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Musbat S, Reuveni I, Magnezi R. Improvements in mental health associated with increased electronic communication and deterioration in physical health in adults aged 50+ during the COVID-19 pandemic. Front Public Health 2024; 12:1369707. [PMID: 38975353 PMCID: PMC11224488 DOI: 10.3389/fpubh.2024.1369707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 06/04/2024] [Indexed: 07/09/2024] Open
Abstract
Background Previous studies have documented changes in physical health, mental health and social parameters during COVID-19. At the same time, there are no comprehensive analyses of these parameters designed as longitudinal studies on large-scale older populations before and during the pandemic. Objective This longitudinal study aims to provide a quantitative analysis of the COVID-19 impact on the physical, mental, and social parameters in adults aged 50 and older before, in the early stages, and during the COVID-19 pandemic. Methods The data for this study were collected from three waves of the Survey of Health, Ageing and Retirement in Europe (SHARE), a supranational longitudinal database: pre-COVID (October 2019-March 2020), early-COVID (June-September 2020), and during-COVID (June-August 2021). The sample included 31,526 individuals, compared across the three-time points through nonparametric group comparison tests. Results Physical health was subjectively rated as poorer in the during-COVID wave compared to the pre-COVID wave. Additionally, the number of illnesses or health conditions reported in the during-COVID wave was significantly higher than in the pre-COVID wave, with the biggest increases registered for cardiovascular diseases. The results also show that employment and overall social contact decreased while loneliness increased over time. Unexpectedly, mental health issues, such as sadness or depression and trouble sleeping, decreased significantly in the COVID waves compared to the pre-COVID wave. The analysis of two additional pre-COVID waves (2015, 2017) revealed that poorer pre-COVID mental health reflected in high values of sadness or depression and trouble sleeping was not an isolated peak but represented a typical baseline. The positive influence on the individuals' mental health during COVID-19 was found to be electronic communication, which showed higher values than face-to-face communication and lowered the odds of sadness or depression. Conclusion Future policies should thus consider the positive impact of electronic contacts on mental health to promote overall health in adults aged 50 and older.
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Affiliation(s)
- Shay Musbat
- Department of Management, Health Systems Management Program, Bar-Ilan University, Ramat Gan, Israel
| | - Inbal Reuveni
- Department of Psychiatry, Hadassah Hebrew University Medical Center, Ein Kerem, Jerusalem, Israel
| | - Racheli Magnezi
- Department of Management, Health Systems Management Program, Bar-Ilan University, Ramat Gan, Israel
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Shibuya F, Hattori-Uchima M, Dacanay P, Peter F, Ngirmang TT, Dacanay R, Takeuchi R, de Los Reyes C, Kobayashi J. Multi-country case study on school health policy and its implementation in relation to COVID-19 control in Micronesia Small Islands Developing States. Trop Med Health 2024; 52:27. [PMID: 38553741 PMCID: PMC10979614 DOI: 10.1186/s41182-024-00590-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 02/25/2024] [Indexed: 04/02/2024] Open
Abstract
INTRODUCTION The COVID-19 pandemic caused school closures and rises in mental illness and non-communicable disease among school children worldwide. The Pacific Small Islands Developing States (SIDS) were also affected, but school health activities, which can effectively reduce negative effects of COVID-19, were not widely implemented compared to other Asia-Pacific countries. This study examined current school health implementation and related policies at national, local, and school levels in the Micronesia SIDS according to phases of COVID-19 control. METHODS Multi-country case study targeted the Federated States of Micronesia (FSM), Republic of the Marshall Islands (RMI), and Republic of Palau (ROP). These studies focused on school health implementation periods according to the PPR (Prevention, Preparedness, and Response) concept: Phase #1: prevention/preparedness, #2: early phase response, and #3: chronic phase response/recovery phase. Data were collected through policy document reviews that identified school health policies related to COVID-19 controls in the three phases and key informant interviews (KIIs) with 44 key informants (FSM, n = 14; RMI, n = 18; ROP, n = 12) whose work related to school health. The collected data were analyzed using content analysis methods according to the conceptual framework in this study. RESULTS This study identified three factors of school health implementation related to COVID-19 controls: promotion of decentralized education (FSM), implementation of COVID-19 controls in the school community (RMI), and disaster management for the protection of students including response to infectious disease (ROP). In Phase #1, no country had established a school health policy. In Phase #2, three enablers were identified in FSM and ROP, as reflected in COVID-19 controls by the education and health sectors. In Phase #3, RMI implemented COVID-19 controls in the school community. Documents on youth policy and disaster management in ROP were updated to reflect the chronic phase response and response to future public health crises. CONCLUSIONS A decentralized education was instrumental in immediately implementing COVID-19 control measures in schools at national and local levels for coordination between education and health sectors. Despite each county's multi-sectoral approach to engage COVID-19 controls in schools, local government organization requires strengthening and implementation of the formulated school health policy. In preparation for the next public health crisis, school health should be promoted that is integrated into both infection control and disaster management.
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Affiliation(s)
- Fumiko Shibuya
- Department of Global Health, Graduate School of Health Sciences, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa, 903-0215, Japan.
- Japanese Consortium for Global School Health Research, Nishihara, Japan.
| | | | - Paul Dacanay
- Division of Health Sciences, College of Micronesia-FSM, Palikir, Pohnpei, Federated States of Micronesia
| | - Florence Peter
- Women United Together Marshall Islands, Majuro, Marshall Islands
| | | | - Rudelyn Dacanay
- Division of Health Sciences, College of Micronesia-FSM, Palikir, Pohnpei, Federated States of Micronesia
| | - Rie Takeuchi
- Department of Global Health, Graduate School of Health Sciences, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa, 903-0215, Japan
- Japanese Consortium for Global School Health Research, Nishihara, Japan
- Faculty of Medicine, International University of Health and Welfare, Narita, Japan
| | - Calvin de Los Reyes
- Department of Global Health, Graduate School of Health Sciences, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa, 903-0215, Japan
- College of Arts and Sciences, University of the Philippines Manila, Manila, Philippines
| | - Jun Kobayashi
- Department of Global Health, Graduate School of Health Sciences, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa, 903-0215, Japan
- Japanese Consortium for Global School Health Research, Nishihara, Japan
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Moncatar TJRT, Gomez AVD, Lorenzo FME, Saniel OP, Faraon EJA, Rosadia RAF, Garcia FB. Effects of the COVID-19 Pandemic on the Implementation of NCD Care at the Primary Care Level in the Philippines: A Qualitative Inquiry. ACTA MEDICA PHILIPPINA 2024; 58:10-21. [PMID: 39005619 PMCID: PMC11239989 DOI: 10.47895/amp.vi0.7678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 07/16/2024]
Abstract
Background and Objective The focusing of resources to COVID-19 response hampered and disadvantaged primary care services including that for Non-Communicable Diseases (NCDs), compromising continuity of care and hence, patients' disease status. However, studies from low- and middle-income countries (LMICs) remain sparse; therefore, evidence generation on how the pandemic impacted the provision of these primary care services in LMICs will help further understand how policies can be reframed, and programs be made more efficient and effective despite similar crises. To bridge this gap, the study investigated how the pandemic affected the implementation of NCD care at the primary care level in the Philippines. Methods Thirty-one online focus group discussions via Zoom Meetings were conducted among 113 consenting physicians, nurses, midwives, and community health workers from various facilities - community health centers and stations, free-standing clinics, infirmaries, and level 1 hospitals - located within two provinces in the Philippines. All interviews were video-recorded upon participants' consent and transcribed verbatim. Inductive thematic analysis was employed through NViVo 12® to generate themes, identify categories, and describe codes. Results The impact of COVID-19 on NCD care at the primary care level revolved around heightened impediments to service delivery, alongside worsening of pre-existing challenges experienced by the healthcare workforce; subsequently compelling the public to resort to unhealthy practices. These detriments to the primary healthcare system involved resource constraints, discontinued programs, referral difficulties, infection, overburden among workers, and interrupted training activities. Citizens were also observed to adopt poor healthcare seeking behavior, thereby discontinuing treatment regimen. Conclusion Healthcare workers asserted that disadvantages caused by the pandemic in their NCD services at the primary care level possibly threaten patients' health status. Besides the necessity to address such detriments, this also emphasizes the need for quantitative studies that will aid in drawing inferences and evaluating the effect of health crises like the pandemic on such services to bridge gaps in improving quality of care.
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Affiliation(s)
- TJ Robinson T. Moncatar
- Department of Health Policy and Administration, College of Public Health, University of the Philippines Manila
| | | | | | - Ofelia P. Saniel
- Department of Epidemiology and Biostatistics, College of Public Health, University of the Philippines Manila
| | - Emerito Jose A. Faraon
- Department of Health Policy and Administration, College of Public Health, University of the Philippines Manila
| | | | - Fernando B. Garcia
- Department of Health Policy and Administration, College of Public Health, University of the Philippines Manila
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Obol SJ, Nzedibe O. Critical perspective on infodemic and infodemic management in previous Ebola outbreaks in Uganda. Front Public Health 2024; 12:1375776. [PMID: 38532966 PMCID: PMC10963486 DOI: 10.3389/fpubh.2024.1375776] [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: 01/24/2024] [Accepted: 02/22/2024] [Indexed: 03/28/2024] Open
Abstract
This research investigates the complex dynamics of Uganda's recent Ebola outbreaks, emphasizing the interplay between disease spread, misinformation, and existing societal vulnerabilities. Highlighting poverty as a core element, it delves into how socioeconomic factors exacerbate health crises. The study scrutinizes the role of political economy, medical pluralism, health systems, and informal networks in spreading misinformation, further complicating response efforts. Through a comprehensive analysis, this study aims to shed light on the multifaceted challenges faced in combating epidemics in resource-limited settings. It calls for integrated strategies that address not only the biological aspects of the disease but also the socioeconomic and informational ecosystems that influence public health outcomes. This perspective research contributes to a better understanding of how poverty, medical pluralism, political economy, misinformation, and health emergencies intersect, offering insights for future preparedness and response initiatives.
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Affiliation(s)
| | - Okechi Nzedibe
- International Public Health, Euclid University, Bangui, Central African Republic
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Yip JLY, Poduval S, de Souza-Thomas L, Carter S, Fenton K. Anti-racist interventions to reduce ethnic disparities in healthcare in the UK: an umbrella review and findings from healthcare, education and criminal justice. BMJ Open 2024; 14:e075711. [PMID: 38418232 PMCID: PMC10910548 DOI: 10.1136/bmjopen-2023-075711] [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: 05/16/2023] [Accepted: 02/07/2024] [Indexed: 03/01/2024] Open
Abstract
OBJECTIVES To assess the evidence for anti-racist interventions which aim to reduce ethnic disparities in healthcare, with a focus on implementation in the UK healthcare system. DESIGN Umbrella review. DATA SOURCES Embase, Medline, Social Policy and Practice, Social Care Online and Web of Science were searched for publications from the year 2000 up to November 2023. ELIGIBILITY CRITERIA Only systematic and scoping reviews of anti-racist interventions reported in English were included. Reviews were excluded if no interventions were reported, no comparator interventions were reported or the study was primarily descriptive. DATA EXTRACTION AND SYNTHESIS A narrative synthesis approach was used to integrate and categorise the evidence on anti-racist interventions for healthcare. Quality appraisal (including risk of bias) was assessed using the AMSTAR-2 tool. RESULTS A total of 29 reviews are included in the final review. 26 are from the healthcare sector and three are from education and criminal justice. The most promising interventions targeting individuals include group-based health education and providing culturally tailored interventions. On a community level, participation in all aspects of care pathway development that empowers ethnic minority communities may provide an effective approach to reducing ethnic health disparities. Interventions to improve quality of care for conditions with disproportionately worse outcomes in ethnic minority communities show promise. At a policy level, structural interventions including minimum wage policies and integrating non-medical interventions such as housing support in clinical care has some evidence for improving outcomes in ethnic minority communities. CONCLUSIONS Many of the included studies were low or critically low quality due to methodological or reporting limitations. For programme delivery, different types of pathway integration, and providing a more person-centred approach with fewer steps for patients to navigate can contribute to reducing disparities. For organisations, there is an overemphasis on individual behaviour change and recommendations should include a shift in focus and resources to policies and practices that seek to dismantle institutional and systemic racism through a multilevel approach.
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Affiliation(s)
| | - Shoba Poduval
- Institute of Health Informatics, University College London, London, UK
| | | | - Sophie Carter
- Office for Health Improvement and Disparities, London, UK
- Health Innovation Manchester, Manchester, UK
| | - Kevin Fenton
- Office for Health Improvement and Disparities, London, UK
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Goh ZZS, Ho MHR, Ng KYY, Chia JMX, Ishak NDB, Shwe TT, Chua ZY, Ngeow JYY, Griva K. Using the Actor-Partner Interdependence Model to explore the psychological impact of COVID-19 on anxiety in dyads of patients with cancer and caregivers. Int J Behav Med 2024; 31:19-30. [PMID: 36788172 PMCID: PMC9928140 DOI: 10.1007/s12529-023-10154-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/09/2023] [Indexed: 02/16/2023]
Abstract
BACKGROUND Delineating the compound psychological effect of the pandemic on cancer care, and the interdependency across cancer patient-caregiver dyads have yet to be explored. This study examines the levels of psychological impact of COVID-19 on patient-caregiver dyads anxiety, and the interdependent associations between their COVID-19 and cancer concerns, and risk perceptions. METHOD There were 352 patients and caregivers (patient-caregiver dyads, N = 176) included in this study (43.2% spousal dyads). Generalized Anxiety Disorder-7 and questionnaires regarding risk perception, perceived confidence in healthcare system, COVID-19, and cancer-related concerns were administered. Actor-Partner Interdependence Model (APIM) analyses were used to determine the interdependent effects. Indirect effects were tested using mediation pathway analyses. RESULTS Patients reported significantly higher levels of risk perceptions and anxiety than their caregivers (p < 0.01). Anxiety rates (GAD-7 ≥ 10) were also significantly higher (26.7% vs 18.2%, p < 0.01). Dyads' anxiety, "general COVID-19 concerns," "cancer-related concerns," and risk perceptions were correlated (ps < 0.01). APIM showed only actor effects of general COVID-19 concerns, cancer-related COVID-19 concerns, and risk perceptions on anxiety (βs = 0.19-0.53, ps < 0.01). No partner effects were observed. Similar results were found in the composite APIM. Indirect effects of the patient/caregiver's variables on their partner's anxiety were observed in the mediation analyses. CONCLUSION Concerns about COVID-19 and cancer care could be indirectly associated in patient-caregiver dyads and need to be proactively addressed. As pandemic evolves into endemicity, engagement with patients and caregivers should strive to be sensitive to their differential needs and messages should be tailored to the informational needs of each.
