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Baldaque P, Coutinho G, de Lima Moreira JP, Luiz RR, Fogaça HS, de Souza LMP, de Souza HSP. Chronic Pancreatitis in a Large Developing Country: Temporal Trends of Over 64,000 Hospitalizations from 2009 to 2019. Dig Dis Sci 2024:10.1007/s10620-024-08488-5. [PMID: 38816599 DOI: 10.1007/s10620-024-08488-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 05/08/2024] [Indexed: 06/01/2024]
Abstract
BACKGROUND/OBJECTIVES Chronic pancreatitis (CP) is a progressive inflammatory disorder associated with marked morbidity and mortality and frequently requires hospitalization. This study aimed to investigate the time trends and geographical distribution of hospital admissions, the lethality rate of CP across Brazil, and the potential relationship with social indicators and associated risk factors. METHODS Data were retrospectively obtained from the Brazilian Public Health System Registry between January 2009 and December 2019. The prevalence and lethality rates of CP per 100,000 inhabitants in each municipality were estimated from hospitalizations to in-hospital deaths and classified by age, sex, and demographic features. RESULTS During the study period, 64,609 admissions were retrieved, and most of the patients were males (63.54%). Hospitalization decreased by nearly half (-54.68%) in both sexes. CP rates in males were higher in all age groups. The greatest reduction in admissions (- 64%) was also noted in patients ≥ 70y. CP In-hospital lethality remained stable (5-6%) and similar for males and females. Patients ≥ 70y showed the highest lethality. The greatest increase in CP lethality rates (+ 10%) was observed in municipalities integrated into metropolises, which was mainly driven by small-sized municipalities (+ 124%). CONCLUSIONS CP hospitalizations decrease in both urban and rural areas, particularly in the North, Northeast, and Central-West regions, and in those above 70 years of age, but are not correlated with lethality rates in the South. This suggests ongoing changes in the environmental and socioeconomic factors in Brazil.
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Affiliation(s)
- Pedro Baldaque
- Department of Clinical Medicine, Federal University of Rio de Janeiro, Rua Prof. Rodolpho Paulo Rocco 255, Rio de Janeiro, 21941-913, Brazil
| | - Gabriela Coutinho
- Department of Clinical Medicine, Federal University of Rio de Janeiro, Rua Prof. Rodolpho Paulo Rocco 255, Rio de Janeiro, 21941-913, Brazil
| | | | - Ronir Raggio Luiz
- Institute of Public Health Studies, Federal University of Rio de Janeiro, Rio de Janeiro, 21941-598, Brazil
| | - Homero Soares Fogaça
- Department of Clinical Medicine, Federal University of Rio de Janeiro, Rua Prof. Rodolpho Paulo Rocco 255, Rio de Janeiro, 21941-913, Brazil
| | - Lucila Marieta Perrotta de Souza
- Department of Clinical Medicine, Federal University of Rio de Janeiro, Rua Prof. Rodolpho Paulo Rocco 255, Rio de Janeiro, 21941-913, Brazil
| | - Heitor Siffert Pereira de Souza
- Department of Clinical Medicine, Federal University of Rio de Janeiro, Rua Prof. Rodolpho Paulo Rocco 255, Rio de Janeiro, 21941-913, Brazil.
- D'Or Institute for Research and Education (IDOR), Rua Diniz Cordeiro 30, Botafogo, Rio de Janeiro, 22281-100, Brazil.
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Jackson-Morris A, Masyuko S, Morrell L, Kataria I, Kocher EL, Nugent R. Tackling syndemics by integrating infectious and noncommunicable diseases in health systems of low- and middle-income countries: A narrative systematic review. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003114. [PMID: 38753811 PMCID: PMC11098501 DOI: 10.1371/journal.pgph.0003114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 03/25/2024] [Indexed: 05/18/2024]
Abstract
The co-occurrence of infectious diseases (ID) and non-communicable diseases (NCD) is widespread, presenting health service delivery challenges especially in low-and middle-income countries (LMICs). Integrated health care is a possible solution but may require a paradigm shift to be successfully implemented. This literature review identifies integrated care examples among selected ID and NCD dyads. We searched PubMed, PsycINFO, Cochrane Library, CINAHL, Web of Science, EMBASE, Global Health Database, and selected clinical trials registries. Eligible studies were published between 2010 and December 2022, available in English, and report health service delivery programs or policies for the selected disease dyads in LMICs. We identified 111 studies that met the inclusion criteria, including 56 on tuberculosis and diabetes integration, 46 on health system adaptations to treat COVID-19 and cardiometabolic diseases, and 9 on COVID-19, diabetes, and tuberculosis screening. Prior to the COVID-19 pandemic, most studies on diabetes-tuberculosis integration focused on clinical service delivery screening. By far the most reported health system outcomes across all studies related to health service delivery (n = 72), and 19 addressed health workforce. Outcomes related to health information systems (n = 5), leadership and governance (n = 3), health financing (n = 2), and essential medicines (n = 4)) were sparse. Telemedicine service delivery was the most common adaptation described in studies on COVID-19 and either cardiometabolic diseases or diabetes and tuberculosis. ID-NCD integration is being explored by health systems to deal with increasingly complex health needs, including comorbidities. High excess mortality from COVID-19 associated with NCD-related comorbidity prompted calls for more integrated ID-NCD surveillance and solutions. Evidence of clinical integration of health service delivery and workforce has grown-especially for HIV and NCDs-but other health system building blocks, particularly access to essential medicines, health financing, and leadership and governance, remain in disease silos.
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Affiliation(s)
- Angela Jackson-Morris
- Center for Global Noncommunicable Diseases, RTI International, Research Triangle Park, North Carolina, United States of America
| | - Sarah Masyuko
- Center for Global Noncommunicable Diseases, RTI International, Research Triangle Park, North Carolina, United States of America
- Department of Global Health, University of Washington, Seattle, Washington, United States of America
| | - Lillian Morrell
- Center for Global Noncommunicable Diseases, RTI International, Research Triangle Park, North Carolina, United States of America
- Wilson Sheehan Lab for Economic Opportunities, University of Notre Dame, Notre Dame, Indiana, United States of America
| | - Ishu Kataria
- Center for Global Noncommunicable Diseases, RTI International, Research Triangle Park, North Carolina, United States of America
| | - Erica L. Kocher
- Center for Global Noncommunicable Diseases, RTI International, Research Triangle Park, North Carolina, United States of America
- Emory University, Emory University, Atlanta, Georgia, United States of America
| | - Rachel Nugent
- Center for Global Noncommunicable Diseases, RTI International, Research Triangle Park, North Carolina, United States of America
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Rutherford G, Hussain R, Tait K. Pattern of multimorbidity in middle-aged and older-aged people with mild intellectual disability in Australia. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2024; 37:e13215. [PMID: 38413378 DOI: 10.1111/jar.13215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 11/15/2023] [Accepted: 12/12/2023] [Indexed: 02/29/2024]
Abstract
BACKGROUND Non-communicable diseases (NCDs), also known as chronic diseases, now constitute a major proportion of ill-health across most adult and older populations including in people with intellectual disability. The current paper is a comparative analysis of prevalence of NCDs across mid-aged and older-aged people with mild intellectual disability. METHOD Comparative data comes from two cross-sectional surveys using similar methodology and timeframes. The analysis sample comprises mid-aged group (30-50 years, N = 291) and older-aged group (≥60 years, N = 391). RESULTS People with mild intellectual disability start developing NCDs in early to mid-adulthood and increases with age. The mean number of NCDs in mid-aged group was 0.86 (SD, 0.84) compared to 3.82 in older group (SD, 2.67). CONCLUSION There needs to be early identification and management of NCDs using relevant health promotion and preventative measures at optimal intervention points. The training of healthcare professionals needs improvement.
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Affiliation(s)
- Grace Rutherford
- School of Medicine & Psychology, Australian National University, Canberra, Australia
| | - Rafat Hussain
- School of Medicine & Psychology, Australian National University, Canberra, Australia
| | - Kathleen Tait
- Macquarie School of Education, Macquarie University, Sydney, Australia
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Tang L, Rhoads WJ, Eichelberg A, Hamilton KA, Julian TR. Applications of Quantitative Microbial Risk Assessment to Respiratory Pathogens and Implications for Uptake in Policy: A State-of-the-Science Review. ENVIRONMENTAL HEALTH PERSPECTIVES 2024; 132:56001. [PMID: 38728217 PMCID: PMC11086748 DOI: 10.1289/ehp12695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 02/28/2024] [Accepted: 03/08/2024] [Indexed: 05/12/2024]
Abstract
BACKGROUND Respiratory tract infections are major contributors to the global disease burden. Quantitative microbial risk assessment (QMRA) holds potential as a rapidly deployable framework to understand respiratory pathogen transmission and inform policy on infection control. OBJECTIVES The goal of this paper was to evaluate, motivate, and inform further development of the use of QMRA as a rapid tool to understand the transmission of respiratory pathogens and improve the evidence base for infection control policies. METHODS We conducted a literature review to identify peer-reviewed studies of complete QMRA frameworks on aerosol inhalation or contact transmission of respiratory pathogens. From each of the identified studies, we extracted and summarized information on the applied exposure model approaches, dose-response models, and parameter values, including risk characterization. Finally, we reviewed linkages between model outcomes and policy. RESULTS We identified 93 studies conducted in 16 different countries with complete QMRA frameworks for diverse respiratory pathogens, including SARS-CoV-2, Legionella spp., Staphylococcus aureus, influenza, and Bacillus anthracis. Six distinct exposure models were identified across diverse and complex transmission pathways. In 57 studies, exposure model frameworks were informed by their ability to model the efficacy of potential interventions. Among interventions, masking, ventilation, social distancing, and other environmental source controls were commonly assessed. Pathogen concentration, aerosol concentration, and partitioning coefficient were influential exposure parameters as identified by sensitivity analysis. Most (84%, n = 78 ) studies presented policy-relevant content including a) determining disease burden to call for policy intervention, b) determining risk-based threshold values for regulations, c) informing intervention and control strategies, and d) making recommendations and suggestions for QMRA application in policy. CONCLUSIONS We identified needs to further the development of QMRA frameworks for respiratory pathogens that prioritize appropriate aerosol exposure modeling approaches, consider trade-offs between model validity and complexity, and incorporate research that strengthens confidence in QMRA results. https://doi.org/10.1289/EHP12695.
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Affiliation(s)
- Lizhan Tang
- Eawag, Swiss Federal Institute of Aquatic Science and Technology, Dübendorf, Switzerland
| | - William J. Rhoads
- Eawag, Swiss Federal Institute of Aquatic Science and Technology, Dübendorf, Switzerland
| | - Antonia Eichelberg
- Eawag, Swiss Federal Institute of Aquatic Science and Technology, Dübendorf, Switzerland
| | - Kerry A. Hamilton
- School of Sustainable Engineering and the Built Environment, Arizona State University, Tempe, Arizona, USA
- Biodesign Institute Center for Environmental Health Engineering, Arizona State University, Tempe, Arizona, USA
| | - Timothy R. Julian
- Eawag, Swiss Federal Institute of Aquatic Science and Technology, Dübendorf, Switzerland
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
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Chattu VK, Mol R, Singh B, Reddy KS, Hatefi A. Pandemic treaty as an instrument to strengthen global health security: Global health diplomacy at its crux. Health Promot Perspect 2024; 14:9-18. [PMID: 38623344 PMCID: PMC11016140 DOI: 10.34172/hpp.42744] [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: 12/17/2023] [Accepted: 02/20/2024] [Indexed: 04/17/2024] Open
Abstract
Background The World Health Assembly (WHA), on 1st December 2021, unanimously agreed to launch a global process to draft and negotiate a convention, agreement, or other international instrument under the World Health Organization's (WHO's) constitution to strengthen pandemic prevention, preparedness, and response. We aimed to explore the role of global health diplomacy (GHD) in pandemic treaty negotiations by providing deep insight into the ongoing drafting process under the WHO leadership. Methods We conducted a narrative review by searching Scopus, Web of Sciences, PubMed, MEDLINE, and Google Scholar search engine using the keywords "Pandemic Treaty," OR "International Health Regulations," OR "International conventions," OR "International treaties" in the context of recent COVID-19 pandemic. Besides, we included articles recommending the need for GHD, leadership and governance mechanisms for this international treaty drafting approved by the WHA. Results Amid the COVID-19 pandemic, the concept of GHD bolstered the international system and remained high on the agendas of many national, regional and global platforms. As per Article 19 of the WHO constitution, the Assembly established an intergovernmental negotiating body (INB) to draft and negotiate this convention/ agreement to protect the world from disease outbreaks of pandemic potential. Since GHD has helped to strengthen international cooperation in health systems and address inequities in achieving health-related global targets, there is a great scope for the successful drafting of this pandemic treaty. Conclusion The pandemic treaty is a defining moment in global health governance, particularly the pandemic governance reforms. However, the treaty's purpose will only be served if the equity considerations are optimized, accountability mechanisms are established, and a sense of shared responsibility is embraced. While fulfilling treaty commitments might be complex and challenging, it provides an opportunity to rethink and build resilient systems for pandemic preparedness and response in the future.
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Affiliation(s)
- Vijay Kumar Chattu
- Center for Global Health Research, Saveetha Medical College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai 600077, India
- Department of Occupational Science & Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5G 1V7, Canada
- Department of Community Medicine, Faculty of Medicine, Datta Meghe Institute of Medical Sciences, Wardha-442107, India
| | - Rajani Mol
- Department of South and Central Asian Studies, School of International Studies, Central University of Punjab, Bathinda, India
| | - Bawa Singh
- Department of South and Central Asian Studies, School of International Studies, Central University of Punjab, Bathinda, India
| | - K. Srikanth Reddy
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
- Center for Evidence-Based Diplomacy, Global Health Research and Innovations Canada (GHRIC), Toronto, ON, Canada
| | - Arian Hatefi
- Institute for Global Health Sciences, School of Medicine, University of California San Francisco, San Francisco, CA 94117, Canada
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Elnagdy MH, Magdy A, Eldars W, Elgamal M, El-Nagdy AH, Salem O, Elmowafy MM, Elborsh OA, Elshafey AW, Kesba MM, Abdulgalil AE, Sobh A. Genetic association of ACE2 and TMPRSS2 polymorphisms with COVID-19 severity; a single centre study from Egypt. Virol J 2024; 21:27. [PMID: 38263160 PMCID: PMC10807154 DOI: 10.1186/s12985-024-02298-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 01/16/2024] [Indexed: 01/25/2024] Open
Abstract
BACKGROUND Since the emergence of the COVID-19 infection in China, it has caused considerable morbidity, mortality, and economic burden. It causes the vast majority of clinical manifestations, ranging from mild or even no symptoms to severe respiratory failure. There are many risk factors for severe COVID-19, such as old age, male gender, and associated comorbidities. A major role for genetic factors may exist. The SARS-CoV-2 virus enters the cell primarily through ACE2 receptors. rs2285666 is one of many polymorphisms found in the ACE2 receptor gene. To enable endosome-independent entry into target cells, the transmembrane protease serine-type 2 (TMPRSS2) is necessary to cleave the virus' spike (S) glycoprotein. TMPRSS2 is characterized by an androgen receptor element. The rs12329760 polymorphism in TMPRSS2 may explain different genetic susceptibilities to COVID-19. METHOD This cross-sectional study was held in Mansoura University Hospitals during the period from June 2020 to April 2022 on patients who had mild and severe COVID-19. Demographic, clinical, and laboratory data were collected, and the TaqMan real-time polymerase chain was used for allelic discrimination in the genotyping of rs2285666 and rs12329760. RESULTS This study included 317 Egyptian patients, aged from 0.2 to 87 years. Males were 146, while females were 171. They were divided into mild and severe groups (91 and 226 patients, respectively) based on their clinical symptoms. There was a significant association between COVID-19 severity and male gender, hypertension, diabetes mellitus, and high CRP. The genotype and allele frequency distributions of the ACE2 rs2285666 polymorphism showed no significant association with the severity of COVID-19 in both. In contrast, in TMPRSS2 rs12329760 minor T allele and CT, TT genotypes were significantly associated with a reduced likelihood of developing severe COVID-19. CONCLUSION Our study indicates that the ACE2 rs2285666 polymorphism is not related to the severity of COVID-19, whether genotypes or alleles. In TMPRSS2 rs12329760, the dominant model and T allele showed significantly lower frequencies in severe cases, with a protective effect against severity. The discrepancies with previous results may be due to variations in other ACE2 receptor-related genes, inflammatory mediators, and coagulation indicators. Haplotype blocks and differences in racial makeup must be taken into consideration. Future research should be done to clarify how ethnicity affects these polymorphisms and how other comorbidities combine to have an additive effect.
