1
|
The impact of an enhanced health surveillance system for COVID-19 management in Serrana, Brazil. PUBLIC HEALTH IN PRACTICE 2022; 4:100301. [PMID: 35946045 PMCID: PMC9354446 DOI: 10.1016/j.puhip.2022.100301] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 07/14/2022] [Accepted: 07/20/2022] [Indexed: 01/03/2023] Open
Abstract
Objective To describe the successful implementation of an enhanced public health surveillance system based on early detection, tracing contacts, and patient follow-up and support. Study design A prospective observational cohort study conducted in Serrana, São Paulo State, Brazil. Methods The implementation was based on four axes: increasing the access to SARS-CoV-2 testing; correct swab collection; testing patients with mild symptoms; and patient follow-up. Positivity rate, patient demographic and clinical characteristics, dynamics of disease severity, SARS-CoV-2 genome evolution, and the impact on COVID-19 research were assessed from August 23, 2020 to February 6, 2021 (between epidemiological week 35/2020 and 5/2021, a total of 24 weeks). Results The number of sites collecting rt-PCR for SARS-CoV-2 was increased from one to seven points and staff was trained in the correct use of personal protective equipment and in the swab collection technique. During the study period, 6728 samples were collected from 6155 participants vs. 2770 collections in a similar period before. SARS-CoV-2 RNA was detected in 1758 (26.1%) swabs vs. 1117 (36.7%) before the implementation of the surveillance system (p < 0.001). Positivity rates varied widely between epidemiological weeks 35/2020 and 5/2021 (IQR, 12.8%-31.3%). Out of COVID-19 patients, 91.1% were adults at a median age of 35 years (IQR, 25-50 years), 42.6% were men and 57.4% were women, with a SARS-CoV-2 positivity rate of 28.6% and 24.4% (p < 0.001), respectively. The most common symptoms were headache (72.6%), myalgia (65.0%), and cough (61.7%). Comorbidities were found in 20.8% of patients, the most common being hypertension and diabetes. According to the World Health Organization clinical progression scale, 93.5% of patients had mild disease, 1.6% were hospitalized with moderate disease, 3.2% were hospitalized with severe disease, and 1.4% died. The enhanced surveillance system led to the development of COVID-19 related research. Conclusions The enhanced surveillance system in Serrana improved COVID-19 understanding and management. By integrating community and academic institutions, it was possible to monitor SARS-CoV-2 positive cases and variants, follow the epidemic trend, guide patients, and develop relevant research projects.
Collapse
|
2
|
Marchi M, Magarini FM, Chiarenza A, Galeazzi GM, Paloma V, Garrido R, Ioannidi E, Vassilikou K, de Matos MG, Gaspar T, Guedes FB, Primdahl NL, Skovdal M, Murphy R, Durbeej N, Osman F, Watters C, van den Muijsenbergh M, Sturm G, Oulahal R, Padilla B, Willems S, Spiritus-Beerden E, Verelst A, Derluyn I. Experience of discrimination during COVID-19 pandemic: the impact of public health measures and psychological distress among refugees and other migrants in Europe. BMC Public Health 2022; 22:942. [PMID: 35538463 PMCID: PMC9090600 DOI: 10.1186/s12889-022-13370-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 05/04/2022] [Indexed: 11/10/2022] Open
Abstract
Background The COVID-19 pandemic has had a disproportionately hard impact on refugees and other migrants who are often exposed to the virus with limited means to protect themselves. We tested the hypothesis that during the COVID-19 pandemic, refugees and other migrants have suffered a negative impact on mental health and have been unjustly discriminated for spreading the disease in Europe (data collection from April to November 2020). Methods Participants in the ApartTogether Survey (N = 8297, after listwise deletion of missing items final N = 3940) provided data regarding to their difficulties to adhere to preventive recommendations against COVID-19 infection (CARE), self-perceived stigmatization (SS), and psychological distress (PD). Structural Equation Modeling was used to investigate PD as a mediator in the pathway linking CARE to SS, while adjusting for the housing and residence status. To improve confidence in the findings, single hold-out sample cross-validation was performed using a train/test split ratio of 0.8/0.2. Results In the exploratory set (N = 3159) SS was associated with both CARE (B = 0.200, p < 0.001) and PD (B = 0.455, p < 0.001). Moreover, PD was also associated with CARE (B = 0.094, p = 0.001) and mediated the effect of CARE on SS (proportion mediated = 17.7%, p = 0.001). The results were successfully replicated in the confirmation set (N = 781; total effect = 0.417, p < 0.001; proportion mediated = 29.7%, p < 0.001). Follow-up analyses also found evidence for an opposite effect (i.e., from SS to CARE, B = 0.132; p < 0.001), suggesting that there might be a vicious circle between the self-perceived stigmatization and the access to health care and the use of preventive measures against COVID-19 infection. Conclusions Refugees and other migrants who had more difficulties in accessing health care and preventive measures against COVID-19 infection experienced worse mental health and increased discrimination. These negative effects appeared to be stronger for those with more insecure housing and residence status, highlighting from one side the specific risk of insecure housing in the impact of COVID-19 upon mental health and infection protection, and for another side the need to proper housing as a strategy to prevent both COVID-19 and mental distress. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13370-y.