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Affiliation(s)
- Zack Zhong Sheng Goh
- Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, 11 Mandalay Road, Singapore, 308232 Singapore
| | - Moon-ho R. Ho
- School of Social Sciences, Nanyang Technological University Singapore, Singapore, Singapore
| | - Kennedy Yao Yi Ng
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | - Jace Ming Xuan Chia
- Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, 11 Mandalay Road, Singapore, 308232 Singapore
| | - Nur Diana Binte Ishak
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | - Than Than Shwe
- Division of Radiation Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | - Zi Yang Chua
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | - Joanne Yuen Yie Ngeow
- Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, 11 Mandalay Road, Singapore, 308232 Singapore
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | - Konstadina Griva
- Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, 11 Mandalay Road, Singapore, 308232 Singapore
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Shelke A, Shelke S, Acharya S, Shukla S. Synergistic Epidemic or Syndemic: An Emerging Pattern of Human Diseases. Cureus 2023; 15:e48286. [PMID: 38058320 PMCID: PMC10696284 DOI: 10.7759/cureus.48286] [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: 08/21/2023] [Accepted: 11/04/2023] [Indexed: 12/08/2023] Open
Abstract
Synergistic epidemics refer to the phenomenon where the occurrence and interaction of multiple diseases or health conditions exacerbate their individual impact, leading to complex health challenges and increased vulnerability in populations. Syndemics are a complex, multilevel phenomenon. In a population with biological interactions, a syndemic is the accumulation of two or more concurrent or sequential epidemics, which significantly worsens the situation. Disease concentration, disease interaction, and their underlying social forces, such as poverty and social inequality, are the fundamental concepts. Extensive political, economic, and cultural factors have contributed to cluster epidemics of several infectious diseases, particularly HIV and tuberculosis. Concerning the SAVA (substance abuse, violence, AIDS) syndemic, this narrative review article explores the complex interactions between substance abuse, violence, and HIV/AIDS. Further, it describes in-depth interactions between the COVID-19 syndemic's health conditions, societal factors, biological factors, and global dynamics. The review also emphasizes how infectious and non-communicable diseases interact, emphasizing how having one condition can make the severity and outcomes of another worse. It investigates the causes of synergistic epidemics and the impact of environmental factors. Syndemics acknowledge that the presence of one condition can worsen the severity and progression of others and take into account the intricate relationships between diseases. We can create more efficient plans to enhance health outcomes, lessen disparities, and promote healthier communities by understanding the connections between disorders and the underlying social determinants. This narrative review provides insights into the emerging patterns of human diseases within synergistic epidemics.
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Affiliation(s)
- Aditi Shelke
- Department of Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Saurabh Shelke
- Department of Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Sourya Acharya
- Department of Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Samarth Shukla
- Department of Pathology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Assaye BT, Belachew M, Worku A, Birhanu S, Sisay A, Kassaw M, Mekonen H. Perception towards the implementation of telemedicine during COVID-19 pandemic: a cross-sectional study. BMC Health Serv Res 2023; 23:967. [PMID: 37679700 PMCID: PMC10486038 DOI: 10.1186/s12913-023-09927-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Accepted: 08/16/2023] [Indexed: 09/09/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has led to a surge in the use of telemedicine as a means of delivering healthcare services remotely. Healthcare providers play a key role in the adoption and implementation of telemedicine for its effectiveness. Despite its benefits, there have been unclear concerns about its effectiveness and acceptance in the process of implementing telemedicine. The objective of the study was to assess health professionals' perceptions towards the implementation of telemedicine during the COVID-19 pandemic. METHODS A cross-sectional study design was conducted among eight hundred forty-five study participants from December 2020 to February 2021. A pre-test was performed on 5% of the total sample size, and the quality of the data was ensured by checking its completeness and consistency. Descriptive statistics and bivariable and multivariable logistic regression were used. The Variables with a P-value equal to or less than 0.25 in bivariable logistic regression were entered into a multivariable logistic regression, and model fitness was assessed. RESULT The study revealed that 60.9% of professionals had a good perception toward telemedicine implementation, with an 87.2% response rate. Health professionals with IT support staff, ICT training, who use social media platforms regularly, and availability of computer or smartphone within/outside their health facility were 4.7, 3.3, 3.7, and 13.2 times more likely to have a positive association towards telemedicine implementation respectively. CONCLUSION More than half of the health professionals had a good perception of telemedicine. Social media use, ICT training, computer accessibility, and the presence of IT support staff were all found to have positive associations with the telemedicine perception. In the era of the COVID-19 pandemic, the government should take the initiative to strengthen opportunities for health professionals to learn and apply telemedicine in their medical practice by providing ICT training, IT infrastructure and support staff, improving computer access, and recommending health professionals' positive use of social media in the health facility.
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Affiliation(s)
- Bayou Tilahun Assaye
- Department of Health Informatics, College Medicine and Health Sciences, Debre Markos University, P.O.Box 269, Debre Markos, Ethiopia.
| | - Muluken Belachew
- Department of Health Informatics, College Medicine and Health Sciences, Debre Markos University, P.O.Box 269, Debre Markos, Ethiopia
| | - Aynadis Worku
- Department of Health Informatics, College Medicine and Health Sciences, Debre Markos University, P.O.Box 269, Debre Markos, Ethiopia
| | - Sefefe Birhanu
- Department of Health Informatics, College Medicine and Health Sciences, Debre Markos University, P.O.Box 269, Debre Markos, Ethiopia
| | - Ayenew Sisay
- Department of Health Informatics, College Medicine and Health Sciences, Debre Markos University, P.O.Box 269, Debre Markos, Ethiopia
| | - Mitiku Kassaw
- Department of Health Informatics, College Medicine and Health Sciences, Debre Markos University, P.O.Box 269, Debre Markos, Ethiopia
| | - Habtamu Mekonen
- Department of Human Nutrition, College Medicine and Health Sciences, Debre Markos University, P.O.Box 269, Debre Markos, Ethiopia
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Salve HR, Daniel RA, Kumar A, Kumar R, Misra P. Prevalence and Determinants of Long COVID Among Patients Attending the Outpatient Department of a Subdistrict Hospital in Haryana. Cureus 2023; 15:e46007. [PMID: 37900449 PMCID: PMC10602202 DOI: 10.7759/cureus.46007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/26/2023] [Indexed: 10/31/2023] Open
Abstract
INTRODUCTION Growing evidence indicates that individuals recovering from COVID-19 may experience prolonged health consequences, resulting in notable morbidity even after the acute phase. Limited published literature exists concerning sequelae of COVID-19 among the Indian population. Therefore, we conducted this study at a subdistrict hospital (secondary level) in Haryana, aiming to estimate the prevalence of long COVID and its determinants. METHODS This hospital-based study focused on outpatients who had a confirmed history of COVID-19, with a minimum of 28 days elapsed since the positive COVID-19 diagnostic test date. We administered a semi-structured questionnaire to gather sociodemographic information, a standardized symptom assessment checklist to identify long COVID symptoms, and the Patient Health Questionnaire (PHQ-9) to evaluate and grade depression severity. Additionally, we conducted pulmonary function tests, chest X-rays, complete blood counts, and kidney and liver function tests to assess the determinants of long COVID. STATA version 14 software (StataCorp. 2015. Stata Statistical Software: Release 14. College Station, TX: StataCorp LP) was used for data analysis, and the bivariate and multivariate analyses (p-value <0.2 in bivariate analysis) were conducted to determine factors associated with long COVID. RESULTS A total of 212 participants (male 53%) were recruited in this study. Among the long COVID symptoms, fatigue, body pain, cough, joint pain, and breathlessness were the most frequently reported symptoms among the study participants. The prevalence of long COVID was found to be 37.3% (95%CI: 30.7-43.8%). In the multivariate model, depression (PHQ-9 scores) AOR-1.21 (95%CI:1.07-1.35) and severity of COVID-19 adjusted odds ratio (AOR)-2.22 (95%CI:1.05-4.69) came out to be statistically significant with long COVID. CONCLUSION Findings show alarming rates of long COVID symptoms persisting in nearly 37% of COVID-19-recovered individuals. Establishing tailored guidelines is crucial to mitigate burdens and complications and enhance the quality of life for those affected.
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Affiliation(s)
- Harshal R Salve
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, IND
| | - Roy A Daniel
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, IND
| | - Alok Kumar
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, IND
| | - Rakesh Kumar
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, IND
| | - Puneet Misra
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, IND
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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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Anwar A, Yadav UN, Huda MN, Das S, Rosenbaum S, Ali ARMM, Mondal PK, Rizwan AAM, Hossain SFA, Das Shuvo S, Mistry SK. Anxiety and Stress Related to COVID-19 Among the Community Dwelling Older Adults Residing in the Largest Refugee Camp of the World. Community Ment Health J 2023; 59:1181-1192. [PMID: 36879112 PMCID: PMC9988202 DOI: 10.1007/s10597-023-01101-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 01/07/2023] [Indexed: 03/08/2023]
Abstract
The current cross-sectional study was conducted among 864 older adults aged ≥ 60 years residing in Rohingya refugee camp through face-to-face interviews during November-December 2021. COVID-19-related anxiety was measured using the five-point Coronavirus Anxiety Scale (CAS) and perceived stress using the 10-point Perceived Stress Scale (PSS). The linear regression model identified the factors associated with COVID-19-related anxiety and perceived stress. The prevalence of COVID-19-related anxiety and perceived stress was 68% and 93%, respectively. The average COVID-19-related anxiety score expected to be significantly higher among those who were physically inactive, concerned about COVID-19, had a close friend/family member diagnosed with COVID-19, and had some difficulty in getting food and routine medical care during the COVID-19 pandemic. Meanwhile, the average perceived stress score was expected to be significantly higher among those without partners, who were feeling overwhelmed by COVID-19, and who experienced COVID-19-related anxiety during the pandemic. The findings suggest providing immediate psychosocial support to older Rohingya adults.
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Affiliation(s)
- Afsana Anwar
- Health and Nutrition, Social Assistance &Amp; Rehabilitation for the Physically Vulnerable (SARPV), SARPV Complex, Link Road, Cox's Bazar, 4700, Bangladesh
| | - Uday Narayan Yadav
- National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australia
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, Australia
| | - Md Nazmul Huda
- School of Medicine, Translational Health Research Institute, Western Sydney University, Campbelltown, NSW, 2560, Australia
- ARCED Foundation, 13/1, Pallabi, Mirpur-12, Dhaka, Bangladesh
| | - Sukanta Das
- Department of Statistics, Begum Rokeya University, Rangpur, Bangladesh
| | - Simon Rosenbaum
- School of Psychiatry, University of New South Wales, Sydney, Australia
| | | | - Probal Kumar Mondal
- Health and Nutrition, Social Assistance &Amp; Rehabilitation for the Physically Vulnerable (SARPV), SARPV Complex, Link Road, Cox's Bazar, 4700, Bangladesh
| | - Abu Ansar Md Rizwan
- Health and Nutrition, Social Assistance &Amp; Rehabilitation for the Physically Vulnerable (SARPV), SARPV Complex, Link Road, Cox's Bazar, 4700, Bangladesh
| | | | - Suvasish Das Shuvo
- Department of Nutrition and Food Technology, Jashore University of Science and Technology, Jashore, Bangladesh
| | - Sabuj Kanti Mistry
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, Australia.
- ARCED Foundation, 13/1, Pallabi, Mirpur-12, Dhaka, Bangladesh.
- Department of Public Health, Daffodil International University, Dhaka, 1207, Bangladesh.
- Brain and Mind Centre, The University of Sydney, Sydney, Australia.
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Sureshkumar S, Mustapha F, Yusoff H, Mwangi KJ, Marcus K, Kohlbrenner B, Issom D, Benissa MR, Aebischer-Perone S, Braha N, Candela E, Chhabra KG, Desikachari BR, Dondi A, Etchebehere M, Gathecha G, Kengne AP, Missoni E, Palafox B, Pati S, Madhu PP, Peer N, Quint J, Tabrizi R, Oris M, Beran D, Balabanova D, Etter JF. An Online Survey of the Perceptions of Clinical and Non-Clinical Professionals on Healthcare for Non-Communicable Diseases and COVID-19 Measures During the Pandemic in Malaysia. Int J Public Health 2023; 68:1605861. [PMID: 37304500 PMCID: PMC10247991 DOI: 10.3389/ijph.2023.1605861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 05/15/2023] [Indexed: 06/13/2023] Open
Abstract
Objectives: This study assesses the opinions of health professionals in Malaysia on the disruption of non-communicable disease (NCD) services during the COVID-19 pandemic from March 2020 to January 2022. Methods: We conducted a cross-sectional online survey with 191 non-clinical public health workers and clinical health service workers in Malaysia from November 2021 to January 2022. Participants were recruited by the Malaysian Ministry of Health using major networks including key experts and practitioners. Secondary respondents were subsequently enrolled through snowballing. Results: The most notable issues raised by the survey participants relate to NCD service disruption, the redirection of NCD care resources, and NCD care being overburdened post-pandemic. Respondents also reported accounts of resilience and prompt reaction from the healthcare system, as well as calls for innovation. Conclusion: Most respondents perceived that the challenges arising from COVID-19 were mostly managed well by the healthcare system, which was able to provide the necessary services to NCD patients during this health emergency. However, the study identifies gaps in the health system response and preparedness capacity, and highlights solutions for strengthening NCD services.