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Affiliation(s)
- Marwa H Elnagdy
- Department of Medical Biochemistry and Molecular Biology, Mansoura University Faculty of Medicine, Mansoura, Egypt
- Department of Basic Medical Sciences, Faculty of Medicine, New Mansoura University, Mansoura, Egypt
| | - Alshimaa Magdy
- Department of Medical Biochemistry and Molecular Biology, Mansoura University Faculty of Medicine, Mansoura, Egypt
| | - Waleed Eldars
- Department of Basic Medical Sciences, Faculty of Medicine, New Mansoura University, Mansoura, Egypt
- Department of Medical Microbiology and Immunology, Mansoura University Faculty of Medicine, Mansoura, Egypt
| | - Mohamed Elgamal
- Department of Chest Medicine, Mansoura University Faculty of Medicine, Mansoura, Egypt
| | - Ahmed Hazem El-Nagdy
- Department of Microbiology, Faculty of Dentistry, Horus University, Damietta El Gadeeda, Egypt
| | - Omnia Salem
- Department of Pediatrics, Mansoura University Children's Hospital, Mansoura University Faculty of Medicine, 60 El Gomhouria Street, Mansoura, 35516, Egypt
| | | | - Omar Ahmed Elborsh
- Intern, Mansoura University Hospitals, Mansoura University, Mansoura, Egypt
| | | | | | - Ahmed Elsaeed Abdulgalil
- Mansoura Nephrology and Dialysis Unit, Internal Medicine Department, Mansoura University Faculty of Medicine, Mansoura, Egypt
| | - Ali Sobh
- Department of Pediatrics, Mansoura University Children's Hospital, Mansoura University Faculty of Medicine, 60 El Gomhouria Street, Mansoura, 35516, Egypt.
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Wypych-Ślusarska A, Krupa-Kotara K, Oleksiuk K, Głogowska-Ligus J, Słowiński J, Niewiadomska E. Socioeconomic and Health Determinants of the Prevalence of COVID-19 in a Population of Children with Respiratory Diseases and Symptoms. CHILDREN (BASEL, SWITZERLAND) 2024; 11:88. [PMID: 38255401 PMCID: PMC10814875 DOI: 10.3390/children11010088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 01/08/2024] [Accepted: 01/10/2024] [Indexed: 01/24/2024]
Abstract
BACKGROUND Most epidemiological studies indicate that bronchial asthma is not a risk factor for COVID-19, but previous analyses have not additionally focused on the socioeconomic determinants of SARS-CoV-2 infection in children with asthma, bronchitis, and respiratory symptoms. AIMS This research aimed to investigate the correlation between the socioeconomic status of families and the prevalence of respiratory conditions such as asthma, bronchitis, and respiratory symptoms in children, in addition to exploring their association with the prevalence of COVID-19. The study involved a cross-sectional epidemiological investigation conducted in 2022, encompassing 2454 students from elementary schools in Poland. The parents of the students completed a questionnaire modeled after the International Study on Asthma and Allergies in Childhood (ISAAC). Socioeconomic status (SES) indicators were determined based on parental education, self-reported economic status, and housing conditions. To assess the impact of social factors and health on the occurrence of COVID-19, odds ratios (ORs) were calculated. The findings revealed several COVID-19 risk factors, including higher maternal (OR 2.2; 95%CI: 1.3-3.0) and paternal education (OR 1.9; 95%CI: 1.3-2.4), urban residence (OR 1.7; 95%CI: 1.3-2.1), the presence of mold in residences (OR 1.7; 95%CI: 1.0-2.3), bronchitis (OR 1.5; 95%CI: 1.2-2.0), and chronic cough (OR 1.8; 95%CI: 1.3-2.4). Further analysis, stratifying children based on their baseline health status (i.e., presence or absence of asthma, bronchitis, and chronic cough), indicated that higher parental education increased the risk of COVID-19 solely for children without pre-existing conditions. The occurrence of SARS-CoV-2 infections was found to be notably associated with mold exposure in children who did not have bronchial asthma. Rigorous multivariate analyses substantiated the collective impact of factors such as residential environment, the existence of mold and moisture, and a history of bronchitis. This study's conclusions highlight a higher frequency of SARS-CoV-2 infections in cases where bronchitis had been diagnosed previously and chronic cough was prevalent. Interestingly, the initially hypothesized higher prevalence of COVID-19 among children with bronchial asthma did not receive confirmation in our findings. This study highlights the importance of urban residence, exposure to mold or dampness, and higher parental education in the incidence of COVID-19. Higher parental education was a significant factor in increasing the risk of COVID-19 among children without bronchitis, chronic cough, and asthma.
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Affiliation(s)
- Agata Wypych-Ślusarska
- Department of Epidemiology, Faculty of Public Health in Bytom, Medical University of Silesia in Katowice, 41-902 Katowice, Poland; (A.W.-Ś.); (K.O.); (J.G.-L.); (J.S.)
| | - Karolina Krupa-Kotara
- Department of Biostatistics, Faculty of Public Health in Bytom, Medical University of Silesia in Katowice, 41-902 Katowice, Poland;
| | - Klaudia Oleksiuk
- Department of Epidemiology, Faculty of Public Health in Bytom, Medical University of Silesia in Katowice, 41-902 Katowice, Poland; (A.W.-Ś.); (K.O.); (J.G.-L.); (J.S.)
| | - Joanna Głogowska-Ligus
- Department of Epidemiology, Faculty of Public Health in Bytom, Medical University of Silesia in Katowice, 41-902 Katowice, Poland; (A.W.-Ś.); (K.O.); (J.G.-L.); (J.S.)
| | - Jerzy Słowiński
- Department of Epidemiology, Faculty of Public Health in Bytom, Medical University of Silesia in Katowice, 41-902 Katowice, Poland; (A.W.-Ś.); (K.O.); (J.G.-L.); (J.S.)
| | - Ewa Niewiadomska
- Department of Biostatistics, Faculty of Public Health in Bytom, Medical University of Silesia in Katowice, 41-902 Katowice, Poland;
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Maccarone MC, Coraci D, Regazzo G, Sarandria N, Scanu A, Masiero S. Evolution of musculoskeletal symptoms in Long COVID syndrome: a lexical analysis to approach requirements for an interdisciplinary management. Joint Bone Spine 2024; 91:105623. [PMID: 37487957 DOI: 10.1016/j.jbspin.2023.105623] [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: 04/12/2023] [Revised: 07/04/2023] [Accepted: 07/05/2023] [Indexed: 07/26/2023]
Abstract
Long COVID syndrome is characterized by new, returning, or persistent symptoms after the initial SARS-CoV-2 infection. Among the potential long-term effects of COVID-19, several different musculoskeletal symptoms have been reported in many patients with an important impact on quality of life. The rehabilitation needs of Long COVID patients could be dynamic. However, to date there are no studies that have evaluated how the rehabilitation needs of patients with Long COVID syndrome have changed over time. We conducted a literature review to summarize the most recurrent manifestations of the Long COVID syndrome during the three years of the pandemic, as well as the evolution of musculoskeletal symptoms, through lexical analysis. This approach allowed us to investigate the literature, highlighting how the most used words to describe Long COVID symptoms and outcomes have changed over different periods. Our analysis showed an increasing involvement of the musculoskeletal system in Long COVID symptomatology, as evidenced by the progressive growth of fatigue and weakness symptoms over time. In addition, arthralgia has always been associated with Long COVID. The lexical analysis we conducted emphasizes the need for interdisciplinary management, as the symptoms reported are interconnected. Moreover, this novel approach highlights that the Long COVID syndrome can be interpreted as a dynamic entity requiring up-to-date rehabilitative interventions. The worldwide healthcare systems should be founded on multidisciplinary teams to guarantee early and comprehensive rehabilitation to reduce the socio-sanitary burden associated with this syndrome.
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Affiliation(s)
- Maria Chiara Maccarone
- Department of Neuroscience, Physical Medicine and Rehabilitation School, University of Padua, Padua, Italy.
| | - Daniele Coraci
- Department of Neuroscience, Rehabilitation Unit, University of Padua, Padua, Italy
| | - Gianluca Regazzo
- Department of Neuroscience, Physical Medicine and Rehabilitation School, University of Padua, Padua, Italy
| | - Nicola Sarandria
- Department of Neuroscience, Physical Medicine and Rehabilitation School, University of Padua, Padua, Italy
| | - Anna Scanu
- Department of Neuroscience, Rehabilitation Unit, University of Padua, Padua, Italy; Department of Women's and Children's Health, University of Padua, Padua, Italy
| | - Stefano Masiero
- Department of Neuroscience, Physical Medicine and Rehabilitation School, University of Padua, Padua, Italy; Department of Neuroscience, Rehabilitation Unit, University of Padua, Padua, Italy
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Alotaibi H, Aldossari A, Alnasser S. Impetiginous Cutaneous Leishmaniasis after COVID-19 Infection in a Patient with Poor Cardiac Profile: A Case Report and Literature Review. Trop Med Infect Dis 2023; 8:443. [PMID: 37755904 PMCID: PMC10536164 DOI: 10.3390/tropicalmed8090443] [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: 07/05/2023] [Revised: 08/31/2023] [Accepted: 09/05/2023] [Indexed: 09/28/2023] Open
Abstract
Cutaneous leishmaniasis incidence has been rising in the past couple of decades. Standard therapy often includes antileishmanial drugs; however, due to their low safety and toxicity threshold, alternative treatments are being investigated. The association between COVID-19 and cutaneous leishmaniasis remains unclear and exploring this connection may offer crucial insights into the pathophysiology of and treatment strategies for infected patients. In this article, we describe a case of a male patient with a history of cardiac and other comorbidities who presented with cutaneous leishmaniasis in the form of impetigo-like skin lesions after being infected with COVID-19. Due to the patient's poor cardiac profile, sodium stibogluconate was not used and an alternative therapeutic approach was employed. The patient was treated with oral terbinafine, cryotherapy on specific lesions, and a course of cephalexin. Following the course of treatment and subsequent follow-up, the patient exhibited complete resolution and healing of the lesions with scarring, and no active lesions or recurrence were observed. This case highlights the potential for alternative treatment strategies for cutaneous leishmaniasis in patients with comorbidities and emphasizes the importance of further research to better understand the link between COVID-19 and cutaneous leishmaniasis.
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Affiliation(s)
- Hend Alotaibi
- Department of Dermatology, College of Medicine, King Saud University, Riyadh 11472, Saudi Arabia;
| | | | - Sultan Alnasser
- College of Medicine, King Saud University, Riyadh 11472, Saudi Arabia;
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Huang H, Leung KSK, Garg T, Mazzoleni A, Miteu GD, Zakariya F, Awuah WA, Yin ETS, Haroon F, Hussain Z, Aji N, Jaiswal V, Tse G. Barriers and shortcomings in access to cardiovascular management and prevention for familial hypercholesterolemia during the COVID-19 pandemic. Clin Cardiol 2023; 46:831-844. [PMID: 37260143 PMCID: PMC10436799 DOI: 10.1002/clc.24059] [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: 02/10/2023] [Revised: 05/04/2023] [Accepted: 05/17/2023] [Indexed: 06/02/2023] Open
Abstract
Familial hypercholesterolemia (FH) is a hereditary condition caused by mutations in the lipid pathway. The goal in managing FH is to reduce circulating low-density lipoprotein cholesterol and, therefore, reduce the risk of developing atherosclerotic cardiovascular disease (ASCVD). Because FH patients were considered high risk groups due to an increased susceptible for contracting COVID-19 infection, we hypothesized whether the effects of the pandemic hindered access to cardiovascular care. In this review, we conducted a literature search in databases Pubmed/Medline and ScienceDirect. We included a comprehensive analysis of findings from articles in English related and summarized the effects of the pandemic on cardiovascular care through direct and indirect effects. During the COVID-19 pandemic, FH patients presented with worse outcomes and prognosis, especially those that have suffered from early ASCVD. This caused avoidance in seeking care due to fear of transmission. The pandemic severely impacted consultations with lipidologists and cardiologists, causing a decline in lipid profile evaluations. Low socioeconomic communities and ethnic minorities were hit the hardest with job displacements and lacked healthcare coverage respectively, leading to treatment nonadherence. Lock-down restrictions promoted sedentary lifestyles and intake of fatty meals, but it is unclear whether these factors attenuated cardiovascular risk in FH. To prevent early atherogenesis in FH patients, universal screening programs, telemedicine, and lifestyle interventions are important recommendations that could improve outcomes in FH patients. However, the need to research in depth on the disproportionate impact within different subgroups should be the forefront of FH research.
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Affiliation(s)
- Helen Huang
- Royal College of Surgeons in IrelandFaculty of Medicine and Health ScienceDublinIreland
| | - Keith S. K. Leung
- Aston University Medical School, Faculty of Health & Life SciencesAston UniversityBirminghamUK
- Epidemiology Research Unit, Cardiovascular Analytics GroupChina‐UK CollaborationHong KongChina
| | - Tulika Garg
- Government Medical College and Hospital ChandigarhChandigarhIndia
| | - Adele Mazzoleni
- Barts and The London School of Medicine and DentistryLondonUK
| | - Goshen D. Miteu
- School of Biosciences, BiotechnologyUniversity of NottinghamNottinghamUK
- Department of BiochemistryCaleb University LagosLagosNigeria
| | - Farida Zakariya
- Department of Pharmaceutical SciencesAhmadu Bello UniversityZariaNigeria
| | | | | | | | - Zarish Hussain
- Royal College of Surgeons in IrelandMedical University of BahrainBusaiteenBahrain
| | - Narjiss Aji
- Faculty of Medicine and Pharmacy of RabatMohammed V UniversityRabatMorocco
| | - Vikash Jaiswal
- Department of Cardiology ResearchLarkin Community HospitalSouth MiamiFloridaUSA
| | - Gary Tse
- Epidemiology Research Unit, Cardiovascular Analytics GroupChina‐UK CollaborationHong KongChina
- Tianjin Key Laboratory of Ionic‐Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of CardiologySecond Hospital of Tianjin Medical UniversityTianjinChina
- Kent and Medway Medical SchoolCanterburyUK
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11
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Sahasakul Y, Amonsusawat N, Phansuea P. Lifestyles, Food Consumption Frequencies, and Eating Behaviors among Three Main Disciplines of Undergraduate Students during the Early COVID-19 Outbreak in Thailand. Nutrients 2023; 15:2765. [PMID: 37375675 DOI: 10.3390/nu15122765] [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: 04/05/2023] [Revised: 05/25/2023] [Accepted: 06/12/2023] [Indexed: 06/29/2023] Open
Abstract
University students' lifestyles and dietary habits have been considerably impacted by the coronavirus disease 2019 (COVID-19) outbreak and its related policies and restrictions. An online cross-sectional survey was conducted from March to May 2020 to compare lifestyles, food consumption frequencies, and eating behaviors among three main disciplines of undergraduate students during the early COVID-19 outbreak in Thailand. The study involved 584 participants from Mahidol University, with 45.2% from Health Sciences (HS), 29.1% from Sciences and Technologies (ST), and 25.7% from Social Sciences and Humanities (SH). The results showed that ST students had the highest proportion of overweight and obese (33.5%) individuals, followed by HS (23.9%) and SH (19.3%) students. ST students skipped breakfast the most (34.7%), followed by SH (34%) and HS (30%) students. Furthermore, 60% of SH students spent 7 h or more daily on social media, and they had the least exercise and the highest frequency of ordering home-delivery food. SH students (43.3%) reported a higher likelihood of making unhealthier food choices and consuming fast food, processed meat, bubble tea, boxed fruit and vegetable juice, and crunchy snacks more frequently than students from other disciplines. The findings show that undergraduate students had poor eating behaviors and lifestyles during the early COVID-19 outbreak, highlighting the urgent need to promote food and nutrition security among students during and after the pandemic.
