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Ghaleb Y, Lami F, Al Nsour M, Rashak HA, Samy S, Khader YS, Al Serouri A, BahaaEldin H, Afifi S, Elfadul M, Ikram A, Akhtar H, Hussein AM, Barkia A, Hakim H, Taha HA, Hijjo Y, Kamal E, Ahmed AY, Rahman F, Islam KM, Hussein MH, Ramzi SR. Mental health impacts of COVID-19 on healthcare workers in the Eastern Mediterranean Region: a multi-country study. J Public Health (Oxf) 2021; 43:iii34-iii42. [PMID: 34642765 PMCID: PMC8524602 DOI: 10.1093/pubmed/fdab321] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [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: 02/09/2021] [Revised: 06/19/2021] [Accepted: 07/27/2021] [Indexed: 12/23/2022] Open
Abstract
Background Healthcare workers (HCWs) fighting against the COVID-19 pandemic are under incredible pressure, which puts them at risk of developing mental health problems. This study aimed to determine the prevalence of depression, anxiety, and stress among HCWs responding to COVID-19 and its associated factors. Methods A multi-country cross-sectional study was conducted during July–August 2020 among HCWs responding to COVID-19 in nine Eastern Mediterranean Region (EMR) countries. Data were collected using an online questionnaire administered using KoBo Toolbox. Mental problems were assessed using the Depression, Anxiety, and Stress Scale (DASS-21). Results A total of 1448 HCWs from nine EMR countries participated in this study. About 51.2% were male and 52.7% aged ≤ 30 years. Of all HCWs, 57.5% had depression, 42.0% had stress, and 59.1% had anxiety. Considering the severity, 19.2%, 16.1%, 26.6% of patients had severe to extremely severe depression, stress, and anxiety, respectively. Depression, stress, anxiety, and distress scores were significantly associated with participants’ residency, having children, preexisting psychiatric illness, and being isolated for COVID-19. Furthermore, females, those working in a teaching hospital, and specialists had significantly higher depression and stress scores. Married status, current smoking, diabetes mellitus, having a friend who died with COVID-19, and high COVID-19 worry scores were significantly associated with higher distress scores. Conclusions Mental problems were prevalent among HCWs responding to COVID-19 in EMR. Therefore, special interventions to promote mental well-being among HCWs responding to COVID-19 need to be immediately implemented.
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Affiliation(s)
- Yasser Ghaleb
- Ministry of Public Health and Population, Yemen Field Epidemiology Training Program, Sana'a, Yemen
| | - Faris Lami
- Department of Community and Family Medicine, University of Baghdad, Baghdad, Iraq
| | - Mohannad Al Nsour
- Global Health Development (GHD), The Eastern Mediterranean Public Health Network (EMPHNET), Amman, Jordan
| | | | - Sahar Samy
- Ministry of Health and Population, Cairo, Egypt
| | - Yousef S Khader
- Professor of Epidemiology, Medical Education and Biostatistics, Department of Public Health, Jordan University of Science & Technology, Irbid 22110, Jordan
| | - Abdulwahed Al Serouri
- Ministry of Public Health and Population, Yemen Field Epidemiology Training Program, Sana'a, Yemen
| | | | - Salma Afifi
- Ministry of Health and Population, Cairo, Egypt
| | - Maisa Elfadul
- Public Health Institute, Federal Ministry of Health, Department of Research, Khartoum, Sudan
| | - Aamer Ikram
- National Institute of Health, Islamabad, Pakistan
| | - Hashaam Akhtar
- Yusra Institute of Pharmaceutical Sciences, Yusra Medical and Dental Collage, Islamabad, Pakistan
| | | | | | - Huda Hakim
- Department of Community Medicine, Al-Majmaah University, AL-Majmaah, Kingdom of Saudi Arabia
| | - Hana Ahmad Taha
- Health Protection and Promotion, Global Health Development (GHD), Eastern Mediterranean Public Health Network, Amman, Jordan
| | - Yasser Hijjo
- Clinical Pharmacy, Public and Tropical Health Programs, University of Medical Sciences & Technology, Khartoum, Sudan
| | - Ehab Kamal
- Ministry of Health and Population, Cairo, Egypt
| | | | - Fazalur Rahman
- Medical Unit 1 Benazir Bhutto Hospital, Rawalpindi Medical University, Rawalpindi, Pakistan
| | - Khwaja Mir Islam
- Afghanistan Field Epidemiology Training Program, Global Health Development (GHD), Afghanistan
| | | | - Shahd Raid Ramzi
- Al-Rusafa Health Directorate, Public Health Department, Ministry of Health, Baghdad, Iraq
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Kyaw NTT, Kumar AMV, Oo MM, Oo HN, Kyaw KWY, Thiha S, Aung TK, Win T, Mon YY, Harries AD. Long-term outcomes of second-line antiretroviral treatment in an adult and adolescent cohort in Myanmar. Glob Health Action 2018; 10:1290916. [PMID: 28594295 PMCID: PMC5496085 DOI: 10.1080/16549716.2017.1290916] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [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] [Indexed: 10/31/2022] Open
