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Al-Kuwari MG, Mohammed AM, Abdulmajeed J, Al-Romaihi H, Al-Mass M, Abushaikha SS, Albyat S, Nadeem S, Kandy MC. COVID-19 testing, incidence, and positivity trends among school age children during the academic years 2020-2022 in the State of Qatar: special focus on using CDC indicators for community transmission to evaluate school attendance policies and public health response. BMC Pediatr 2024; 24:374. [PMID: 38811909 PMCID: PMC11137921 DOI: 10.1186/s12887-024-04833-9] [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] [Received: 06/15/2023] [Accepted: 05/14/2024] [Indexed: 05/31/2024] Open
Abstract
BACKGROUND There exists a gap in our understanding of the age-dependent epidemiological dynamics of SARS-CoV-2 among school-age children in comparison to adults within the State of Qatar. Additionally, there has been limited assessment of the timely implementation of physical distancing interventions, notably national school closures, and their impact on infection trends. METHODS We used the national database to capture all records of polymerase-chain-reaction (PCR) testing, and rapid antigen tests (RAT) conducted at all health care venues in Qatar and administered between August 26, 2020, and August 21, 2022, across all age groups (≥ 5 years old). Study participants under 18 years old were categorized into two age brackets: (5-11) and (12-17), aligning with the Primary and Preparatory/Secondary grade levels in Qatar, respectively. We assessed age group testing rates, incidence rates, and positivity rates in relation to adults. These epidemiological metrics were compared with the CDC's thresholds for COVID-19 community transmission. RESULTS Throughout the school years of 2020-2021 and 2021-2022, a total of 5,063,405 and 6,130,531 tests were respectively conducted. In the 2020-2021 school year, 89.6% of the tests were administered to adults, while 13.7% were conducted on children in the following year. The overall test positivity rates for the 2020-2021 and 2021-2022 school years were 5.8% and 8.1%, respectively. Adolescents underwent the fewest tests during the full study period compared to both adults and young children. Using the CDC indicators, we found that children and adolescents can significantly contribute to elevated infection rates, potentially driving community transmission upon relaxation of social restrictions. CONCLUSION It is crucial to acknowledge the potential for higher transmission among youth and adolescents when formulating transmission control strategies and making decisions regarding school closures. Employing data-driven indicators and thresholds to monitor COVID-19 community levels is important for informing decision-making. These approaches also enable the prompt implementation of infection control transmission mitigation measures in future pandemics.
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Affiliation(s)
- Mohamed Ghaith Al-Kuwari
- Primary Health Care Corporation-Qatar, Corporation, Doha, Qatar
- College of Medicine, Qatar University, Doha, Qatar
| | | | | | | | - Maryam Al-Mass
- Primary Health Care Corporation-Qatar, Corporation, Doha, Qatar
| | | | - Soha Albyat
- Ministry of Public Health- Qatar, Doha, Qatar