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Affiliation(s)
- Yuraporn Sahasakul
- Food and Nutrition Academic and Research Cluster, Institute of Nutrition, Mahidol University, Salaya, Phutthamonthon, Nakhon Pathom 73170, Thailand
| | - Nantakan Amonsusawat
- Food and Nutrition Academic and Research Cluster, Institute of Nutrition, Mahidol University, Salaya, Phutthamonthon, Nakhon Pathom 73170, Thailand
| | - Phenphop Phansuea
- Food and Nutrition Academic and Research Cluster, Institute of Nutrition, Mahidol University, Salaya, Phutthamonthon, Nakhon Pathom 73170, Thailand
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12
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Iqbal U, Imtiaz R, Saudagar AKJ, Alam KA. CRV-NET: Robust Intensity Recognition of Coronavirus in Lung Computerized Tomography Scan Images. Diagnostics (Basel) 2023; 13:diagnostics13101783. [PMID: 37238266 DOI: 10.3390/diagnostics13101783] [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: 04/16/2023] [Revised: 05/01/2023] [Accepted: 05/10/2023] [Indexed: 05/28/2023] Open
Abstract
The early diagnosis of infectious diseases is demanded by digital healthcare systems. Currently, the detection of the new coronavirus disease (COVID-19) is a major clinical requirement. For COVID-19 detection, deep learning models are used in various studies, but the robustness is still compromised. In recent years, deep learning models have increased in popularity in almost every area, particularly in medical image processing and analysis. The visualization of the human body's internal structure is critical in medical analysis; many imaging techniques are in use to perform this job. A computerized tomography (CT) scan is one of them, and it has been generally used for the non-invasive observation of the human body. The development of an automatic segmentation method for lung CT scans showing COVID-19 can save experts time and can reduce human error. In this article, the CRV-NET is proposed for the robust detection of COVID-19 in lung CT scan images. A public dataset (SARS-CoV-2 CT Scan dataset), is used for the experimental work and customized according to the scenario of the proposed model. The proposed modified deep-learning-based U-Net model is trained on a custom dataset with 221 training images and their ground truth, which was labeled by an expert. The proposed model is tested on 100 test images, and the results show that the model segments COVID-19 with a satisfactory level of accuracy. Moreover, the comparison of the proposed CRV-NET with different state-of-the-art convolutional neural network models (CNNs), including the U-Net Model, shows better results in terms of accuracy (96.67%) and robustness (low epoch value in detection and the smallest training data size).
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Affiliation(s)
- Uzair Iqbal
- Department of Artificial Intelligence and Data Science, National University of Computer and Emerging Sciences, Islamabad Campus, Islamabad 44000, Pakistan
| | - Romil Imtiaz
- Information and Communication Engineering, Northwestern Polytechnical University, Xi'an 710072, China
| | - Abdul Khader Jilani Saudagar
- Information Systems Department, College of Computer and Information Sciences, Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh 11432, Saudi Arabia
| | - Khubaib Amjad Alam
- Department of Software Engineering, National University of Computer and Emerging Sciences, Islamabad Campus, Islamabad 44000, Pakistan
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Alinia C, Bolbanabad AM, Moradi G, Shokri A, Ghaderi E, Adabi J, Rezaei S, Piroozi B. Burden of COVID‐19 disease in Kurdistan province in west of Iran using disability‐adjusted life years. Health Sci Rep 2023; 6:e1154. [PMID: 36970642 PMCID: PMC10033847 DOI: 10.1002/hsr2.1154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Revised: 01/08/2023] [Accepted: 03/02/2023] [Indexed: 03/25/2023] Open
Abstract
Background and Aims During the coronavirus disease 2019 (COVID‐19) pandemic, about seven million people were infected with the disease, of which more than 133,000 died. Health policymakers need to know the extent and magnitude of the disease burden to decide on how much to allocate resources for disease control. The results of this investigation could be helpful in this field. Methods We used the secondary data released by the Kurdistan University of Medical Sciences between February 2020 to October 2021 to estimate the age‐sex standardized disability‐adjusted life years (DALY) by the sum of the years of life lived with disability (YLD) and the years of life lost (YLL). We also applied the local and specific values of the disease utility in the calculations. Results The total DALY was estimated at 23316.5 and 1385.5 per 100,000 populations The YLD and YLL constituted 1% and 99% of the total DALY, respectively. The DALY per 100,000 populations was highest in the men and people aged more than 65 years, but the prevalence was the highest in people under the age of 40. Conclusions Compared to the findings of the “burden of disease study 2019,” the burden of COVID‐19 in Iran is ranked first and eighth among communicable and noncommunicable diseases, respectively. Although the disease affects all groups, the elderly suffer the most from it. Given the very high YLL of COVID‐19, the best strategy to reduce the burden of COVID‐19 in subsequent waves should be to focus on preventing infection in the elderly population and reducing mortality.
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Affiliation(s)
- Cyrus Alinia
- Healthcare Management & Economics Department, School of Public HealthUrmia University of Medical SciencesUrmiaIran
| | - Amjad M. Bolbanabad
- Social Determinants of Health Research Center, Research Institute for Health DevelopmentKurdistan University of Medical SciencesSanandajIran
| | - Ghobad Moradi
- Social Determinants of Health Research Center, Research Institute for Health DevelopmentKurdistan University of Medical SciencesSanandajIran
| | - Azad Shokri
- Social Determinants of Health Research Center, Research Institute for Health DevelopmentKurdistan University of Medical SciencesSanandajIran
| | - Ebrahim Ghaderi
- Social Determinants of Health Research Center, Research Institute for Health DevelopmentKurdistan University of Medical SciencesSanandajIran
| | - Jalil Adabi
- Social Determinants of Health Research Center, Research Institute for Health DevelopmentKurdistan University of Medical SciencesSanandajIran
| | - Satar Rezaei
- School of Public HealthKermanshah University of Medical SciencesKermanshahIran
| | - Bakhtiar Piroozi
- Healthcare Management & Economics Department, School of Public HealthUrmia University of Medical SciencesUrmiaIran
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14
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Baatiema L, Sanuade OA, Allen LN, Abimbola S, Hategeka C, Koram KA, Kruk ME. Health system adaptions to improve care for people living with non-communicable diseases during COVID-19 in low-middle income countries: A scoping review. J Glob Health 2023; 13:06006. [PMID: 36862142 PMCID: PMC9980283 DOI: 10.7189/iogh.13.06006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023] Open
Abstract
Background During the COVID-19 pandemic, access to health care for people living with non-communicable diseases (NCDs) has been significantly disrupted. Calls have been made to adapt health systems and innovate service delivery models to improve access to care. We identified and summarized the health systems adaptions and interventions implemented to improve NCD care and their potential impact on low- and middle-income countries (LMICs). Methods We comprehensively searched Medline/PubMed, Embase, CINAHL, Global Health, PsycINFO, Global Literature on coronavirus disease, and Web of Science for relevant literature published between January 2020 and December 2021. While we targeted articles written in English, we also included papers published in French with abstracts written in English. Results After screening 1313 records, we included 14 papers from six countries. We identified four unique health systems adaptations/interventions for restoring, maintaining, and ensuring continuity of care for people living with NCDs: telemedicine or teleconsultation strategies, NCD medicine drop-off points, decentralization of hypertension follow-up services and provision of free medication to peripheral health centers, and diabetic retinopathy screening with a handheld smartphone-based retinal camera. We found that the adaptations/interventions enhanced continuity of NCD care during the pandemic and helped bring health care closer to patients using technology and easing access to medicines and routine visits. Telephonic aftercare services appear to have saved a significant amount of patients' time and funds. Hypertensive patients recorded better blood pressure controls over the follow-up period. Conclusions Although the identified measures and interventions for adapting health systems resulted in potential improvements in access to NCD care and better clinical outcomes, further exploration is needed to establish the feasibility of these adaptations/interventions in different settings given the importance of context in their successful implementation. Insights from such implementation studies are critical for ongoing health systems strengthening efforts to mitigate the impact of COVID-19 and future global health security threats for people living with NCDs.
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Affiliation(s)
- Leonard Baatiema
- Department of Health Policy, Planning and Management, School of Public Health, University of Ghana, Legon, Accra, Ghana.,Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Olutobi A Sanuade
- Department of Population Health Sciences, Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City, Utah, USA
| | - Luke N Allen
- Department of Clinical Research, Faculty of Infectious and Tropical Diseases London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Seye Abimbola
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Celestin Hategeka
- Centre for Health Services and Policy Research, School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Kwadwo A Koram
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
| | - Margaret E Kruk
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
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15
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Luciani S, Caixeta R, Chavez C, Ondarsuhu D, Hennis A. What is the NCD service capacity and disruptions due to COVID-19? Results from the WHO non-communicable disease country capacity survey in the Americas region. BMJ Open 2023; 13:e070085. [PMID: 36863746 PMCID: PMC9990165 DOI: 10.1136/bmjopen-2022-070085] [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] [Indexed: 03/04/2023] Open
Abstract
OBJECTIVE This article presents the Americas regional results of the WHO non-communicable diseases (NCDs) Country Capacity Survey from 2019 to 2021, on NCD service capacity and disruptions from the COVID-19 pandemic. SETTING Information on public sector primary care services for NCDs, and related technical inputs from 35 countries in the Americas region are provided. PARTICIPANTS All Ministry of Health officials managing a national NCD programme, from a WHO Member State in the Americas region, were included throughout this study. Government health officials from countries that are not WHO Member States were excluded. OUTCOME MEASURES The availability of evidence-based NCD guidelines, essential NCD medicines and basic technologies in primary care, cardiovascular disease risk stratification, cancer screening and palliative care services were measured in 2019, 2020 and 2021. NCD service interruptions, reassignments of NCD staff during the COVID-19 pandemic and mitigation strategies to reduce disruptions for NCD services were measured in 2020 and 2021. RESULTS More than 50% of countries reported a lack of comprehensive package of NCD guidelines, essential medicines and related service inputs. Extensive disruptions in NCD services resulted from the pandemic, with only 12/35 countries (34%), reporting that outpatient NCD services were functioning normally. Ministry of Health staff were largely redirected to work on the COVID-19 response, either full time or partially, reducing the human resources available for NCD services. Six of 24 countries (25%) reported stock out of essential NCD medicines and/or diagnostics at health facilities which affected service continuity. Mitigation strategies to ensure continuity of care for people with NCDs were deployed in many countries and included triaging patients, telemedicine and teleconsultations, and electronic prescriptions and other novel prescribing practices. CONCLUSIONS The findings from this regional survey suggest significant and sustained disruptions, affecting all countries regardless of the country's level of investments in healthcare or NCD burden.
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Affiliation(s)
- Silvana Luciani
- Department of Noncommunicable Diseases and Mental Health, Pan American Health Organization, Washington, District of Columbia, USA
| | - Roberta Caixeta
- Department of Noncommunicable Diseases and Mental Health, Pan American Health Organization, Washington, District of Columbia, USA
| | - Carolina Chavez
- Department of Noncommunicable Diseases and Mental Health, Pan American Health Organization, Washington, District of Columbia, USA
| | - Dolores Ondarsuhu
- Department of Noncommunicable Diseases and Mental Health, Pan American Health Organization, Washington, District of Columbia, USA
| | - Anselm Hennis
- Department of Noncommunicable Diseases and Mental Health, Pan American Health Organization, Washington, District of Columbia, USA
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Revu J, Anand MP, Aadil R, Mini GK. Non-communicable disease management: Access to healthcare during COVID-19 pandemic in rural Kerala, India. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2023; 20:101231. [PMID: 36691659 PMCID: PMC9850649 DOI: 10.1016/j.cegh.2023.101231] [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: 06/11/2022] [Revised: 01/12/2023] [Accepted: 01/16/2023] [Indexed: 01/20/2023] Open
Abstract
Background Globally, data on the coronavirus disease (COVID-19) pandemic showed a higher risk of infection and complications in people with non-communicable diseases (NCDs). In India, the prevalence of NCDs and their risk factors vary significantly between states. Compared to other states, Kerala has the highest prevalence of non-communicable diseases in the country, along with the highest proportion of the elderly population. The study evaluates the disease management patterns and changes in healthcare behaviors among adults with NCDs in Kerala during the COVID-19 pandemic. Methods A cross-sectional study was conducted among 410 adult NCD patients in rural Thiruvananthapuram district, Kerala. Using a semi-structured interview schedule, the present study gathered information on socio-demographic characteristics, disease patterns, healthcare utilization, and behavioral change during the pandemic. Results Mean age of the participants was 62 years (range: 37-88; women: 64%). The most prevalent NCD was hypertension (74%) and diabetes (65%) followed by chronic respiratory disease (12%), cardiovascular disease (11%), and cancer (2%). Nearly 76% had difficulty in obtaining consultation/medical follow-up. Around 10% relied on telecommunication and 32% reported increased stress during the pandemic. Those with low socio-economic status and with a single NCD were more vulnerable to the challenges faced during the pandemic. Conclusion A higher proportion of adults with NCDs faced difficulties in healthcare access and had negative healthcare behaviors during the pandemic. The findings highlight the need to ensure better healthcare for people living with NCDs during the times of pandemic.
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Affiliation(s)
- J Revu
- Global Institute of Public Health, Ananthapuri Hospitals and Research Institute, Thiruvananthapuram, Kerala, India
| | - Marthada Pillai Anand
- Global Institute of Public Health, Ananthapuri Hospitals and Research Institute, Thiruvananthapuram, Kerala, India
- Department of Cardiology, Ananthapuri Hospitals and Research Institute, Thiruvananthapuram, Kerala, India
| | - Rafi Aadil
- Department of Cardiology, Ananthapuri Hospitals and Research Institute, Thiruvananthapuram, Kerala, India
| | - G K Mini
- Global Institute of Public Health, Ananthapuri Hospitals and Research Institute, Thiruvananthapuram, Kerala, India
- Department of Public Health Dentistry, Saveetha Dental Colleges & Hospitals, Saveetha Institute of Medical and Technical Sciences, Chennai, India
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COVID-19 Vaccine Uptake and Associated Factors in Sub-Saharan Africa: Evidence from a Community-Based Survey in Tanzania. Vaccines (Basel) 2023; 11:vaccines11020465. [PMID: 36851342 PMCID: PMC9961769 DOI: 10.3390/vaccines11020465] [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: 11/30/2022] [Revised: 01/05/2023] [Accepted: 02/15/2023] [Indexed: 02/19/2023] Open
Abstract
COVID-19 is a major public health threat associated with the increased global burden of infectious diseases, mortality, and enormous economic loss to countries and communities. Safe and efficacious COVID-19 vaccines are crucial in halting the pandemic. We assessed the COVID-19 vaccine uptake and associated factors among community members from eight regions in Tanzania. The interviewer-administered questionnaire collected data. Multiple logistic regression models determined the factors associated with vaccine uptake. The median age of 3470 respondents was 37 years (interquartile range of 29-50 years) and 66% of them were females. Only 18% of them had received the COVID-19 vaccine, ranging from 8% in Dar es Salaam to 37% in Simiyu regions. A third (34%) of those vaccinated people did not know which vaccine they were given. Significantly higher rates of COVID-19 vaccine uptake were among the respondents aged 30+ years, males, and with a history of COVID-19 infection. Unfavorable perceptions about vaccine safety and efficacy lowered the rates of vaccine uptake. Setting-specific interventions and innovations are critical to improving vaccine uptake, given the observed differences between regions. Efforts are needed to increase vaccine uptake among women and younger people aged less than 30 years. Knowledge-based interventions should enhance the understanding of the available vaccines, benefits, target groups, and availability.