Abstract
BACKGROUND Myanmar has a high burden of Human Immunodeficiency Virus (HIV) and second-line antiretroviral treatment (ART) has been available since 2008 in the public health sector. However, there have been no published data about the outcomes of such patients until now. OBJECTIVE To assess the treatment and programmatic outcomes and factors associated with unfavorable outcomes (treatment failure, death and loss to follow-up from care) among people living with HIV (aged ≥ 10 years) receiving protease inhibitor-based second-line ART under the Integrated HIV Care Program in Myanmar between October 2008 and June 2015. DESIGN Retrospective cohort study using routinely collected program data. RESULTS Of 824 adults and adolescents on second-line ART, 52 patients received viral load testing and 19 patients were diagnosed with virological failure. However, their treatment was not modified. At the end of a total follow-up duration of 7 years, 88 (11%) patients died, 35 (4%) were lost to follow-up, 21 (2%) were transferred out to other health facilities and 680 (83%) were still under care. The incidence rate of unfavorable outcomes was 7.9 patients per 100 person years follow-up. Patients with a history of injecting drug use, with a history of lost to follow-up, with a higher baseline viral load and who had received didanosine and abacavir had a higher risk of unfavorable outcomes. Patients with higher baseline C4 counts, those having taken first-line ART at a private clinic, receiving ART at decentralized sites and taking zidovudine and lamivudine had a lower risk of unfavorable outcomes. CONCLUSIONS Long-term outcomes of patients on second-line ART were relatively good in this cohort. Virological failure was relatively low, possibly because of lack of viral load testing. No patient who failed on second-line ART was switched to third-line treatment. The National HIV/AIDS Program should consider making routine viral load monitoring and third-line ART drugs available after a careful cost-benefit analysis.
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Affiliation(s)
- Nang Thu Thu Kyaw
- a The Union Office in Myanmar , International Union Against Tuberculosis and Lung Disease , Mandalay , Myanmar
| | - Ajay M V Kumar
- b The Union South-East Asia Regional Office , International Union Against Tuberculosis and Lung Disease , New Delhi , India.,c Research Department , International Union Against Tuberculosis and Lung Disease , Paris , France
| | - Myo Minn Oo
- a The Union Office in Myanmar , International Union Against Tuberculosis and Lung Disease , Mandalay , Myanmar
| | - Htun Nyunt Oo
- d Department of Public Health , National HIV/AIDS Program , Nay Pyi Taw , Myanmar
| | - Khine Wut Yee Kyaw
- a The Union Office in Myanmar , International Union Against Tuberculosis and Lung Disease , Mandalay , Myanmar
| | - Soe Thiha
- a The Union Office in Myanmar , International Union Against Tuberculosis and Lung Disease , Mandalay , Myanmar
| | - Thet Ko Aung
- a The Union Office in Myanmar , International Union Against Tuberculosis and Lung Disease , Mandalay , Myanmar
| | - Than Win
- d Department of Public Health , National HIV/AIDS Program , Nay Pyi Taw , Myanmar
| | - Yin Yin Mon
- a The Union Office in Myanmar , International Union Against Tuberculosis and Lung Disease , Mandalay , Myanmar
| | - Anthony D Harries
- c Research Department , International Union Against Tuberculosis and Lung Disease , Paris , France.,e Department of Infectious and Tropical Diseases , London School of Hygiene and Tropical Medicine , London , UK
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Weldegebreal F, Mitiku H, Teklemariam Z. Treatment outcome of tuberculosis among Human Immunodeficiency Virus positive patients in Eastern Ethiopia: a retrospective study. Pan Afr Med J 2018; 30:32. [PMID: 30167059 PMCID: PMC6110564 DOI: 10.11604/pamj.2018.30.32.12554] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Accepted: 03/05/2018] [Indexed: 11/29/2022] Open
Abstract
Introduction Tuberculosis is the leading cause of morbidity and mortality among people living with Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome worldwide. Although Human Immunodeficiency Virus related tuberculosis is both treatable and preventable, incidence rates continue to climb in developing countries where both infections are endemic. The aim of this study was to assess the treatment outcome of tuberculosis among Human Immunodeficiency Virus positive patients attending in three hospitals of Eastern Ethiopia. Methods A retrospective clinical record review was conducted for 627 Tuberculosis and Human immunodeficiency virus co-infected patients registered from January 2008 to January 2014 cards were reviewed in three hospitals of tuberculosis clinics of Eastern Ethiopia from December 2015 to February 2016. The three hospitals were