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Affiliation(s)
| | - Feisul Mustapha
- Disease Control Division, Ministry of Health (Malaysia), Putrajaya, Malaysia
| | - Haironi Yusoff
- Department of Medicine and Public Health, Universiti Malaysia Sarawak, Kota Samarahan, Malaysia
| | - Kibachio Joseph Mwangi
- Institute of Global Health, University of Geneva, Geneva, Switzerland
- Department of Non-Communicable Diseases, Ministry of Health (Kenya), Nairobi, Kenya
| | - Kailing Marcus
- Institute of Global Health, University of Geneva, Geneva, Switzerland
| | | | - David Issom
- Institute of Global Health, University of Geneva, Geneva, Switzerland
| | | | | | | | - Egidio Candela
- IRCCS Azienda Ospedaliero, Universitaria di Bologna, Bologna, Italy
| | | | | | - Arianna Dondi
- IRCCS Azienda Ospedaliero, Universitaria di Bologna, Bologna, Italy
| | - Marina Etchebehere
- Faculty of Health Sciences (FICSAE), Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Gladwell Gathecha
- Department of Non-Communicable Diseases, Ministry of Health (Kenya), Nairobi, Kenya
| | - Andre Pascal Kengne
- Non-Communicable Diseases Research Unit, South African Medical Research Council, Cape Town, South Africa
| | | | - Benjamin Palafox
- London School of Hygiene and Tropical Medicine, University of London, London, United Kingdom
| | | | | | - Nasheeta Peer
- Non-Communicable Diseases Research Unit, South African Medical Research Council, Cape Town, South Africa
| | | | - Reza Tabrizi
- Noncommunicable Diseases Research Centre, Fasa University of Medical Sciences, Fasa, Iran
| | - Michel Oris
- Institute of Global Health, University of Geneva, Geneva, Switzerland
| | - David Beran
- University Hospitals of Geneva, Geneva, Switzerland
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Dina Balabanova
- London School of Hygiene and Tropical Medicine, University of London, London, United Kingdom
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13
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Matus Gonzalez A, Lorca E, Cabrera S, Hernandez A, Zúñiga-Sm C, Sola L, Michea L, Ferreiro Fuentes A, Cervantes L, Madero M, Teixeira-Pinto A, Wong G, Craig J, Jaure A. Nephrologists' perspectives on the impact of COVID-19 on caring for patients undergoing dialysis in Latin America: a qualitative study. BMJ Open 2023; 13:e062321. [PMID: 37173110 PMCID: PMC10186081 DOI: 10.1136/bmjopen-2022-062321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/15/2023] Open
Abstract
OBJECTIVE To describe the experiences of nephrologists on caring for patients undergoing in-centre haemodialysis during the COVID-19 pandemic in Latin America. DESIGN Twenty-five semistructured interviews were conducted by Zoom videoconference in English and Spanish languages during 2020 until data saturation. Using thematic analysis, we conducted line-by-line coding to inductively identify themes. SETTING 25 centres across nine countries in Latin America. PARTICIPANTS Nephrologists (17 male and 8 female) were purposively sampled to include diverse demographic characteristics and clinical experience. RESULTS We identified five themes: shock and immediate mobilisation for preparedness (overwhelmed and distressed, expanding responsibilities to manage COVID-19 infection and united for workforce resilience); personal vulnerability (being infected with COVID-19 and fear of transmitting COVID-19 to family); infrastructural susceptibility of dialysis units (lacking resources and facilities for quarantine, struggling to prevent cross-contamination, and depletion of personal protective equipment and cleaning supplies); helplessness and moral distress (being forced to ration life-sustaining equipment and care, being concerned about delayed and shortened dialysis sessions, patient hesitancy to attend to dialysis sessions, being grieved by socioeconomic disparities, deterioration of patients with COVID-19, harms of isolation and inability to provide kidney replacement therapy); and fostering innovative delivery of care (expanding use of telehealth, increasing uptake of PD and shifting focus on preventing syndemics). CONCLUSION Nephrologists felt personally and professionally vulnerable and reported feeling helpless and morally distressed because they doubted their capacity to provide safe care for patients undergoing dialysis. Better availability and mobilisation of resources and capacities to adapt models of care, including telehealth and home-based dialysis, are urgently needed.
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Affiliation(s)
- Andrea Matus Gonzalez
- Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
- Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Eduardo Lorca
- Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | | | | | - Carlos Zúñiga-Sm
- Facultad de Medicina, Universidad Católica de la Santísima Concepción, Concepción, Chile
- Facultad de Medicina, Universidad de Concepción, Concepción, Chile
| | - Laura Sola
- Centro de Hemodiálisis Crónica, Centro de Asistencia del Sindicato Medico del Uruguay- Institución de Asistencia Medica Privada de Profesionales sin fines de lucro (CASMU-IAMPP), Montevideo, Uruguay
| | - Luis Michea
- Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | | | - Lilia Cervantes
- Department of Medicine and Office of Research, Denver Health, Denver, Colorado, USA
| | - Magdalena Madero
- Departamento de Nefrologia, Instituto Nacional de Cardiología, Ciudad de México, ciudad de Mexico (CDMX), México
| | - Armando Teixeira-Pinto
- Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
- Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Germaine Wong
- Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
- Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Jonathan Craig
- College of Medicine and Public Health, Faculty of Medicine Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Allison Jaure
- Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
- Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
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14
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Liyanage A, Darshana ILAN, Ponnaperuma T, De Silva J, Rajakaruna VPC, Perera B, Amarasena S, Wijesinghe CJ, De Silva PV. COVID-19 Vaccination Acceptance and Non-Communicable Disease Status Among Urban-Dwelling Elders in Southern Sri Lanka. Asia Pac J Public Health 2023; 35:304-307. [PMID: 36941744 PMCID: PMC10033497 DOI: 10.1177/10105395231162159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Affiliation(s)
- Achala Liyanage
- Department of Community Medicine, Faculty of Medicine, University of Ruhuna, Matara, Sri Lanka
| | | | - Thyagi Ponnaperuma
- Department of Community Medicine, Faculty of Medicine, University of Ruhuna, Matara, Sri Lanka
| | - Janithra De Silva
- Department of Community Medicine, Faculty of Medicine, University of Ruhuna, Matara, Sri Lanka
| | | | - Bilesha Perera
- Department of Community Medicine, Faculty of Medicine, University of Ruhuna, Matara, Sri Lanka
| | - Sujeewa Amarasena
- Department of Pediatrics, Faculty of Medicine, University of Ruhuna, Matara, Sri Lanka
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15
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Mohammed A, Putnis N, Kakunze A, Riches SP, Humphreys E, Eaton J, Bhatia T, Dar O, Raji T, Walker IF, Ogwell A. Non-communicable diseases, injuries, and mental ill-health in Africa: the role of the Africa Centres for Disease Control and Prevention. Lancet Glob Health 2023; 11:e495-e496. [PMID: 36925164 DOI: 10.1016/s2214-109x(23)00054-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 01/20/2023] [Indexed: 03/16/2023]
Affiliation(s)
- Abdulaziz Mohammed
- Africa Centres for Disease Control and Prevention, Addis Ababa, Ethiopia.
| | - Nina Putnis
- United Kingdom Health Security Agency, London, UK; Office for Health Improvement and Disparities, Department of Health and Social Care, London, UK
| | - Adelard Kakunze
- Africa Centres for Disease Control and Prevention, Addis Ababa, Ethiopia
| | - Sarah Payne Riches
- United Kingdom Health Security Agency, London, UK; Office for Health Improvement and Disparities, Department of Health and Social Care, London, UK
| | | | - Julian Eaton
- London School of Hygiene and Tropical Medicine, London, UK; CBM Global Disability and Inclusion, Amsterdam, Netherlands
| | - Tazeem Bhatia
- Office for Health Improvement and Disparities, Department of Health and Social Care, London, UK
| | - Osman Dar
- United Kingdom Health Security Agency, London, UK
| | - Tajudeen Raji
- Africa Centres for Disease Control and Prevention, Addis Ababa, Ethiopia
| | - Ian F Walker
- Office for Health Improvement and Disparities, Department of Health and Social Care, London, UK
| | - Ahmed Ogwell
- Africa Centres for Disease Control and Prevention, Addis Ababa, Ethiopia
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Malekpour MR, Abbasi-Kangevari M, Shojaee A, Saeedi Moghaddam S, Ghamari SH, Rashidi MM, Namazi Shabestari A, Effatpanah M, Nasehi M, Rezaei M, Farzadfar F. Effect of the chronic medication use on outcome measures of hospitalized COVID-19 patients: Evidence from big data. Front Public Health 2023; 11:1061307. [PMID: 36908454 PMCID: PMC9998941 DOI: 10.3389/fpubh.2023.1061307] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 01/11/2023] [Indexed: 03/14/2023] Open
Abstract
Background Concerns about the role of chronically used medications in the clinical outcomes of the coronavirus disease 2019 (COVID-19) have remarkable potential for the breakdown of non-communicable diseases (NCDs) management by imposing ambivalence toward medication continuation. This study aimed to investigate the association of single or combinations of chronically used medications in NCDs with clinical outcomes of COVID-19. Methods This retrospective study was conducted on the intersection of two databases, the Iranian COVID-19 registry and Iran Health Insurance Organization. The primary outcome was death due to COVID-19 hospitalization, and secondary outcomes included length of hospital stay, Intensive Care Unit (ICU) admission, and ventilation therapy. The Anatomical Therapeutic Chemical (ATC) classification system was used for medication grouping. The frequent pattern growth algorithm was utilized to investigate the effect of medication combinations on COVID-19 outcomes. Findings Aspirin with chronic use in 10.8% of hospitalized COVID-19 patients was the most frequently used medication, followed by Atorvastatin (9.2%) and Losartan (8.0%). Adrenergics in combination with corticosteroids inhalants (ACIs) with an odds ratio (OR) of 0.79 (95% confidence interval: 0.68-0.92) were the most associated medications with less chance of ventilation therapy. Oxicams had the least OR of 0.80 (0.73-0.87) for COVID-19 death, followed by ACIs [0.85 (0.77-0.95)] and Biguanides [0.86 (0.82-0.91)]. Conclusion The chronic use of most frequently used medications for NCDs management was not associated with poor COVID-19 outcomes. Thus, when indicated, physicians need to discourage patients with NCDs from discontinuing their medications for fear of possible adverse effects on COVID-19 prognosis.
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Affiliation(s)
- Mohammad-Reza Malekpour
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohsen Abbasi-Kangevari
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Shojaee
- Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Sahar Saeedi Moghaddam
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Kiel Institute for the World Economy, Kiel, Germany
| | - Seyyed-Hadi Ghamari
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad-Mahdi Rashidi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Namazi Shabestari
- Department of Geriatric Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- National Center for Health Insurance Research, Iran Health Insurance Organization, Tehran, Iran
| | - Mohammad Effatpanah
- National Center for Health Insurance Research, Iran Health Insurance Organization, Tehran, Iran
- Department of Pediatrics, Imam Khomeini Hospital Complex, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammadmehdi Nasehi
- National Center for Health Insurance Research, Iran Health Insurance Organization, Tehran, Iran
- Pediatric Neurology Department, Mofid Children Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mehdi Rezaei
- National Center for Health Insurance Research, Iran Health Insurance Organization, Tehran, Iran
- Department of Orthopedics, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Farshad Farzadfar
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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17
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Saqib K, Qureshi AS, Butt ZA. COVID-19, Mental Health, and Chronic Illnesses: A Syndemic Perspective. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3262. [PMID: 36833955 PMCID: PMC9962717 DOI: 10.3390/ijerph20043262] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 02/10/2023] [Accepted: 02/11/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND The COVID-19 pandemic is an epidemiological and psychological crisis; what it does to the body is quite well known by now, and more research is underway, but the syndemic impact of COVID-19 and mental health on underlying chronic illnesses among the general population is not completely understood. METHODS We carried out a literature review to identify the potential impact of COVID-19 and related mental health issues on underlying comorbidities that could affect the overall health of the population. RESULTS Many available studies have highlighted the impact of COVID-19 on mental health only, but how complex their interaction is in patients with comorbidities and COVID-19, the absolute risks, and how they connect with the interrelated risks in the general population, remain unknown. The COVID-19 pandemic can be recognized as a syndemic due to; synergistic interactions among different diseases and other health conditions, increasing overall illness burden, emergence, spread, and interactions between infectious zoonotic diseases leading to new infectious zoonotic diseases; this is together with social and health interactions leading to increased risks in vulnerable populations and exacerbating clustering of multiple diseases. CONCLUSION There is a need to develop evidence to support appropriate and effective interventions for the overall improvement of health and psychosocial wellbeing of at-risk populations during this pandemic. The syndemic framework is an important framework that can be used to investigate and examine the potential benefits and impact of codesigning COVID-19/non-communicable diseases (NCDs)/mental health programming services which can tackle these epidemics concurrently.
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Affiliation(s)
- Kiran Saqib
- School of Public health Sciences, University of Waterloo, Waterloo, ON N2L 3G1, Canada
| | - Afaf Saqib Qureshi
- Whiting School of Engineering, Johns Hopkins University, Baltimore, MD 21218, USA
| | - Zahid Ahmad Butt
- School of Public health Sciences, University of Waterloo, Waterloo, ON N2L 3G1, Canada
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18
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T Sathyapalan D, V Nair C, Moni M, Edathadathil F, A A, Prasanna P, Pushpa Raghavan R, Jayant A. Incidence and characterisation of post-COVID-19 symptoms in hospitalized COVID-19 survivors: A single centre, prospective observational cohort study to recognize the syndemic connotations in India. JMIR Form Res 2023; 7:e40028. [PMID: 36920842 PMCID: PMC10131721 DOI: 10.2196/40028] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 01/03/2023] [Accepted: 01/20/2023] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Long COVID or post-COVID-19 syndrome is the persistence of signs and symptoms that develop during or after COVID-19 infection for more than 12 weeks and are not explained by an alternative diagnosis. In spite of health care recouping to pre pandemic states, post-COVID-19 state tends to be less recognised from low middle income country settings and holistic therapeutic protocols do not exist. Owing to the syndemic nature of the COVID 19, it is important to characterise post-COVID-19 syndrome. OBJECTIVE We aimed to determine the incidence of post-COVID-19 symptoms in a cohort of inpatients who recovered from COVID-19 from February 2021 to July 2021 from a tertiary care centre in South India. In addition, we aimed at comparing the prevalence of post-COVID-19 manifestations in non-ICU and ICU patients, assessing the persistence, severity and characteristics of post-COVID-19 manifestations and elucidating the risk factors associated with the presence of post-COVID-19 manifestations. METHODS 120 adult patients admitted with COVID-19 in the specified time frame were recruited into the study after informed written consent. The cohort included 50 patients requiring Intensive care unit and 70 patients with non-intensive care. The follow-up was conducted on the second and sixth week after discharge with a structured questionnaire. The questionnaire was filled by the patient/family member of the patient during their visit to the hospital for follow-up at 2 weeks and through telephone follow up at 6 weeks. RESULTS : Mean age of the cohort was 55 years and 55% were males. Only (5%) of the cohort had taken the first dose of COVID-19 vaccination.58.3% had mild COVID-19 and 41.7% had moderate to severe COVID-19 infection. 60.8% (n=73) of patients had at least one persistent symptom at sixth week of discharge. 50 (41.7%) patients required intensive care during their inpatient stay. Presence of persistent symptoms at 6 weeks was not associated with severity of illness, age or requirement for intensive care. Fatigue was the most common reported persistent symptom with a prevalence of 55.8% followed by dyspnoea (20%) and weight loss (16.7%). Female sex (OR 2.4, 95% CI: 1.03-5.58, P=.04) and steroid administration during hospital stay (OR: 4.43; 95% CI: 1.9-10.28, P=.001), were found to be significant risk factors for the presence of post-COVID-19 symptoms at 6 weeks as revealed by logistic regression analysis. CONCLUSIONS 60.8% of inpatients treated for COVID-19 had post-COVID-19 symptoms at 6 week's post- discharge from hospital. Incidence of post-COVID-19 syndrome in the cohort did not significantly differ across the mild, moderate and severe COVID-19 severity categories. Female sex and steroid administration during hospital stay were identified as predictors of persistence of post-COVID-19 symptoms at 6 weeks. CLINICALTRIAL
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Affiliation(s)
- Dipu T Sathyapalan
- Division of Infectious Disease, Department of General Medicine, Amrita Institute of Medical Science and Research Centre, Amrita Institute of Medical Science and Research Centre, Kochi, IN
| | - Chithira V Nair
- Division of Infectious Disease, Department of General Medicine, Amrita Institute of Medical Science and Research Centre, Amrita Institute of Medical Science and Research Centre, Kochi, IN
| | - Merlin Moni
- Division of Infectious Disease, Department of General Medicine, Amrita Institute of Medical Science and Research Centre, Amrita Institute of Medical Science and Research Centre, Kochi, IN
| | - Fabia Edathadathil
- Department of Infection Control and Epidemiology, Amrita Institute of Medical Science and Research Centre, Kochi, IN
| | - Appukuttan A
- Division of Infectious Disease, Department of General Medicine, Amrita Institute of Medical Science and Research Centre, Amrita Institute of Medical Science and Research Centre, Kochi, IN
| | - Preetha Prasanna
- Department of Medical Administration, Amrita Institute of Medical Science and Research Centre, Kochi, IN
| | | | - Aveek Jayant
- Department of Anaesthesia, Critical Care and Pain, Homi Bhabha Cancer Hospital and Research Centre, Visakhapatnam, IN
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19
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AlShurman BA, Butt ZA. Proposing a New Conceptual Syndemic Framework for COVID-19 Vaccine Hesitancy: A Narrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1561. [PMID: 36674314 PMCID: PMC9864682 DOI: 10.3390/ijerph20021561] [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: 12/12/2022] [Revised: 01/09/2023] [Accepted: 01/12/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND Discussions regarding syndemics have dominated research in recent years. Vaccine hesitancy has also been propelled to the forefront. In this narrative review, we aim to frame a novel syndemic framework to understand the interaction between vaccine hesitancy, COVID-19, and negative health outcomes. METHODS A non-systematic electronic search was conducted in PubMed and Google Scholar. Search criteria were limited to articles published between November 2019 and June 2022. Articles related to the COVID-19 syndemic and vaccine hesitancy were included. RESULTS Our review revealed that the adherence to COVID-19 regulations-although they were effective in preventing COVID-19 transmission, cases, and deaths-created a dynamically unstable 'vicious cycle' between undesirable health, economic, and social outcomes. The "accumulation" of complex stressors decreased individuals' cognitive flexibility and hindered them from making decisions and getting vaccinated. Furthermore, it increased individuals' risk of acquiring COVID-19, losing their employment, increasing poverty, and decreasing healthcare utilization. We illustrated how the amalgamation of sociodemographic and contextual factors associated with COVID-19 might impact people's vaccine decisions, making them more hesitant toward COVID-19 vaccination. Failing to receive vaccinations increases the chances of COVID-19 transmission, hospitalization, and other negative health outcomes. CONCLUSIONS Understanding the interaction between these factors is essential to provide policymakers with inspiration to set appropriate interventions for promoting COVID-19 vaccination acceptance to decrease the overall burden of pandemics.