Collapse
Affiliation(s)
- Mattia Marchi
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Via Giuseppe Campi, 287 -, 41125, Modena, Italy.,Dipartimento di Salute Mentale e Dipendenze Patologiche, Azienda USL-IRCCS di Reggio Emilia, Via Giovanni Amendola 2 -, 42122, Reggio Emilia, Italy
| | - Federica Maria Magarini
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Via Giuseppe Campi, 287 -, 41125, Modena, Italy
| | - Antonio Chiarenza
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Via Giuseppe Campi, 287 -, 41125, Modena, Italy
| | - Gian Maria Galeazzi
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Via Giuseppe Campi, 287 -, 41125, Modena, Italy. .,Dipartimento di Salute Mentale e Dipendenze Patologiche, Azienda USL-IRCCS di Reggio Emilia, Via Giovanni Amendola 2 -, 42122, Reggio Emilia, Italy.
| | - Virginia Paloma
- Department of Social Psychology, Universidad de Sevilla, 41018, Seville, Spain
| | - Rocío Garrido
- Department of Social Psychology, Universidad de Sevilla, 41018, Seville, Spain
| | - Elisabeth Ioannidi
- Research Center for Greek Society, Academy of Athens, 15126, Athens, Greece
| | | | | | - Tania Gaspar
- Institute of Environmental Health/ISAMB, University of Lisbon, Lisbon, Portugal
| | | | - Nina Langer Primdahl
- Department of Public Health, University of Copenhagen, 1014, Copenhagen, Denmark
| | - Morten Skovdal
- Department of Public Health, University of Copenhagen, 1014, Copenhagen, Denmark
| | - Rebecca Murphy
- Department of Psychology, Maynooth University, W23 F2K8, Co. Kildare, Maynooth, Ireland
| | - Natalie Durbeej
- Department of Child Health and Parenting, Uppsala University, 75236, Uppsala, Sweden
| | - Fatumo Osman
- Department of Child Health and Parenting, Uppsala University, 75236, Uppsala, Sweden.,School of Health and Welfare, Dalarna University, Högskolegatan 2, 79188, Falun, Sweden
| | - Charles Watters
- Department of School of Education and Social Work, University of Sussex, Sussex, UK
| | | | - Gesine Sturm
- LCPI Laboratory, EA-4591, Department Clinique du Sujet, University of Toulouse 2, 31058, Toulouse, France
| | - Rachid Oulahal
- La Reunion University FR, DIRE research center, French Collaborative Institute on Migration, CS, 92003, 15 Av. René Cassin, Saint-Denis, Cedex 9 97400, Réunion
| | - Beatriz Padilla
- Department of Sociology, University of South Florida, Tampa, FL, 33620, USA
| | - Sara Willems
- Department of Public Health and Primary Care, Quality and Safety Ghent, Ghent University, 9000, Ghent, Belgium
| | - Eva Spiritus-Beerden
- Department of Social Work and Social Pedagogy, Ghent University, 9000, Ghent, Belgium
| | - An Verelst
- Department of Social Work and Social Pedagogy, Ghent University, 9000, Ghent, Belgium
| | - Ilse Derluyn
- Department of Social Work and Social Pedagogy, Ghent University, 9000, Ghent, Belgium
| |
Collapse
|
3
|
Youssef D, Berry A, Ghosn N, Zalzali M, Fadlallah R, Abou-Abbas L, Hassan H. Phased repatriation of Lebanese expatriates stranded abroad during coronavirus disease 2019 (COVID-19) pandemic. Arch Public Health 2021; 79:206. [PMID: 34814944 PMCID: PMC8609176 DOI: 10.1186/s13690-021-00740-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 11/14/2021] [Indexed: 01/08/2023] Open
Abstract
