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Shahrin L, Nowrin I, Afrin S, Rahaman MZ, Al Hasan MM, Saif-Ur-Rahman KM. Monitoring and evaluation practices and operational research during public health emergencies in southeast Asia region (2012-2022) - a systematic review. THE LANCET REGIONAL HEALTH. SOUTHEAST ASIA 2024; 21:100340. [PMID: 38361592 PMCID: PMC10866922 DOI: 10.1016/j.lansea.2023.100340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 11/01/2023] [Accepted: 11/22/2023] [Indexed: 02/17/2024]
Abstract
This systematic review aimed to explore the monitoring and evaluation (M&E) and operational research (OR) practices during public health emergencies (PHE) in the southeast Asian region (SEAR) over the last decade. We searched electronic databases and grey literature sources for studies published between 2012 and 2022. The studies written in English were included, and a narrative synthesis was undertaken. A total of 29 studies were included in this review. Among these 25 studies documented M&E and four studies documented OR practices. The majority of the studies were from India and Bangladesh, with no evidence found from Sri Lanka, Bhutan, Myanmar, and Timor-Leste. M&E of surveillance programs were identified among which PHE due to COVID-19 was most prevalent. M&E was conducted in response to COVID-19, cholera, Nipah, Ebola, Candida auris, and hepatitis A. OR practice was minimal and reported from India and Indonesia. India conducted OR on COVID-19 and malaria, whereas Indonesia focused on COVID-19 and influenza. While most SEAR countries have mechanisms for conducting M&E, there is a noticeable limitation in OR practices. There is a compelling need to develop a standard framework for M&E. Additionally, enhancing private sector engagement is crucial for strengthening preparedness against PHE. Furthermore, there is a necessity to increase awareness about the importance of conducting M&E and OR during PHE.
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Affiliation(s)
- Lubaba Shahrin
- Clinical and Diagnostic Services, icddr,b, Dhaka, Bangladesh
- Nutrition Research Division, icddr,b, Dhaka, Bangladesh
| | - Iffat Nowrin
- Maternal and Child Health Division, icddr,b, Dhaka, Bangladesh
| | - Sadia Afrin
- Maternal and Child Health Division, icddr,b, Dhaka, Bangladesh
| | - Md Zamiur Rahaman
- Health Systems and Population Studies Division, icddr,b, Dhaka, Bangladesh
| | | | - KM Saif-Ur-Rahman
- College of Medicine, Nursing, and Health Sciences, University of Galway, Galway, Ireland
- Evidence Synthesis Ireland and Cochrane Ireland, University of Galway, Galway, Ireland
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Nair P, Nair CV, Kulirankal KG, Corley EM, Edathadathil F, Gutjahr G, Moni M, Sathyapalan DT. Characterization and predictive risk scoring of long COVID in a south indian cohort after breakthrough COVID infection; a prospective single centre study. BMC Infect Dis 2023; 23:670. [PMID: 37814234 PMCID: PMC10563355 DOI: 10.1186/s12879-023-08600-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 09/12/2023] [Indexed: 10/11/2023] Open
Abstract
BACKGROUND With the World Health Organization (WHO) declaring an end to the COVID-19 pandemic, the focus has shifted to understanding and managing long-term post-infectious complications. "Long COVID," characterized by persistent or new onset symptoms extending beyond the initial phase of infection, is one such complication. This study aims to describe the incidence, clinical features and risk profile of long COVID among individuals in a South Indian cohort who experienced post-ChAdOx1 n-Cov-2 vaccine breakthrough infections. METHODS A single-centre hospital-based prospective observational study was conducted from October to December 2021. The study population comprised adult patients (> 18 years) with a confirmed COVID-19 diagnosis who had received at least a single dose of vaccination. Data was collected using a specially tailored questionnaire at week 2, week 6, and week 12 post-negative COVID-19 test. A propensity score based predictive scoring system was developed to assess the risk of long COVID. RESULTS Among the 414 patients followed up in the study, 164 (39.6%) reported long COVID symptoms persisting beyond 6 week's post-infection. The presence of long COVID was significantly higher among patients above 65 years of age, and those with comorbidities such as Type II Diabetes Mellitus, hypertension, dyslipidemia, coronary artery disease, asthma, and cancer. Using backwards selection, a reduced model was developed, identifying age (OR 1.053, 95% CI 0.097-1.07, p < 0.001), hypertension (OR 2.59, 95% CI 1.46-4.59, p = 0.001), and bronchial asthma (OR 3.7176, 95% CI 1.24-11.12, p = 0.018) as significant predictors of long COVID incidence. A significant positive correlation was observed between the symptomatic burden and the number of individual comorbidities. CONCLUSIONS The significant presence of long COVID at 12 weeks among non-hospitalised patients underscores the importance of post-recovery follow-up to assess for the presence of long COVID. The predictive risk score proposed in this study may help identify individuals at risk of developing long COVID. Further research is needed to understand the impact of long COVID on patients' quality of life and the potential role of tailored rehabilitation programs in improving patient outcomes.
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Affiliation(s)
- Pranav Nair
- Department of Radiation Oncology, Amrita Institute of Medical Science and Research Centre, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India
| | - Chithira V Nair
- Division of Infectious Diseases, Department of General Medicine, Amrita Institute of Medical Science and Research Centre, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India
| | - Kiran G Kulirankal
- Division of Infectious Diseases, Department of General Medicine, Amrita Institute of Medical Science and Research Centre, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India
| | | | - Fabia Edathadathil
- Department of Infection Control and Epidemiology, Amrita Institute of Medical Science and Research Centre, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India
| | - Georg Gutjahr
- Center for Research in Analytics and Technologies for Education (CREATE), Amrita Vishwa Vidyapeetham, Amritapuri, Kollam, Kerala, India
| | - Merlin Moni
- Division of Infectious Diseases, Department of General Medicine, Amrita Institute of Medical Science and Research Centre, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India
| | - Dipu T Sathyapalan
- Division of Infectious Diseases, Department of General Medicine, Amrita Institute of Medical Science and Research Centre, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India.
