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Elbarazi I, Yacoub M, Reyad OA, Abdou MS, Elhadi YAM, Kheirallah KA, Ababneh BF, Hamada BA, El Saeh HM, Ali N, Rahma AT, Tahoun MM, Ghazy RM. Exploring enablers and barriers toward COVID-19 vaccine acceptance among Arabs: A qualitative study. Int J Disaster Risk Reduct 2022; 82:103304. [PMID: 36193257 PMCID: PMC9519527 DOI: 10.1016/j.ijdrr.2022.103304] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 07/02/2022] [Accepted: 09/13/2022] [Indexed: 05/26/2023]
Abstract
BACKGROUND With the emergence of the coronavirus disease 2019 (COVID-19) and rapid vaccine development, research interest in vaccine hesitancy (VH) has increased. Research usually focuses on quantitative estimates which largely neglected the qualitative underpinnings of this phenomenon. This study aimed to explore the beliefs and views towards COVID-19 vaccination among Arabs in different countries. Furthermore, we explored the effect of confidence in the healthcare system, misinformation, and scientific approaches adopted to mitigate COVID-19 on how individuals are following the recommended preventative actions including vaccination. METHODS This study was based on the Strategic Advisory Group of Experts (SAGE)-VH Model: A qualitative design that utilized in-depth, online interviews. The study was conducted in seven Arab countries (Egypt, Qatar, Kingdom of Saudi Arabia, Libya, Sudan, United Arab Emirates and Jordan) from June 2020 to December 2021. Transcripts were analyzed using NVivo 12 Software. RESULTS A total of 100 participants, 44 males and 56 females, of different age groups (37.1 ± 11.56 years) were interviewed. Findings revealed six themes as enablers and barriers to COVID-19 vaccination. Many participants indicated trusting the vaccines, the healthcare systems, and the vaccination policies were the main driver to get the vaccine. Participants showed concerns towards potential long-term vaccine effects. A consistent inclination towards collective responsibility, which is the willingness to protect others by own vaccination, was also reported. CONCLUSION Enablers and barriers of COVID-19 vaccination acceptance in the Arab region, from sociocultural and political perspectives, are critical to guide policymakers in designing target-oriented interventions that can improve vaccine acceptance.
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Key Words
- Arab Countries
- COVID-19
- COVID-19, Coronavirus disease 2019
- ECDC, European Centre for Disease Prevention and Control
- GDP, Gross Domestic Product
- HCWs, Health care workers
- KSA, Kingdom of Saudia Arabia
- LMIC, Low- and middle-income countries
- PI, Principal investigator
- Qualitative
- SAGE
- SAGE, Strategic Advisory Group of Experts on immunization
- SARS-CoV-2
- UAE, United Arab Emirates
- US, United States
- VH, Vaccine hesitancy
- Vaccine acceptance
- Vaccine hesitancy
- WHO, World Health Organization
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Affiliation(s)
- Iffat Elbarazi
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, AlAin, United Arab Emirates
| | - Mohamed Yacoub
- English Department, Florida International University, Miami, FL, USA
| | - Omar Ahmed Reyad
- Internal Medicine and Cardiology Clinical Pharmacy Department, Alexandria Main University Hospital, Alexandria, Egypt
| | - Marwa Shawky Abdou
- Department of Epidemiology, High Institute of Public Health, Alexandria University, Egypt
| | - Yasir Ahmed Mohammed Elhadi
- Department of Public Health, Medical Research Office, Sudanese Medical Research Association, Khartoum, Sudan
| | - Khalid A Kheirallah
- Department of Public Health, Medical School of Jordan University of Science and Technology, Irbid, Jordan
| | - Bayan F Ababneh
- Department of Public Health, Medical School of Jordan University of Science and Technology, Irbid, Jordan
| | - Bayan Abu Hamada
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, AlAin, United Arab Emirates
| | - Haider M El Saeh
- Community Medicine Department, Faculty of Medicine, University of Tripoli, Tripoli, Libya
| | - Nancy Ali
- Department of Communication and Media, Indiana University of Pennsylvania, Pennsylvania, USA
| | - Azhar T Rahma
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, AlAin, United Arab Emirates
| | - Mohamed Mostafa Tahoun
- Department of Epidemiology, High Institute of Public Health, Alexandria University, Egypt
| | - Ramy Mohamed Ghazy
- Tropical Health Department, High Institute of Public Health, Alexandria University, Egypt
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Singer ME, Dorrance KA, Oxenreiter MM, Yan KR, Close KL. The type 2 diabetes 'modern preventable pandemic' and replicable lessons from the COVID-19 crisis. Prev Med Rep 2021; 25:101636. [PMID: 34909369 PMCID: PMC8660571 DOI: 10.1016/j.pmedr.2021.101636] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 11/10/2021] [Accepted: 11/12/2021] [Indexed: 01/08/2023] Open
Abstract
To frame the substantial prevalence of type 2 diabetes (T2D) as a ‘Modern Preventable Pandemic’ (MPP) and present certain replicable policy lessons from the COVID-19 crisis to address it. A literature and policy review was performed to analyze data about the COVID-19 and T2D pandemics to establish their multi-factorial health, social, and economic impacts. With the global prevalence of T2D tripling in the last two decades, T2D has become an MPP largely due to modifiable human behaviors. Certain successful elements of the response to the COVID-19 pandemic provide important lessons that can be adapted for the growing T2D MPP. With proper education and access to resources, it is possible to mitigate the T2D MPP through focused government policies as illustrated by many of the lessons of the COVID-19 pandemic response. Without such government intervention, the T2D MPP will continue to grow at an unsustainable pace with enormous health, social and economic implications. Immediate action is necessary. The scale of the T2D pandemic warrants a robust response in health policy as outlined through eight coordinated efforts; the lessons of the COVID-19 crisis should be studied and applied to the T2D MPP.