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Maleki A, Mehrbod P, Bokharaei-Salim F, Eybpoosh S, Tavakoli M, Mohammadnejad AE, Hosseini Z, Kashanian S, Asadi LF, Salehi-Vaziri M, Fotouhi F. Epidemiological surveillance of respiratory viral infections in SARS-CoV-2-negative samples during COVID-19 pandemic in Iran. Virol J 2023; 20:296. [PMID: 38093303 PMCID: PMC10720196 DOI: 10.1186/s12985-023-02226-5] [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] [Received: 08/28/2023] [Accepted: 11/02/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND To improve the patient care, public health surveillance, and infection control, it is crucial to identify the presence and frequency of the common respiratory infections in individuals with COVID-19 symptoms but tested negative for SARS-CoV-2. This study aimed to shed light on this during the COVID-19 pandemic in Iran. METHODS In this cross-sectional study, a total of 1,002 patients with acute respiratory infection who had negative SARS-CoV-2 test results and referred to Valfajr Health Center, the National Collaborating Laboratory of Influenza and COVID-19 National Reference Laboratory at Pasteur Institute of Iran were recruited between January 2020 and January 2022. Nasopharyngeal and oropharyngeal swab samples were collected to detect 17 common respiratory viruses via TaqMan one-step real-time multiplex PCR. Demographic and clinical data of the participants were obtained from their electronic medical records. RESULTS In total, 218 samples (21.8%) were tested positive for at least one respiratory virus infection. Most of the common investigated respiratory viruses belonged to the years 2020 and 2022. The number of investigated patients in 2021 was few, which highlights the impact of health measures following the COVID-19 pandemic in Iran. Influenza A was the most common virus (5.8%), while adenovirus had the lowest prevalence (0.1%). Although the rate of respiratory virus infection was higher in men (24%) compared to women (19.3%), this difference was not statistically significant (P = 0.069). The prevalence of respiratory viruses had an inverse association with increasing age, with the highest rate (55.6%) observed in the age group below 2 years and the lowest rate (12.7%) in those above 65 years. CONCLUSION Our findings underscore the significance of adopting a comprehensive approach to respiratory infections detection and management. These results can be employed for the development of syndromic surveillance systems and implementation of the effective infection control measures. Furthermore, the results contribute to better understanding of the dynamics of respiratory viruses, both during pandemic periods and in non-pandemic contexts.
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Affiliation(s)
- Ali Maleki
- COVID-19 National Reference Laboratory, Pasteur Institute of Iran, Tehran, Iran
- Department of Influenza and Respiratory Viruses, Pasteur Institute of Iran, Tehran, Iran
| | - Parvaneh Mehrbod
- Department of Influenza and Respiratory Viruses, Pasteur Institute of Iran, Tehran, Iran
| | - Farah Bokharaei-Salim
- Department of Virology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Sana Eybpoosh
- Department of Epidemiology and Biostatistics, Research Centre for Emerging and Reemerging Infectious Diseases, Pasteur Institute of Iran, Tehran, Iran
| | - Mahsa Tavakoli
- Department of Arboviruses and Viral Hemorrhagic Fevers (National Reference Laboratory), Pasteur Institute of Iran, Tehran, Iran
| | | | - Zahra Hosseini
- COVID-19 National Reference Laboratory, Pasteur Institute of Iran, Tehran, Iran
| | - Setareh Kashanian
- COVID-19 National Reference Laboratory, Pasteur Institute of Iran, Tehran, Iran
| | - Laya Farhan Asadi
- Department of Arboviruses and Viral Hemorrhagic Fevers (National Reference Laboratory), Pasteur Institute of Iran, Tehran, Iran
| | - Mostafa Salehi-Vaziri
- COVID-19 National Reference Laboratory, Pasteur Institute of Iran, Tehran, Iran.
- Department of Arboviruses and Viral Hemorrhagic Fevers (National Reference Laboratory), Pasteur Institute of Iran, Tehran, Iran.
| | - Fatemeh Fotouhi
- Department of Influenza and Respiratory Viruses, Pasteur Institute of Iran, Tehran, Iran.
