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Winalai C, Anupong S, Modchang C, Chadsuthi S. LSTM-Powered COVID-19 prediction in central Thailand incorporating meteorological and particulate matter data with a multi-feature selection approach. Heliyon 2024; 10:e30319. [PMID: 38711630 PMCID: PMC11070856 DOI: 10.1016/j.heliyon.2024.e30319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 04/23/2024] [Accepted: 04/23/2024] [Indexed: 05/08/2024] Open
Abstract
The COVID-19 pandemic has significantly impacted public health and necessitated urgent actions to mitigate its spread. Monitoring and predicting the outbreak's progression have become vital to devise effective strategies and allocate resources efficiently. This study presents a novel approach utilizing Multivariate Long Short-Term Memory (LSTM) to analyze and predict COVID-19 trends in Central Thailand, particularly emphasizing the multi-feature selection process. To consider a comprehensive view of the pandemic's dynamics, our research dataset encompasses epidemiological, meteorological, and particulate matter features, which were gathered from reliable sources. We propose a multi-feature selection technique to identify the most relevant and influential features that significantly impact the spread of COVID-19 in the region to enhance the model's performance. Our results highlight that relative humidity is the key factor driving COVID-19 transmission in Central Thailand. The proposed multi-feature selection technique significantly improves the model's accuracy, ensuring that only the most informative variables contribute to the predictions, avoiding the potential noise or redundancy from less relevant features. The proposed LSTM model demonstrates its capability to forecast COVID-19 cases, facilitating informed decision-making for public health authorities and policymakers.
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Affiliation(s)
- Chanidapa Winalai
- Department of Physics, Faculty of Science, Naresuan University, Phitsanulok 65000, Thailand
| | - Suparinthon Anupong
- Department of Chemistry, Mahidol Wittayanusorn School (MWIT), Salaya, Nakhon Pathom 73170, Thailand
| | - Charin Modchang
- Biophysics Group, Department of Physics, Faculty of Science, Mahidol University, Bangkok 10400, Thailand
- Centre of Excellence in Mathematics, CHE, Bangkok 10400, Thailand
- Thailand Center of Excellence in Physics, CHE, 328 Si Ayutthaya Road, Bangkok 10400, Thailand
| | - Sudarat Chadsuthi
- Department of Physics, Faculty of Science, Naresuan University, Phitsanulok 65000, Thailand
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Douedari Y, Alhaffar M, Khanshor A, Alrashid Alhiraki O, Marzouk M, Howard N. ' COVID-19 is just another way to die…': a qualitative longitudinal study of frontline COVID-19 response governance across Syria. BMJ Glob Health 2023; 8:e013199. [PMID: 38084479 PMCID: PMC10711850 DOI: 10.1136/bmjgh-2023-013199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 11/12/2023] [Indexed: 12/18/2023] Open
Abstract
INTRODUCTION Governance of COVID-19 responses has been challenging for all countries. Syria has been particularly challenged due to protracted multiparty conflict and debilitated health systems fragmented across different areas of control. To improve response governance, better understanding of frontline response policy implementation across the country is needed. This study thus explored perspectives of COVID-19 response governance among frontline healthcare providers over time and across major areas of control. METHODS We used a qualitative longitudinal study design, conducting five rounds of remote semistructured interviews in Arabic (ie, approximately eight interviews each in March 2020, July 2020, September 2020, December 2020 and September 2021) with 14 purposively sampled public and private healthcare providers in the three main areas of control (ie, opposition-controlled area, Autonomous Administration-controlled area and al-Assad government-controlled area (GCA)). We conducted integrative thematic analysis in Arabic within and across geography and time. RESULTS Almost all participants across all areas and rounds expressed distrust of local health authorities and dissatisfaction with COVID-19 response governance. This was most apparent in initial rounds and in GCA. Response planning was identified as insufficient, non-participatory and non-transparent. Limited infrastructure and resources were the main challenges across time, though anticipated rapid virus spread and health systems' collapse did not occur and participant optimism increased over time. Public adherence to prevention measures varied-initially weak due to general scepticism, increasing after first cases were confirmed and then fluctuating with case numbers and challenges of insecurity and misinformation. Perceptions of COVID-19 vaccination varied, with low uptake and hesitancy attributed to misinformation, disinformation and disinterest. Suggested improvements to COVID-19 response governance focused on strengthening health systems' capacity and coordination. CONCLUSION This is a unique longitudinal study of COVID-19 responses. Addressing transparency and misinformation should be a first step to improving public engagement and trust and thus response governance for health emergencies in Syria.