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Affiliation(s)
| | - Zahid Ahmad Butt
- School of Public Health Sciences, University of Waterloo, Waterloo, ON N2L 3G1, Canada
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20
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Abraham S, John SM, Gupta A, Biswas S, Khare MM, Mukherjee P, Frankline AC. Primary care for the urban poor in India during the pandemic: Uninterrupted management of non-communicable diseases and home-based care of patients with COVID-19 infection. Front Public Health 2023; 10:1043597. [PMID: 36699918 PMCID: PMC9868695 DOI: 10.3389/fpubh.2022.1043597] [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: 09/13/2022] [Accepted: 12/19/2022] [Indexed: 01/11/2023] Open
Abstract
Problem The two waves of COVID-19 severely affected the healthcare system in India. The government responded to the first wave with a strict nationwide lockdown which disrupted primary care, including the management of non-communicable diseases (NCDs). The second wave overwhelmed healthcare facilities leading to inadequate access to hospital services. Collectively, these issues required urgent responses, including the adaptation of primary care. Approach The Low-Cost Effective Care Unit (LCECU) of Christian Medical College, Vellore (CMC) has a network of community volunteers, community health workers, an outreach nurse, social workers and doctors who operate clinics in six poorer areas of Vellore. The network adapted quickly, responding to the lockdown during the first wave and ensuring ongoing primary care for patients with non-communicable diseases. During the second wave, the team developed a system in collaboration with other CMC departments to provide home-based care for patients with COVID-19. Local setting The LCECU is a 48-bed unit of the Department of Family Medicine, part of the 3,000-bed CMC. It originated in 1982, aiming to care for the poor populations of Vellore town. It has been actively working among urban communities since 2002, with a focus on delivering Community Oriented Primary Care (COPC), for six poor urban communities since 2016. Relevant changes During the first wave of COVID the LCECU team ensured patients with NCDs had uninterrupted primary care and medications by visiting them in their homes. The team also addressed food insecurity by organizing a daily lunch service for 600 people for over 2 months. In the second wave, the team responded to community needs by organizing and delivering home-based care to monitor patients affected by COVID-19. Lessons learned The COVID-19 pandemic raises many questions about the preparedness of health systems for disasters that disproportionately affect marginalized populations globally. COVID-19 is only one of the many potential disasters, including non-communicable diseases, mental health problems, pollution, climate change, and lifestyle illness. There is an urgent need to study models of care that support vulnerable communities in an accessible, cost-effective, and patient-oriented way, particularly in low- and middle-income countries. This paper outlines lessons on how the LCECU team addressed disaster management:1. The COVID-19 pandemic has highlighted the importance of primary care-based rapid response interventions in disaster management.2. The LCECU model demonstrated the effectiveness of a primary care intervention based on pre-existing networks and familiarity between primary care teams and the community.3. Establishing community-based health care via interdisciplinary teams, including community health workers, community volunteers, outreach nurses, and doctors, is key.4. Addressing other social determinants of health, such as food insecurity, is an important component of care delivery.
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Affiliation(s)
- Sunil Abraham
- Department of Family Medicine and LCECU, Christian Medical College and Hospital, Vellore, India,*Correspondence: Sunil Abraham ✉
| | - Sushil Mathew John
- Department of Family Medicine and LCECU, Christian Medical College and Hospital, Vellore, India
| | - Archna Gupta
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
| | | | - Manorama M. Khare
- Department of Family and Community Medicine, University of Illinois College of Medicine Rockford, Rockford, IL, United States
| | - Pavan Mukherjee
- Department of Family Medicine and LCECU, Christian Medical College and Hospital, Vellore, India
| | - Augustine C. Frankline
- Department of Family Medicine and LCECU, Christian Medical College and Hospital, Vellore, India
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Hassan M, Butt ZA. Applying the syndemic framework to cancer research for effective cancer control in low- and middle-income countries. Ecancermedicalscience 2023; 17:1532. [PMID: 37138967 PMCID: PMC10151077 DOI: 10.3332/ecancer.2023.1532] [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: 12/08/2022] [Indexed: 05/05/2023] Open
Abstract
Cancer burden is increasing rapidly globally, especially in low- and middle-income countries (LMICs), which already face a double burden of infectious diseases and other non-communicable diseases (NCDs). LMICs also struggle with poor social determinants of health, leading to cancer health disparities, such as delayed diagnoses and increased death rates due to cancer. Contextually, relevant research needs to be prioritised in these regions to ensure feasible, evidence-based healthcare planning and delivery for cancer prevention and control. A syndemic framework has been used to study the disease clustering of infectious diseases and NCDs across varied social contexts to understand how diseases interact adversely and how the wider environmental context and other socioeconomic factors contribute to poor health outcomes within specific populations. We propose using this model to study the 'syndemic of cancers' in the disadvantaged population of LMICs and suggest ways for the clear operationalisation of the syndemic framework through multidisciplinary evidence-generation models for the delivery of integrated, socially conscious interventions for effective cancer control.
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Affiliation(s)
- Mariam Hassan
- Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore 54000, Pakistan
| | - Zahid Ahmad Butt
- School of Public Health Sciences, University of Waterloo, Waterloo, ON N2L 3G1, Canada
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22
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Almas A, Awan S, Bloomfield G, Nisar MI, Siddiqi S, Ahmed A, Ali A, Shafqat SH, Bhutta ZA, Mark DB, Douglas P, Bartlett J, Jafar TH, Samad Z. Opportunities and challenges to non-communicable disease (NCD) research and training in Pakistan: a qualitative study from Pakistan. BMJ Open 2022; 12:e066460. [PMID: 36535721 PMCID: PMC9764671 DOI: 10.1136/bmjopen-2022-066460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION Most of the global non-communicable disease (NCD)-related death burden is borne by low and middle-income countries (LMICs). In LMICs like Pakistan, however, a major gap in responding to NCDs is a lack of high-quality research leading to policy development and implementation of NCDs. To assess institutional opportunities and constraints to NCD research and training we conducted a situational analysis for NCD research and training at Aga Khan University Pakistan. METHODS We conducted a descriptive exploratory study using grounded theory as a qualitative approach: semistructured interviews of 16 NCD stakeholders (three excluded) and two focus group discussions with postgraduate and undergraduate trainees were conducted. A simple thematic analysis was done where themes were identified, and then recurring ideas were critically placed in their specific themes and refined based on the consensus of the investigators. RESULTS The major themes derived were priority research areas in NCDs; methods to improve NCD research integration; barriers to NCD research in LMICs like Pakistan; design of NCD research programme and career paths; and NCD prevention at mass level, policy and link to the government. In general, participants opined that while there was an appetite for NCD research and training, but few high-quality research training programmes in NCDs existed, such programmes needed to be established. The ideal NCD research and training programmes would have in-built protected time, career guidance and dedicated mentorship. Most participants identified cardiovascular diseases as a priority thematic area and health information technology and data science as key methodological approaches to be introduced into research training. CONCLUSION We conclude from this qualitative study on NCD research and training that high-quality research training programmes for NCDs are rare. Such programmes need to be established with in-built protected time, career guidance and mentorship for the trainees to improve their research capacity in Pakistan.
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Affiliation(s)
- Aysha Almas
- Department of Medicine, Aga Khan University, Karachi, Pakistan
| | - Safia Awan
- Department of Medicine, Aga Khan University, Karachi, Pakistan
| | - Gerald Bloomfield
- Department of Medicine, Duke University, Durham, North Carolina, USA
- Global health, Duke university, Durhum, North Carolina, USA
| | - Muhammad Imran Nisar
- Department of Paediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | - Sameen Siddiqi
- Community Health Sciences Department, Aga Khan University Medical College, Karachi, Pakistan
| | - Asma Ahmed
- Department of Medicine, Aga Khan University, Karachi, Pakistan
| | - Asad Ali
- Department of Paediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | | | - Zulfiqar Ahmed Bhutta
- Division of Women and Child Health, Aga Khan University, Karachi, Pakistan
- Global Child Health, Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
| | - Daniel Benjamin Mark
- Department of Medicine, Duke University, Durham, North Carolina, USA
- Duke Clinical Research Institute, Duke University, Durham, North Carolina, USA
| | - Pamela Douglas
- Department of Medicine, Duke University, Durham, North Carolina, USA
- Duke Clinical Research Institute, Duke University, Durham, North Carolina, USA
| | - John Bartlett
- Department of Medicine and Global Health, Duke University, Durham, North Carolina, USA
| | - Tazeen H Jafar
- Health Services & Systems Research Programme, Duke-NUS Medical School, Singapore
- Department of Global Health, Duke University, Durhum, North Carolina, USA
| | - Zainab Samad
- Department of Medicine, Aga Khan University, Karachi, Pakistan
- Department of Medicine, Duke University, Durham, North Carolina, USA
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Saulnier DD, Duchenko A, Ottilie-Kovelman S, Tediosi F, Blanchet K. Re-evaluating Our Knowledge of Health System Resilience During COVID-19: Lessons From the First Two Years of the Pandemic. Int J Health Policy Manag 2022; 12:6659. [PMID: 37579465 PMCID: PMC10125099 DOI: 10.34172/ijhpm.2022.6659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 11/12/2022] [Indexed: 08/16/2023] Open
Abstract
BACKGROUND Health challenges like coronavirus disease 2019 (COVID-19) are becoming increasingly complex, transnational, and unpredictable. Studying health system responses to the COVID-19 pandemic is an opportunity to enhance our understanding of health system resilience and establish a clearer link between theoretical concepts and practical ideas on how to build resilience. METHODS This narrative literature review aims to address four questions using a health system resilience framework: (i) What do we understand about the dimensions of resilience? (ii) What aspects of the resilience dimensions remain uncertain? (iii) What aspects of the resilience dimensions are missing from the COVID-19 discussions? and (iv) What has COVID-19 taught us about resilience that is missing from the framework? A scientific literature database search was conducted in December 2020 and in April 2022 to identify publications that discussed health system resilience in relation to COVID-19, excluding articles on psychological and other types of resilience. A total of 63 publications were included. RESULTS There is good understanding around information sharing, flexibility and good leadership, learning, maintaining essential services, and the need for legitimate, interdependent systems. Decision-making, localized trust, influences on interdependence, and transformation remain uncertain. Vertical interdependence, monitoring risks beyond the health system, and consequences of changes on the system were not discussed. Teamwork, actor legitimacy, values, inclusivity, trans-sectoral resilience, and the role of the private sector are identified as lessons from COVID-19 that should be further explored for health system resilience. CONCLUSION Knowledge of health system resilience has continued to cohere following the pandemic. The eventual consequences of system changes and the resilience of subsystems are underexplored. Through governance, the concept of health system resilience can be linked to wider issues raised by the pandemic, like inclusivity. Our findings show the utility of resilience theory for strengthening health systems for crises and the benefit of continuing to refine existing resilience theory.
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Affiliation(s)
- Dell D. Saulnier
- Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Anna Duchenko
- Swiss Tropical and Public Health Institute, Basel, Switzerland
| | | | - Fabrizio Tediosi
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Karl Blanchet
- Geneva Centre of Humanitarian Studies, Faculty of Medicine, University of Geneva, Geneva, Switzerland
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STACHTEAS P, STACHTEAS C, SYMVOULAKIS EK, SMYRNAKIS E. The Role of Telemedicine in the Management of Patients with Chronic Diseases in Primary Care During the COVID-19 Pandemic. MAEDICA 2022; 17:931-938. [PMID: 36818259 PMCID: PMC9923072 DOI: 10.26574/maedica.2022.17.4.931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
Introduction:The COVID-19 pandemic has rapidly spread to many countries and has led various primary healthcare services of chronic diseases to be neglected and only partially be replaced by telemedicine services. This study aims to investigate the role of telemedicine in the management of patients with noncommunicable diseases in primary health care during the COVID-19 pandemic. Method: A narrative review of the literature was carried out through searching the PubMed and Google Scholar databases. Results: From the initial stages of the pandemic, several scientific medical societies issued guidelines which urged citizens and health personnel to adopt digital means in the provision of regular chronic care as much as possible. The significant benefits of the telemedicine sessions partially only filled the gap of the deferred chronic care. On the other hand, many barriers need to be addressed in order to achieve an equitable and high-quality implementation of telemedicine services. Conclusion:The widespread application of telemedicine and self-monitoring was brought about by the COVID-19 pandemic and currently, they have become common ways of managing non-communicable diseases in primary health care. Innovations introduced need to be maintained and integrated into conventional traditional practices, so that health systems are more resilient to future public health emergencies.