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Moradzadeh M, Karamouzian M, Najafizadeh S, Yazdi-Feyzabadi V, Haghdoost AA. International Journal of Health Policy and Management (IJHPM): A Decade of Advancing Knowledge and Influencing Global Health Policy (2013-2023). Int J Health Policy Manag 2023; 12:8124. [PMID: 37579384 PMCID: PMC10425691 DOI: 10.34172/ijhpm.2023.8124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 05/23/2023] [Indexed: 08/16/2023] Open
Affiliation(s)
- Mina Moradzadeh
- Health Services Management Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohammad Karamouzian
- Centre On Drug Policy Evaluation, St. Michael’s Hospital, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV, Kerman University of Medical Sciences, Kerman, Iran
| | - Sahar Najafizadeh
- Health Services Management Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Vahid Yazdi-Feyzabadi
- Health Services Management Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Ali-Akbar Haghdoost
- Modeling in Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
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Nakhaeizadeh M, Eybpoosh S, Jahani Y, Ahmadi Gohari M, Haghdoost AA, White L, Sharifi H. Impact of Non-pharmaceutical Interventions on the Control of COVID-19 in Iran: A Mathematical Modeling Study. Int J Health Policy Manag 2022; 11:1472-1481. [PMID: 34273920 PMCID: PMC9808365 DOI: 10.34172/ijhpm.2021.48] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 04/19/2021] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND During the first months of the coronavirus disease 2019 (COVID-19) pandemic, Iran reported high numbers of infections and deaths. In the following months, the burden of this infection decreased significantly, possibly due to the impact of a package of interventions. We modeled the dynamics of COVID-19 infection in Iran to quantify the impacts of these interventions. METHODS We used a modified susceptible-exposed-infected-recovered (SEIR) model to model the COVID-19 epidemic in Iran, from January 21, 2020 to September 21, 2020. We estimated the 95% uncertainty intervals (UIs) using Markov chain Monte Carlo simulation. Under different scenarios, we assessed the effectiveness of non-pharmaceutical interventions (NPIs) including physical distancing measures and self-isolation. We also estimated the time-varying reproduction number (Rt ), using our mathematical model and epidemiologic data. RESULTS If no NPIs were applied, there could have been a cumulative number of 51 800 000 (95% UI: 1 910 000- 77 600 000) COVID-19 infections and 266 000 (95% UI: 119 000-476 000) deaths by September 21, 2020. If physical distancing interventions, such as school/border closures and self-isolation interventions had been introduced a week earlier than they were actually launched, 30.8% and 35.2% reduction in the number of deaths and infections respectively could have been achieved by September 21, 2020. The observed daily number of deaths showed that the Rt was one or more than one almost every day during the analysis period. CONCLUSION Our models suggest that the NPIs implemented in Iran between January 21, 2020 and September 21, 2020 had significant effects on the spread of the COVID-19 epidemic. Our study also showed that the timely implementation of NPIs showed a profound effect on further reductions in the numbers of infections and deaths. This highlights the importance of forecasting and early detection of future waves of infection and of the need for effective preparedness and response capabilities.
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Affiliation(s)
- Mehran Nakhaeizadeh
- Modeling in Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
- Department of Biostatistics and Epidemiology, School of Public Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Sana Eybpoosh
- Department of Epidemiology and Biostatistics, Research Centre for Emerging and Reemerging Infectious Diseases, Pasteur Institute of Iran, Tehran, Iran
| | - Yunes Jahani
- Modeling in Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
- Department of Biostatistics and Epidemiology, School of Public Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Milad Ahmadi Gohari
- Modeling in Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
- Department of Biostatistics and Epidemiology, School of Public Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Ali Akbar Haghdoost
- Modeling in Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Lisa White
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Hamid Sharifi
- Department of Biostatistics and Epidemiology, School of Public Health, Kerman University of Medical Sciences, Kerman, Iran
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
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Projection of the Epidemics Trend of COVID-19 in Qom, Iran: A Modeling Study. ARCHIVES OF CLINICAL INFECTIOUS DISEASES 2022. [DOI: 10.5812/archcid-113091] [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]
Abstract
Background: Coronavirus is one of the major pathogens of the human respiratory system and a major threat to the human health. Objectives: This modeling study aimed to project the epidemics trend of coronavirus disease 2019 (COVID-19) in Qom, Iran Methods: This study projected the COVID-19 outbreak in Qom using a modified susceptible-exposed-infectious-recovered (SEIR) compartmental model by the end of December 2020. The model was calibrated based on COVID-19 epidemic trend in Qom from 1 January to 11 July. The number of infected, hospitalized, and death cases were projected by 31 December. A Monte Carlo uncertainty analysis was applied to obtain 95% uncertainty interval (UI) around the estimates. Results: According to the results, the reduced contact rate and increased isolation rate were effective in reducing the size of the epidemic in all scenarios. By reducing the contact rate from eight to six, the number of new cases on the peak day, as well as the total number of cases admitted to the hospital by the end of the period (31 December), decreased. For example, in Scenario A, compared to Scenario E, with a decrease in contact rate from eight to six, the number of new cases on peak days decreased from 15,700 to 1,100. The largest decrease in the number of new cases on peak days was related to Scenario F with 270 cases. Also, the total number of cases decreased from 948,000 to 222,000 between the scenarios, and the largest decrease in this regard was related to Scenario F, with 188,000 cases. Conclusions: The parameters of contact rate and isolation rate can reduce the number of infected cases and prevent the outbreak, or at least delay the onset of the peak. This can help health policymakers and community leaders to upgrade their health care systems.