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18
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Yaghoobi A, Lord JS, Rezaiezadeh JS, Yekaninejad MS, Amini M, Izadi P. TMPRSS2 polymorphism (rs12329760) and the severity of the COVID-19 in Iranian population. PLoS One 2023; 18:e0281750. [PMID: 36795725 PMCID: PMC9934348 DOI: 10.1371/journal.pone.0281750] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 01/31/2023] [Indexed: 02/17/2023] Open
Abstract
Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has been responsible for the recent pandemic since early 2020. Due to the wide range of clinical symptoms of this disease, from asymptomatic to severe and critical forms, it seems that genetic differences among patients, along with other factors (such as gender, age, and underlying diseases), can explain part of the variation in disease symptoms. The TMPRSS2 enzyme plays a vital role in the early stages of the interaction of the SARS-CoV-2 with the host cells by facilitating viral entry. There is a polymorphism in the TMPRSS2 gene, called rs12329760(C to T) as a missense variant, which causes the replacement of valine to methionine in the TMPRSS2 protein at position 160. The present study investigated the association between the TMPRSS2 genotype and the severity of the Coronavirus disease 2019 (COVID-19) in Iranian patients. The TMPRSS2 genotype of 251 COVID-19 patients (151 patients with asymptomatic to mild and 100 patients with severe to critical symptoms) was detected on genomic DNA extracted from patients' peripheral blood via the ARMS-PCR method. Our results showed a significant association between the minor T allele and the severity of the COVID-19 (P-value = 0.043) under the dominant and additive inheritance model. In conclusion, the results of this study showed that the T allele of the rs12329760 in the TMPRSS2 gene is a risk allele for severe form of COVID-19 in Iranian patients in contrast to most previous studies on this variant in European ancestry populations which suggested this variant as a protective allele. Our results reiterate to the ethnic-specific risk alleles and hidden unknown complexity behind the host genetic susceptibility. However, further studies are needed to address the complex mechanisms behind the interaction of the TMPRSS2 protein and the SARS-CoV-2 and the role of rs12329760 polymorphism in determining the disease severity.
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Affiliation(s)
- Arash Yaghoobi
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Javad Safdari Lord
- Department of Medical Genetics, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Javad Soltani Rezaiezadeh
- Department of Medical Genetics, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mir Saeed Yekaninejad
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Masoumeh Amini
- Department of Medical Genetics, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Pantea Izadi
- Department of Medical Genetics, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- * E-mail:
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Mazaherifar S, Solhjoo K, Rasti S, Heidarnejadi SM, Abdoli A. Patterns of cutaneous leishmaniasis during the COVID-19 pandemic in four endemic regions of Iran. Trans R Soc Trop Med Hyg 2023; 117:38-44. [PMID: 36068660 DOI: 10.1093/trstmh/trac081] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 06/16/2022] [Accepted: 08/04/2022] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Both zoonotic cutaneous leishmaniasis (ZCL) and anthroponotic cutaneous leishmaniasis are endemic in different regions of Iran. It is important to know the type of cutaneous leishmaniasis (CL) for prevention strategies. On the other hand, Iran is one of the countries that was severely affected by the coronavirus 2019 (COVID-19) pandemic. However, little is known about the causative agents of CL during the COVID-19 pandemic in Iran. METHODS In this study, a total of 181 samples were isolated from patients with CL lesions in four different endemic cities of Iran (Jahrom, Juyom, Kashan and Shoushtar) during the COVID-19 pandemic (the summer and autumn of 2021). The nested-PCR targeting kinetoplast DNA (kDNA) minicircles was applied for species identification of the parasite and the internal transcribed spacer-1 (ITS-1) gene was applied for sequencing and phylogenetic analysis. RESULTS Molecular detection of kDNA minicircles revealed that all isolates from the four cities were Leishmania major, indicating the ZCL pattern. Ten isolates were sequenced by the ITS-1 gene and deposited in GenBank [accession numbers: OL627363-72]. Sequencing and phylogenetic analysis displayed a high similarity rate of the isolates with sequences from other parts of Iran and Iraq. Over half of the patients (53.59%) had a single lesion, while 17.12, 14.92, 2.21 and 12.16% of cases had two, three, four and more than four lesions, respectively. About half of the patients (50.27%) had lesions on their hands, while the rest had lesions on multiple locations (19.34%), legs (16.58%), face (9.94%), ears (1.66%) and waist (2.21%). CONCLUSIONS This study revealed the occurrence of ZCL during the COVID-19 pandemic in four endemic regions of Iran. Strategies for prevention and control of the disease should be considered to mitigate the occurrence of ZCL.
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Affiliation(s)
- Samaneh Mazaherifar
- Zoonoses Research Center, Jahrom University of Medical Sciences, Jahrom 74148-46199, Iran
- Department of Parasitology and Mycology, Jahrom University of Medical Sciences, Jahrom 74148-46199, Iran
| | - Kavous Solhjoo
- Zoonoses Research Center, Jahrom University of Medical Sciences, Jahrom 74148-46199, Iran
- Department of Parasitology and Mycology, Jahrom University of Medical Sciences, Jahrom 74148-46199, Iran
| | - Sima Rasti
- Department of Parasitology and Mycology and Infectious Diseases Research Center, Faculty of Medicine, Kashan University of Medical Sciences, Kashan 8115187159, I.R.Iran
| | | | - Amir Abdoli
- Zoonoses Research Center, Jahrom University of Medical Sciences, Jahrom 74148-46199, Iran
- Department of Parasitology and Mycology, Jahrom University of Medical Sciences, Jahrom 74148-46199, Iran
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Ortiz-Rodríguez MA, Martínez-Salazar MF, Antunez-Bautista PK, Jiménez-Osorio AS. Strategies for the study of neuroepigenetics and aging with a translational approach. AGING AND HEALTH RESEARCH 2023. [DOI: 10.1016/j.ahr.2023.100122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
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Loots DT, Adeniji AA, Van Reenen M, Ozturk M, Brombacher F, Parihar SP. The metabolomics of a protein kinase C delta (PKCδ) knock-out mouse model. Metabolomics 2022; 18:92. [PMID: 36371785 PMCID: PMC9660189 DOI: 10.1007/s11306-022-01949-w] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Accepted: 10/29/2022] [Indexed: 11/15/2022]
Abstract
INTRODUCTION PKCδ is ubiquitously expressed in mammalian cells and its dysregulation plays a key role in the onset of several incurable diseases and metabolic disorders. However, much remains unknown about the metabolic pathways and disturbances induced by PKC deficiency, as well as the metabolic mechanisms involved. OBJECTIVES This study aims to use metabolomics to further characterize the function of PKC from a metabolomics standpoint, by comparing the full serum metabolic profiles of PKC deficient mice to those of wild-type mice. METHODS The serum metabolomes of PKCδ knock-out mice were compared to that of a wild-type strain using a GCxGC-TOFMS metabolomics research approach and various univariate and multivariate statistical analyses. RESULTS Thirty-seven serum metabolite markers best describing the difference between PKCδ knock-out and wild-type mice were identified based on a PCA power value > 0.9, a t-test p-value < 0.05, or an effect size > 1. XERp prediction was also done to accurately select the metabolite markers within the 2 sample groups. Of the metabolite markers identified, 78.4% (29/37) were elevated and 48.65% of these markers were fatty acids (18/37). It is clear that a total loss of PKCδ functionality results in an inhibition of glycolysis, the TCA cycle, and steroid synthesis, accompanied by upregulation of the pentose phosphate pathway, fatty acids oxidation, cholesterol transport/storage, single carbon and sulphur-containing amino acid synthesis, branched-chain amino acids (BCAA), ketogenesis, and an increased cell signalling via N-acetylglucosamine. CONCLUSION The charaterization of the dysregulated serum metabolites in this study, may represent an additional tool for the early detection and screening of PKCδ-deficiencies or abnormalities.
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Affiliation(s)
- Du Toit Loots
- Human Metabolomics, North-West University, Hoffman Street, 2531, Potchefstroom, South Africa.
| | | | - Mari Van Reenen
- Human Metabolomics, North-West University, Hoffman Street, 2531, Potchefstroom, South Africa
| | - Mumin Ozturk
- Human Metabolomics, North-West University, Hoffman Street, 2531, Potchefstroom, South Africa
- International Centre for Genetic Engineering and Biotechnology (ICGEB), Cape Town-Component, Cape Town, South Africa
| | - Frank Brombacher
- Human Metabolomics, North-West University, Hoffman Street, 2531, Potchefstroom, South Africa
- International Centre for Genetic Engineering and Biotechnology (ICGEB), Cape Town-Component, Cape Town, South Africa
- Institute of Infectious Diseases and Molecular Medicine (IDM), Division of Immunology and South African Medical Research Council (SAMRC) Immunology of Infectious Diseases, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
- Wellcome Center for Infectious Disease Research in Africa (CIDRI-Africa), Institute of Infectious Diseases and Molecular Medicine (IDM), Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Suraj P Parihar
- Human Metabolomics, North-West University, Hoffman Street, 2531, Potchefstroom, South Africa.
- International Centre for Genetic Engineering and Biotechnology (ICGEB), Cape Town-Component, Cape Town, South Africa.
- Institute of Infectious Diseases and Molecular Medicine (IDM), Division of Immunology and South African Medical Research Council (SAMRC) Immunology of Infectious Diseases, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
- Wellcome Center for Infectious Disease Research in Africa (CIDRI-Africa), Institute of Infectious Diseases and Molecular Medicine (IDM), Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
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Di Ciaula A, Moshammer H, Lauriola P, Portincasa P. Environmental health, COVID-19, and the syndemic: internal medicine facing the challenge. Intern Emerg Med 2022; 17:2187-2198. [PMID: 36181580 PMCID: PMC9525944 DOI: 10.1007/s11739-022-03107-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 09/16/2022] [Indexed: 11/29/2022]
Abstract
Internists are experts in complexity, and the COVID-19 pandemic is disclosing complex and unexpected interactions between communicable and non-communicable diseases, environmental factors, and socio-economic disparities. The medicine of complexity cannot be limited to facing comorbidities and to the clinical management of multifaceted diseases. Evidence indicates how climate change, pollution, demographic unbalance, and inequalities can affect the spreading and outcomes of COVID-19 in vulnerable communities. These elements cannot be neglected, and a wide view of public health aspects by a "one-health" approach is strongly and urgently recommended. According to World Health Organization, 35% of infectious diseases involving the lower respiratory tract depend on environmental factors, and infections from SARS-Cov-2 is not an exception. Furthermore, environmental pollution generates a large burden of non-communicable diseases and disabilities, increasing the individual vulnerability to COVID-19 and the chance for the resilience of large communities worldwide. In this field, the awareness of internists must increase, as privileged healthcare providers. They need to gain a comprehensive knowledge of elements characterizing COVID-19 as part of a syndemic. This is the case when pandemic events hit vulnerable populations suffering from the increasing burden of chronic diseases, disabilities, and social and economic inequalities. Mastering the interplay of such events requires a change in overall strategy, to adequately manage not only the SARS-CoV-2 infection but also the growing burden of non-communicable diseases by a "one health" approach. In this context, experts in internal medicine have the knowledge and skills to drive this change.
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Affiliation(s)
- Agostino Di Ciaula
- Clinica Medica “A. Murri”, Department of Biomedical Sciences and Human Oncology, University of Bari Medical School, Bari, Italy
- International Society of Doctors for Environment (ISDE), Geneva, Switzerland
| | - Hanns Moshammer
- International Society of Doctors for Environment (ISDE), Geneva, Switzerland
- Department of Environmental Health, Center for Public Health, Medical University Vienna, 1090 Vienna, Austria
- Department of Hygiene, Medical University of Karakalpakstan, Nukus, Uzbekistan 230100
| | - Paolo Lauriola
- International Society of Doctors for Environment (ISDE), Geneva, Switzerland
| | - Piero Portincasa
- Clinica Medica “A. Murri”, Department of Biomedical Sciences and Human Oncology, University of Bari Medical School, Bari, Italy
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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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24
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Birungi C, Haacker M, Taramusi I, Mpofu A, Madzima B, Apollo T, Mugurungi O, Odiit M, Obst MA. Economic implications of COVID-19 for the HIV epidemic and the response in Zimbabwe. AFRICAN JOURNAL OF AIDS RESEARCH 2022; 21:330-344. [DOI: 10.2989/16085906.2022.2154231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Charles Birungi
- Equitable Financing Practice, Joint United Nations Programme on HIV/AIDS (UNAIDS), Geneva, Switzerland
- The UCL Centre for Global Health Economics, University College London, United Kingdom
| | - Markus Haacker
- The UCL Centre for Global Health Economics, University College London, United Kingdom
- Harvard TH Chan School of Public Health, Harvard University, Boston, Massachusetts, United States of America
- Center for Global Development, Washington, DC, United States of America
| | | | | | | | | | | | - Martin Odiit
- Joint United Nations Programme on HIV/AIDS (UNAIDS), Harare, Zimbabwe
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Ezzeddin N, Eini-Zinab H, Kalantari N, Ahmadi M, Beheshti Z. Fear of COVID-19 Higher among Food-Insecure Households: A Model-Based Study, Mediated by Perceived Stress among Iranian Populations. IRANIAN JOURNAL OF PSYCHIATRY 2022; 17:401-410. [PMID: 36817807 PMCID: PMC9922359 DOI: 10.18502/ijps.v17i4.10689] [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: 10/19/2021] [Revised: 01/29/2022] [Accepted: 08/23/2022] [Indexed: 11/24/2022]
Abstract
Objective: The COVID-19 pandemic is a crisis accompanied by multiple psychological consequences (including fear of COVID-19) and threatens the food security status of millions of people. This study aimed to examine the association between fear of COVID-19 and food insecurity, mediated by perceived stress. Method : This cross-sectional study was conducted among 2871 Iranian participants (18-80 years), recruited through the Social Media during the COVID-19 epidemic. The demographic and socio-economic information questionnaire, Household Food Insecurity Access Scale (HFIAS), COVID-19 fear scale (FCV-19S), Cohen's Perceived Stress Scale (PSS-14) and Perceived Social Support Questionnaire (MSPSS) were used in data gathering. Descriptive and analytical analyses were done using SPSS 22.0 and Amos 22.0 was used for structural equation modeling (SES). Results: Food insecurity has significant positive direct and indirect (mediated by perceived stress) correlations with fear of COVID-19 (P < 0.05). It was also shown that perceived social support could negatively relate to fear of COVID-19 through the pathways of food security status or perceived stress (P < 0.05). Among women, the presence of a child under 5 had a significant direct association with fear of COVID-19 (P < 0.05). Conclusion: Food insecurity was associated with more perceived fear of COVID-19 among the studied population. The crisis caused by COVID-19 highlights the need to increase social resilience through developing and implementing appropriate strategies to prevent and mitigate social costs (whether physical, psychological, or nutritional).