Background The coronavirus disease (COVID-19) pandemic represents a serious worldwide threat. Stranded Lebanese citizens abroad appealed to the Lebanese government to embark on citizen repatriation missions. We aim to document the Lebanese experience in the repatriation of citizens during COVID-19 which allow us to disclose encountered challenges and lessons learned. Methods This is a retrospective description of processes involved in the phased repatriation of Lebanese citizens. The Mission consisted of 4 phases starting, April 5th until June 19th 2020. The prioritization of returnees was based on both medical and social risk assessment. The repatriation team was divided into four groups: the aircraft team, the airport team, the hotel team and the follow up team. On arrival, all returning citizens were tested using Polymerase chain Reaction (PCR) based technique, and were obliged to adhere to a mandatory facility quarantine for 24 to 48 h. Returning travelers who were tested positive for COVID-19 were transferred to the hospital. Those who were tested negative were urged to strictly comply with home-quarantine for a duration of 14 days. They were followed up on a daily basis by the repatriation team. Results Overall, 25,783 Lebanese citizens have returned home during the phased repatriation. The third phase ranked the uppermost in regard of the number of citizens repatriated. The total number of performed PCR tests at the airport upon arrival was 14,893 with an average percentage of around 1% positivity for COVID-19. On the other hand, more than 10,687 repatriates underwent external PCR requisite in the third and fourth phases. Two hundred seventy-two repatriates were tested positive for COVID-19 upon their arrival. Conclusion Considering the limited human and financial resources besides the economic and political crisis, the overall repatriation mission could be considered as a successful experience. Such processes would not have been achieved without the professionalism of all involved stakeholders.
Collapse
Affiliation(s)
- Dalal Youssef
- Preventive Medicine Department, Ministry of Public Health, Beirut, Lebanon.
| | - Atika Berry
- Preventive Medicine Department, Ministry of Public Health, Beirut, Lebanon
| | - Nada Ghosn
- Epidemiological Surveillance Program, Ministry of public Health, Beirut, Lebanon
| | | | | | - Linda Abou-Abbas
- Epidemiological Surveillance Program, Ministry of public Health, Beirut, Lebanon
| | | |
Collapse
|
4
|
MacKay M, Colangeli T, Thaivalappil A, Del Bianco A, McWhirter J, Papadopoulos A. A Review and Analysis of the Literature on Public Health Emergency Communication Practices. J Community Health 2021; 47:150-162. [PMID: 34515962 PMCID: PMC8436583 DOI: 10.1007/s10900-021-01032-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/30/2021] [Indexed: 11/25/2022]
Abstract
A systematic review using structured and transparent methods was carried out to collect and review the qualitative literature investigating trust in crisis communication during emerging infectious diseases. Qualitative synthesis was conducted using a descriptive thematic analysis approach. The GRADE-CERQual assessment was used to determine the confidence in each thematic finding to support decisions when implementing review findings. Overall, 13 studies were included in the review, resulting in 10 thematic categories that describe characteristics associated with crisis communication information and sources of crisis communication that can enhance or maintain public trust. The results of this review suggest the public judges the trustworthiness of crisis communication based on the information characteristics, including consistency, repetition, and timeliness, and especially transparency and uncertainty. Public health is a trusted source of crisis communication when the presenting spokesperson is a health official, the information is not perceived as politicized, and is timely. Community leaders, such as family doctors, are also trusted sources of crisis communication, whereas media and government officials face distrust because of perceived sensationalized information, and defensiveness and unreliable information respectively. Qualitative data in this area is limited, especially involving the public and priority populations, and should be the focus of future research.