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Estimating the Number of COVID-19 Cases and Impact of New COVID-19 Variants and Vaccination on the Population in Kerman, Iran: A Mathematical Modeling Study. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:6624471. [PMID: 35495892 PMCID: PMC9039779 DOI: 10.1155/2022/6624471] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Revised: 11/24/2021] [Accepted: 02/09/2022] [Indexed: 12/23/2022]
Abstract
COVID-19 is spreading all over Iran, and Kerman is one of the most affected cities. We conducted this study to predict COVID-19-related deaths, hospitalization, and infected cases under different scenarios (scenarios A, B, and C) by 31 December 2021 in Kerman. We also aimed to assess the impact of new COVID-19 variants and vaccination on the total number of COVID-19 cases, deaths, and hospitalizations (scenarios D, E, and F) using the modified susceptible-exposed-infected-removed (SEIR) model. We calibrated the model using deaths reported from the start of the epidemic to August 30, 2021. A Monte Carlo Markov Chain (MCMC) uncertainty analysis was used to estimate 95% uncertainty intervals (UI). We also calculated the time-varying reproductive number (Rt) following time-dependent methods. Under the worst-case scenario (scenario A; contact rate = 10, self‐isolation rate = 30%, and average vaccination shots per day = 5,000), the total number of infections by December 31, 2021, would be 1,625,000 (95% UI: 1,112,000–1,898,000) with 6,700 deaths (95% UI: 5,200–8,700). With the presence of alpha and delta variants without vaccine (scenario D), the total number of infected cases and the death toll were estimated to be 957,000 (95% UI: 208,000–1,463,000) and 4,500 (95% UI: 1,500–7,000), respectively. If 70% of the population were vaccinated when the alpha variant was dominant (scenario E), the total number of infected cases and deaths would be 608,000 (95% UI: 122,000–743,000) and 2,700 (95% UI: 700–4,000), respectively. The Rt was ≥1 almost every day during the epidemic. Our results suggest that policymakers should concentrate on improving vaccination and interventions, such as reducing social contacts, stricter limitations for gathering, public education to promote social distancing, incensing case finding and contact tracing, effective isolation, and quarantine to prevent more COVID-19 cases, hospitalizations, and deaths in Kerman.
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Nojomi M, Moradi-Lakeh M, Pourmalek F. COVID-19 in Iran: What was done and what should be done. Med J Islam Repub Iran 2021; 35:97. [PMID: 34956943 PMCID: PMC8683782 DOI: 10.47176/mjiri.35.97] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Indexed: 11/09/2022] Open
Abstract
The current COVID-19 pandemic started in Wuhan, China, in December 2019. The World health Organization (WHO) declared the COVID-19 as a public health emergency of international concern on January 30, 2020, and recognized the situation as a pandemic on March 11, 2020. Around 135 million confirmed cases and around 2.9 million deaths until the first week of April 2021 have been among its direct impacts on human health. All countries have been affected in different degrees, and each of them has used different strategies to protect themselves against health and nonhealth consequences of this epidemic. Although all approaches are full of mistakes with fatal and painful results, some of them were successful in limiting the epidemic. One of the astonishing improvements is development of several vaccines in a relatively short period of time, which has increased hopes for epidemic control. This review aims to critically appraise the strategies for COVID-19 epidemic control in Iran since the beginning of the disease until the fourth peak of disease in March 2021.
