations.

The Relationship Between CEO Duality and Business Firms' Performance: The Moderating Role of Firm Size and Corporate Social Responsibility

This study focuses on exploring the relationship between chief executive officer (CEO) duality and firm performance. We focus on how the size and corporate social responsibility (CSR) of firms moderate this relationship. In terms of size, business organizations are of two types: small and large firms. This study uses datasets of listed Chinese business firms included in the China Stock Market and Accounting Research database. It employs a generalized method of moment's technique to explore the connection between CEO duality and the performance of Chinese business firms through double mediation effects. Our empirical analysis showed that CEO duality has a significant negative relationship with firm performance. We also explored the moderating effects of firm size (small and large) and CSR practices on the relationship between CEO duality and improved performance of Chinese firms. Large firms and CSR practices showed significant and positive moderating effects on the relationship between CEO duality and firm performance. Conversely, with CEO duality, small firms showed a negative moderating influence on firm performance. This inclusive model provides valuable insights into how the dual role of the CEO of a firm affected the performance of Chinese firms through the moderating role of CSR practices and firm size for better business performance. The study offers empirical and theoretical contributions to the corporate governance literature. This research framework might help researchers in designing robust strategies to evaluate the effects on firm performance. Researchers may gain helpful insights using this methodology.

Crisis management, transnational healthcare challenges and opportunities: The intersection of COVID-19 pandemic and global mental health

The existing literature has paid insufficient attention to crisis management of global health challenges in the advent of epidemics and pandemics. This study articulates resilience importance and opportunities in the COVID-19 from crisis management challenges in essential ways. The second wave of the COVID-19 infectious disease's rapid global spread has developed a severe threat to global peace, which has posed global mental health and crisis management issues worldwide. Public health implementations' aggressive actions recommended a series of precautionary safety measures by the health specialists to suppress, sustain, and manage the local transmission of the COVID-19 pandemic. This study explores adverse consequences of the COVID-19 on communities' behavioral and interventional changes that might specify transmission dynamics. This present study recommends two model strategies that help sustain the rapid transmission and COVID-19′s adverse impacts on mental health in the general population and patients needing treatment. This study proposes mitigation and suppression models in the absence of a vaccine to decrease and manage the healthcare systems' burdens of treating patients. This global health emergency has challenged the global healthcare systems worldwide, and Governments are struggling to upgrade the healthcare systems to provide the best possible healthcare facilities to the patients. The healthcare systems in Pakistan are undeveloped to manage this global health emergency efficiently. Scientists' have already initiated experimental trials worldwide to develop vaccines to treat this infectious disease; however, the proposed two models are useful in managing the health emergency in the present situation. This study discusses global healthcare challenges, crisis management, and two model interventional strategies that help minimize the COVID-19′s rapid spread with practical crisis management preventive measures to reduce burden on healthcare systems.

Exploring the impact of COVID-19 on tourism: transformational potential and implications for a sustainable recovery of the travel and leisure industry

The study stipulates phases to observe the proposed mechanism in formulating the travel and leisure industry's recovery strategies. The present pandemic COVID-19 has resulted in global challenges, economic and healthcare crises, and posed spillover impacts on the global industries, including tourism and travel that the major contributor to the service industry worldwide. The tourism and leisure industry has faced the COVID-19 tourism impacts hardest-hit and lies among the most damaged global industries. The leisure and internal tourism indicated a steep decline amounting to 2.86 trillion US dollars, which quantified more than 50% revenue losses. In the first step, the study explores the consequences and settings of the COVID-19 pandemic and how innovation and change can contribute to the tourism industry's revival to the next normal. Thus, the study determines that tourism enterprises and scholars must consider and change the basic principles, main assumptions, and organizational situations related to research and practice framework through rebuilding and establishing the tourism sector. In the second step, the study discusses direct COVID-19 tourism impacts, attitudes, and practices in gaining the leisure industry's boom and recovery. In the third phase, the study proposes to observe the characteristics and COVID-19 tourism consequences on the travel and tourism research. The findings provide insights in regaining the tourism industry's operational activities and offer helpful suggestions to government officials, scholars, and tourism firms to reinvest in the tourism industry to set it back to a normal position.

Society, family, and individual characteristics as double-edged swords in the social reintegration of Iranian female survivors from unintentional severe burns: a qualitative study of enablers and barriers

Background

Reintegrating to society is a significant challenge during burn survivors’ rehabilitation.

Aim

This study aims to describe what Iranian female survivors from unintentional severe burns experience as enablers and barriers of social reintegration (SR).