selected based on their high patient load of TB-HIV co infection and the presence of ART and TB units. Data on patient's details and tuberculosis treatment outcome were collected using standardized report format of National Tuberculosis and Leprosy Control Programme (NTLCP). The collected data were analyzed by Statistical Package for Social Sciences (SPSS) software Version 16. Results The overall treatment success rate was 78.3%. Of the total TB-HIV co infected study participants, 17.9% cured, 60.4% treatment completed, 8.6% died, 0.6% failure, 1.8% defaulter and 10.7% transferred out. Those participants in the age groups of less than or equals to 18 years old (Adjusted Odds Ratio = 1.990, 95% Confidence Interval: 1.01, 3.350), extra pulmonary tuberculosis (Adjusted Odds Ratio = 1.51, 95% Confidence Interval = 1.12, 3.42), on antiretro viral therapy (Adjusted Odds Ratio = 1.54, 95% Confidence Interval = 1.252, 3.910) were more likely to have higher treatment outcome than each of the above variables counter parts. Conclusion The rate of treatment success in this study was lower than recommended rate by World Health Organization. Thus this study recommends improving counseling during tuberculosis treatment, providing home visits and motivation of patients, improving defaulter tracing and health information dissemination in order to reduce treatment interruption.
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Affiliation(s)
- Fitsum Weldegebreal
- Haramaya University, College of Health and Medical Sciences, Harar, Ethiopia
| | - Habtamu Mitiku
- Haramaya University, College of Health and Medical Sciences, Harar, Ethiopia
| | - Zelalem Teklemariam
- Haramaya University, College of Health and Medical Sciences, Harar, Ethiopia
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Simonovska L, Ilievska-Popovska B. Comparison of Results from Inpatient and Outpatient Treatment of Tuberculosis in Republic of Macedonia. Open Access Maced J Med Sci 2015; 3:337-40. [PMID: 27275247 PMCID: PMC4877879 DOI: 10.3889/oamjms.2015.050] [Citation(s) in RCA: 3] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Revised: 04/22/2015] [Accepted: 04/23/2015] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND: The successful treatment of patients with active tuberculosis is one of the priorities in the Tuberculosis Control Programs. AIM: The aim was to establish whether there was a statistically significant difference in the treatment outcome in patients with tuberculosis who began their initial treatment phase and/or pursued it as inpatient, as opposed to patients with tuberculosis who underwent their entire treatment regime as outpatient. Moreover, our goal was to determine whether there is a statistically significant difference in the outcome from the treatment between patients with tuberculosis who were hospitalized up to one month, two months, or more than two months. MATERIALS AND METHOD: The study includes 355 patients, divided into two groups. The first group, which consists of 219 patients, began their initial treatment phase as inpatient, and then they continued the treatment as outpatient. The second group, 136 patients, underwent their entire treatment as outpatient. The treatment outcome is determined with every patient (cured, treatment completed, treatment default, treatment failed, died, treatment in progress). For the statistical data analysis and for establishing the significance of the findings regarding the differences between the two groups we used the Pearson Chi-Square Test and the Yates Corrected Test. RESULTS: The statistical analysis with the Pearson Chi-Square Test showed that the treatment outcome does not significantly depend on the model of treatment (p = 0.31). The statistical data analysis showed that there is no statistically significant difference in the achievement of conversion of the bacterial result of the sputum at the end of the initial phase of treatment regarding the studied groups (p = 0.89). The statistical data analysis showed that the length of inpatient treatment affects the outcome of the treatment and that the difference is statistically highly significant (p < 0.00005). CONCLUSION: There are no statistically significant differences in the sputum conversion and the treatment outcome among inpatient/outpatient with tuberculosis or outpatient only; however, the length of inpatient treatment is statistically significant regarding its effect on the treatment outcome.
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Affiliation(s)
- Ljiljana Simonovska
- Institute for Lung Diseases and Tuberculosis, Faculty of Medicine, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia
| | - Biljana Ilievska-Popovska
- Institute for Lung Diseases and Tuberculosis, Faculty of Medicine, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia
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