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Affiliation(s)
- Neda Ezzeddin
- Department of Community Nutrition, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hassan Eini-Zinab
- Department of Community Nutrition, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Naser Kalantari
- Department of Community Nutrition, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Corresponding Author: Address: Shahid Farahzadi Boulvard, Shahid Hafezi Street (Western Arghavan), Ghods Town (West), Tehran, Iran, Postal Code: 1981619573. Tel: 98-21 22077424, Fax: 98-21 22360660,
| | - Mohammad Ahmadi
- Department of Community Nutrition, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zeinab Beheshti
- Department of Community Nutrition, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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26
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Palmer K, Nemer L, Datta SS, Menne BM. COVID-19 vaccination roll-outs in eleven small countries within the WHO European region; Lessons learned. Front Public Health 2022; 10:959227. [PMID: 36211689 PMCID: PMC9541336 DOI: 10.3389/fpubh.2022.959227] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 06/27/2022] [Indexed: 01/24/2023] Open
Abstract
The development and administration of COVID-19 vaccines has been an essential element in controlling the COVID-19 pandemic. However, countries worldwide have faced challenges in planning and implementing vaccination strategies. The aim of the current paper is to describe the situation faced by small countries in the WHO European Region in implementing their national vaccination strategies during the first stages of the planned roll-out (up to May 2021). This paper uses information from the WHO Small Countries Initiative (SCI), which includes a network of 11 countries with populations of ≤ 2 million (Andorra, Cyprus, Estonia, Iceland, Latvia, Luxembourg, Malta, Monaco, Montenegro, San Marino, and Slovenia). The SCI countries faced many challenges including: a lack of appropriate vaccination centers, adequate workforce, and registration/booking systems to cope with the unprecedented vaccine storage and administration demands; difficulties for high-risk groups (e.g., older individuals and those with health problems or cognitive impairment) to access vaccination sites or use digital registration/booking systems; vaccine wastage due to canceled appointments; and inequalities in vaccine uptake. Innovative programmatic interventions were implemented to facilitate the vaccination uptake of the populations such as: the creation of non-medical vaccination sites and mobile vaccination units; on-site vaccination of people in long-term residential facilities and long-term medical wards; diversifying health workforce like redeployment of healthcare professionals and use of medical students and retired medical professionals; campaigns with clear information to the general public (in multiple languages where necessary) both offline and online; use of digital registration/booking systems and alternative (non-digital) registration/booking systems for relevant individuals; and administration of excess vaccine doses to non-priority groups to avoid wastage.
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Affiliation(s)
- Katie Palmer
- WHO European Office for Investment for Health and Development, Venice, Italy
| | - Leda Nemer
- WHO European Office for Investment for Health and Development, Venice, Italy,*Correspondence: Leda Nemer
| | | | - Bettina Maria Menne
- WHO European Office for Investment for Health and Development, Venice, Italy
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27
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Wang C, Wang J. Ethnolinguistic diversity and the spread of communicable diseases: a cross-country study on the COVID-19 pandemic. Health Promot Int 2022; 37:6674366. [PMID: 36000530 PMCID: PMC9452158 DOI: 10.1093/heapro/daac082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Motivated by the varying effectiveness of government intervention policies to contain the COVID-19 pandemic, and the potential positive relationship between ethnolinguistic diversity and social distance, this paper aims to provide empirical evidence on the relationship between ethnolinguistic diversity and the spread of COVID-19. In particular, using global data from 113 developed and developing countries during the early stages of the pandemic (from 31 December 2019 to 8 July 2020), we have found a significant negative effect of ethnolinguistic diversity on the spread of the virus. The result is robust to alternative measures of ethnolinguistic diversity and estimator that addresses endogeneity. Moreover, we also show that the impact of ethnolinguistic diversity on the spread of COVID-19 differs in economies characterized by different levels of democracy, policy stringency on addressing COVID-19 and health expenditure.
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Affiliation(s)
- Cong Wang
- Department of Economics, Macquarie University, North Ryde, NSW 2109, Australia
| | - Jimin Wang
- Accounting and Finance, University of Western Australia, Perth, WA, Australia
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Faramarzi A, Javan‐Noughabi J, Mousavi SA, Bahrami Asl F, Shabanikiya H. Socioeconomic status and COVID‐19‐related cases and fatalities in the world: A cross‐sectional ecological study. Health Sci Rep 2022; 5:e628. [PMID: 35539445 PMCID: PMC9069551 DOI: 10.1002/hsr2.628] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 03/21/2022] [Accepted: 04/13/2022] [Indexed: 11/30/2022] Open
Abstract
Background and Aims The COVID‐19 pandemic poses an extraordinary threat to global public health. We designed an ecological study to explore the association between socioeconomic factors and the COVID‐19 outcomes in 184 countries, using the geographic map and multilevel regression models. Methods We conducted a cross‐sectional ecological study in 184 countries. We performed regression analysis to assess the association of various socioeconomic variables with COVID‐19 outcomes in 184 countries, using ordinary least squares and multilevel modeling analysis. We performed two‐level analyses with countries at Level 1 and geographical regions at Level 2 in multilevel modeling analysis, using the same set of predictor variables used in ordinary least squares. Results There was a significant relationship between COVID‐19 cases rate (Log) per 100,000 inhabitants‐day at risk with human development index (HDI), percentage of the urban population, unemployment, and cardiovascular disease prevalence. The results displayed that the variances are varied between Level 1 (country level) and Level 2 (World Health Organization [WHO] regions), meaning that the geographic distribution represented a proportion of the changes in the COVID‐19 outcomes. Conclusion The study suggests that in addition to the socioeconomic status affects the COVID‐19 outcomes, countries' geographical location makes a part of changes in outcomes of diseases. Therefore, health policy‐makers could overcome morbidity and mortality in COVID‐19 by controlling the socioeconomics factors.
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Affiliation(s)
- Ahmad Faramarzi
- Department of Health Management and Economics, School of Public Health Urmia University of Medical Sciences Urmia Iran
| | - Javad Javan‐Noughabi
- Social Determinants of Health Research Center Mashhad University of Medical Sciences Mashhad Iran
- Department of Health Economics and Management Sciences, School of Health Mashhad University of Medical Sciences Mashhad Iran
| | - Sayed Ali Mousavi
- Department of Health Shoushtar Faculty of Medical Science Shoushtar Iran
| | - Farshad Bahrami Asl
- Environmental Health Engineering Department, School of Health Urmia University of Medical Sciences Urmia Iran
| | - Hamidreza Shabanikiya
- Social Determinants of Health Research Center Mashhad University of Medical Sciences Mashhad Iran
- Department of Health Economics and Management Sciences, School of Health Mashhad University of Medical Sciences Mashhad Iran
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Tranchita E, Murri A, Grazioli E, Cerulli C, Emerenziani GP, Ceci R, Caporossi D, Dimauro I, Parisi A. The Beneficial Role of Physical Exercise on Anthracyclines Induced Cardiotoxicity in Breast Cancer Patients. Cancers (Basel) 2022; 14:cancers14092288. [PMID: 35565417 PMCID: PMC9104319 DOI: 10.3390/cancers14092288] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 04/15/2022] [Accepted: 04/29/2022] [Indexed: 12/24/2022] Open
Abstract
The increase in breast cancer (BC) survival has determined a growing survivor population that seems to develop several comorbidities and, specifically, treatment-induced cardiovascular disease (CVD), especially those patients treated with anthracyclines. Indeed, it is known that these compounds act through the induction of supraphysiological production of reactive oxygen species (ROS), which appear to be central mediators of numerous direct and indirect cardiac adverse consequences. Evidence suggests that physical exercise (PE) practised before, during or after BC treatments could represent a viable non-pharmacological strategy as it increases heart tolerance against many cardiotoxic agents, and therefore improves several functional, subclinical, and clinical parameters. At molecular level, the cardioprotective effects are mainly associated with an exercise-induced increase of stress response proteins (HSP60 and HSP70) and antioxidant (SOD activity, GSH), as well as a decrease in lipid peroxidation, and pro-apoptotic proteins such as Bax, Bax-to-Bcl-2 ratio. Moreover, this protection can potentially be explained by a preservation of myosin heavy chain (MHC) isoform distribution. Despite this knowledge, it is not clear which type of exercise should be suggested in BC patient undergoing anthracycline treatment. This highlights the lack of special guidelines on how affected patients should be managed more efficiently. This review offers a general framework for the role of anthracyclines in the physio-pathological mechanisms of cardiotoxicity and the potential protective role of PE. Finally, potential exercise-based strategies are discussed on the basis of scientific findings.
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Affiliation(s)
- Eliana Tranchita
- Laboratory of Physical Exercise and Sport Science, Department of Exercise, Human and Health Sciences, University of Rome Foro Italico, Piazza Lauro de Bosis 15, 00135 Rome, Italy; (E.T.); (A.M.); (C.C.); (A.P.)
| | - Arianna Murri
- Laboratory of Physical Exercise and Sport Science, Department of Exercise, Human and Health Sciences, University of Rome Foro Italico, Piazza Lauro de Bosis 15, 00135 Rome, Italy; (E.T.); (A.M.); (C.C.); (A.P.)
| | - Elisa Grazioli
- Laboratory of Physical Exercise and Sport Science, Department of Exercise, Human and Health Sciences, University of Rome Foro Italico, Piazza Lauro de Bosis 15, 00135 Rome, Italy; (E.T.); (A.M.); (C.C.); (A.P.)
- Department of Experimental and Clinical Medicine, Magna Graecia University, 88100 Catanzaro, Italy;
- Correspondence: ; Tel.: +39-06-3673-3532
| | - Claudia Cerulli
- Laboratory of Physical Exercise and Sport Science, Department of Exercise, Human and Health Sciences, University of Rome Foro Italico, Piazza Lauro de Bosis 15, 00135 Rome, Italy; (E.T.); (A.M.); (C.C.); (A.P.)
| | - Gian Pietro Emerenziani
- Department of Experimental and Clinical Medicine, Magna Graecia University, 88100 Catanzaro, Italy;
| | - Roberta Ceci
- Laboratory of Biochemistry and Molecular Biology, Department of Exercise, Human and Health Sciences, University of Rome Foro Italico, 00135 Rome, Italy;
| | - Daniela Caporossi
- Unit of Biology and Genetics of Movement, Department of Movement, Human and Health Sciences, University of Rome Foro Italico, Piazza Lauro de Bosis 15, 00135 Rome, Italy; (D.C.); (I.D.)
| | - Ivan Dimauro
- Unit of Biology and Genetics of Movement, Department of Movement, Human and Health Sciences, University of Rome Foro Italico, Piazza Lauro de Bosis 15, 00135 Rome, Italy; (D.C.); (I.D.)
| | - Attilio Parisi
- Laboratory of Physical Exercise and Sport Science, Department of Exercise, Human and Health Sciences, University of Rome Foro Italico, Piazza Lauro de Bosis 15, 00135 Rome, Italy; (E.T.); (A.M.); (C.C.); (A.P.)
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Yan LD, Matuja SS, Pain KJ, McNairy ML, Etyang AO, Peck RN. Emerging Viral Infections, Hypertension, and Cardiovascular Disease in Sub-Saharan Africa: A Narrative Review. Hypertension 2022; 79:898-905. [PMID: 35272495 PMCID: PMC9010372 DOI: 10.1161/hypertensionaha.121.17949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Sub-Saharan Africa (SSA) has the highest age-adjusted burden of hypertension and cardiovascular disease (CVD). SSA also experiences many viral infections due to unique environmental and societal factors. The purpose of this narrative review is to examine evidence around how hypertension, CVD, and emerging viral infections interact in SSA. METHODS In September 2021, we conducted a search in MEDLINE, Embase, and Scopus, limited to English language studies published since 1990, and found a total of 1169 articles. Forty-seven original studies were included, with 32 on COVID-19 and 15 on other emerging viruses. RESULTS Seven articles, including those with the largest sample size and most robust study design, found an association between preexisting hypertension or CVD and COVID-19 severity or death. Ten smaller studies found no association, and 17 did not calculate statistics to compare groups. Two studies assessed the impact of COVID-19 on incident CVD, with one finding an increase in stroke admissions. For other emerging viruses, 3 studies did not find an association between preexisting hypertension or CVD on West Nile and Lassa fever mortality. Twelve studies examined other emerging viral infections and incident CVD, with 4 finding no association and 8 not calculating statistics. CONCLUSIONS Growing evidence from COVID-19 suggests viruses, hypertension, and CVD interact on multiple levels in SSA, but research gaps remain especially for other emerging viral infections. SSA can and must play a leading role in the study and control of emerging viral infections, with expansion of research and public health infrastructure to address these interactions.
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Affiliation(s)
- Lily D Yan
- Center for Global Health and Division of General Internal Medicine, Weill Cornell Medicine, New York, NY, USA
| | - Sarah S Matuja
- Department of Medicine, Weill Bugando School of Medicine, Mwanza, Tanzania
| | - Kevin J Pain
- Samuel J. Wood Library and C. V. Starr Biomedical Information Center, Weill Cornell Medicine, New York, NY, USA
| | - Margaret L McNairy
- Center for Global Health and Division of General Internal Medicine, Weill Cornell Medicine, New York, NY, USA
| | | | - Robert N Peck
- Center for Global Health and Division of General Internal Medicine, Weill Cornell Medicine, New York, NY, USA
- Department of Medicine, Weill Bugando School of Medicine, Mwanza, Tanzania
- Mwanza Interventions Trial Unit, Mwanza, Tanzania
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31
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Gebremichael B, Haile D, Biadgilign S. Population vitamin D status might be related to COVID-19 mortality but not with infection rate in Africa: evidence from ecological analysis. Pan Afr Med J 2022; 41:249. [PMID: 35734324 PMCID: PMC9187979 DOI: 10.11604/pamj.2022.41.249.29619] [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: 05/02/2021] [Accepted: 03/21/2022] [Indexed: 11/11/2022] Open
Abstract
Introduction there is a large body of literature that has linked vitamin D status in the population with COVID-19 infection risk and disease severity. However, there is paucity of evidence in African context. Hence, this study aimed to conduct an ecological analysis to explore correlation between population level vitamin D status, COVID-19 infection, and mortality in Africa. Methods an ecological study was conducted using data from different open sources, published literatures and organizational databases. In the final analysis, we included 23 African countries which had data on prevalence of vitamin D deficiency, population level mean serum 25 (OH) D concentrations and COVID-19 data. We employed spearman correlation and linear regression. All tests were two-sided, and P- value <0.05 was considered statistically significant. Results based on our analysis, the prevalence of vitamin D deficiency is positively correlated (r=0.6265; p= 0.0094) while mean 25(OH) D concentration is negatively correlated (r=-0.4941; p= 0.0194) with COVID-19 mortality. In addition, the median age of the national population (r=0.7015; p= 0.0003), prevalence of current use of tobacco (r=0.6071; p= 0.0075) and prevalence of obesity among adult population (r=0.7143; p= 0.0003) were positively correlated with both COVID-19 infection and mortality in Africa. Nonetheless, vitamin D status was not positively correlated with observed case fatality rate and COVID-19 infection rate. Conclusion population vitamin D status might be related to COVID-19 mortality but not with infection rate in Africa. Due to the increasing weight of evidence that shows a link between COVID-19 and vitamin D, we strongly recommend well-designed controlled studies to explore causality and clinical trials to find out the effect of vitamin-D supplementation in the treatment and prevention of COVID-19 in African settings.
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Affiliation(s)
| | - Demewoz Haile
- College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Sibhatu Biadgilign
- Public Health Nutrition Research Consultant, Addis Ababa, Ethiopia,Corresponding author: Sibhatu Biadgilign, Public Health Nutrition Research Consultant, Addis Ababa, Ethiopia.