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Affiliation(s)
- Panagiotis STACHTEAS
- Laboratory of Primary Health Care, General Practice and Health Services Research, Faculty of Medicine, Aristotle University of Thessaloniki, Greece
| | - Charalampos STACHTEAS
- Laboratory of Primary Health Care, General Practice and Health Services Research, Faculty of Medicine, Aristotle University of Thessaloniki, Greece
| | - Emmanouil K. SYMVOULAKIS
- Laboratory of Primary Health Care, General Practice and Health Services Research, Faculty of Medicine, Aristotle University of Thessaloniki, Greece
| | - Emmanouil SMYRNAKIS
- Laboratory of Primary Health Care, General Practice and Health Services Research, Faculty of Medicine, Aristotle University of Thessaloniki, Greece
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25
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Mistry SK, Ali ARMM, Yadav UN, Das S, Akter N, Huda MN, Hadisuyatmana S, Rahman S, Lim D, Rahman MM. COVID-19 related anxiety and its associated factors: a cross-sectional study on older adults in Bangladesh. BMC Psychiatry 2022; 22:737. [PMID: 36443729 PMCID: PMC9702614 DOI: 10.1186/s12888-022-04403-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Accepted: 11/17/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic has resulted in serious mental health conditions, particularly among older adults. This research explored the prevalence of COVID-19-related anxiety and its associated factors among older adults residing in Bangladesh. METHODS This cross-sectional study was conducted among 1,045 older Bangladeshi adults aged ≥ 60 years through telephone interviews in September 2021. A semi-structured interview schedule was used to collect data on participants' characteristics and COVID-19-related anxiety. The anxiety level was measured using the Bengali version of the five-point Coronavirus Anxiety Scale (CAS). A linear regression model explored the factors associated with COVID-19-related anxiety. RESULTS Overall, the prevalence of COVID-19-related anxiety was 23.2%. The regression analysis revealed that the average COVID-19-related anxiety score was significantly higher among females (β: 0.43, 95% CI: 0.05 to 0.81), and among those who faced difficulty getting medicine (β: 0.57, 95% CI: 0.16 to 0.97), felt isolated (β: 0.60, 95% CI: 0.24 to 0.95), and felt requiring additional care during the pandemic (β: 0.53, 95% CI: 0.16 to 0.91). Alternatively, the average COVID-19-related anxiety score was significantly lower among those who were widowed (β: -0.46, 95% CI: -0.87 to -0.04) and living distant from the health centre (β: -0.48, 95% CI: -0.79 to -0.17). CONCLUSION The findings of the present study suggest providing immediate psychosocial support package to the older adults, particularly females and those who are vulnerable to receive health and social care support during the COVID-19 pandemic in Bangladesh.
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Affiliation(s)
- Sabuj Kanti Mistry
- ARCED Foundation, 13/1 Pallabi, Mirpur-12, Dhaka, 1216, Bangladesh. .,Centre for Primary Health Care and Equity, University of New South Wales, Sydney, NSW, 2052, Australia. .,Department of Public Health, Daffodil International University, Dhaka, 1207, Bangladesh.
| | - ARM Mehrab Ali
- ARCED Foundation, 13/1 Pallabi, Mirpur-12, Dhaka, 1216 Bangladesh
| | - Uday Narayan Yadav
- grid.1005.40000 0004 4902 0432Centre for Primary Health Care and Equity, University of New South Wales, Sydney, NSW 2052 Australia ,grid.1001.00000 0001 2180 7477National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, Canberra, ACT Australia
| | - Sukanta Das
- grid.443106.40000 0004 4684 0312Department of Statistics, Begum Rokeya University, Rangpur, Bangladesh
| | - Nahida Akter
- grid.414142.60000 0004 0600 7174 Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, (ICDDR,B), Dhaka, Bangladesh
| | - Md. Nazmul Huda
- ARCED Foundation, 13/1 Pallabi, Mirpur-12, Dhaka, 1216 Bangladesh ,grid.1029.a0000 0000 9939 5719 School of Medicine, Translational Health Research Institute, Western Sydney University, Campbeltown, NSW Australia
| | - Setho Hadisuyatmana
- grid.440745.60000 0001 0152 762XThe Faculty of Nursing, Universitas Airlangga, Surabaya, 60115 Indonesia
| | - Sajedur Rahman
- grid.492922.6Save the Children in Bangladesh, Dhaka, 1212 Bangladesh
| | - David Lim
- grid.1029.a0000 0000 9939 5719 School of Medicine, Translational Health Research Institute, Western Sydney University, Campbeltown, NSW Australia ,grid.1029.a0000 0000 9939 5719School of Health Sciences, Western Sydney University, Campbeltown, NSW Australia
| | - Mohammad Mahmudur Rahman
- grid.8198.80000 0001 1498 6059Department of Clinical Psychology, University of Dhaka, Dhaka, Bangladesh
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Khaustova OO, Markova MV, Driuchenko MO, Burdeinyi AO. Proactive psychological and psychiatric support of patients with chronic non-communicable diseases in a randomised trial: a Ukrainian experience. Gen Psychiatr 2022; 35:e100881. [PMID: 36569174 PMCID: PMC9703355 DOI: 10.1136/gpsych-2022-100881] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 10/13/2022] [Indexed: 11/27/2022] Open
Abstract
Background Presently, approaches for the early treatment of pathological anxiety in patients with chronic non-communicable diseases are lacking, thus delaying the initiation of symptom management at the early onset of the illness. Proactive psychological and psychiatric support, to alleviate subclinical symptoms of anxiety and to improve the quality of life in patients with chronic non-communicable diseases, is a promising candidate for the role of such therapy. Aims To investigate and determine the effectiveness of proactive psychological and psychiatric support for alleviating subclinical symptoms of anxiety and improving quality of life, in patients with chronic non-communicable diseases. Methods The study design was a monocentric randomised controlled trial with parallel groups. The study, involving 193 inpatients with chronic non-communicable diseases, complied with the ethical and deontological norms in accordance with the principles set out in the Declaration of Helsinki. Instruments used in the study included the Hamilton Anxiety Scale (HAM-A) to assess subclinical symptoms, the Scale of Somatic Symptoms and the Chaban Quality of Life Scale. Block randomisation was used to randomise patients to a 2-month-long study group with a proactive counselling psychiatry model care or a control group with standard regulated treatment for chronic non-communicable diseases. The allocation ratio was 1.15:1 owing to the expectancy of a higher percentage of dropout in the intervention group. Results After 60 days of treatment (T2), there was a statistically significant difference in all clinical parameters between the study and control groups. The median HAM-A value differed between the groups by 4.87 points, with statistically significant lower results in the study group. The comparison of the study group's scale values on day 1 and day 60 demonstrated statistically significant changes in all three indicators. Conclusions Our results support existing evidence for the effectiveness of proactive psychological and psychiatric support to reduce subclinical anxiety and somatisation symptoms and to improve the quality of life for patients with common chronic non-communicable diseases. However, continued research on the effectiveness of proactive psychological and psychiatric support for patients with chronic non-communicable diseases is needed.
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Affiliation(s)
- O O Khaustova
- Medical Psychology, Psychosomatic Medicine and Psychotherapy, Bogomolets National Medical University, Kyiv, Ukraine
| | - M V Markova
- Sexology, Psychotherapy and Medical Psychology, Kharkiv Medical Academy of Postgraduate Education, Kharkiv, Ukraine
| | | | - A O Burdeinyi
- Bogomolets National Medical University, Kyiv, Ukraine
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Tarta C, Marian M, Capitanio M, Faur FI, Duta C, Diaconescu R, Oprescu-Macovei AM, Totolici B, Dobrescu A. The Challenges of Colorectal Cancer Surgery during the COVID-19 Pandemic in Romania: A Three-Year Retrospective Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14320. [PMID: 36361200 PMCID: PMC9658781 DOI: 10.3390/ijerph192114320] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 10/27/2022] [Accepted: 10/31/2022] [Indexed: 06/16/2023]
Abstract
The predictions on the influence of the SARS-CoV-2 pandemic on access to medical services in Romania predicted a 35% drop in oncological hospitalizations in 2020 compared to the previous decade, raising the hypothesis that patients with colorectal cancer can become indirect victims of the ongoing pandemic. Therefore, the aim of the current research was to observe how the COVID-19 pandemic influenced colorectal cancer surgery in Romania, to determine the level of addressability towards specialized care, to compare the cancer staging between the pandemic and pre-pandemic periods, and to observe the risk factors for disease progression. This retrospective study was spread over three years, respectively, from March 2019 to March 2022, and included a total of 198 patients with a history of colorectal cancer surgery. It was decided to perform a parallel comparison of 2019, 2020, and 2021 to observe any significant changes during the pandemic. Our clinic encountered a significant decrease in all interventions during the pandemic; although the number of CRC surgeries remained constant, the cases were more difficult, with significantly more patients presenting in emergency situations, from 31.3% in 2019 to 50.0% in 2020 and 57.1% in 2021. Thus, the number of elective surgeries decreased significantly. The proportion of TNM (tumor-node-metastasis) staging was, however, statistically significant between the pre-pandemic and pandemic period. In 2019, 13.3% of patients had stage IIa, compared with 28.8% in 2020 and 13.1% in 2021. Similarly, the proportion of very advanced colorectal cancer was higher during the pandemic period of 2020 and 2021 (12.0% in 2019 vs. 12.5% in 2020 and 25.0% in 2021), which was represented by a significantly higher proportion of patients with bowel perforation. Patients with an advanced TNM stage had a 6.28-fold increased risk of disease progression, followed by lymphovascular invasion (HR = 5.19). However, the COVID-19 pandemic, represented by admission years 2020 and 2021, did not pose a significant risk for disease progression and mortality. In-hospital mortality during the pandemic also did not change significantly. After the pandemic restrictions have been lifted, it would be advisable to conduct a widespread colorectal cancer screening campaign in order to identify any instances of the disease that went undetected during the SARS-CoV-2 pandemic.
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Affiliation(s)
- Cristi Tarta
- Department X, 2nd Surgical Clinic of General Surgery, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Marco Marian
- Department X, 2nd Surgical Clinic of General Surgery, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Marco Capitanio
- Department X, 2nd Surgical Clinic of General Surgery, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Flaviu Ionut Faur
- Department X, 2nd Surgical Clinic of General Surgery, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Ciprian Duta
- Department X, 2nd Surgical Clinic of General Surgery, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Razvan Diaconescu
- Department of Gastroenterology, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Department of General Surgery, Faculty of Medicine, “Vasile Goldis” Western University of Arad, 310025 Arad, Romania
| | - Anca Monica Oprescu-Macovei
- Department of Gastroenterology, Emergency Hospital “Prof. Dr. Agripa Ionescu”, University of Medicine and Pharmacy “Carol Davila”, 050474 Bucharest, Romania
| | - Bogdan Totolici
- Department of General Surgery, Faculty of Medicine, “Vasile Goldis” Western University of Arad, 310025 Arad, Romania
| | - Amadeus Dobrescu
- Department X, 2nd Surgical Clinic of General Surgery, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
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Noh JW, Kim KB, Jang HE, Heo MH, Kim YJ, Cha J. Non-Communicable Diseases and Transitioning Health System in the Democratic People’s Republic of Korea during COVID-19 Lockdown. Healthcare (Basel) 2022; 10:healthcare10102095. [PMID: 36292542 PMCID: PMC9602564 DOI: 10.3390/healthcare10102095] [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: 09/27/2022] [Revised: 10/17/2022] [Accepted: 10/18/2022] [Indexed: 11/16/2022] Open
Abstract
While there are increasing concerns on COVID-19 situation in Democratic People’s Republic of Korea (DPRK, or North Korea), little is known about North Korea’s health system function for Non-Communicable Diseases. Given the scarcity of available evidence, a scoping review was conducted in peer review articles from MEDLINE, SCOPUS, and Web of Science, and policy literatures from Rodongshinmun, state-run media in North Korea to analyze the North Korea health system and COVID-19 pandemic. The transition to a market economy is expected to deepen the gap between the rich and the poor over access to health care, causing a new type of health inequality in North Korea. COVID-19 lockdown intensified the DPRK’s economic predicament exacerbating shortage of health financing on non-communicable diseases. The case study of mixed evidence from scoping review indicates that NCDs prevention and management are not functional in the transitioning health system under chronic economic crisis and isolation. This study indicates that NCDs prevention and management are not functional in the transitioning health system under chronic economic crisis and isolation. The destabilized markets under COVID-19 lockdown intensified the DPRK’s economic predicament and exacerbated the chronic shortage of health financing especially to NCDs.