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Affiliation(s)
- Marzieh Nojomi
- Preventive Medicine & Public Health Research Center, Psychosocial Health Research Institute, Department of Community and Family Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Maziar Moradi-Lakeh
- Preventive Medicine & Public Health Research Center, Psychosocial Health Research Institute, Department of Community and Family Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
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Van Hout MC, Haddad P, Aaraj E. The Impact of COVID-19 on Drug Use and Harm Reduction Programming in the Middle East and North Africa (MENA) Region: a Regional Consultation of Stakeholders and People Who Use Drugs. Int J Ment Health Addict 2021; 20:2072-2085. [PMID: 34276260 PMCID: PMC8276543 DOI: 10.1007/s11469-021-00500-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/17/2021] [Indexed: 12/24/2022] Open
Abstract
The Middle East and North Africa (MENA) region has witnessed a slow but steady increase in the harm reduction response since 2016. It is likely that such gains are threatened by the impact of COVID-19. Very little is known about the health response and situation of people who use drugs (PWUD) during the pandemic in the region. A mixed method study was conducted by the MENA Harm Reduction Association (MENAHRA) to assess the situation of PWUD and impacts on harm reduction services during COVID-19. Twelve countries and two regional viewpoints responded to the survey. A virtual focus group was held with the MENA Network of People who Use Drugs (MENANPUD) focal points (n = 11). The study highlights how COVID-19 aggravated existing marginalization and stigmatization of PWUD and other key populations in the MENA region, with government level resourcing severely impacted by COVID-19. It further illustrates the commitment by harm reduction non-governmental organizations (NGOs) in diversifying their response, particularly through mobile outreach to drug hot spots, and the reliance of technology to support awareness raising, telemedicine, and medicine supplies. Positive shifts are observed in harm reduction policy by governments in some MENA countries and the continued commitment to support PWUD communities by existing harm reduction NGOs. Continued advocacy for and implementation of harm reduction responses at the domestic and regional levels should be underpinned by inclusion in state health emergency planning and disease control efforts, awareness raising around innovation and telemedicine to support health and NGO support systems and medicine supply chains, resourcing of NGOs, and provision of economic support for PWUD, disease surveillance, and research.
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Affiliation(s)
| | - Patricia Haddad
- Middle East and North African Harm Reduction Association (MENAHRA), Beirut, Lebanon
| | - Elie Aaraj
- Middle East and North African Harm Reduction Association (MENAHRA), Beirut, Lebanon
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Impact of COVID-19 pandemic on plastic surgery activities and residency programs in a tertiary referral centre in Iran. EUROPEAN JOURNAL OF PLASTIC SURGERY 2021; 44:817-823. [PMID: 34103788 PMCID: PMC8175059 DOI: 10.1007/s00238-021-01827-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 05/03/2021] [Indexed: 11/30/2022]
Abstract