Collapse
Affiliation(s)
- Melissa MacKay
- Department of Population Medicine, University of Guelph, 50 Stone Road East, Guelph, ON, N1G 2W1, Canada.
| | - Taylor Colangeli
- Department of Population Medicine, University of Guelph, 50 Stone Road East, Guelph, ON, N1G 2W1, Canada
| | - Abhinand Thaivalappil
- Department of Population Medicine, University of Guelph, 50 Stone Road East, Guelph, ON, N1G 2W1, Canada
| | - Ariana Del Bianco
- Department of Population Medicine, University of Guelph, 50 Stone Road East, Guelph, ON, N1G 2W1, Canada
| | - Jennifer McWhirter
- Department of Population Medicine, University of Guelph, 50 Stone Road East, Guelph, ON, N1G 2W1, Canada
| | - Andrew Papadopoulos
- Department of Population Medicine, University of Guelph, 50 Stone Road East, Guelph, ON, N1G 2W1, Canada
| |
Collapse
|
5
|
Brønholt RLL, Langer Primdahl N, Jensen AMB, Verelst A, Derluyn I, Skovdal M. "I Just Want Some Clear Answers": Challenges and Tactics Adopted by Migrants in Denmark When Accessing Health Risk Information about COVID-19. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18178932. [PMID: 34501520 PMCID: PMC8431280 DOI: 10.3390/ijerph18178932] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 08/17/2021] [Accepted: 08/21/2021] [Indexed: 11/17/2022]
Abstract
Health risk communication plays a crucial role in preventing the spread of infectious disease outbreaks such as the current coronavirus (SARS-CoV-2). Yet, migrants are far too often forgotten in health risk communication responses. We investigate the challenges and efforts made by migrants in Denmark—in the initial months of the pandemic—to access information about COVID-19. We draw on 18 semi-structured interviews conducted in May and June 2020. All interviews are thematically coded and analyzed. Our analysis reveals that many of the migrants faced several challenges, including accessing information in a language understandable to them and navigating constant streams of official news flows issuing instructions about which actions to take. However, we also note that the participating migrants found numerous creative ways to address some of these challenges, often aided by digital tools, helping them access crucial health and risk information. This paper highlights that migrants constitute an underserved group in times of crises. They are vulnerable to getting left behind in pandemic communication responses. However, we also identify key protective factors, social resources, and agentic capabilities, which help them cope with health and risk information deficits. National governments need to take heed of these findings to inform future pandemic responses.
Collapse
Affiliation(s)
- Rasmus Luca Lyager Brønholt
- Department of Public Health, University of Copenhagen, Øster Farimagsgade 5B, 1014 Copenhagen, Denmark; (N.L.P.); (A.M.B.J.); (M.S.)
- Correspondence: ; Tel.: +45-2815-6529
| | - Nina Langer Primdahl
- Department of Public Health, University of Copenhagen, Øster Farimagsgade 5B, 1014 Copenhagen, Denmark; (N.L.P.); (A.M.B.J.); (M.S.)
| | - Anja M. B. Jensen
- Department of Public Health, University of Copenhagen, Øster Farimagsgade 5B, 1014 Copenhagen, Denmark; (N.L.P.); (A.M.B.J.); (M.S.)
| | - An Verelst
- Centre for the Social Study of Migration and Refugees, Department of Social Work and Social Pedagogy, Ghent University, H. Dunantlaan 2, 9000 Gent, Belgium; (A.V.); (I.D.)
| | - Ilse Derluyn
- Centre for the Social Study of Migration and Refugees, Department of Social Work and Social Pedagogy, Ghent University, H. Dunantlaan 2, 9000 Gent, Belgium; (A.V.); (I.D.)