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Affiliation(s)
- Michael E Singer
- The diaTribe Foundation, an Advocacy and Information 501(c)(3) Organization for People with Diabetes, Prediabetes, and Obesity, USA.,Vital Tech Partners, USA
| | - Kevin A Dorrance
- The diaTribe Foundation, an Advocacy and Information 501(c)(3) Organization for People with Diabetes, Prediabetes, and Obesity, USA.,Transformcare, Inc, USA
| | - Monica M Oxenreiter
- The diaTribe Foundation, an Advocacy and Information 501(c)(3) Organization for People with Diabetes, Prediabetes, and Obesity, USA
| | - Karena R Yan
- The diaTribe Foundation, an Advocacy and Information 501(c)(3) Organization for People with Diabetes, Prediabetes, and Obesity, USA
| | - Kelly L Close
- The diaTribe Foundation, an Advocacy and Information 501(c)(3) Organization for People with Diabetes, Prediabetes, and Obesity, USA
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Varghese JS, Adair LS, Patel SA, Bechayda SA, Bhargava SK, Carba DB, Horta BL, Lima NP, Martorell R, Menezes AMB, Norris SA, Richter LM, Ramirez-Zea M, Sachdev HS, Wehrmeister FC, Stein AD. Changes in asset-based wealth across the life course in birth cohorts from five low- and middle-income countries. SSM Popul Health 2021; 16:100976. [PMID: 34901377 PMCID: PMC8637637 DOI: 10.1016/j.ssmph.2021.100976] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 11/16/2021] [Accepted: 11/18/2021] [Indexed: 01/08/2023] Open
Abstract
Background Temporally-harmonized asset-based measures of wealth can be used to study the association of life-course wealth exposures in the same scale with health outcomes in low- and middle-income countries (LMICs). The within-individual longitudinal stability of asset-based indices of wealth in LMICs is poorly understood. Methods Using data from five birth cohorts from three continents, we developed temporally-harmonized asset indices over the life course through polychoric principal component analysis of a common set of assets collected consistently over time (18 years in Brazil to 50 years in Guatemala). For each cohort, we compared the harmonized index to cross-sectional indices created using more comprehensive asset measures using rank correlations. We evaluated the rank correlation of the harmonized index in early life and adulthood with maternal schooling and own attained schooling, respectively. Results Temporally-harmonized asset indices developed from a consistently-collected set of assets (range: 10 in South Africa to 30 in Philippines) suggested that mean wealth improved over time for all birth cohorts. Cross-sectional indices created separately for each study wave were correlated with the harmonized index for all cohorts (Brazil: r = 0.78 to 0.96; Guatemala: r = 0.81 to 0.95; India: 0.75 to 0.93; Philippines: r = 0.92 to 0.99; South Africa: r = 0.84 to 0.96). Maternal schooling (r = 0.15 to 0.56) and attained schooling (r = 0.23 to 0.53) were positively correlated with the harmonized asset index in childhood and adulthood respectively. Conclusions Temporally-harmonized asset indices displayed coherence with cross-sectional indices as well as construct validity with schooling. Temporally-harmonized asset indices are useful to assess relative importance of wealth at different life stages with health on the same scale. Harmonized indices using a subset of assets were correlated with cross-sectional asset indices using all available assets in five LMIC birth cohorts. Harmonized indices displayed construct validity, as demonstrated by its correlation with schooling. Harmonized indices were robust to alternate specifications such as shorter lists of assets, study years, and factor extraction procedures.