Background On March 11, 2020, the World Health Organization (WHO) announced the COVID-19 outbreak as a new pandemic. In the meantime, plastic surgeons postponed their appointments due to the fair and rational allocation of medical supplies. These limitations made all junior and senior residents perform operations only on traumatic patients rather than those needing reconstructive procedures. This study aims to determine the effects of the COVID-19 pandemic on plastic surgery training programs in Iran. Also, the number of canceled surgeries will be determined to see the effects of the pandemic on the patients. Methods This retrospective case study considers a six-month timeframe in two consecutive years before and after the COVID-19 pandemic. For this purpose, the researchers evaluated the number of surgeries, types of procedures, age distribution, and gender distribution. The training program data of plastic surgery residents were collected from their logbooks and then analyzed in IBM SPSS Statistics 26. Differences were considered significant if p < 0.05 at a 95% confidence level. Results The total number of surgeries decreased by 23.5% after the COVID-19 outbreak (p < 0.05). There was a 29.9% reduction in trauma cases, -78.9% in aesthetic surgeries, -17.7% in reconstructive surgeries, -51.8% in craniofacial surgeries, and -59.5%in microscopic surgeries for each resident. Conclusions This study provides an insight into the severity of the pandemic effects on the plastic surgery training programs and the patients. The reduced number of surgeries led to a depletion in surgical skills training. These effects will not wear off immediately after the pandemic; therefore, it is necessary to observe whether the pandemic will have any lasting effects on this subspecialty. Level of evidence: Level IV, risk/prognostic study
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Mahmoudi H, Saffari M, Movahedi M, Sanaeinasab H, Rashidi-Jahan H, Pourgholami M, Poorebrahim A, Barshan J, Ghiami M, Khoshmanesh S, Potenza MN, Lin CY, Pakpour AH. A mediating role for mental health in associations between COVID-19-related self-stigma, PTSD, quality of life, and insomnia among patients recovered from COVID-19. Brain Behav 2021; 11:e02138. [PMID: 33811451 PMCID: PMC8119851 DOI: 10.1002/brb3.2138] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 02/07/2021] [Accepted: 03/16/2021] [Indexed: 12/31/2022] Open
Abstract
INTRODUCTION Patients with COVID-19 often suffer from psychological problems such as post-traumatic stress disorder (PTSD) and self-stigmatization that may negatively impact their quality of life and sleep. This study examined mental health as a potential mediating factor linking self-stigmatization and PTSD to quality of life and sleep. METHODS Using a cross-sectional design, 844 people who had recovered from COVID-19 were called and interviewed. Data were collected using structured scales. Structural equation modeling was applied to assess fitness of a mediation model including self-stigma and PTSD as independent factors and quality of life and insomnia as dependent variables. RESULTS Mental health, COVID-19-related self-stigma, and mental quality of life were associated. Insomnia, PTSD, and COVID-19-related self-stigma displayed significant direct associations (r = .334 to 0.454; p < .01). A mediation model indicated satisfactory goodness of fit (CFI = 0.968, TLI = 0.950, SRMR = 0.071, RMSEA = 0.068). Mental health as a mediator had negative relationships with COVID-19-related self-stigma, PTSD, and insomnia and positive associations with quality of life. CONCLUSION Mental health may mediate effects of COVID-19-related self-stigma and PTSD on quality of life and insomnia. Designing programs to improve mental health among patients with COVID-19 may include efforts to reduce negative effects of PTSD and COVID-19-related self-stigma on quality of life and insomnia.