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Liu H. Official social media and its impact on public behavior during the first wave of COVID-19 in China. BMC Public Health 2022; 22:428. [PMID: 35241057 PMCID: PMC8893355 DOI: 10.1186/s12889-022-12803-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 02/17/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND During the COVID-19 pandemic, official social media became a critical channel for the public to obtain pandemic information. No matter the positive function or negative effect of information dissemination, it involves the public's risk perception and behavior. This study was designed to contribute to the existing research on how official social media information quality (IQ) and risk perception (RP) affect preventive behavior (PB) and continued use behavior (CB) of official social media during the first wave of COVID-19. METHODS The required data were extracted from a national online survey of the Chinese Mainland during March 24-30 2020, a random sample was asked to participate in the survey (n = 666). Data analysis was performed using regression analysis, structural equation modeling, mediating effect analysis, and one-way ANOVA analysis. RESULTS The results show that IQ (10.010 ± 3.568) has direct and indirect positive impact on PB (9.475 ± 3.571), and has a low significant positive indirect impact on CB (3.739 ± 1.566). The IQ has a significant positive impact on RP (β = 0.548), which show that there is no "risk perception paradox" in COVID-19. Furth more, this study also provides new evidence indicating that RP mediates the relationship between IQ and PB. According to the region, gender, age and annual income, and there are significant differences in PB and CB. CONCLUSION The study findings have remarkable implications for improving the information quality and public behaviors. Too high or too low level of risk perception is not conducive to pandemic prevention and control. Official social media should indirectly affect information flow through the reasonable supply of pandemic information and constantly improve the quality of pandemic information to avoid public's undue panic and excessive health concerns during this ongoing outbreak and subsequent national public emergency events.
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Affiliation(s)
- Huan Liu
- School of Journalism and New Media, Xi'an Jiaotong University, Xi'an, China.
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Alhowaymel F, Abdelmalik MA, Mohammed AM, Mohamaed MO, Alenezi A. Reported Side Effects of COVID-19 Vaccination among Adults in Saudi Arabia: A Cross-Sectional Study. SAGE Open Nurs 2022; 8:23779608221103208. [PMID: 35694214 PMCID: PMC9178992 DOI: 10.1177/23779608221103208] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 04/25/2022] [Accepted: 05/08/2022] [Indexed: 12/15/2022] Open
Abstract
Background The coronavirus disease 2019 (COVID-19) pandemic, caused by the severe acute respiratory syndrome coronavirus 2, is a major international crisis. Although vaccination is the only hope to end this pandemic, adverse effects attributable to vaccines are still being reported. Active surveillance is critical for generating near-real-time, high-quality evidence for potential safety hazards, allowing us to respond quickly to vaccination Purpose To investigate the prevalence of side effects following COVID-19 vaccination with Oxford–AstraZeneca among adults in northwestern Riyadh Province, Saudi Arabia. Methods This is a cross-sectional and community-based study performed among individuals who had received any type of COVID-19 vaccination. A convenience sampling method was used to collect data using an online survey. Results A total of 222 individuals responded to the survey, and the majority frequently reported both localized and systemic side effects after vaccination. The most reported side effects include pain at the site of injection, myalgia, headache, and fever. Some demographic factors were significantly associated with the reported post-vaccination side effects. Conclusion The most prevalent side effects experienced by individuals after receiving the COVID-19 vaccine were determined in this study. Prior to the administration of a vaccination, counseling programs should be established to help people understand and deal with the possible side effects, with a special focus on demographic differences.
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Affiliation(s)
- Fahad Alhowaymel
- Department of Nursing, College of Applied Medical Sciences, Shaqra University, Shaqra, Saudi Arabia
| | - Mohammed A. Abdelmalik
- Department of Nursing, College of Applied Medical Sciences, Shaqra University, Shaqra, Saudi Arabia
- Faculty of Nursing, University of ELImam EL Mhadai, Kosti City, Sudan
| | - Almoez M. Mohammed
- Department of Nursing, College of Applied Medical Sciences, Shaqra University, Shaqra, Saudi Arabia
- University of Sinnar, Sinnar City, Sudan
| | - Mohamaed O. Mohamaed
- Department of Nursing, College of Applied Medical Sciences, Shaqra University, Shaqra, Saudi Arabia
| | - Atallah Alenezi
- Department of Nursing, College of Applied Medical Sciences, Shaqra University, Shaqra, Saudi Arabia
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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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35
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Libório MP, Ekel PY, de Abreu JF, Laudares S. Factors that most expose countries to COVID-19: a composite indicators-based approach. GEOJOURNAL 2022; 87:5435-5449. [PMID: 34873361 PMCID: PMC8636286 DOI: 10.1007/s10708-021-10557-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/17/2021] [Indexed: 05/04/2023]
Abstract
Studies carried out in different countries correlate social, economic, environmental, and health factors with the number of cases and deaths from COVID-19. However, such studies do not reveal which factors make one country more exposed to COVID-19 than other. Based on the composite indicators approach, this research identifies the factors that most impact the number of cases and deaths of COVID-19 worldwide and measures countries' exposure to COVID-19. Three composite indicators of exposure to COVID-19 were constructed through Principal Component Analysis, Simple Additive Weighting, and k-means clustering. The number of cases and deaths from COVID-19 is strongly correlated ( R > 0.60) with composite indicator scores and moderately concordant ( K > 0.4) with country clusters. Factors directly or indirectly associated with the age of the population are the ones that most expose countries to COVID-19. The population of countries most exposed to COVID-19 is 12 years older on average. The proportion of the elderly population in these countries is at least twice that of countries less exposed to COVID-19. Factors that can increase the population's life expectancy, such as Gross Domestic Product per capita and the Human Development Index, are four times and 1.3 times higher in more exposed countries to COVID-19. Providing better living conditions increases both the population's life expectancy and the country's exposure to COVID-19.
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Affiliation(s)
| | | | | | - Sandro Laudares
- Pontifical Catholic University of Minas Gerais, Belo Horizonte, 30535-012 Brazil
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36
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Moyo I, Mgolozeli SE, Risenga PR, Mboweni SH, Tshivhase L, Mudau TS, Ndou ND, Mavhandu-Mudzusi AH. Experiences of Nurse Managers during the COVID-19 Outbreak in a Selected District Hospital in Limpopo Province, South Africa. Healthcare (Basel) 2021; 10:healthcare10010076. [PMID: 35052240 PMCID: PMC8775488 DOI: 10.3390/healthcare10010076] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 12/22/2021] [Accepted: 12/27/2021] [Indexed: 11/16/2022] Open
Abstract
The South African health care system was hard hit by the second wave of Coronavirus disease (COVID-19), which affected nurse managers as healthcare facilities became overwhelmed due to an increased workload emanating from the overflow of admissions. Therefore, this study sought to explore and describe the nurse managers’ experiences during COVID-19 in order to identify gaps and lessons learnt. A descriptive phenomenological research approach was used to explore the experiences of ten nurse managers who were purposively selected from different units of a selected district hospital. Data was collected through telephonic unstructured individual interviews and analysed using Colaizzi’s seven steps method. The study revealed that nurse managers experienced human resource related challenges during COVID-19, worsened by the fact that vacant posts were frozen. It also emerged that there was a shortage of material resources that affected patient care. Nurse managers also indicated that COVID-19 brought a lot of administrative duties plus an additional duty of patient care. Also, nurse managers who had previously contracted COVID-19 experienced stigma and discrimination. The government needs to address resource related challenges in rural public hospitals and provide continuous support to nurse managers, particularly during a pandemic like COVID-19.
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Affiliation(s)
- Idah Moyo
- Department of Health Studies, School of Social Sciences, College of Human Sciences, University of South Africa, Preller Street, Muckleneuk Ridge, Pretoria 0002, South Africa; (S.E.M.); (P.R.R.); (S.H.M.); (A.H.M.-M.)
- HIV Services, Population Services International Zimbabwe, Emerald Office Park, 30 The Chase, Harare, Zimbabwe
- Correspondence: ; Tel.: +263-776-306-719
| | - Siyabulela Eric Mgolozeli
- Department of Health Studies, School of Social Sciences, College of Human Sciences, University of South Africa, Preller Street, Muckleneuk Ridge, Pretoria 0002, South Africa; (S.E.M.); (P.R.R.); (S.H.M.); (A.H.M.-M.)
| | - Patrone Rebecca Risenga
- Department of Health Studies, School of Social Sciences, College of Human Sciences, University of South Africa, Preller Street, Muckleneuk Ridge, Pretoria 0002, South Africa; (S.E.M.); (P.R.R.); (S.H.M.); (A.H.M.-M.)
| | - Sheilla Hlamalani Mboweni
- Department of Health Studies, School of Social Sciences, College of Human Sciences, University of South Africa, Preller Street, Muckleneuk Ridge, Pretoria 0002, South Africa; (S.E.M.); (P.R.R.); (S.H.M.); (A.H.M.-M.)
| | - Livhuwani Tshivhase
- Department of Nursing Science, School of Health Care Sciences, Sefako Makgatho Health Sciences University, Molotlegi Street, Ga-Rankuwa, Pretoria 0204, South Africa; (L.T.); (T.S.M.)
| | - Tshimangadzo Selina Mudau
- Department of Nursing Science, School of Health Care Sciences, Sefako Makgatho Health Sciences University, Molotlegi Street, Ga-Rankuwa, Pretoria 0204, South Africa; (L.T.); (T.S.M.)
| | - Nthomeni Dorah Ndou
- Department of Advanced Nursing Science, Faculty of Health Sciences, University of Venda, University Road, Thohoyandou 0950, South Africa;
| | - Azwihangwisi Helen Mavhandu-Mudzusi
- Department of Health Studies, School of Social Sciences, College of Human Sciences, University of South Africa, Preller Street, Muckleneuk Ridge, Pretoria 0002, South Africa; (S.E.M.); (P.R.R.); (S.H.M.); (A.H.M.-M.)
- Office of Graduate Studies and Research, College of Human Sciences, University of South Africa, Preller Street, Muckleneuk Ridge, Pretoria 0002, South Africa
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Hamdan M, Badrasawi M, Zidan S, Sayarah A, Zahra LA, Dana S, Almasry T. Risk factors associated with hospitalization owing to COVID-19: a cross-sectional study in Palestine. J Int Med Res 2021; 49:3000605211064405. [PMID: 34939466 PMCID: PMC8721739 DOI: 10.1177/03000605211064405] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 11/16/2021] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVES We aimed to identify the risk factors for coronavirus disease 2019 (COVID-19)-associated hospitalization to provide evidence for improved clinical care of patients with COVID-19 infection. METHODS We conducted a cross-sectional study among 300 participants. The collected data comprised sociodemographic data, lifestyle habits, physical activity, medical history, anthropometric measurements, COVID-19-related symptoms, dietary habits prior to and after COVID-19 infection, and psychological status. RESULTS Fifty-nine participants were hospitalized. Fever, dry cough, joint pain, chills, diarrhea, and shortness of breath were significantly associated with hospitalization owing to COVID-19. Adults with obesity, diabetes mellitus, hypertension, respiratory diseases, and cardiovascular diseases had higher rates of hospitalization. The findings also showed that residential area and age were related to COVID-19 hospitalization. Furthermore, our analysis revealed that certain dietary habits were associated with hospitalization rates. CONCLUSION Our study confirmed that older age, urban residence, illiteracy, obesity, hypertension, diabetes mellitus, respiratory diseases, cardiovascular diseases, and symptoms of loss of smell and sneezing elevated the risk of hospitalization among patients with COVID-19 infection. Patients with a higher risk of hospitalization may benefit from targeted therapeutic and preventive interventions.
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Affiliation(s)
- May Hamdan
- Program of Health and Therapeutic Nutrition, College of Medicine and Health Sciences, Palestine Polytechnic University, Hebron, Palestine
| | - Manal Badrasawi
- Department of Nutrition and Food Technology, Faculty of Agriculture and Veterinary Medicine, An-Najah National University, Nablus, West Bank, Palestine
| | - Souzan Zidan
- Department of Nutrition and Food Technology, Faculty of Agriculture, Hebron University, Hebron, West Bank, Palestine
| | - Asma Sayarah
- Program of Health and Therapeutic Nutrition, College of Medicine and Health Sciences, Palestine Polytechnic University, Hebron, Palestine
| | - Lamia Abu Zahra
- Program of Health and Therapeutic Nutrition, College of Medicine and Health Sciences, Palestine Polytechnic University, Hebron, Palestine
| | - Shahd Dana
- Program of Health and Therapeutic Nutrition, College of Medicine and Health Sciences, Palestine Polytechnic University, Hebron, Palestine
| | - Tasneem Almasry
- Program of Health and Therapeutic Nutrition, College of Medicine and Health Sciences, Palestine Polytechnic University, Hebron, Palestine
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Asiri AM, Alomary SA, Alqahtani SA, Adam IF, Amer SA. Determinants of the Underlying Causes of Mortality during the First Wave of COVID-19 Pandemic in Saudi Arabia: A Descriptive National Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312647. [PMID: 34886379 PMCID: PMC8657172 DOI: 10.3390/ijerph182312647] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Revised: 11/17/2021] [Accepted: 11/18/2021] [Indexed: 12/20/2022]
Abstract
Since the emergence of the COVID-19 pandemic, the mortality statistics are constantly changing globally. Mortality statistics analysis has vital implications to implement evidence-based policy recommendations. This study aims to study the demographic characteristics, patterns, determinants, and the main causes of death during the first half of 2020, in the Kingdom of Saudi Arabia (KSA). Methodology: A retrospective descriptive study targeted all death (29,291) registered in 286 private and governmental health settings, from all over KSA. The data was extracted from the ministry of health’s death records after the ethical approval. The International Classification of Diseases (ICD-10) and WHO grouping, were used to classify the underlying causes of deaths. The collected data were analyzed using the appropriate tables and graphs. Results: 7055 (24.9%) died at the middle age (40–59 year), and 19,212 (65.6%) were males, and 18,110 (61.8%) were Saudi. The leading causes of deaths were non-communicable diseases (NCDs) 15,340 (62.1%), mainly Cardiovascular diseases (CVDs) 10,103 (34.5%). There was a significant relationship between the main causes of deaths and sex (p < 0.05) and nationality (p = 0.01). Conclusion: NCDs mainly CVDs are the leading cause of death. The COVID-19 mortalities were mainly in males, and old age > 55 year. The lockdown was associated with a reduction in the NCDs and Road traffic accidents mortalities.
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Affiliation(s)
- Abdullah M. Asiri
- Department of Infectious Diseases, Preventive Health, Ministry of Health, Riyadh 11176, Saudi Arabia;
| | - Shaker A. Alomary
- Department of Health Programs and Chronic Diseases, Ministry of Health, Riyadh 11176, Saudi Arabia; (S.A.A.); (S.A.A.); (I.F.A.)
| | - Saeed A. Alqahtani
- Department of Health Programs and Chronic Diseases, Ministry of Health, Riyadh 11176, Saudi Arabia; (S.A.A.); (S.A.A.); (I.F.A.)
| | - Izzeldin F. Adam
- Department of Health Programs and Chronic Diseases, Ministry of Health, Riyadh 11176, Saudi Arabia; (S.A.A.); (S.A.A.); (I.F.A.)
- Department of Epidemiology, University of Khartoum, Khartoum 11115, Sudan
| | - Samar A. Amer
- Department of Health Programs and Chronic Diseases, Ministry of Health, Riyadh 11176, Saudi Arabia; (S.A.A.); (S.A.A.); (I.F.A.)