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Affiliation(s)
- Yazan Douedari
- Department of Global Health and Development, London School of Hygiene & Tropical Medicine Faculty of Public Health and Policy, London, UK
- Free Aleppo University, Azaz, Syria
- Syria Research Group, London School of Hygiene & Tropical Medicine and NUS Saw Swee Hock School of Public Health, London, UK
| | - Mervat Alhaffar
- Department of Global Health and Development, London School of Hygiene & Tropical Medicine Faculty of Public Health and Policy, London, UK
- Syria Research Group, London School of Hygiene & Tropical Medicine and NUS Saw Swee Hock School of Public Health, London, UK
| | - Ahmad Khanshor
- Syria Research Group, London School of Hygiene & Tropical Medicine and NUS Saw Swee Hock School of Public Health, London, UK
| | - Omar Alrashid Alhiraki
- Syria Research Group, London School of Hygiene & Tropical Medicine and NUS Saw Swee Hock School of Public Health, London, UK
- Acute Medicine Department, United Lincolnshire Hospitals NHS Trust, Lincoln, UK
| | - Manar Marzouk
- Department of Global Health and Development, London School of Hygiene & Tropical Medicine Faculty of Public Health and Policy, London, UK
- Syria Research Group, London School of Hygiene & Tropical Medicine and NUS Saw Swee Hock School of Public Health, London, UK
| | - Natasha Howard
- Department of Global Health and Development, London School of Hygiene & Tropical Medicine Faculty of Public Health and Policy, London, UK
- Syria Research Group, London School of Hygiene & Tropical Medicine and NUS Saw Swee Hock School of Public Health, London, UK
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
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Mohamed AA, Bocher TF, Magan MA, Siameja C, Mohamoud SA. Hesitancy in COVID-19 Vaccine Uptake and Its Correlated Factors Using Multi-Theory Model among Adult Women: A Cross-Sectional Study in Three States of Somalia. Vaccines (Basel) 2023; 11:1489. [PMID: 37766165 PMCID: PMC10534331 DOI: 10.3390/vaccines11091489] [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: 01/29/2023] [Revised: 03/16/2023] [Accepted: 03/17/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND In developing countries, access to information, awareness, and availability of COVID-19 vaccines are key challenges. Somalia launched the COVID-19 vaccination in March 2021; however, the uptake of the vaccination is slow, which creates fear of further loss of life in the country unless intentional and organized campaigning and efforts are made to improve both the availability of the vaccine and its acceptance by the community. This study aimed to understand the current level of awareness, accessibility, trust, and hesitancy toward the COVID-19 vaccine among women in Somalia. METHODS To assess COVID-19 vaccine uptake, acceptance, community awareness, and hesitancy rates in Somalia, we carried out a cross-sectional mixed methods study in three regions of Somalia that were selected randomly out of the 18 regions of Somalia. A multi-theory model (MTM) was developed to identify correlated factors associated with the hesitancy or non-hesitancy toward COVID-19 vaccination among women of all ages (18 years and above). RESULTS A total of 999 eligible women (333 in each district) of 18-98 years old were interviewed in March 2022. About two-thirds (63.76%) of participants reported hesitancy about receiving the COVID-19 vaccine. The theory model initiation construct indicated that behavioral confidence in the vaccine (b = 0.476, p < 0.001), participatory dialogue (at b = 0.136, p < 0.004), and changes in the physical environment (b = 0.248, p = 0.015) were significantly associated with COVID-19 vaccine acceptance among women who were not hesitant to take the vaccine. CONCLUSIONS The availability of COVID-19 vaccines may not translate into their uptake. The decision to get the vaccine was determined by multiple factors, including the perceived value of the vaccination, previous experience with the vaccine, perceived risk of infection, accessibility and affordability, and trust in the vaccine itself. Public health education programming and messaging must be developed to encourage vaccine uptake among women with varying levels of vaccine hesitancy.