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Affiliation(s)
- Hosein Mahmoudi
- Trauma Research Center and Faculty of Nursing, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Mohsen Saffari
- Health Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran.,Health Education Department, Faculty of Health, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Mahmoud Movahedi
- Behavioral Sciences Research Center and Faculty of Nursing, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Hormoz Sanaeinasab
- Health Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran.,Health Education Department, Faculty of Health, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Hojat Rashidi-Jahan
- Health Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Morteza Pourgholami
- Health Education and Health Promotion unit, Rasht Health Center,Guilan University of Medical Sciences, Rasht, Iran
| | - Ali Poorebrahim
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Jalal Barshan
- Rasht Health Center,Guilan University of Medical Sciences, Rasht, Iran
| | - Milad Ghiami
- Health, Safety and Environment Management, Expert of Occupational Health of Health Center, Rasht, Iran
| | - Saman Khoshmanesh
- Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Marc N Potenza
- Departments of Psychiatry and Neuroscience and the Child Study Center, School of Medicine, Yale University, New Haven, CT, USA
| | - Chung-Ying Lin
- Institute of Allied Health Sciences, Department of Occupational Therapy, Department of Public Health, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Amir H Pakpour
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran.,Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden
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Adib K, Hancock PA, Rahimli A, Mugisa B, Abdulrazeq F, Aguas R, White LJ, Hajjeh R, Al Ariqi L, Nabeth P. A participatory modelling approach for investigating the spread of COVID-19 in countries of the Eastern Mediterranean Region to support public health decision-making. BMJ Glob Health 2021; 6:e005207. [PMID: 33762253 PMCID: PMC7992384 DOI: 10.1136/bmjgh-2021-005207] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 02/28/2021] [Accepted: 03/01/2021] [Indexed: 01/16/2023] Open
Abstract
Early on in the COVID-19 pandemic, the WHO Eastern Mediterranean Regional Office recognised the importance of epidemiological modelling to forecast the progression of the COVID-19 pandemic to support decisions guiding the implementation of response measures. We established a modelling support team to facilitate the application of epidemiological modelling analyses in the Eastern Mediterranean Region (EMR) countries. Here, we present an innovative, stepwise approach to participatory modelling of the COVID-19 pandemic that engaged decision-makers and public health professionals from countries throughout all stages of the modelling process. Our approach consisted of first identifying the relevant policy questions, collecting country-specific data and interpreting model findings from a decision-maker's perspective, as well as communicating model uncertainty. We used a simple modelling methodology that was adaptable to the shortage of epidemiological data, and the limited modelling capacity, in our region. We discuss the benefits of using models to produce rapid decision-making guidance for COVID-19 control in the WHO EMR, as well as challenges that we have experienced regarding conveying uncertainty associated with model results, synthesising and comparing results across multiple modelling approaches, and modelling fragile and conflict-affected states.
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Affiliation(s)
- Keyrellous Adib
- World Health Organization Regional Office for the Eastern Mediterranean, Cairo, Egypt
| | - Penelope A Hancock
- World Health Organization Regional Office for the Eastern Mediterranean, Cairo, Egypt
- Nuffield Department of Medicine, University of Oxford, Oxford, Oxfordshire, UK
| | - Aysel Rahimli
- World Health Organization Regional Office for the Eastern Mediterranean, Cairo, Egypt
| | - Bridget Mugisa
- World Health Organization Regional Office for the Eastern Mediterranean, Cairo, Egypt
| | - Fayez Abdulrazeq
- World Health Organization Regional Office for the Eastern Mediterranean, Cairo, Egypt
| | - Ricardo Aguas
- Nuffield Department of Medicine, University of Oxford, Oxford, Oxfordshire, UK
- MAEMOD, Mahidol Oxford Tropical Medicine Research Unit, Bangkok, Thailand
| | - Lisa J White
- Nuffield Department of Medicine, University of Oxford, Oxford, Oxfordshire, UK
- Nuffield Department of Medicine, University of Oxford Centre for Tropical Medicine and Global Health, Oxford, Oxfordshire, UK
| | - Rana Hajjeh
- World Health Organization Regional Office for the Eastern Mediterranean, Cairo, Egypt
| | - Lubna Al Ariqi
- World Health Organization Regional Office for the Eastern Mediterranean, Cairo, Egypt
| | - Pierre Nabeth
- World Health Organization Regional Office for the Eastern Mediterranean, Cairo, Egypt