- Department of Public Health and Community Medicine, Zagazig University, Zagazig 44519, Egypt
- Correspondence:
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Wood S, Harrison SE, Judd N, Bellis MA, Hughes K, Jones A. The impact of behavioural risk factors on communicable diseases: a systematic review of reviews. BMC Public Health 2021; 21:2110. [PMID: 34789209 PMCID: PMC8596356 DOI: 10.1186/s12889-021-12148-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 10/22/2021] [Indexed: 12/24/2022] Open
Abstract
Background The coronavirus (COVID-19) pandemic has highlighted that individuals with behavioural risk factors commonly associated with non-communicable diseases (NCDs), such as smoking, harmful alcohol use, obesity, and physical inactivity, are more likely to experience severe symptoms from COVID-19. These risk factors have been shown to increase the risk of NCDs, but less is known about their broader influence on communicable diseases. Taking a wide focus on a range of common communicable diseases, this review aimed to synthesise research examining the impact of behavioural risk factors commonly associated with NCDs on risks of contracting, or having more severe outcomes from, communicable diseases. Methods Literature searches identified systematic reviews and meta-analyses that examined the association between behavioural risk factors (alcohol, smoking, illicit drug use, physical inactivity, obesity and poor diet) and the contraction/severity of common communicable diseases, including infection or associated pathogens. An a priori, prospectively registered protocol was followed (PROSPERO; registration number CRD42020223890). Results Fifty-three systematic reviews were included, of which 36 were also meta-analyses. Reviews focused on: tuberculosis, human immunodeficiency virus, hepatitis C virus, hepatitis B virus, invasive bacterial diseases, pneumonia, influenza, and COVID-19. Twenty-one reviews examined the association between behavioural risk factors and communicable disease contraction and 35 examined their association with communicable disease outcomes (three examined their association with both contraction and outcomes). Fifty out of 53 reviews (94%) concluded that at least one of the behavioural risk factors studied increased the risk of contracting or experiencing worse health outcomes from a communicable disease. Across all reviews, effect sizes, where calculated, ranged from 0.83 to 8.22. Conclusions Behavioural risk factors play a significant role in the risk of contracting and experiencing more severe outcomes from communicable diseases. Prevention of communicable diseases is likely to be most successful if it involves the prevention of behavioural risk factors commonly associated with NCDs. These findings are important for understanding risks associated with communicable disease, and timely, given the COVID-19 pandemic and the need for improvements in future pandemic preparedness. Addressing behavioural risk factors should be an important part of work to build resilience against any emerging and future epidemics and pandemics. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-12148-y.
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Affiliation(s)
- Sara Wood
- Policy and International Health, World Health Organization Collaborating Centre on Investment for Health and Well-being, Public Health Wales, Wrexham, UK
| | - Sophie E Harrison
- Public Health Collaborating Unit, School of Medical and Health Sciences, Bangor University, Wrexham, UK.,Institute for Applied Human Physiology, School of Human and Behavioural Sciences, Bangor University, Bangor, UK
| | - Natasha Judd
- Policy and International Health, World Health Organization Collaborating Centre on Investment for Health and Well-being, Public Health Wales, Wrexham, UK.,Public Health Collaborating Unit, School of Medical and Health Sciences, Bangor University, Wrexham, UK
| | - Mark A Bellis
- Policy and International Health, World Health Organization Collaborating Centre on Investment for Health and Well-being, Public Health Wales, Wrexham, UK. .,Public Health Collaborating Unit, School of Medical and Health Sciences, Bangor University, Wrexham, UK.
| | - Karen Hughes
- Policy and International Health, World Health Organization Collaborating Centre on Investment for Health and Well-being, Public Health Wales, Wrexham, UK.,Public Health Collaborating Unit, School of Medical and Health Sciences, Bangor University, Wrexham, UK
| | - Andrew Jones
- Health Protection and Screening Services, Public Health Wales, Cardiff, UK
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Cuschieri S, Grech S, Grech V. Insight into the Attitudes and Experiences of Adults with Non-Communicable Diseases a Year into the COVID-19 Pandemic: The Malta Experience. DUBAI MEDICAL JOURNAL 2021. [PMCID: PMC8678259 DOI: 10.1159/000519570] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Introduction Non-communicable diseases (NCDs) have been a global epidemic long before the advent of COVID-19. Understandably, with the onset of COVID-19, health priorities shifted. The aim of this study was to explore the impact of COVID-19 through attitudes and experiences on the health and well-being of the Malta adult population suffering from NCDs, a year into COVID-19. Methods An anonymous survey was distributed online between February 1 and 26, 2021 using Google Forms®. This assessed the impact of COVID-19 on medical care, intention to take a COVID-19 vaccine, and whether COVID-19 was acquired. Quantitative and qualitative analyses were performed. Results Out of the 1,034 participants, 34.82% (95% CI, 31.97–37.77; n = 360) reported to suffer from NCDs (single NCD, n = 276; 2 NCDs, n = 56; 3 NCDs, n = 28) with 6.94% (95% CI, 4.71–10.09) of these reported acquiring COVID-19. Since COVID-19, the NCD population visited the general practitioners less (47%) than those without NCDs (32%) (p ≤ 0.001). With a consensus of concern and fear, “I rather skip check-ups than risk getting COVID-19 in waiting room or clinic.” Postponement and cancellations of medical appointments were reported: “had to do blood tests privately as health centre was not doing them” and “delayed treatment and still awaiting further appointments that were postponed more than once.” The majority intended to take COVID-19 vaccine. Conclusions It is clear that individuals with NCDs have experienced a general negative effect on their medical care. It's recommended that a dual action strategy is embraced to ensure that both NCDs and COVID-19 are treated simultaneously, leaving no one behind.
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Affiliation(s)
- Sarah Cuschieri
- Anatomy Department, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
- *Sarah Cuschieri,
| | - Stephan Grech
- Trauma and Orthopaedic Department, Mater Dei Hospital, Msida, Malta
| | - Victor Grech
- Paediatric Department, Mater Dei Hospital, Msida, Malta
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Cuschieri S, Mamo J. Taking care of the ordinary in extraordinary times-delayed routine care means more morbidity and pre-mature mortality. Eur J Public Health 2021; 31:iv27-iv30. [PMID: 34751363 PMCID: PMC8576302 DOI: 10.1093/eurpub/ckab156] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Individuals with chronic diseases are more susceptible to its grave complications and negative outcomes if infected by COVID-19. Furthermore, mandatory isolation and cancellations of routine healthcare services led to the disruption of the screening and management plans for chronic diseases. Fear of attending health services as well as disruptions to public transport are other factors increasing health risks among persons with chronic conditions during the pandemic. Ensuring access to universal healthcare services, increasing use of digital services, targeted interventions to risk groups are examples of measures that need to be taken when reviewing health systems preparedness for future pandemics and other disasters.
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Affiliation(s)
- Sarah Cuschieri
- Faculty of Medicine and Surgery, University of Malta, Msida, Malta
| | - Julian Mamo
- Faculty of Medicine and Surgery, University of Malta, Msida, Malta
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Telehealth in low- and middle-income countries: Bridging the gap or exposing health disparities? HEALTH POLICY AND TECHNOLOGY 2021; 10:100577. [PMID: 34745854 PMCID: PMC8561751 DOI: 10.1016/j.hlpt.2021.100577] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 09/27/2021] [Accepted: 10/31/2021] [Indexed: 10/31/2022]
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Yassi N, Hayward KS, Campbell BCV, Churilov L. Use of the Estimand Framework to Manage the Disruptive Effects of COVID-19 on Stroke Clinical Trials. Stroke 2021; 52:3739-3747. [PMID: 34587797 PMCID: PMC8547578 DOI: 10.1161/strokeaha.121.036537] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has presented unique challenges to stroke care and research internationally. In particular, clinical trials in stroke are vulnerable to the impacts of the pandemic at multiple stages, including design, recruitment, intervention, follow-up, and interpretation of outcomes. A carefully considered approach is required to ensure the appropriate conduct of stroke trials during the pandemic and to maintain patient and participant safety. This has been recently addressed by the International Council for Harmonisation which, in November 2019, released an addendum to the Statistical Principles for Clinical Trials guidelines entitled Estimands and Sensitivity Analysis in Clinical Trials. In this article, we present the International Council for Harmonisation estimand framework for the design and conduct of clinical trials, with a specific focus on its application to stroke clinical trials. This framework aims to align the clinical and scientific objectives of a trial with its design and end points. It also encourages the prospective consideration of potential postrandomization intercurrent events which may occur during a trial and either impact the ability to measure an end point or its interpretation. We describe the different categories of such events and the proposed strategies for dealing with them, specifically focusing on the COVID-19 pandemic as a source of intercurrent events. We also describe potential practical impacts posed by the COVID-19 pandemic on trials, health systems, study groups, and participants, all of which should be carefully reviewed by investigators to ensure an adequate practical and statistical strategy is in place to protect trial integrity. We provide examples of the implementation of the estimand framework within hypothetical stroke trials in intracerebral hemorrhage and stroke recovery. While the focus of this article is on COVID-19 impacts, the strategies and principles proposed are well suited for other potential events or issues, which may impact clinical trials in the field of stroke.
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Affiliation(s)
- Nawaf Yassi
- Departments of Medicine and Neurology, Melbourne Brain Centre, The Royal Melbourne Hospital (N.Y., B.C.V.C., L.C.), University of Melbourne, Parkville, Australia
- Population Health and Immunity Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, Australia (N.Y.)
| | - Kathryn S Hayward
- Department of Physiotherapy, Melbourne School of Health Sciences (K.S.H.), University of Melbourne, Parkville, Australia
- Florey Institute of Neuroscience and Mental Health, Parkville, Australia (K.S.H., B.C.V.C.)
| | - Bruce C V Campbell
- Departments of Medicine and Neurology, Melbourne Brain Centre, The Royal Melbourne Hospital (N.Y., B.C.V.C., L.C.), University of Melbourne, Parkville, Australia
- Florey Institute of Neuroscience and Mental Health, Parkville, Australia (K.S.H., B.C.V.C.)
| | - Leonid Churilov
- Departments of Medicine and Neurology, Melbourne Brain Centre, The Royal Melbourne Hospital (N.Y., B.C.V.C., L.C.), University of Melbourne, Parkville, Australia
- Melbourne Medical School (L.C.), University of Melbourne, Parkville, Australia
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Zhang F, Karamagi H, Nsenga N, Nanyunja M, Karinja M, Amanfo S, Chase-Topping M, Calder-Gerver G, McGibbon M, Huber A, Wagner-Gamble T, Guo CG, Haynes S, Morrison A, Ferguson M, Awandare GA, Mutapi F, Yoti Z, Cabore J, Moeti MR, Woolhouse MEJ. Predictors of COVID-19 epidemics in countries of the World Health Organization African Region. Nat Med 2021; 27:2041-2047. [PMID: 34480125 PMCID: PMC8604723 DOI: 10.1038/s41591-021-01491-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 08/05/2021] [Indexed: 11/20/2022]
Abstract
Countries of the World Health Organization (WHO) African Region have experienced a wide range of coronavirus disease 2019 (COVID-19) epidemics. This study aimed to identify predictors of the timing of the first COVID-19 case and the per capita mortality in WHO African Region countries during the first and second pandemic waves and to test for associations with the preparedness of health systems and government pandemic responses. Using a region-wide, country-based observational study, we found that the first case was detected earlier in countries with more urban populations, higher international connectivity and greater COVID-19 test capacity but later in island nations. Predictors of a high first wave per capita mortality rate included a more urban population, higher pre-pandemic international connectivity and a higher prevalence of HIV. Countries rated as better prepared and having more resilient health systems were worst affected by the disease, the imposition of restrictions or both, making any benefit of more stringent countermeasures difficult to detect. Predictors for the second wave were similar to the first. Second wave per capita mortality could be predicted from that of the first wave. The COVID-19 pandemic highlights unanticipated vulnerabilities to infectious disease in Africa that should be taken into account in future pandemic preparedness planning.
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Affiliation(s)
- Feifei Zhang
- Usher Institute, University of Edinburgh, Edinburgh, United Kingdom.
| | | | - Ngoy Nsenga
- WHO Regional Office for Africa, Brazzaville, Republic of Congo
| | - Miriam Nanyunja
- WHO Regional Office for Africa, Brazzaville, Republic of Congo
| | - Miriam Karinja
- University of Nairobi Institute of Tropical and Infectious Diseases, Nairobi, Kenya
| | - Seth Amanfo
- Usher Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Margo Chase-Topping
- School of Biological Sciences, University of Edinburgh, Edinburgh, United Kingdom
- Roslin Institute and Royal (Dick) School of Veterinary Studies, University of Edinburgh, Edinburgh, United Kingdom
| | | | - Miles McGibbon
- Usher Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Alexandra Huber
- Usher Institute, University of Edinburgh, Edinburgh, United Kingdom
| | | | - Chuan-Guo Guo
- Department of Medicine, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China
| | - Samuel Haynes
- School of Biological Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | | | - Miranda Ferguson
- Usher Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Gordon A Awandare
- West African Centre for Cell Biology of Infectious Pathogens, University of Ghana, Accra, Ghana
| | - Francisca Mutapi
- School of Biological Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Zabulon Yoti
- WHO Regional Office for Africa, Brazzaville, Republic of Congo
| | - Joseph Cabore
- WHO Regional Office for Africa, Brazzaville, Republic of Congo
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Yadav S, Yadav PK, Yadav N. Impact of COVID-19 on life expectancy at birth in India: a decomposition analysis. BMC Public Health 2021; 21:1906. [PMID: 34670537 PMCID: PMC8528662 DOI: 10.1186/s12889-021-11690-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 08/30/2021] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Quantifying excess deaths and their impact on life expectancy at birth (e0) provide a more comprehensive understanding of the burden of coronavirus disease of 2019 (COVID-19) on mortality. The study aims to comprehend the repercussions of the burden of COVID-19 disease on the life expectancy at birth and inequality in age at death in India. METHODS The mortality schedule of COVID-19 disease in the pandemic year 2020 was considered one of the causes of death in the category of other infectious diseases in addition to other 21 causes of death in the non-pandemic year 2019 in the Global Burden of Disease (GBD) data. The measures e0 and Gini coefficient at age zero (G0) and then sex differences in e0 and G0 over time were analysed by assessing the age-specific contributions based on the application of decomposition analyses in the entire period of 2010-2020. RESULTS The e0 for men and women decline from 69.5 and 72.0 years in 2019 to 67.5 and 69.8 years, respectively, in 2020. The e0 shows a drop of approximately 2.0 years in 2020 when compared to 2019. The sex differences in e0 and G0 are negatively skewed towards men. The trends in e0 and G0 value reveal that its value in 2020 is comparable to that in the early 2010s. The age group of 35-79 years showed a remarkable negative contribution to Δe0 and ΔG0. By causes of death, the COVID-19 disease has contributed - 1.5 and - 9.5%, respectively, whereas cardiovascular diseases contributed the largest value of was 44.6 and 45.9%, respectively, to sex differences in e0 and G0 in 2020. The outcomes reveal a significant impact of excess deaths caused by the COVID-19 disease on mortality patterns. CONCLUSIONS The COVID-19 pandemic has negative repercussions on e0 and G0 in the pandemic year 2020. It has severely affected the distribution of age at death in India, resulting in widening the sex differences in e0 and G0. The COVID-19 disease demonstrates its potential to cancel the gains of six to eight years in e0 and five years in G0 and has slowed the mortality transition in India.
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Affiliation(s)
- Suryakant Yadav
- Department of Development Studies, International Institute for Population Sciences (IIPS), Mumbai, 400088, India.
| | - Pawan Kumar Yadav
- Department of Development Studies, International Institute for Population Sciences (IIPS), Mumbai, 400088, India
| | - Neha Yadav
- Centre of Social Medicine and Community Health, Jawaharlal Nehru University (JNU), New Delhi, 110067, India
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Udoakang A, Oboh M, Henry-Ajala A, Anyigba C, Omoleke S, Amambua-Ngwa A, Paemka L, Awandare G, Quashie P. Low COVID-19 impact in Africa: The multifactorial Nexus. AAS Open Res 2021. [DOI: 10.12688/aasopenres.13261.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Africa has defied predictions of being the worst hit by the novel coronavirus disease (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, which has devastated Europe, the Americas, and some Asian countries. However, with a current second and third wave of the COVID-19 pandemic across other continents, pertinent questions have arisen regarding the lower disease severity and seemingly better outcomes in most African countries. Several factors have been proposed as discussed in this review including, underreporting, quick lockdown measures, effective public health intervention, younger population structure, cross-immunity and experience from fighting previous epidemics, such as the Ebola virus outbreak, previous infections or vaccinations, genetic predisposition, and tropical climate. We have discussed the implications of these factors on the magnitude of the outbreak and the better-than-expected outcomes observed in Africa. In addition, other potential factors like vitamin-D deficiency and chronic non-communicable diseases could predispose non-African regions to severe COVID-19 outcome. Therefore, this review further advocates for research to understand the precise mechanisms responsible for the pandemic’s relatively mild impact in Africa and proposed recommendations to prevent an infection surge.