Methods

Fourteen adult female burn survivors whose burns were unintentional participated in this qualitative study. Data were gathered through semi-structured face-to-face or telephone interviews and analyzed using inductive content analysis.

Results

Thirteen subcategories and six categories were emerged. Categories and subcategories of enablers content area were as follows: positive impact of society on SR (normal treatment of society, instrumental support), positive impact of family on SR (magnifying personal abilities assets, empathy and emotional support), and positive impact of personal characteristics on SR (coping with others stares, right to have a normal social life). Categories and subcategories of Barriers content area were as follows: negative impact of society on SR (being questioned in public, incorrect judgment about intent of burns, burns as a contagious disease), negative impact of family on SR (embarrassment of appearing in public with the survivor, family mistrust), and negative impact of intra-personal factors on SR (exaggeration of the post-burn changes, being over-sensitive to the others looks). From the deep interpretation of the data two overarching themes were emerged: “acceptance of the new normal by the society and the individual” and “being encompassed by misconceptions and mistreatments”.

Conclusions

Society, family and the individual characteristics have a dual role to play in the success of social reintegration in Iranian female unintentional burn survivors.

Primary school students' poetic malaria messages from Jimma zone, Oromia, Ethiopia: a qualitative content analysis

Background

The engagement of schools in malaria control is an emerging strategy. Little is known about the involvement of students in the development of malaria messages. This study evaluated the message content of primary school students’ malaria poems.

Methods

A qualitative content analysis was conducted to explore malaria messages conveyed in poems produced by students. Twenty poems were purposively selected from twenty schools across rural villages in five districts of the Jimma Zone. Data were analyzed using Atlas.ti version 7.1.4 software. The message contents were quantified in terms of frequency, and including metaphors, presented using central themes, categories, and supportive quotations.

Results

A total of 602 malarial contents were generated, and organized into 21 categories under five central themes. 1) Malaria-related knowledge (causation and modes of transmission, mosquito breeding and biting behavior, signs and symptoms, care for insecticide-treated nets (ITNs), and prevention methods), 2) Perceived threats from malaria, 3)The effectiveness of prevention methods (i.e., related to the adaption of ITNs, environmental cleaning, indoor residual spray (IRS), treatment for fever, and drug adherence practices), 4) Misconceptions, beliefs, and malpractices regarding the cause of malaria and drug use) and 5) Direct calls to the adopt ITN, IRS, clean surroundings, treatment, and drug use. The most commonly conveyed message contents were about the severity of malaria, distinguishable signs and symptoms, calls for community participation for malaria elimination, knowledge of preventive methods, and effectiveness of ITN use. Metaphoric expressions (war and death) were used to convey messages about the severity and the need to manage the prognosis of malaria through the active ITN use, which itself was metaphorically represented as ‘a trap’ to mosquitoes.

Conclusions

The poetic analysis indicated that the students developed and disseminated rich malarial messages, especially on malarial knowledge, and perceptions, beliefs, norms and practices of the local community to prevent and control malaria. Therefore, primary school students can be a source of information and would effectively communicate knowledge, perceptions, and promote malaria related practices, particularly in rural settings.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-11641-8.

Religious Affiliation, Daily Spirituals, and Private Religious Factors Promote Marital Commitment Among Married Couples: Does Religiosity Help People Amid the COVID-19 Crisis?

Religious studies are a vital branch of social science that seeks to explain the beliefs of human society and deals with the practices and beliefs of individuals. This distinctive study focuses on such influential aspects of a healthy life, which could play a vital role in the marital quality and matrimonial commitment of individuals. The study principally focused on inspecting the role of religiosity in healthy marital commitment among individuals. It is a distinctive and central value in regulating a healthy social life. This research designed a conceptual model for assessing marital commitment, and the study model comprised two primary variables. The study received datasets through a survey questionnaire based on participants from five private and public sectors. The research study conducted an empirical analysis to test the proposed conceptual framework. The findings exhibited that the value of the R 2 model was 0.484, meaning the level of religiosity had a substantial impression on healthy and lasting marital commitment. According to the final outline of the model factors associated with building religious support factors (β = 0.491), the marital commitment had a better and healthier impact. The goodness-of-fit of the measurement of the conceptual model showed a value of 0.51, which indicated that the theoretical model had sufficient consistency and rationality, and accurately fitted the data. Such an advanced statistical model is missing from the previous literature. The study results provide helpful insight to elucidate the social dynamics of marital commitment. The findings designate that religious practices strengthen and promote nuptial commitment. The study is novel in the context of religiosity impact on martial commitment with a cultural background of Pakistan. The generalizability of the study does not apply to the entire population or other regions. Future studies can investigate other religious variables to explore further research findings. The findings are helpful for decision-makers and policymakers to concentrate on marital issues and challenges confronted by couples worldwide.