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Jalilian Khave L, Vahidi M, Shirini D, Sanadgol G, Ashrafi F, Arab-Ahmadi M, Fatemi A, Shabani Barzegar M, Hassanzadeh T, Rezaei B, Zali A, Ommi D, Nohesara S, Jalili Khoshnood R, Abdi S, Pirsalehi A, Masarat E, Shokoohi M, Karamouzian M. Clinical and Epidemiological Characteristics of Postdischarge Patients With COVID-19 in Tehran, Iran: Protocol for a Prospective Cohort Study (Tele-COVID-19 Study). JMIR Res Protoc 2021; 10:e23316. [PMID: 33471777 PMCID: PMC7857388 DOI: 10.2196/23316] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Revised: 12/16/2020] [Accepted: 01/05/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND COVID-19 was declared a pandemic on March 11, 2020. Given that the severe shortage of hospital beds has led to early discharge and insufficient patient education on home care routines and isolation protocols, the close follow-up of patients and their immediate relatives is an integral part of transitioning from hospital care to home care for patients with COVID-19. OBJECTIVE We designed the Tele-COVID-19 prospective cohort to follow-up with COVID-19 patients in Tehran, Iran, and improve health care delivery and the recording of postdischarge patients' clinical profiles. METHODS All adult patients who were admitted to the COVID-19 wards of teaching hospitals in Tehran, Iran were eligible to participate in this cohort study. At baseline, patients were recruited from 4 major hospitals from March 9, 2020 to May 20, 2020. Telephone follow-ups, which were led by volunteer medical students, were conducted on postdischarge days 1-3, 5, 7, 10, and 14. We collected data on a range of sociodemographic, epidemiological, and clinical characteristics by using a standard questionnaire. RESULTS Of the 950 patients with confirmed COVID-19 who were approached, 823 (response rate: 86.6%) consented and were enrolled into the cohort. Of the 823 participants, 449 (54.5%) were male. The mean age of participants was 50.1 years (SD 12.6 years). During the initial data collection phase, more than 5000 phone calls were made and over 577 reports of critical patients who were in need of urgent medical attention were recorded. CONCLUSIONS The Tele-COVID-19 cohort will provide patients with sufficient education on home care and isolation, and medical advice on care and the proper use of drugs. In addition, by preventing unnecessary hospital returns and providing information on household SARS-CoV-2 transmission as early as possible, this cohort will help with effective disease management in resource-limited settings. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/23316.
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Affiliation(s)
- Laya Jalilian Khave
- Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Vahidi
- Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Dorsa Shirini
- Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ghazal Sanadgol
- Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farzad Ashrafi
- Functional Neurosurgery Research Center, Shohada Tajrish Neurosurgical Center of Excellence, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mehran Arab-Ahmadi
- Advanced Diagnostic and Interventional Radiology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Fatemi
- Taleghani Hospital Research Development Committee, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Minoosh Shabani Barzegar
- Taleghani Hospital Research Development Committee, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Taha Hassanzadeh
- Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Behandokht Rezaei
- Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Alireza Zali
- Taleghani Hospital Research Development Committee, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Davood Ommi
- Taleghani Hospital Research Development Committee, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shabnam Nohesara
- Mental Health Research Center, Psychosocial Health Research Institute, Iran University of Medical Sciences, Tehran, Iran
| | - Reza Jalili Khoshnood
- Taleghani Hospital Research Development Committee, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Saeed Abdi
- Taleghani Hospital Research Development Committee, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Pirsalehi
- Taleghani Hospital Research Development Committee, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ehsan Masarat
- Kashan University of Medical Sciences and Health Services, Kashan, Iran
| | - Mostafa Shokoohi
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- HIV/Sexually Transmitted Infection Surveillance Research Center, and World Health Organization Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohammad Karamouzian
- HIV/Sexually Transmitted Infection Surveillance Research Center, and World Health Organization Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
- Faculty of Medicine, School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
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Karamouzian M, Madani N. COVID-19 response in the Middle East and north Africa: challenges and paths forward. Lancet Glob Health 2020; 8:e886-e887. [PMID: 32416767 PMCID: PMC7255278 DOI: 10.1016/s2214-109x(20)30233-3] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 05/01/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Mohammad Karamouzian
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada; HIV/STI Surveillance Research Centre, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Navid Madani
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA 02215, USA; Center for Science Health Education in the Middle East and North Africa, Dana-Farber Cancer Institute, Department of Cancer Immunology and Virology, Boston, MA, USA.
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