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Sasanejad P, Afshar Hezarkhani L, Arsang-Jang S, Tsivgoulis G, Ghoreishi A, Kristian B, Rahmig J, Farhoudi M, Sadeghi Hokmabadi E, Borhani-Haghighi A, Sariaslani P, Sharifi-Razavi A, Ghandehari K, Khosravi A, Smith C, Nilanont Y, Akbari Y, Nguyen TN, Bersano A, Yassi N, Yoshimoto T, Lattanzi S, Gupta A, Zand R, Rafie S, Pourandokht Mousavian S, Reza Shahsavaripour M, Amini S, Kamenova SU, Kondybayeva A, Zhanuzakov M, Macri EM, Nobleza COS, Ruland S, Cervantes-Arslanian AM, Desai MJ, Ranta A, Moghadam Ahmadi A, Rostamihosseinkhani M, Foroughi R, Hooshmandi E, Akhoundi FH, Shuaib A, Liebeskind DS, Siegler J, Romano JG, Mayer SA, Bavarsad Shahripour R, Zamani B, Woolsey A, Fazli Y, Mojtaba K, Isaac CF, Biller J, Di Napoli M, Azarpazhooh MR. Safety and Outcomes of Intravenous Thrombolytic Therapy in Ischemic Stroke Patients with COVID-19: CASCADE Initiative. J Stroke Cerebrovasc Dis 2021; 30:106121. [PMID: 34601242 PMCID: PMC8450304 DOI: 10.1016/j.jstrokecerebrovasdis.2021.106121] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 09/09/2021] [Accepted: 09/13/2021] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND There is little information regarding the safety of intravenous tissue plasminogen activator (IV-tPA) in patients with stroke and COVID-19. METHODS This multicenter study included consecutive stroke patients with and without COVID-19 treated with IV-tPA between February 18, 2019, to December 31, 2020, at 9 centers participating in the CASCADE initiative. Clinical outcomes included modified Rankin Scale (mRS) at hospital discharge, in-hospital mortality, the rate of hemorrhagic transformation. Using Bayesian multiple regression and after adjusting for variables with significant value in univariable analysis, we reported the posterior adjusted odds ratio (OR, with 95% Credible Intervals [CrI]) of the main outcomes. RESULTS A total of 545 stroke patients, including 101 patients with COVID-19 were evaluated. Patients with COVID-19 had a more severe stroke at admission. In the study cohort, 85 (15.9%) patients had a hemorrhagic transformation, and 72 (13.1%) died in the hospital. After adjustment for confounding variables, discharge mRS score ≥2 (OR: 0.73, 95% CrI: 0.16, 3.05), in-hospital mortality (OR: 2.06, 95% CrI: 0.76, 5.53), and hemorrhagic transformation (OR: 1.514, 95% CrI: 0.66, 3.31) were similar in COVID-19 and non COVID-19 patients. High-sensitivity C reactive protein level was a predictor of hemorrhagic transformation in all cases (OR:1.01, 95%CI: 1.0026, 1.018), including those with COVID-19 (OR:1.024, 95%CI:1.002, 1.054). CONCLUSION IV-tPA treatment in patients with acute ischemic stroke and COVID-19 was not associated with an increased risk of disability, mortality, and hemorrhagic transformation compared to those without COVID-19. IV-tPA should continue to be considered as the standard of care in patients with hyper acute stroke and COVID-19.
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Affiliation(s)
- Payam Sasanejad
- Department of Neurology Mashhad Fellowship of interventional radiology Mashhad University of Medical Sciences.
| | - Leila Afshar Hezarkhani
- Department of Neurology School of Medicine Farabi Hospital Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Shahram Arsang-Jang
- Department of Biostatistics and Epidemiology School of Medicine Zanjan University of Medical Sciences, Zanjan, Iran
| | - Georgios Tsivgoulis
- Second Department of Neurology National & Kapodistrian University of Athens,Professor of Neurology, Athens, Greece
| | - Abdoreza Ghoreishi
- Department of Neurology, Vali-e-Asr Hospital, School of Medicine, Zanjan University of Medical Sciences
| | - Barlinn Kristian
- University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden
| | - Jan Rahmig
- Department of Neurology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Mehdi Farhoudi
- Neurosciences Research Center, Imam Reza Hospital, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Elyar Sadeghi Hokmabadi
- Neurosciences Research Center, Imam Reza Hospital, Tabriz University of Medical Sciences, Tabriz
| | | | - Payam Sariaslani
- Department of Neurology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Athena Sharifi-Razavi
- Clinical Research Development Unit of Bou-Ali Sina Hospital, Mazandaran University of Medical Sciences, Sari, Iran
| | - Kavian Ghandehari
- Department of Neurology Mashhad University of Medical Sciences, Mashhad, Iran
| | - Alireza Khosravi
- Clinical Immunology Research Center, Department of Neurology, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Craig Smith
- Manchester Centre for Clinical Neurosciences, Geoffrey Jefferson Brain Research Centre, Manchester Academic Health Science Centre, Salford Royal NHS Foundation Trust, Salford, UK; Division of Cardiovascular Sciences, Lydia Becker Institute of Immunology and Inflammation, University of Manchester, Manchester, UK
| | - Yongchai Nilanont
- Siriraj Stroke Center, Department of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Yama Akbari
- Departments of Neurology, Neurological Surgery, and Anatomy & Neurobiology, and Beckman Laser Institute & Medical Clinic, School of Medicine, University of California, Irvine, CA, USA
| | - Thanh N Nguyen
- Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Anna Bersano
- Cerebrovascular Unit, Fondazione IRCCS Istituto Neurologico carlo Besta, Milano, Italy
| | - Nawaf Yassi
- Department of Medicine and Neurology, Melbourne Brain Centre at The Royal Melbourne Hospital, University of Melbourne, Parkville, Australia; Population Health and Immunity Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, Australia
| | - Takeshi Yoshimoto
- Department of Neurology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Simona Lattanzi
- Department of Experimental and Clinical Medicine, Marche Polytechnic University, Via Conca, Ancona, Italy
| | - Animesh Gupta
- Department of Neurology, School of Medicine, University of New Mexico, Albuquerque, New Mexico, USA
| | - Ramin Zand
- Department of Neurology, Neuroscience Institute, Geisinger Medical Center, Danville, PA, USA
| | - Shahram Rafie
- Department of Neurology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | | | | | - Shahram Amini
- Department of Anesthesia, Intensive care Unit, Lung Research Center, Mashhad, Mashhad University of Medical Sciences
| | - Saltanat U Kamenova
- Department of Medicine, Al-Farabi Kazakh National University, Doctor of Medical Science, Professor. Almaty, Kazakhstan
| | - Aida Kondybayeva
- Doctor of Medical Science, Professor Doctor of Medical Science, Professor, Department of Medicine, Al-Farabi Kazakh National University. Almaty, Kazakhstan
| | - Murat Zhanuzakov
- Doctor of Medical Science Professor, Department of Internal Medicine, Kazakh-Russian Medical University. Almaty, Kazakhstan
| | | | | | - Sean Ruland
- Department of Neurology, Loyola University Chicago-Stritch School of Medicine, Chicago, IL
| | - Anna M Cervantes-Arslanian
- Departments of Neurology, Neurosurgery, and Medicine (Infectious Disease), Boston University School of Medicine, Boston Medical Center, Boston, MA
| | - Masoom J Desai
- Assistant Professor of Neurology, University of New Mexico, Albuquerque
| | - Annemarei Ranta
- Department of Medicine, University of Otago, Wellington and Department of Neurology, Wellington Regional Hospital, New Zealand
| | - Amir Moghadam Ahmadi
- Associate Professor of Neurology, School of Medicine, Non-communicable Diseases Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | | | - Razieh Foroughi
- Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Etrat Hooshmandi
- Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Fahimeh H Akhoundi
- Department of Neurology, Iran University of medical Sciences, Tehran, Iran
| | - Ashfaq Shuaib
- Professor of Neurology and Director Stroke Program University of Alberta, Alberta, Canada
| | | | - James Siegler
- Cooper Neurological Institute, Cooper University Hospital, Camden, NJ
| | - Jose G Romano
- Department of Neurology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Stephan A Mayer
- Professor of Neurology and Neurosurgery, New York Medical College, Westchester Medical Center, Valhalla, NY
| | - Reza Bavarsad Shahripour
- University of California San Diego Neurosciences center, Comprehensive Stroke center, San Diego, CA
| | - Babak Zamani
- Department of Neurology, Iran University of Medical Sciences, Tehran, Iran
| | - Amadene Woolsey
- Stroke Prevention and Atherosclerosis Research Centre, Robarts Research Institute, Western University, London, Ontario, Canada. Schulich School of Medicine & Dentistry, University of Western Ontario, London, Ontario, Canada
| | - Yasaman Fazli
- School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Khazaei Mojtaba
- Assistant Professor of Neurology, Assistant Professor of Neurology, Hamadan Medical University of Medical Sciences, Fellowship of neurovascular intervention
| | | | - Jose Biller
- Department of Neurology, Loyola University Health System, Stritch School of Medicine, Chicago, IL, USA
| | - Mario Di Napoli
- Department of Neurology and Stroke Unit, San Camillo de' Lellis General District Hospital, Rieti, Italy; Neurological Section, Neuro-epidemiology Unit, SMDN-Centre for Cardiovascular Medicine and Cerebrovascular Disease Prevention, Sulmona, L'Aquila, Italy
| | - M Reza Azarpazhooh
- Stroke Prevention and Atherosclerosis Research Centre, Robarts Research Institute, Western University, London, Ontario, Canada; Department of Clinical Neurological Sciences, Western University, London, ON, Canada; Department of Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Ontario, Canada
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Hassan TA, Sáenz JE, Ducinskiene D, Cook JP, Imperato JS, Zou KH. New Strategies to Improve Patient Adherence to Medications for Noncommunicable Diseases During and After the COVID-19 Era Identified via a Literature Review. J Multidiscip Healthc 2021; 14:2453-2465. [PMID: 34522102 PMCID: PMC8434910 DOI: 10.2147/jmdh.s313626] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 06/28/2021] [Indexed: 12/21/2022] Open
Abstract
Noncommunicable diseases (NCDs) place a huge burden on healthcare systems and society as a whole. Relatively early in the coronavirus disease 2019 (COVID-19) pandemic, clinicians became aware that in individuals infected with COVID-19, those with preexisting NCDs such as diabetes mellitus and cardiovascular disease (CVD) were at a greater risk of poor outcomes and mortality than those without. The importance of adherence to medications and lifestyle changes to control and prevent NCDs has been a major focus for many years, but with limited success - the proportion of patients adherent and persistent to their medications remains very low. There are many facets to adherence and persistence. Recent evidence suggests that a patient-centric approach is important, and ensuring that a patient is both motivated and empowered is critical to improving adherence/persistence. The COVID-19 pandemic has brought many changes to the way in which patients with NCDs are managed, with telemedicine and ehealth becoming more common. Changes have also occurred in the way in which patients can gain access to medications during the pandemic. The potential for these changes forms the basis of improving the management of patients with NCDs both during and after the pandemic. Over the coming months, a huge amount of work will be put into initiatives to promote adherence to COVID-19 vaccination programs. Those at highest risk of severe COVID-19, such as people aged 80 years and older, are likely to receive the vaccine first in some parts of world. Finally, social determinants of health are critical elements that can impact not just the likelihood of having an NCD or becoming infected with COVID-19, but also access to healthcare, and a patient's adherence and persistence with their treatments.
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Affiliation(s)
- Tarek A Hassan
- Global Medical and Clinical, Viatris, Canonsburg, PA, USA
| | | | | | - Joseph P Cook
- Global Medical and Clinical, Viatris, Canonsburg, PA, USA
| | | | - Kelly H Zou
- Global Medical and Clinical, Viatris, Canonsburg, PA, USA
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Balqis-Ali NZ, Fun WH, Ismail M, Ng RJ, Jaaffar FSA, Low LL. Addressing Gaps for Health Systems Strengthening: A Public Perspective on Health Systems' Response towards COVID-19. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18179047. [PMID: 34501637 PMCID: PMC8431426 DOI: 10.3390/ijerph18179047] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 08/13/2021] [Accepted: 08/21/2021] [Indexed: 01/12/2023]
Abstract
Strengthening the health systems through gaps identification is necessary to ensure sustainable improvements especially in facing a debilitating outbreak such as COVID-19. This study aims to explore public perspective on health systems’ response towards COVID-19, and to identify gaps for health systems strengthening by leveraging on WHO health systems’ building blocks. A qualitative study was conducted using open-ended questions survey among public followed by in-depth interviews with key informants. Opinions on Malaysia’s health systems response towards COVID-19 were gathered. Data were exported to NVIVO version 12 and analysed using content analysis approach. The study identified various issues on health systems’ response towards COVID-19, which were then mapped into health systems’ building blocks. The study showed the gaps were embedded among complex interactions between the health systems building blocks. The leadership and governance building block had cross-cutting effects, and all building blocks influenced service deliveries. Understanding the complexities in fostering whole-systems strengthening through a holistic measure in facing an outbreak was paramount. Applying systems thinking in addressing gaps could help addressing the complexity at a macro level, including consideration of how an action implicates other building blocks and approaching the governance effort in a more adaptive manner to develop resilient systems.
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Affiliation(s)
- Nur Zahirah Balqis-Ali
- Institute for Health Systems Research, National Institutes of Health, Ministry of Health Malaysia, Shah Alam 40170, Selangor, Malaysia; (W.H.F.); (L.L.L.)
- Correspondence: ; Tel.: +60-3-3362-7500 (ext. 8519)
| | - Weng Hong Fun
- Institute for Health Systems Research, National Institutes of Health, Ministry of Health Malaysia, Shah Alam 40170, Selangor, Malaysia; (W.H.F.); (L.L.L.)
| | - Munirah Ismail
- Institute for Health Management, National Institutes of Health, Ministry of Health Malaysia, Shah Alam 40170, Selangor, Malaysia; (M.I.); (R.J.N.); (F.S.A.J.)
| | - Rui Jie Ng
- Institute for Health Management, National Institutes of Health, Ministry of Health Malaysia, Shah Alam 40170, Selangor, Malaysia; (M.I.); (R.J.N.); (F.S.A.J.)
| | - Faeiz Syezri Adzmin Jaaffar
- Institute for Health Management, National Institutes of Health, Ministry of Health Malaysia, Shah Alam 40170, Selangor, Malaysia; (M.I.); (R.J.N.); (F.S.A.J.)
| | - Lee Lan Low
- Institute for Health Systems Research, National Institutes of Health, Ministry of Health Malaysia, Shah Alam 40170, Selangor, Malaysia; (W.H.F.); (L.L.L.)
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Abstract
OBJECTIVES This study sought to identify coronavirus disease 2019 (COVID-19) risk communication materials distributed in Jamaica to mitigate the effects of the disease outbreak. It also sought to explore the effects of health risk communication on vulnerable groups in the context of the pandemic. METHODS A qualitative study was conducted, including a content analysis of health risk communications and in-depth interviews with 35 purposively selected elderly, physically disabled, persons with mental health disorders, representatives of government agencies, advocacy and service groups, and caregivers of the vulnerable. Axial coding was applied to data from the interviews, and all data were analyzed using the constant comparison technique. RESULTS Twelve of the 141 COVID-19 risk communication messages directly targeted the vulnerable. All participants were aware of the relevant risk communication and largely complied. Barriers to messaging awareness and compliance included inappropriate message medium for the deaf and blind, rural location, lack of Internet service or digital devices, limited technology skills, and limited connection to agencies that serve the vulnerable. CONCLUSION The vulnerable are at increased risk in times of crisis. Accessibility of targeted information was inadequate for universal access to health information and support for vulnerable persons regardless of location and vulnerability.
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