- Amrita Institute of Medical Science and Research Centre, Amrita Vishwa Vidhyapeetham, Kochi, 682041, Kerala, India.
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Ma R, Shi L, Sun G. Policy Disparities Between Singapore and Israel in Response to the First Omicron Wave. Risk Manag Healthc Policy 2023; 16:489-502. [PMID: 37035268 PMCID: PMC10078824 DOI: 10.2147/rmhp.s402813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 03/14/2023] [Indexed: 04/04/2023] Open
Abstract
Purpose The purpose of this study is to evaluate public health measures during the first Omicron wave in Singapore and Israel to inform other countries confronted by COVID-19 outbreaks. Methods A comparative analysis was conducted using epidemiological data from Singapore and Israel between November 25th, 2021 and May 2nd, 2022 and policy information to examine the effects of public health measures in the two countries during the COVID-19 pandemic. Results Public health measures implemented by Singapore and Israel in response to the first Omicron wave were primarily intended to mitigate the effects of the COVID-19 pandemic. In Singapore, the pandemic led to more than 910,000 confirmed cases, a mortality rate of approximately 0.047%, a hospitalization rate of approximately 10.95%, and a severe illness rate of approximately 0.48%, without a second peak. In Israel, the pandemic not only resulted in over 2.74 million confirmed cases, a mortality rate of 0.095%, a hospitalization rate of about 7.39%, and a severe illness rate of approximately 2.30% but also returned after the significant relaxation of prevention regulations from March 1st, 2022. Conclusion Early and strict border control measures and surveillance measures are more effective in preventing and controlling the rapid spread of new strains of COVID-19 in the early stage. Furthermore, to prevent and control this highly infectious disease, COVID-19 vaccinations and booster shots must be promoted as soon as possible, medical service capacity must be enhanced, the hierarchical medical system must be improved, and non-pharmacological interventions must be implemented.
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Affiliation(s)
- Rongcai Ma
- Department of Health Management, School of Health Management, Southern Medical University, Guangzhou, Guangdong, 510515, People’s Republic of China
| | - Leiyu Shi
- Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, 21205, USA
| | - Gang Sun
- Department of Health Management, School of Health Management, Southern Medical University, Guangzhou, Guangdong, 510515, People’s Republic of China
- Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, 21205, USA
- Correspondence: Gang Sun, Department of Health Management, School of Health Management, Southern Medical University, Guangzhou, Guangdong, 510515, People’s Republic of China, Email
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Ngiam JN, Chhabra S, Goh W, Sim MY, Chew NWS, Sia CH, Cross GB, Tambyah PA. Continued demographic shifts in hospitalised patients with COVID-19 from migrant workers to a vulnerable and more elderly local population at risk of severe disease. Int J Infect Dis 2023; 127:77-84. [PMID: 36509335 PMCID: PMC9733964 DOI: 10.1016/j.ijid.2022.12.007] [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: 10/24/2022] [Revised: 11/22/2022] [Accepted: 12/06/2022] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVES In the early months of the COVID-19 pandemic in Singapore, the vast majority of infected persons were migrant workers living in dormitories who had few medical comorbidities. In 2021, with the Delta and Omicron waves, this shifted to the more vulnerable, elderly population within the local community. We examined evolving trends among the hospitalised cases of COVID-19. METHODS All patients with polymerase chain reaction-positive SARS-CoV-2 admitted from February 2020 to October 2021 were included and subsequently stratified by their year of admission (2020 or 2021). We compared the baseline clinical characteristics, clinical course, and outcomes. RESULTS A majority of cases were seen in 2020 (n = 1359), compared with 2021 (n = 422), due to the large outbreaks in migrant worker dormitories. Nevertheless, the greater proportion of locally transmitted cases outside of dormitories in 2021 (78.7% vs 12.3%) meant a significantly older population with more medical comorbidities had COVID-19. This led to an observably higher proportion of patients with severe disease presenting with raised inflammatory markers, need for therapeutics, supplemental oxygenation, and higher mortality. CONCLUSION Changing demographics and the characteristics of the exposed populations are associated with distinct differences in clinical presentation and outcomes. Older age remained consistently associated with adverse outcomes.
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Affiliation(s)
- Jinghao Nicholas Ngiam
- Department of Infectious Diseases, National University Health System, Singapore,Corresponding author: Fax: (65) 67794112, Tel: (65) 67795555
| | - Srishti Chhabra
- Department of Medicine, National University Health System, Singapore
| | - Wilson Goh
- Department of Medicine, National University Health System, Singapore
| | - Meng Ying Sim
- Department of Medicine, National University Health System, Singapore
| | - Nicholas WS Chew
- Department of Cardiology, National University Heart Centre Singapore, Singapore
| | - Ching-Hui Sia
- Department of Cardiology, National University Heart Centre Singapore, Singapore,Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Gail Brenda Cross
- Department of Infectious Diseases, National University Health System, Singapore,Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Paul Anantharajah Tambyah
- Department of Cardiology, National University Heart Centre Singapore, Singapore,Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore,Infectious Diseases Translational Research Programme, Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore
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