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Affiliation(s)
- Jin-Won Noh
- Division of Health Administration, College of Software and Digital Health Care Convergence, Yonsei University, Wonju 26493, Korea
| | - Kyoung-Beom Kim
- Industry-Academic Cooperation Foundation, Yonsei University, Wonju 26493, Korea
| | - Ha-Eun Jang
- Department of Health Care Management, College of Bio Convergence, Eulji University, Seongnam 34824, Korea
| | - Min-Hee Heo
- Department of Health Administration, Yonsei University Graduate School, Wonju 26493, Korea
| | - Young-Jin Kim
- Department of Health Administration, Dankook University, Cheonan 31116, Korea
| | - Jiho Cha
- Moonsoul Graduate School of Future Strategy, KAIST, Daejeon 34141, Korea
- Correspondence: ; Tel.: +82-42-350-4040
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Ayele TA, Alamneh TS, Shibru H, Sisay MM, Yilma TM, Melak MF, Bisetegn TA, Belachew T, Haile M, Zeru T, Asres MS, Shitu K. Effect of COVID-19 pandemic on missed medical appointment among adults with chronic disease conditions in Northwest Ethiopia. PLoS One 2022; 17:e0274190. [PMID: 36194566 PMCID: PMC9531804 DOI: 10.1371/journal.pone.0274190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 08/23/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND COVID-19 had affected the health-care-seeking behavior of people with chronic medical conditions. The impact is even worse in resource-limited settings like Ethiopia. Therefore, this study was aimed to assess the extent and correlates of missed appointments among adults with chronic disease conditions before and during the COVID-19 pandemic in the Northwest Ethiopia. METHODS A retrospective chart review and cross-sectional survey were conducted from December 2020 to February 2021. A total of 1833 patients with common chronic disease were included by using a stratified systematic random sampling technique. Web-based data collection was done using Kobo collect. The data were explored using descriptive statistical techniques, the rate of missed appointments s before and during the COVID-19 pandemic was determined. A negative binomial regression model was fitted to identify the factors of missed appointment. An incidence rate ratio with its 95% confidence interval (CI) and p-value of the final model were reported. RESULTS The rate of missed appointments was 12.5% (95% CI: 11.13%, 14.20%) before the pandemic, increased to 26.8% (95% CI: 24.73%, 28.82%) during the pandemic (p-value < 0.001). Fear of COVID-19 infection and lack of transport was the most common reasons for missing appointments. Older patients (Adjusted Incidence Rate Ratio (AIRR) = 1.01, 95% CI: 1.001; 1.015), having treatment follow up more than 5 years (AIRR = 1.36, 95%CI: 1.103; 1.69), shorter frequency of follow-up (AIRR = 2.22, 95% CI: 1.63; 2.49), covering expense out of pocket (AIRR = 2.26, 95%CI: 1.41; 2.95), having a sedentary lifestyle (AIRR = 1.36, 95%CI: 1.12; 1.71), and history of missed appointments before COVID-19 pandemic (AIRR = 4.27, 95%CI: 3.35; 5.43) were positively associated with the incidence of missed appointments. CONCLUSION The rate of missed appointment increased significantly during the COVID-19 pandemic. Older age, longer duration of follow up, more frequent follow-up, out-of-pocket expenditure for health service, history of poor follow-up, and sedentary lifestyle had positive relationship with missed appointments during the pandemic. Therefore, it is important to give special emphasis to individuals with these risk factors while designing and implementing policies and strategies for peoples with chronic diseases to ensure the continuity of care and to avoid the long-term impact on their health.
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Affiliation(s)
- Tadesse Awoke Ayele
- Epidemiology & Biostatistics Department, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tesfa Sewunet Alamneh
- Epidemiology & Biostatistics Department, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Habtewold Shibru
- Internal Medicine Department, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Malede Mequanent Sisay
- Epidemiology & Biostatistics Department, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tesfahun Melese Yilma
- Health Informatics Department, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Melkitu Fentie Melak
- Nutrition Department, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Telake Azale Bisetegn
- Health Education & Behavioral Science Department, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | | | | | - Taye Zeru
- Amhara Public Health Institute, Bahir-Dar, Ethiopia
| | - Mezgebu Selamsew Asres
- Internal Medicine Department, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Kegnie Shitu
- Health Education & Behavioral Science Department, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Prediction of hepatocellular carcinoma risk in patients with type-2 diabetes using supervised machine learning classification model. Heliyon 2022; 8:e10772. [PMID: 36203910 PMCID: PMC9529545 DOI: 10.1016/j.heliyon.2022.e10772] [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: 03/20/2022] [Revised: 05/26/2022] [Accepted: 09/22/2022] [Indexed: 11/21/2022] Open
Abstract
Background Hepatocellular carcinoma (HCC) among type-2 diabetes (T2D) patients is an increasing burden to diabetes management. This study aims to develop and select the best machine learning (ML) classification model for predicting HCC in T2D for HCC early detection. Methods A case-control study was conducted utilising computerised medical records in two hepatobiliary centres. The predictors were chosen using multiple logistic regression. IBM SPSS Modeler® was used to assess the discriminative performance of support vector machine (SVM), logistic regression (LR), artificial neural network (ANN), chi-square automatic interaction detection (CHAID), and their ensembles. Results Subjects (N = 424) were split into 60% training (n = 248) and 40% testing (n = 176) groups. The independent predictors identified were race, viral hepatitis, abdominal pain/discomfort, unintentional weight loss, statins, alcohol consumption, non-alcoholic fatty liver, platelet <150 ×103/μL, alkaline phosphatase >129 IU/L, and alanine transaminase ≥25 IU/L. The performances of all models differed significantly (Cochran’s Q-test,p = 0.001) but not between the ensembled and SVM model (McNemar test, p = 0.687). SVM model was selected as the best model due to its simplicity, high accuracy (85.28%), and high AUC (0.914). A web-based application was developed using the best model’s algorithm for HCC prediction. Conclusions If further validation studies confirm these results, the SVM model’s application potentially augments early HCC detection in T2D patients. Hepatocellular carcinoma (HCC) in type-2 diabetes (T2D) is increasing. A web-based application using a machine learning model has been developed. The model has 85.28% accuracy and high AUC (0.914) in HCC prediction. Potential risk stratification tool in T2D clinic to predict HCC. HCC prediction in T2D clinic may aid early detection and improve survival.
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Mistry SK, Ali ARMM, Yadav UN, Das Gupta R, Anwar A, Basu S, Huda MN, Mitra DK. A tale of osteoarthritis among older adults during the COVID-19 pandemic in Bangladesh: A repeated cross-sectional study. PLoS One 2022; 17:e0274838. [PMID: 36126037 PMCID: PMC9488814 DOI: 10.1371/journal.pone.0274838] [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: 04/25/2022] [Accepted: 09/05/2022] [Indexed: 11/18/2022] Open
Abstract
Background Due to restrictions in social gatherings imposed due to the COVID-19 pandemic, physical and other daily activities were limited among the older adults. The present study aimed to estimate the change in osteoarthritis prevalence among older adults during the COVID-19 pandemic in Bangladesh. Methods This repeated cross-sectional study was conducted through telephone interviews among older adults aged 60 years and above on two successive occasions (October 2020 and September 2021) during the COVID-19 pandemic in Bangladesh. The prevalence of osteoarthritis was measured by asking the participants if they had osteoarthritis or joint pain problems. Results A total of 2077 participants (1032 in 2020-survey and 1045 in 2021-survey) participated in the study. The prevalence of self-reported joint pains or osteoarthritis significantly increased from 45.3% in 2020 to 54.7% in 2021 (P = 0.006), with an increasing odd in the adjusted analysis (aOR 1.27, 95% CI 1.04–1.54). We also found that osteoarthritis prevalence significantly increased among the participants from the Chattogram and Mymensingh divisions, aged 60–69 years, males, married, rural residents, and living with a family. A significant increase was also documented among those who received formal schooling, had a family income of 5000–10000 BDT, resided with a large family, were unemployed or retired, and lived away from a health facility. Conclusions Our study reported a significant increased prevalence of osteoarthritis among older adults from 2020 to 2021 during this pandemic in Bangladesh. This study highlights the need for the development and implementation of initiatives for the screening and management of osteoarthritis through a primary health care approach during any public health emergencies.
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Affiliation(s)
- Sabuj Kanti Mistry
- ARCED Foundation, Dhaka, Bangladesh
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, Australia
- Department of Public Health, Daffodil International University, Dhaka, Bangladesh
- * E-mail:
| | | | - Uday Narayan Yadav
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, Australia
- National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australia
| | - Rajat Das Gupta
- Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, United States of America
| | - Afsana Anwar
- Health and Nutrition, Social Assistance &, Rehabilitation for the Physically Vulnerable (SARPV), SARPV Complex, Dhaka, Bangladesh
| | - Saurav Basu
- Indian Institute of Public Health–Delhi, New Delhi, India
| | - Md. Nazmul Huda
- ARCED Foundation, Dhaka, Bangladesh
- School of Population Health, The University of New South Wales, Sydney, NSW, Australia
- Translational Health Research Institute, Western Sydney University, Campbeltown, NSW, Australia
| | - Dipak Kumar Mitra
- Department of Public Health, North South University, Dhaka, Bangladesh
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Katz BA, Yovel I. Mood symptoms predict COVID-19 pandemic distress but not vice versa: An 18-month longitudinal study. PLoS One 2022; 17:e0273945. [PMID: 36054108 PMCID: PMC9439223 DOI: 10.1371/journal.pone.0273945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 08/18/2022] [Indexed: 11/18/2022] Open
Abstract
The COVID-19 pandemic has had medical, economic and behavioral implications on a global scale, with research emerging to indicate that it negatively impacted the population's mental health as well. The current study utilizes longitudinal data to assess whether the pandemic led to an increase in depression and anxiety across participants or whether a diathesis-stress model would be more appropriate. An international group of 218 participants completed measures of depression, anxiety, rumination and distress intolerance at two baselines six months apart as well as during the onset of the COVID-19 pandemic exactly 12 months later. Contrary to expectations, depression, rumination, and distress intolerance were at equivalent levels during the pandemic as they were at baseline. Anxiety was reduced by a trivial degree (d = .10). Furthermore, a comparison of quantitative explanatory models indicated that symptom severity and pandemic-related environmental stressors predicted pandemic-related distress. Pandemic-related distress did not predict symptom severity. These findings underscore the necessity of longitudinal designs and diathesis-stress models in the study of mental health during the COVID-19 pandemic. They also emphasize that individuals with higher rates of baseline psychopathology are as particularly at risk for higher levels of distress in response to disaster-related stressors.
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Affiliation(s)
| | - Iftah Yovel
- The Hebrew University of Jerusalem, Jerusalem, Israel
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Ahmed T, Dumka N, Bhagat D, Hannah E, Kotwal A. Effect on essential health services during COVID-19 at the Primary level in India. J Family Med Prim Care 2022; 11:5423-5429. [PMID: 36505582 PMCID: PMC9731057 DOI: 10.4103/jfmpc.jfmpc_390_22] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 03/28/2022] [Accepted: 03/30/2022] [Indexed: 12/15/2022] Open
Abstract
Background Coronavirus diesease (COVID-19) led to increased demand on the Indian health system due to the pandemic as well as other communicable and non-communicable diseases. Guidance was thus issued by the Ministry of Health and Family Welfare (MoHFW), India, in April 2020 to maintain the delivery of essential health services. Objectives To determine the extent of disruptions of essential healthcare services, identify associated factors, and establish pertinent correlations to address specific needs. Methods The Mother and child tracking facilitation centre (MCTFC) conducted a telephonic survey with the front-line workers (FLWs) and beneficiaries in 21 Indian states. The sample size was determined using the infinite population sample size formula, and respondents were selected through a computer-generated random sequence technique. Data were quantitatively analysed using STATA-16. Descriptive univariate analysis was conducted using the Chi-square test. Findings The majority of the essential health services were being satisfactorily delivered by FLWs (N = 1596; accredited social health activist (ASHA) = 798, auxiliary nurse midwife (ANM) = 798), where most of the beneficiaries (N = 1410; Pregnant Women = 708, Postnatal Women = 702) continued accessing services with minor issues concerning referral transport. FLWs reported issues in the provisioning of medicines (P = 0.000) for patients with non-communicable diseases and more ANMs than ASHAs reported it. FLWs commonly experienced challenges in extending services due to community resistance and unavailability of general health services at healthcare facilities, where a greater number of ASHAs faced it (P = 0.000). Both FLWs and beneficiaries (N = 3006; FLWs = 1596, beneficiaries = 1410) demonstrated appropriate COVID-19 knowledge and behavior. Conclusion Although overwhelmed, the Indian health system performed satisfactorily well during pandemic in terms of essential health services.
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Affiliation(s)
- Tarannum Ahmed
- Knowledge Management Division, National Health Systems Resource Centre, Munirka, New Delhi, India,Address for correspondence: Dr. Tarannum Ahmed, National Health Systems and Resource Centre, National Institute of Health and Family Welfare, Baba Gang Nath Marg, Munirka, New Delhi - 110 067, India. E-mail:
| | - Neha Dumka
- Knowledge Management Division, National Health Systems Resource Centre, Munirka, New Delhi, India
| | - Deepak Bhagat
- Centre of Social Medicine and Community Health, Jawaharlal Nehru University, New Delhi, India
| | - Erin Hannah
- Knowledge Management Division, National Health Systems Resource Centre, Munirka, New Delhi, India
| | - Atul Kotwal
- Executive Director, National Health Systems Resource, Ministry of Health and Family Welfare, India
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Stachteas P, Symvoulakis M, Tsapas A, Smyrnakis E. The impact of the COVID-19 pandemic on the management of patients with chronic diseases in Primary Health Care. POPULATION MEDICINE 2022. [DOI: 10.18332/popmed/152606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Baral S, Rao A, Rwema JOT, Lyons C, Cevik M, Kågesten AE, Diouf D, Sohn AH, Phaswana-Mafuya RN, Kamarulzaman A, Millett G, Marcus JL, Mishra S. Competing health risks associated with the COVID-19 pandemic and early response: A scoping review. PLoS One 2022; 17:e0273389. [PMID: 36037216 PMCID: PMC9423636 DOI: 10.1371/journal.pone.0273389] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Accepted: 08/09/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND COVID-19 has rapidly emerged as a global public health threat with infections recorded in nearly every country. Responses to COVID-19 have varied in intensity and breadth, but generally have included domestic and international travel limitations, closure of non-essential businesses, and repurposing of health services. While these interventions have focused on testing, treatment, and mitigation of COVID-19, there have been reports of interruptions to diagnostic, prevention, and treatment services for other public health threats. OBJECTIVES We conducted a scoping review to characterize the early impact of COVID-19 on HIV, tuberculosis, malaria, sexual and reproductive health, and malnutrition. METHODS A scoping literature review was completed using searches of PubMed and preprint servers (medRxiv/bioRxiv) from November 1st, 2019 to October 31st, 2020, using Medical Subject Headings (MeSH) terms related to SARS-CoV-2 or COVID-19 and HIV, tuberculosis, malaria, sexual and reproductive health, and malnutrition. Empiric studies reporting original data collection or mathematical models were included, and available data synthesized by region. Studies were excluded if they were not written in English. RESULTS A total of 1604 published papers and 205 preprints were retrieved in the search. Overall, 8.0% (129/1604) of published studies and 10.2% (21/205) of preprints met the inclusion criteria and were included in this review: 7.3% (68/931) on HIV, 7.1% (24/339) on tuberculosis, 11.6% (26/224) on malaria, 7.8% (19/183) on sexual and reproductive health, and 9.8% (13/132) on malnutrition. Thematic results were similar across competing health risks, with substantial indirect effects of the COVID-19 pandemic and response on diagnostic, prevention, and treatment services for HIV, tuberculosis, malaria, sexual and reproductive health, and malnutrition. DISCUSSION COVID-19 emerged in the context of existing public health threats that result in millions of deaths every year. Thus, effectively responding to COVID-19 while minimizing the negative impacts of COVID-19 necessitates innovation and integration of existing programs that are often siloed across health systems. Inequities have been a consistent driver of existing health threats; COVID-19 has worsened disparities, reinforcing the need for programs that address structural risks. The data reviewed here suggest that effective strengthening of health systems should include investment and planning focused on ensuring the continuity of care for both rapidly emergent and existing public health threats.