| | - Morten Skovdal
- Department of Public Health, University of Copenhagen, Øster Farimagsgade 5B, 1014 Copenhagen, Denmark; (N.L.P.); (A.M.B.J.); (M.S.)
| |
Collapse
|
6
|
Peres IT, Bastos LSL, Gelli JGM, Marchesi JF, Dantas LF, Antunes BBP, Maçaira PM, Baião FA, Hamacher S, Bozza FA. Sociodemographic factors associated with COVID-19 in-hospital mortality in Brazil. Public Health 2021; 192:15-20. [PMID: 33607516 PMCID: PMC7836512 DOI: 10.1016/j.puhe.2021.01.005] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Revised: 12/15/2020] [Accepted: 01/08/2021] [Indexed: 12/12/2022]
Abstract
OBJECTIVES The coronavirus disease 2019 (COVID-19) pandemic has highlighted inequalities in access to healthcare systems, increasing racial disparities and worsening health outcomes in these populations. This study analysed the association between sociodemographic characteristics and COVID-19 in-hospital mortality in Brazil. STUDY DESIGN A retrospective analysis was conducted on quantitative reverse transcription polymerase chain reaction-confirmed hospitalised adult patients with COVID-19 with a defined outcome (i.e. hospital discharge or death) in Brazil. Data were retrieved from the national surveillance system database (SIVEP-Gripe) between February 16 and August 8, 2020. METHODS Clinical characteristics, sociodemographic variables, use of hospital resources and outcomes of hospitalised adult patients with COVID-19, stratified by self-reported race, were investigated. The primary outcome was in-hospital mortality. The association between self-reported race and in-hospital mortality, after adjusting for clinical characteristics and comorbidities, was evaluated using a logistic regression model. RESULTS During the study period, Brazil had 3,018,397 confirmed COVID-19 cases and 100,648 deaths. The study population included 228,196 COVID-19-positive adult in-hospital patients with a defined outcome; the median age was 61 years, 57% were men, 35% (79,914) self-reported as Black/Brown and 35.4% (80,853) self-reported as White. The total in-hospital mortality was 37% (85,171/228,196). Black/Brown patients showed higher in-hospital mortality than White patients (42% vs 37%, respectively), were admitted less frequently to the intensive care unit (ICU) (32% vs 36%, respectively) and used more invasive mechanical ventilation (21% vs 19%, respectively), especially outside the ICU (17% vs 11%, respectively). Black/Brown race was independently associated with high in-hospital mortality after adjusting for sex, age, level of education, region of residence and comorbidities (odds ratio = 1.15; 95% confidence interval = 1.09-1.22). CONCLUSIONS Among hospitalised Brazilian adults with COVID-19, Black/Brown patients showed higher in-hospital mortality, less frequently used hospital resources and had potentially more severe conditions than White patients. Racial disparities in health outcomes and access to health care highlight the need to actively implement strategies to reduce inequities caused by the wider health determinants, ultimately leading to a sustainable change in the health system.
Collapse
Affiliation(s)
- I T Peres
- Department of Industrial Engineering, Pontifical Catholic University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
| | - L S L Bastos
- Department of Industrial Engineering, Pontifical Catholic University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
| | - J G M Gelli
- Department of Industrial Engineering, Pontifical Catholic University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
| | - J F Marchesi
- Instituto Tecgraf, Pontifical Catholic University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
| | - L F Dantas
- Department of Industrial Engineering, Pontifical Catholic University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
| | - B B P Antunes
- Department of Industrial Engineering, Pontifical Catholic University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
| | - P M Maçaira
- Department of Industrial Engineering, Pontifical Catholic University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
| | - F A Baião
- Department of Industrial Engineering, Pontifical Catholic University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
| | - S Hamacher
- Department of Industrial Engineering, Pontifical Catholic University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
| | - F A Bozza
- National Institute of Infectious Diseases Evandro Chagas (INI), Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, RJ, Brazil; D'Or Institute for Research and Education (IDOR), Rio de Janeiro, RJ, Brazil.
| |
Collapse
|