Acceptability of patient-centered hypertension education delivered by community health workers among people living with HIV/AIDS in rural Uganda

Background

The prevalence of hypertension is increasing among people living with HIV/AIDS (PLWHA) in low- and middle-income countries (LMICs). However, knowledge of the complications and management of hypertension among PLWHA in Uganda remains low. We explored the acceptability of implementing hypertension (HTN) specific health education by community health workers (CHWs) among PLWHA in rural Uganda.

Methods

We conducted a qualitative study consisting of 22 in-depth interviews (14 PLWHA/HTN and 8 CHWs), 3 focus group discussions (FGDs), 2 with PLWHA/HTN and 1 with CHWs from Nakaseke district, Uganda. Participants were interviewed after a single session interaction with the CHW. Data were transcribed from luganda (local language) into English and analyzed using thematic analysis. We used Sekhon’s model of acceptability of health Interventions to explore participants’ perceptions.

Results

Participants believed CHWs utilized easy-to-understand, colloquial, non-technical language during education delivery, had a pre-existing rapport with the CHWs that aided faster communication, and had more time to explain illness than medical doctors had. Participants found the educational material (PocketDoktor™) to be simple and easy to understand, and perceived that the education would lead to improved health outcomes. Participants stated their health was a priority and sought further disease-specific information. We also found that CHWs were highly motivated to carry out the patient-centered education. While delivering the education, CHWs experienced difficulties in keeping up with the technical details regarding hypertension in the PocketDoktor™, financial stress and patient questions beyond their self-perceived skill level and experience. PLWHA/HTN had challenges accessing the health facility where the intervention was delivered and preferred a household setting.

Conclusions

Hypertension patient-centered education delivered by CHWs using the PocketDoktor™ was acceptable to PLWHA and hypertension in Nakaseke area in rural, Uganda. There is need for further studies to determine the cost implications of delivering this intervention among PLWHA across LMIC settings.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-11411-6.

Prevalence of Malaria and Chikungunya Co-Infection in Febrile Patients: A Systematic Review and Meta-Analysis

Background: Co-infection with malaria and chikungunya could exert a significant public health impact with infection misdiagnosis. Therefore, this study aimed to collect qualitative and quantitative evidence of malaria and chikungunya co-infection among febrile patients. Methods: Potentially relevant studies were identified using PubMed, Web of Science, and Scopus. The bias risk of the included studies was assessed using the checklist for analytical cross-sectional studies developed by the Joanna Briggs Institute. The pooled prevalence of malaria and chikungunya co-infection among febrile patients and the pooled prevalence of chikungunya virus (CHIKV) infection among malaria patients were estimated with the random effect model. The odds of malaria and chikungunya co-infection among febrile patients were also estimated using a random effect model that presumed the heterogeneity of the outcomes of the included studies. The heterogeneity among the included studies was assessed using the Cochran Q test and I² statistics. Publication bias was assessed using the funnel plot and Egger’s test. Results: Of the 1924 studies that were identified from the three databases, 10 fulfilled the eligibility criteria and were included in our study. The pooled prevalence of malaria and chikungunya co-infection (182 cases) among febrile patients (16,787 cases), stratified by diagnostic tests for CHIKV infection, was 10% (95% confidence interval (CI): 8–11%, I²: 99.5%) using RDT (IgM), 7% (95% CI: 4–10%) using the plaque reduction neutralization test (PRNT), 1% (95% CI: 0–2%, I²: 41.5%) using IgM and IgG ELISA, and 4% (95% CI: 2–6%) using real-time RT-PCR. When the prevalence was stratified by country, the prevalence of co-infection was 7% (95% CI: 5–10%, I²: 99.5%) in Nigeria, 1% (95% CI: 0–2%, I²: 99.5%) in Tanzania, 10% (95% CI: 8–11%) in Sierra Leone, 1% (95% CI: 0–4%) in Mozambique, and 4% (95% CI: 2–6%) in Kenya. The pooled prevalence of CHIKV infection (182 cases) among malaria patients (8317 cases), stratified by diagnostic tests for CHIKV infection, was 39% (95% CI: 34–44%, I²: 99.7%) using RDT (IgM), 43% (95% CI: 30–57%) using PRNT, 5% (95% CI: 3–7%, I²: 5.18%) using IgM and IgG ELISA, and 9% (95% CI: 6–15%) using real-time RT-PCR. The meta-analysis showed that malaria and chikungunya co-infection occurred by chance (p: 0.59, OR: 0.32, 95% CI: 0.6–1.07, I²: 78.5%). Conclusions: The prevalence of malaria and chikungunya co-infection varied from 0% to 10% as per the diagnostic test for CHIKV infection or the country where the co-infection was reported. Hence, the clinicians who diagnose patients with malaria infections in areas where two diseases are endemic should further investigate for chikungunya co-infection to prevent misdiagnosis or delayed treatment of concurrent infection.