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Affiliation(s)
- Adam A. Mohamed
- Save the Children International, Mogadishu P.O. Box 39664-00623, Somalia
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Bardosh K, Jean L, Desir L, Yoss S, Poovey B, Beau de Rochars MV, Noland GS. Was lockdown worth it? community perspectives and experiences of the Covid-19 pandemic in remote southwestern Haiti. Soc Sci Med 2023; 331:116076. [PMID: 37441975 DOI: 10.1016/j.socscimed.2023.116076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 06/29/2023] [Accepted: 07/02/2023] [Indexed: 07/15/2023]
Abstract
Public experiences of COVID-19 pandemic lockdown differed dramatically between countries and socio-economic groups. Low-income countries raise unique empirical and ethical concerns about (1) the balance between benefits and social harms and (2) how explanatory disease models and everyday life realities influenced the experience and interpretation of lockdown itself. In this paper, we present qualitative data on community perceptions and experiences of the pandemic from a remote area of Haiti, with a focus on the 2020 lockdown. We conducted in-depth interviews with 30 community leaders in Grand'Anse Department, southwest Haiti, at two time periods: May 2020 and October-December 2021. We divide our results into five sections. First, our analysis showed that lockdown was widely considered ineffective at controlling COVID-19. Despite the lack of testing, community leaders believed most of the local population had caught COVID-19 in the first half of 2020, with limited reported mortality. Public concern about the pandemic largely ended at this time, overtaken by other socio-economic and political crises. Second, we found that popular explanations for the low fatality rate were related to various coping strategies: the strength of people's immune systems, use of natural prophylactic folk teas, beliefs about the virus, spiritual protections and the tropical weather. Third, we found that lockdown was widely seen to have not been appropriate for the Haitian context due to various challenges with compliance in the face of socio-economic vulnerability. Fourth, we found strong negative feelings about the social consequences of lockdown measures, which lasted from March-August 2020, including adverse effects on: food security, household income, education, health, and psychosocial well-being. Finally, these perceptions and experiences reinforced popular ideas that lockdown had been imposed by elites for financial and/or political gain, something that was also reflected in the discourse about the low vaccine acceptance rate. Our study showed that pandemic respiratory virus response in Haiti should better balance restrictive non-pharmaceutical interventions (NPIs) with existing socio-economic vulnerability. Local socio-behavioral dynamics and risk perceptions decrease the overall effectiveness of NPIs in fragile states and alternatives to lockdown, such as shielding the most vulnerable, are likely to be a more appropriate strategy.
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Affiliation(s)
- Kevin Bardosh
- School of Public Health, University of Washington, Seattle, WA, USA; The Carter Center, Atlanta, GA, USA.
| | | | | | | | | | - Madsen Valerie Beau de Rochars
- The Carter Center, Atlanta, GA, USA; Department of Health Services Research, Management and Policy, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA.
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The moderating role of Covid-19-related support on urban livelihood capitals: Evidence from suburban Accra. URBAN GOVERNANCE 2023. [PMCID: PMC10060801 DOI: 10.1016/j.ugj.2023.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/03/2023]
Abstract
In the Global South, the COVID-19 crisis has compelled varied efforts to quickly address the pandemic's impact on urban livelihoods. Families, friends as well as public, private, and civil society organizations have mobilized various resources to avert the pandemic's onslaught on the survival of the urban vulnerable. Indeed, there is a burgeoning ‘pandemic urban scholarship’ that shed insights on COVID-19 risks, local responses, and impacts on everyday urban life. Yet, it is unclear how many of these responses are affecting urban livelihoods. This paper thus investigates the impact of COVID-19 on urban livelihood capitals (financial, human, social, and physical) and analyses the moderating role of COVID-19-related support (from families, friends, government agencies, faith-based and non-governmental organizations) to address the pandemic's impact on these capitals. Drawing on a quantitative study in Adenta Municipality of the Greater Accra Region, Ghana, the study finds a negative association between COVID-19 impacts and all urban livelihood capitals. Crucially, COVID-19-related support only reduced the negative impact of the pandemic on financial capital, and not on the other forms of capital. The study suggests that building post-pandemic community resilience warrants the need to transition from the usual reactive, fragmented support to integrated, holistic, and contextually embedded long-term strategies that consider the multi-dimensionality of everyday urban life.