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Affiliation(s)
- Stefan Baral
- Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, Maryland, United States of America
| | - Amrita Rao
- Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, Maryland, United States of America
| | - Jean Olivier Twahirwa Rwema
- Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, Maryland, United States of America
| | - Carrie Lyons
- Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, Maryland, United States of America
| | - Muge Cevik
- Division of Infection and Global Health Research, School of Medicine, University of St. Andrews, St. Andrews, Scotland
| | - Anna E. Kågesten
- Department of Global Public Health, Karolinska Institutet, Solna, Sweden
| | | | - Annette H. Sohn
- TREAT Asia, amfAR, The Foundation for AIDS Research, Bangkok, Thailand
| | - Refilwe Nancy Phaswana-Mafuya
- South African Medical Research Council/University of Johannesburg Pan African Centre for Epidemics Research Extramural Unit, Johannesburg, South Africa
- Department of Environmental Health, Faculty of Health Sciences, University of Johannesburg, Johannesburg, South Africa
| | - Adeeba Kamarulzaman
- Department of Medicine and Infectious Diseases, University of Malaya, Kuala Lumpur, Malaysia
| | - Gregorio Millett
- Public Policy Office, amfAR, Washington, District of Columbia, United States of America
| | - Julia L. Marcus
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, United States of America
| | - Sharmistha Mishra
- Li Ka Shing Knowledge Institute, St. Michael’s Hospital, University of Toronto, Toronto, Canada
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Triangulating evidence for the causal impact of single-intervention zinc supplement on glycaemic control for type 2 diabetes: systematic review and meta-analysis of randomised controlled trial and two-sample Mendelian randomisation. Br J Nutr 2022; 129:1929-1944. [PMID: 35946077 PMCID: PMC10167665 DOI: 10.1017/s0007114522002616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Abstract
Although previous studies suggested the protective effect of Zn for type 2 diabetes (T2D), the unitary causal effect remains inconclusive. We investigated the causal effect of Zn as a single intervention on glycaemic control for T2D, using a systematic review of randomised controlled trials and two-sample Mendelian randomisation (MR). Four primary outcomes were identified: fasting blood glucose/fasting glucose, HbA1c, homeostatic model assessment for insulin resistance (HOMA-IR) and serum insulin/fasting insulin level. In the systematic review, four databases were searched until June 2021. Studies, in which participants had T2D and intervention did not comprise another co-supplement, were included. Results were synthesised through the random-effects meta-analysis. In the two-sample MR, we used single-nucleotide polymorphisms (SNP) from MR-base, strongly related to Zn supplements, to infer the relationship causally, but not specified T2D. In the systematic review and meta-analysis, fourteen trials were included with overall 897 participants initially. The Zn supplement led to a significant reduction in the post-trial mean of fasting blood glucose (mean difference (MD): −26·52 mg/dl, 95 % CI (−35·13, −17·91)), HbA1c (MD: −0·52 %, 95 % CI: (−0·90, −0·13)) and HOMA-IR (MD: −1·65, 95 % CI (−2·62, −0·68)), compared to the control group. In the two-sample MR, Zn supplement with two SNP reduced the fasting glucose (inverse-variance weighted coefficient: −2·04 mmol/l, 95 % CI (−3·26, −0·83)). From the two methods, Zn supplementation alone may causally improve glycaemic control among T2D patients. The findings are limited by power from the small number of studies and SNP included in the systematic review and two-sample MR analysis, respectively.
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Philip S, Suhas S, Nirisha PL, Pandey P, Manjunatha N, Kumar CN, Math SB. Ethical and legal issues concerning COVID 19 vaccinations in persons with mental illness in India. Ind Psychiatry J 2022; 31:183-190. [PMID: 36419684 PMCID: PMC9678180 DOI: 10.4103/ipj.ipj_228_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 04/22/2022] [Accepted: 05/11/2022] [Indexed: 11/04/2022] Open
Abstract
Mental healthcare in India faces severe challenges amid the ongoing pandemic. India runs the largest vaccination drive globally, including booster doses to rapidly vaccinate its population of over a billion. As persons with mental illness are at greater risk of adverse outcomes from COVID 19, they need prioritized access and administration of these vaccines. This manuscript examines the current legislation and identifies how the legal and ethical frameworks can prioritize COVID 19 vaccinations for persons with mental illness in India through a review of the various legislations of India concerning persons with mental illness and judicial judgments concerning the pandemic and vaccination. Subsequently, we discuss ethical and legal challenges associated with vaccination in this vulnerable population and possible solutions. Based on the current review, the authors recommend the guidelines for capacity assessment for vaccination decisions and discuss existing legal frameworks relevant to the vaccination of persons with mental illness.
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Affiliation(s)
- Sharad Philip
- Department of Psychiatry, National Institute of Mental Health and Neurosciences [NIMHANS], Bengaluru, Karnataka, India
| | - Satish Suhas
- Department of Psychiatry, National Institute of Mental Health and Neurosciences [NIMHANS], Bengaluru, Karnataka, India
| | - P Lakshmi Nirisha
- Department of Psychiatry, National Institute of Mental Health and Neurosciences [NIMHANS], Bengaluru, Karnataka, India
| | - Praveen Pandey
- Department of Psychiatry, National Institute of Mental Health and Neurosciences [NIMHANS], Bengaluru, Karnataka, India
| | - Narayana Manjunatha
- Department of Psychiatry, National Institute of Mental Health and Neurosciences [NIMHANS], Bengaluru, Karnataka, India
| | - Channaveerachari Naveen Kumar
- Department of Psychiatry, National Institute of Mental Health and Neurosciences [NIMHANS], Bengaluru, Karnataka, India
| | - Suresh Bada Math
- Department of Psychiatry, National Institute of Mental Health and Neurosciences [NIMHANS], Bengaluru, Karnataka, India
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Abstract
South Africa had the privilege of learning from how other countries responded to the crisis engendered by the COVID-19 pandemic. However, this opportunity seems to have been lost as the South African government made the mistake of transposing a developed world preventive response onto a largely developing-world populace. The government failed to map out how factors such as South Africa’s demographic composition, spatial architecture, the incidence of poverty and informality, and competing epidemics would interact synergistically and shape epidemiological outcomes. In this article shaped by sociological insights, we show how the application of governance systems can give rise to many unintended social consequences when the knowledge forms upon which they are based are not suitably tailored to meet the needs of the specific local context. We highlight how informality can play a valuable role in fighting the COVID crisis and suggest that, to truly succeed, the government should include rather than override informal principles of governance.
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Affiliation(s)
- D. Trevor van Wyk
- Department of Sociology, University of Pretoria, Pretoria, South Africa
| | - Vasu Reddy
- Department of Sociology, University of Pretoria, Pretoria, South Africa
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Hossain MM, Saha N, Rodela TT, Tasnim S, Nuzhath T, Roy TJ, Burdine JN, Ahmed HU, McKyer ELJ, Basu BK, Ma P. Global research on syndemics: a meta-knowledge analysis (2001-2020). F1000Res 2022; 11:253. [PMID: 36936050 PMCID: PMC10015119 DOI: 10.12688/f1000research.74190.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/28/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Syndemics or synergies of cooccurring epidemics are widely studied across health and social sciences in recent years. METHODS We conducted a meta-knowledge analysis of articles published between 2001 to 2020 in this growing field of academic scholarship. RESULTS We found a total of 830 articles authored by 3025 authors, mostly from high-income countries. Publications on syndemics are gradually increasing since 2003, with rapid development in 2013. Each article was cited more than 15 times on average, and most (n = 604) articles were original studies. Syndemics research focused on several areas, including HIV/AIDS, substance abuse, mental health, gender minority stressors, racism, violence, chronic physical and mental disorders, food insecurity, social determinants of health, and coronavirus disease 2019. Moreover, biopsychosocial interactions between multiple health problems were studied across medical, anthropological, public health, and other disciplines of science. CONCLUSIONS The limited yet rapidly evolving literature on syndemics informs transdisciplinary interests to understand complex coexisting health challenges in the context of systematic exclusion and structural violence in vulnerable populations. The findings also suggest applications of syndemic theory to evaluate clinical and public health problems, examine the socioecological dynamics of factors influencing health and wellbeing, and use the insights to alleviate health inequities in the intersections of synergistic epidemics and persistent contextual challenges for population health.
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Affiliation(s)
- Md Mahbub Hossain
- EviSyn Health, Khulna, Bangladesh
- Department of Health Promotion and Community Health Sciences, Texas A&M Health Science Center, College Stataion, Texas, 77840, USA
| | - Nobonita Saha
- Institute of Nutrition and Food Science, University of Dhaka, Dhaka, Bangladesh
| | - Tahmina Tasnim Rodela
- Department of Economics, Mawlana Bhashani Science and Technology University, Tangail, Bangladesh
| | - Samia Tasnim
- EviSyn Health, Khulna, Bangladesh
- Department of Health Promotion and Community Health Sciences, Texas A&M Health Science Center, College Stataion, Texas, 77840, USA
| | - Tasmiah Nuzhath
- EviSyn Health, Khulna, Bangladesh
- Department of Health Promotion and Community Health Sciences, Texas A&M Health Science Center, College Stataion, Texas, 77840, USA
| | - Tamal Joyti Roy
- Institute of Information and Communication Technology, Khulna, Bangladesh
| | - James N. Burdine
- Department of Health Promotion and Community Health Sciences, Texas A&M Health Science Center, College Stataion, Texas, 77840, USA
| | | | - E. Lisako J. McKyer
- Department of Health Promotion and Community Health Sciences, Texas A&M Health Science Center, College Stataion, Texas, 77840, USA
| | | | - Ping Ma
- Department of Health Promotion and Community Health Sciences, Texas A&M Health Science Center, College Stataion, Texas, 77840, USA
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Hossain MM, Saha N, Rodela TT, Tasnim S, Nuzhath T, Roy TJ, Burdine JN, Ahmed HU, McKyer ELJ, Basu BK, Ma P. Global research on syndemics: a meta-knowledge analysis (2001-2020). F1000Res 2022; 11:253. [PMID: 36936050 PMCID: PMC10015119 DOI: 10.12688/f1000research.74190.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/26/2023] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Syndemics or synergies of cooccurring epidemics are widely studied across health and social sciences in recent years. METHODS We conducted a meta-knowledge analysis of articles published between 2001 to 2020 in this growing field of academic scholarship. RESULTS We found a total of 830 articles authored by 3025 authors, mostly from high-income countries. Publications on syndemics are gradually increasing since 2003, with rapid development in 2013. Each article was cited more than 15 times on average, and most (n = 604) articles were original studies. Syndemics research focused on several areas, including HIV/AIDS, substance abuse, mental health, gender minority stressors, racism, violence, chronic physical and mental disorders, food insecurity, social determinants of health, and coronavirus disease 2019. Moreover, biopsychosocial interactions between multiple health problems were studied across medical, anthropological, public health, and other disciplines of science. CONCLUSIONS The limited yet rapidly evolving literature on syndemics informs transdisciplinary interests to understand complex coexisting health challenges in the context of systematic exclusion and structural violence in vulnerable populations. The findings also suggest applications of syndemic theory to evaluate clinical and public health problems, examine the socioecological dynamics of factors influencing health and wellbeing, and use the insights to alleviate health inequities in the intersections of synergistic epidemics and persistent contextual challenges for population health.
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Affiliation(s)
- Md Mahbub Hossain
- EviSyn Health, Khulna, Bangladesh
- Department of Health Promotion and Community Health Sciences, Texas A&M Health Science Center, College Stataion, Texas, 77840, USA
| | - Nobonita Saha
- Institute of Nutrition and Food Science, University of Dhaka, Dhaka, Bangladesh
| | - Tahmina Tasnim Rodela
- Department of Economics, Mawlana Bhashani Science and Technology University, Tangail, Bangladesh
| | - Samia Tasnim
- EviSyn Health, Khulna, Bangladesh
- Department of Health Promotion and Community Health Sciences, Texas A&M Health Science Center, College Stataion, Texas, 77840, USA
| | - Tasmiah Nuzhath
- EviSyn Health, Khulna, Bangladesh
- Department of Health Promotion and Community Health Sciences, Texas A&M Health Science Center, College Stataion, Texas, 77840, USA
| | - Tamal Joyti Roy
- Institute of Information and Communication Technology, Khulna, Bangladesh
| | - James N. Burdine
- Department of Health Promotion and Community Health Sciences, Texas A&M Health Science Center, College Stataion, Texas, 77840, USA
| | | | - E. Lisako J. McKyer
- Department of Health Promotion and Community Health Sciences, Texas A&M Health Science Center, College Stataion, Texas, 77840, USA
| | | | - Ping Ma
- Department of Health Promotion and Community Health Sciences, Texas A&M Health Science Center, College Stataion, Texas, 77840, USA
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Giolo SR, Giordani RCF, Zanoni da Silva M, Dias PCA, Estavela A, Ismael Mabuie J. Cross-cultural measurement invariance of the fear of COVID-19 scale in three Portuguese-speaking countries. J Health Psychol 2022; 27:2997-3012. [DOI: 10.1177/13591053221076578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This study evaluated the measurement invariance of the Portuguese version of the Fear of COVID-19 Scale (FCV-19S) across three countries: Brazil (South America), Mozambique (East Africa), and Portugal (Southwest Europe). A total of 8694 participants were recruited through convenience sampling (7430 Brazilians, 387 Mozambicans, and 877 Portuguese adults). The unidimensional structure of the FCV-19S fitted well with each country’s data. Multigroup confirmatory factor analysis showed that the FCV-19S was partially invariant across countries and fully invariant across gender and age groups, thus providing a solid basis for cross-group comparisons. Structural invariance tests revealed different levels of fear across countries and genders but not across age groups.