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Key Words
- CLHNS, Cebu Longitudinal Health and Nutrition Survey
- COHORTS, Consortium On Health Orientated Research in Transitioning Societies
- EFA, Exploratory Factor Analysis
- INCAP, Institute of Nutrition for Central America and Panama
- LMIC, Low- and middle-income countries
- Life course epidemiology
- MCA, Multiple Correspondence Analysis
- NDBC, New Delhi Birth Cohort
- PCA, Principal Component Analysis
- SD, standard deviation
- SEP, Socio-economic position
- Social mobility
- Wealth index
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Affiliation(s)
- Jithin Sam Varghese
- Nutrition and Health Sciences Program, Laney Graduate School, Emory University, Atlanta, GA, USA
| | - Linda S Adair
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Shivani A Patel
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Sonny Agustin Bechayda
- USC-Office of Population Studies Foundation, Inc, University of San Carlos, Cebu City, Philippines.,Department of Anthropology, Sociology, and History, University of San Carlos, Cebu City, Philippines
| | | | - Delia B Carba
- USC-Office of Population Studies Foundation, Inc, University of San Carlos, Cebu City, Philippines
| | - Bernardo L Horta
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Natalia P Lima
- Postgraduate Program in Health and Behavior, Catholic University of Pelotas, Pelotas, Brazil
| | - Reynaldo Martorell
- Nutrition and Health Sciences Program, Laney Graduate School, Emory University, Atlanta, GA, USA.,Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Ana M B Menezes
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Shane A Norris
- SAMRC Developmental Pathways for Health Research Unit, University of the Witwatersrand, Johannesburg, South Africa
| | - Linda M Richter
- DSI-NRF Centre of Excellence in Human Development, University of the Witwatersrand, Johannesburg, South Africa
| | - Manuel Ramirez-Zea
- INCAP Research Center for the Prevention of Chronic Diseases (CIIPEC), Institute of Nutrition of Central America and Panama (INCAP), Guatemala City, Guatemala
| | | | | | - Aryeh D Stein
- Nutrition and Health Sciences Program, Laney Graduate School, Emory University, Atlanta, GA, USA.,Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
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Caldwell JM, de Lara-Tuprio E, Teng TR, Estuar MRJE, Sarmiento RFR, Abayawardana M, Leong RNF, Gray RT, Wood JG, Le LV, McBryde ES, Ragonnet R, Trauer JM. Understanding COVID-19 dynamics and the effects of interventions in the Philippines: A mathematical modelling study. Lancet Reg Health West Pac 2021; 14:100211. [PMID: 34308400 PMCID: PMC8279002 DOI: 10.1016/j.lanwpc.2021.100211] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 06/10/2021] [Accepted: 06/24/2021] [Indexed: 01/08/2023]
Abstract
BACKGROUND COVID-19 initially caused less severe outbreaks in many low- and middle-income countries (LMIC) compared with many high-income countries, possibly because of differing demographics, socioeconomics, surveillance, and policy responses. Here, we investigate the role of multiple factors on COVID-19 dynamics in the Philippines, a LMIC that has had a relatively severe COVID-19 outbreak. METHODS We applied an age-structured compartmental model that incorporated time-varying mobility, testing, and personal protective behaviors (through a "Minimum Health Standards" policy, MHS) to represent the first wave of the Philippines COVID-19 epidemic nationally and for three highly affected regions (Calabarzon, Central Visayas, and the National Capital Region). We estimated effects of control measures, key epidemiological parameters, and interventions. FINDINGS Population age structure, contact rates, mobility, testing, and MHS were sufficient to explain the Philippines epidemic based on the good fit between modelled and reported cases, hospitalisations, and deaths. The model indicated that MHS reduced the probability of transmission per contact by 13-27%. The February 2021 case detection rate was estimated at ~8%, population recovered at ~9%, and scenario projections indicated high sensitivity to MHS adherence. INTERPRETATION COVID-19 dynamics in the Philippines are driven by age, contact structure, mobility, and MHS adherence. Continued compliance with low-cost MHS should help the Philippines control the epidemic until vaccines are widely distributed, but disease resurgence may be occurring due to a combination of low population immunity and detection rates and new variants of concern.
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Affiliation(s)
| | | | - Timothy Robin Teng
- Department of Mathematics, Ateneo de Manila University, Quezon City, Philippines
| | | | | | - Milinda Abayawardana
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Robert Neil F. Leong
- School of Population Health and Community Medicine, University of New South Wales, Sydney, Australia
| | - Richard T. Gray
- The Kirby Institute, University of New South Wales Sydney, Sydney, Australia
| | - James G. Wood
- School of Population Health and Community Medicine, University of New South Wales, Sydney, Australia
| | - Linh-Vi Le
- World Health Organization Regional Office for the Western Pacific, Manila, Philippines
| | - Emma S. McBryde
- Australian Institute of Tropical Health and Medicine, James Cook University, Queensland, Australia
| | - Romain Ragonnet
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - James M. Trauer
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
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