The Role of Social Media in the Advent of COVID-19 Pandemic: Crisis Management, Mental Health Challenges and Implications

BACKGROUND

This study focuses on how educating people through social media platforms can help reduce the mental health consequences of the COVID-19 to manage the global health crisis. The pandemic has posed a global mental health crisis, and correct information is indispensable to dispel uncertainty, fear, and mental stress to unify global communities in collective combat against COVID-19 disease worldwide. Mounting studies specified that manifestly endless coronavirus-related newsfeeds and death numbers considerably increased the risk of global mental health issues. Social media provided positive and negative data, and the COVID-19 has resulted in a worldwide infodemic. It has eroded public trust and impeded virus restraint, which outlived the coronavirus pandemic itself.

METHODS

The study incorporated the narrative review analysis based on the existing literature related to mental health problems using the non-pharmaceutical interventions (NPIs) approach to minimize the COVID-19 adverse consequences on global mental health. The study performed a search of the electronic databases available at PsycINFO, PubMed, and LISTA. This research incorporates the statistical data related to the COVID-19 provided by the WHO, John Hopkins University, and Pakistani Ministry of Health.

RESULTS

Pakistan reported the second-highest COVID-19 cases within South Asia, the fifth-highest number of cases in Asia after Iran, India, Russia, Saudi Arabia, and the 14th highest recorded cases, as of October 14, 2020. Pakistan effectively managed the COVID-19 pandemic in the second wave. It stands at the eighth-highest number of confirmed cases in Asia, the 3rd-highest in South Asia, and the 28th-highest number of established patients globally, as of February20, 2021.

CONCLUSION

The COVID-19 has resulted in over 108.16 million confirmed cases, deaths over 2.374 million, and a recovery of 80.16 million people worldwide, as of February 12, 2021. This study focused on exploring the COVID-19 pandemic's adverse effects on global public health and the indispensable role of social media to provide the correct information in the COVID-19 health crisis. The findings' generalizability offers helpful insight for crisis management and contributes to the scientific literature. The results might provide a stepping-stone for conduct future empirical studies by including other factors to conclude exciting developments.

Global Financial Crisis, Smart Lockdown Strategies, and the COVID-19 Spillover Impacts: A Global Perspective Implications From Southeast Asia

This present study primarily emphasizes to seek the COVID-19 adverse impacts posing health challenges and global economic crisis. The pandemic (COVID-19) continues to hit the global economies adversely. Pakistan is the 5th-most-populous nation, and recorded positive cases with the third-highest positivity ratio in South Asia, and 26th-highest deaths toll of 21,450 and 29th number of most COVID-19 positive cases with 933,750 worldwide, as of June 6, 2021. The first wave appeared at the end of May 2020, and mid of June reported its peak, which ended by mid-July 2020. Early November 2020 witnessed the second wave with low intensity reached the climax by mid-December. The COVID-19's third wave severely affected the country during mid-March 2021. It exhibited the highest positivity rate, around 20%. New positive patients and deaths toll commenced to skyrocket and reported peak by April 15, 2021. Then situation gradually improved with effective measures and restrictions. The pandemic coronavirus (COVID-19) has affected 220 territories, regions, and countries and resulted in more than 174.116 million infections, deaths, 3.75 million, and 157.157 million positive cases fully recovered from this infectious disease, as of June 7, 2021. The pandemic has caused a severe crisis of healthcare facilities and economic challenges worldwide. Pakistani economy reported GPD's negative growth (-0.05) for the first time over the last 60 years in 2020, which caused a massive financial crisis. The Government's relief package intervened to reduce public mental stress and improve the quality of their lives. IMF reported that Pakistan's GPD bounced back at 4% growth by June 2021. This article determines that economic instability and health burden happened in Pakistan for a longer time than financial disequilibrium that occurred globally. Pakistan encountered this crisis due to its feeble healthcare systems and fragile economy. This study explores adverse health issues and spillover consequences on the economic crisis in Pakistan with global implications. It recommends smart lockdown restrictions in most affected areas to reopen the economic cycle with strict preventive measures to minimize the COVD-19 adverse consequences.