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Solerdelcoll M. A Wake-Up Call: Recognizing and Reimaging Responses to Children's Mental Health and Protection Needs as an Integral Part of the COVID-19 Pandemic. Front Psychiatry 2022; 13:841515. [PMID: 35222129 PMCID: PMC8866847 DOI: 10.3389/fpsyt.2022.841515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 01/13/2022] [Indexed: 11/25/2022] Open
Affiliation(s)
- Mireia Solerdelcoll
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
- Department of Medicine, University of Barcelona, Barcelona, Spain
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Ghimire S, Shrestha A, Yadav UN, Mistry SK, Chapadia B, Yadav OP, Ali AM, Rawal LB, Yadav P, Mehata S, Harris M. Older adults with pre-existing noncommunicable conditions and their healthcare access amid COVID-19 pandemic: a cross-sectional study in eastern Nepal. BMJ Open 2022; 12:e056342. [PMID: 35115356 PMCID: PMC8814747 DOI: 10.1136/bmjopen-2021-056342] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND COVID-19 has greatly impacted older adults with pre-existing noncommunicable conditions (hereafter called pre-existing conditions) in terms of their access to essential healthcare services. Based on the theory of vertical health equity, this study investigated access to healthcare by Nepali older adults with pre-existing conditions during the COVID-19 pandemic. METHODS A cross-sectional study surveyed 847 randomly selected older adults (≥60 years) in three districts of eastern Nepal. Survey questionnaires, administered by trained community health workers, collected information on participants reported difficulty obtaining routine care and medications during the pandemic, in addition to questions on demographics, socioeconomic factors and pre-existing conditions. Cumulative scores for pre-existing conditions were recoded as no pre-existing condition, single condition and multimorbidity for the analyses. χ2 tests and binary logistic regressions determined inferences. RESULTS Nearly two-thirds of the participants had a pre-existing condition (43.8% single condition and 22.8% multimorbid) and reported experiencing difficulty obtaining routine care (52.8%) and medications (13.5%). Participants with single (OR 3.06, 95% CI 2.17 to 4.32) and multimorbid (OR 5.62, 95% CI 3.63 to 8.71) conditions had threefold and fivefold increased odds of experiencing difficulty accessing routine care. Findings were similar for difficulty obtaining medication (OR single: 3.12, 95% CI 1.71 to 5.69; OR multimorbid: 3.98, 95% CI 2.01 to 7.87) where odds were greater than threefolds. CONCLUSIONS Older adults with pre-existing conditions in Nepal, who require routine medical care and medication, faced significant difficulties obtaining them during the pandemic, which may lead to deterioration in their pre-existing conditions. Public health emergency preparedness should incorporate plans for both managing the emergency and providing continuing care.
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Affiliation(s)
- Saruna Ghimire
- Department of Sociology and Gerontology, Miami University, Oxford, Ohio, USA
| | - Aman Shrestha
- Department of Sociology and Gerontology, Miami University, Oxford, Ohio, USA
| | - Uday Narayan Yadav
- National Centre for Epidemiology & Population Health, The Australian National University, Canberra, ACT, Australia
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, NSW, Australia
- Centre for Reserach Policy and Implementation, Biratnagar, Nepal
| | - Sabuj Kanti Mistry
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, NSW, Australia
- ARCED Foundation, Dhaka, Bangladesh
- BRAC James P Grant School of Public Health, Dhaka, Bangaladesh
- Department of Public Health, Daffodil International University, Dhaka, Bangladesh
| | - Bunsi Chapadia
- Department of Microbiology, Miami University, Oxford, Ohio, USA
| | - Om Prakash Yadav
- Government of Nepal Ministry of Health and Population, Kathmandu, Nepal
| | | | - Lal B Rawal
- School of Health Medical and Applied Sciences, Central Queensland University, Sydney, New South Wales, Australia
| | - Priyanka Yadav
- Centre for Reserach Policy and Implementation, Biratnagar, Nepal
| | - Suresh Mehata
- Government of Nepal Ministry of Health and Population, Kathmandu, Nepal
| | - Mark Harris
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, NSW, Australia
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Shahin K, Zhang L, Mehraban MH, Collard JM, Hedayatkhah A, Mansoorianfar M, Soleimani-Delfan A, Wang R. Clinical and experimental bacteriophage studies: Recommendations for possible approaches for standing against SARS-CoV-2. Microb Pathog 2022; 164:105442. [PMID: 35151823 PMCID: PMC8830156 DOI: 10.1016/j.micpath.2022.105442] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 02/05/2022] [Accepted: 02/07/2022] [Indexed: 12/23/2022]
Abstract
In 2019, the world faced a serious health challenge, the rapid spreading of a life-threatening viral pneumonia, coronavirus disease 2019 (COVID-19) caused by a betacoronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). As of January 2022 WHO statistics shows more than 5.6 million death and about 350 million infection by SARS-CoV-2. One of the life threatening aspects of COVID-19 is secondary infections and reduced efficacy of antibiotics against them. Since the beginning of COVID-19 many researches have been done on identification, treatment, and vaccine development. Bacterial viruses (bacteriophages) could offer novel approaches to detect, treat and control COVID-19. Phage therapy and in particular using phage cocktails can be used to control or eliminate the bacterial pathogen as an alternative or complementary therapeutic agent. At the same time, phage interaction with the host immune system can regulate the inflammatory response. In addition, phage display and engineered synthetic phages can be utilized to develop new vaccines and antibodies, stimulate the immune system, and elicit a rapid and well-appropriate defense response. The emergence of SARS-CoV-2 new variants like delta and omicron has proved the urgent need for precise, efficient and novel approaches for vaccine development and virus detection techniques in which bacteriophages may be one of the plausible solutions. Therefore, phages with similar morphology and/or genetic content to that of coronaviruses can be used for ecological and epidemiological modeling of SARS-CoV-2 behavior and future generations of coronavirus, and in general new viral pathogens. This article is a comprehensive review/perspective of potential applications of bacteriophages in the fight against the present pandemic and the post-COVID era.
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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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46
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Global challenges and policy solutions in breast cancer control. Cancer Treat Rev 2022; 104:102339. [DOI: 10.1016/j.ctrv.2022.102339] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 01/12/2022] [Accepted: 01/14/2022] [Indexed: 02/08/2023]
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47
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Alam MS, Sultana R, Haque MA. Vulnerabilities of older adults and mitigation measures to address COVID-19 outbreak in Bangladesh: A review. SOCIAL SCIENCES & HUMANITIES OPEN 2022; 6:100336. [PMID: 36124099 PMCID: PMC9474424 DOI: 10.1016/j.ssaho.2022.100336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 08/24/2022] [Accepted: 09/14/2022] [Indexed: 11/27/2022]
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Afkar M, Rezanejad Asl P, Mahdavi Hezaveh A, Akrami F, Riazi-Isfahani S, Peykari N, Payab M, Moghisi A, Yousefi E, Ranjbar M, Soleymani Nejad M, Hamelmann C, Slama S, Sadegh Tabrizi J, Larijani B, Raeisi A, Ostovar A. The Effect of the COVID-19 Pandemic on Non-Communicable Disease Prevention and Management Services in the Primary Health Care System of Iran. Med J Islam Repub Iran 2022; 36:174. [PMID: 36908938 PMCID: PMC9997416 DOI: 10.47176/mjiri.36.174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Indexed: 03/14/2023] Open
Abstract
Background: The COVID-19 pandemic has caused significant disruptions in the provision of non-communicable disease (NCDs) prevention and control services in many countries, and there is a concern that it would lead to long-term complications of the diseases. The aim of this study is to assess the changes in the provisions of selected NCD services before and after the COVID-19 epidemic in Iran's primary healthcare system. Methods: In this descriptive-analytical retrospective study, the number of eight NCD services provided during the first 10 months of the COVID-19 pandemic from Feb 2020 to Dec 2020 were compared with the same period in the previous year using the data from the Iranian integrated electronic health record system (SIB) and also the association between the number of deaths due to COVID-19 and a sample of NCD services were assessed using cross-correlation analysis. The statistical analysis was performed in Stata Software v.14. Results: The NCD services have decreased by an average of 18.89% compared to the same period in the previous year; this decline was much more severe at the beginning of the epidemic period (up to 75% in some services) and was greater in physician-provided services than in non-physician services. Also, examining the course of the selected services during this period, a gradual compensation was evident after the initial reduction. Conclusion: The general trend of the selected services of prevention and control of NCDs in the PHC system of Iran within 10 months after the onset of COVID-19 showed a sharp decline and subsequent gradual compensation. Although the process of compensation in some services may be considered somewhat reassuring, in the case of some essential services, more effort and attention to the implementation of programs or compensatory policies seem necessary.
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Affiliation(s)
- Mehdi Afkar
- Department of Community Medicine, Faculty of Medicine, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Parisa Rezanejad Asl
- Network Management Center, Deputy of Public Health, Ministry of Health and Medical Education, Tehran, Iran
| | - Alireza Mahdavi Hezaveh
- Deputy Director of the Center for Non-communicable Disease Control & Prevention, Deputy of Public Health, Ministry of Health and Medical Education, Tehran, Iran
| | - Forouzan Akrami
- Medical Ethics and Law Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Center for Non-communicable Disease Control & Prevention, Deputy of Public Health, Ministry of Health and Medical Education, Tehran, Iran
| | - Sahand Riazi-Isfahani
- National Institute for Health Research, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Moloud Payab
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Moghisi
- Department of Community Medicine, Faculty of Medicine, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Elham Yousefi
- Center for Non-communicable Disease Control & Prevention, Deputy of Public Health, Ministry of Health and Medical Education, Tehran, Iran
| | - Mansour Ranjbar
- National Professional Officer, NCDs and Mental Health Unit Head, WHO Iran
| | | | | | - Slim Slama
- Regional Adviser Noncommunicable Diseases Prevention (NCP), UHC/NCDs, WHO EMRO
| | - Jafar Sadegh Tabrizi
- Department of Health Policy and Management, School of Management and Medical Informatics Health Services, Tabriz University of Medical Sciences, Tabriz, Iran.,Network Management Center, Deputy of Public Health, Ministry of Health and Medical Education, Tehran, Iran
| | - Bagher Larijani
- Department of Internal Medicine, School of Medicine, Director and Chief Scientific Officer, Institute, Endocrinology and Metabolism Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.,Deputy Chairman of the Iranian Non-communicable Diseases Committee (INCDC), Tehran, Iran
| | - Alireza Raeisi
- Department of Internal Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.,Deputy Minister of Health of the Ministry of Health and Medical Education, Tehran, Iran
| | - Afshin Ostovar
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.,Center for Non-communicable Disease Control & Prevention, Deputy of Public Health, Ministry of Health and Medical Education, Tehran, Iran
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Sharifi Y, Ebrahimpur M, Payab M, Larijani B. The Syndemic Theory, the COVID-19 Pandemic, and The Epidemics of Non-Communicable Diseases (NCDs). Med J Islam Repub Iran 2022; 36:177. [PMID: 36919009 PMCID: PMC10008253 DOI: 10.47176/mjiri.36.177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Indexed: 03/16/2023] Open
Abstract
Background: The syndemic theory is based on the interaction of two or more epidemics. This phenomenon is important in the current COVID-19 pandemic. Results: This pandemic affects all aspects of human life, including the management of non-communicable diseases (NCDs) such as cancer, diabetes, hypertension, and so on. This effect may have an impact not only on the management of the underlying NCDs but also on the infection and prognosis of COVID-19. Another aspect of this syndemic is that the health policies in each country have been revolutionized as a result of this pandemic, and the association of COVID-19 with other NCDs necessitates the implementation of new policies to properly manage this syndemic. Conclusion: In this paper, we review the syndemic theory, how the COVID-19 pandemic could be classified as a syndemic with other NCDs, and how this pandemic changes circumstances for policymakers in any country, particularly the Islamic Republic of Iran.
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Affiliation(s)
- Yasaman Sharifi
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.,Department of Radiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Mahbube Ebrahimpur
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Moloud Payab
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Bagher Larijani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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Akik C, Asfahani F, Elghossain T, Mesmar S, Rabkin M, El Sadr W, Fouad FM, Ghattas H. Healthcare system responses to non-communicable diseases’ needs of Syrian refugees: The cases of Jordan and Lebanon. J Migr Health 2022; 6:100136. [PMID: 36148323 PMCID: PMC9486618 DOI: 10.1016/j.jmh.2022.100136] [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: 02/24/2022] [Revised: 06/08/2022] [Accepted: 09/13/2022] [Indexed: 12/02/2022] Open
Abstract
Hosting governments were moderately successful in providing health services to Syrian refugees through existing national health systems. Coverage and quality of care remain suboptimal and continuity is often interrupted due to inadequate implementation of national NCD guidelines, major government policy changes and UNHCR policy changes in cost sharing, eligibility, and vulnerability criteria which made the health system difficult to navigate. The latter are related to the lack of financing for NCDs at global level. There is a need for evidence-based guidelines and effective implementation models for continued NCD care in protracted emergency settings. Innovative financing solutions and increased advocacy for funding and prioritization of NCD care for refugees need to be envisioned. Strengthening existing national health systems and striving for equity in achieving universal health coverage for both nationals of host countries and refugees is imperative.
Introduction Since the start of the Syrian conflict in 2011, Jordan and Lebanon have hosted large refugee populations, with a high pre-conflict burden of non-communicable diseases (NCDs). We aimed to explore NCD service provision to Syrian refugees in these two host countries and to identify lessons learned that may inform the global response to the changing health needs of refugees. Methods Between January 2017 and June 2018, we conducted 36 in-depth interviews with stakeholders from Jordan and Lebanon, as well as global stakeholders, to understand the context, the achievements, gaps and priorities in the provision and uptake of NCD prevention, testing and treatment services to Syrian refugees. Findings Both countries succeeded in embedding refugee health care within national health systems, yet coverage and quality of NCD health services offered to Syrian refugees in both contexts were affected by under-funding and consequent policy constraints. Changes in policies relating to cost sharing, eligibility and vulnerability criteria led to difficulties navigating the system and increased out-of-pocket payments for Syrians. Funding shortages were reported as a key barrier to NCD screening, diagnosis and management, including at the primary care level and referral from primary to secondary healthcare, particularly in Lebanon. These barriers were compounded by suboptimal implementation of NCD guidelines and high workloads for healthcare providers resulting from the large numbers of refugees. Conclusions Despite the extraordinary efforts made by host countries, provision and continuity of high quality NCD services at scale remains a tremendous challenge given ongoing funding shortfalls and lack of prioritization of NCD care for refugees. The development of innovative, effective and sustainable solutions is necessary to counter the threat of NCDs.
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Affiliation(s)
- Chaza Akik
- Center for Research on Population and Health, Faculty of Health Sciences, American University of Beirut, Lebanon
| | - Farah Asfahani
- Center for Research on Population and Health, Faculty of Health Sciences, American University of Beirut, Lebanon
| | - Tatiana Elghossain
- Center for Research on Population and Health, Faculty of Health Sciences, American University of Beirut, Lebanon
| | - Sandra Mesmar
- Center for Research on Population and Health, Faculty of Health Sciences, American University of Beirut, Lebanon
| | - Miriam Rabkin
- ICAP, Columbia University Mailman School of Public Health, New York, United States
| | - Wafaa El Sadr
- ICAP, Columbia University Mailman School of Public Health, New York, United States
| | - Fouad M. Fouad
- Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, Lebanon
| | - Hala Ghattas
- Center for Research on Population and Health, Faculty of Health Sciences, American University of Beirut, Lebanon
- Corresponding author.
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