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Grant C, Sams K. Global narratives on unequal outcomes produced by lockdown in Africa: A social science perspective on the “one-size-fits all” COVID-19 response. Front Public Health 2023; 11:1046404. [PMID: 37064673 PMCID: PMC10095145 DOI: 10.3389/fpubh.2023.1046404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 02/22/2023] [Indexed: 03/31/2023] Open
Abstract
IntroductionLockdown measures were introduced worldwide to prevent the spread of COVID-19, and several studies showed the positive impacts of these policies in places such as China and Europe. Many African governments also imposed lockdowns at the beginning of the pandemic. These lockdowns met with mixed reactions; some were positive, but others focused on concerns about the consequences of lockdowns.MethodsIn this article, we use social listening to examine social media narratives to investigate how people balanced concerns about preventing the spread of COVID-19 with other priorities. Analyzing social media conversations is one way of accessing different voices in real time, including those that often go unheard. As internet access grows and social media becomes more popular in Africa, it provides a different space for engagement, allowing people to connect with opinions outside of their own conceptual frameworks and disrupting hierarchies of how knowledge is shaped.ResultsThis article indicates which narratives were favored by different organizations, stakeholders, and the general public, and which of these narratives are most dominant in policy discourses. The range of narratives is found to be reflective of the blindness to inequality and social difference of much decision-making by policymakers.DiscussionThus, contrary to the “we are all in this together” narrative, diseases and public health responses to them clearly discriminate, accentuating long-standing structural inequalities locally, nationally, and globally, as well as interplaying with multiple, dynamic, and negotiated sources of marginalization. These and other insights from this article could play a useful role in understanding and interpreting how social media could be included in pandemic preparedness plans.
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Affiliation(s)
- Catherine Grant
- Institute of Development Studies, University of Sussex, Brighton, United Kingdom
- *Correspondence: Catherine Grant
| | - Kelley Sams
- Institut de Recherche pour le Développement, France and School of Health Sciences, Walden University, Columbia, MD, United States
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Value of Verbal Autopsy in a Fragile Setting: Reported versus Estimated Community Deaths Associated with COVID-19, Banadir, Somalia. Pathogens 2023; 12:pathogens12020328. [PMID: 36839600 PMCID: PMC9961735 DOI: 10.3390/pathogens12020328] [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: 11/29/2022] [Revised: 01/30/2023] [Accepted: 02/04/2023] [Indexed: 02/18/2023] Open
Abstract
BACKGROUND Accurate mortality data associated with infectious diseases such as coronavirus disease 2019 (COVID-19) are often unavailable in countries with fragile health systems such as Somalia. We compared officially reported COVID-19 deaths in Somalia with COVID-19 deaths estimated using verbal autopsy. METHODS We interviewed relatives of deceased persons to collect information on symptoms, cause, and place of death. We compared these data with officially reported data and estimated the positive and negative predictive values of verbal autopsy. RESULTS We identified 530 deaths during March-October 2020. We classified 176 (33.2%) as probable COVID-19 deaths. Most deaths (78.5%; 416/530) occurred at home and 144 (34.6%) of these were attributed to COVID-19. The positive predictive value of verbal autopsy was lower for home deaths (22.3%; 95% CI: 15.7-30.1%) than for hospital deaths (32.3%; 95% CI: 16.7-51.4%). The negative predictive value was higher: 97.8% (95% CI: 95.0-99.3%) for home deaths and 98.4% (95% CI: 91.5-100%) for hospital deaths. Conclusions Verbal autopsy has acceptable predictive value to estimate COVID-19 deaths where disease prevalence is high and can provide data on the COVID-19 burden in countries with low testing and weak mortality surveillance where home deaths may be missed.
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Nopour R, Shanbezadeh M, Kazemi-Arpanahi H. Predicting intubation risk among COVID-19 hospitalized patients using artificial neural networks. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2023; 12:16. [PMID: 37034879 PMCID: PMC10079178 DOI: 10.4103/jehp.jehp_20_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 04/26/2022] [Indexed: 06/19/2023]
Abstract
BACKGROUND Accurately predicting the intubation risk in COVID-19 patients at the admission time is critical to optimal use of limited hospital resources, providing customized and evidence-based treatments, and improving the quality of delivered medical care services. This study aimed to design a statistical algorithm to select the best features influencing intubation prediction in coronavirus disease 2019 (COVID-19) hospitalized patients. Then, using selected features, multiple artificial neural network (ANN) configurations were developed to predict intubation risk. MATERIAL AND METHODS In this retrospective single-center study, a dataset containing 482 COVID-19 patients who were hospitalized between February 9, 2020 and July 20, 2021 was used. First, the Phi correlation coefficient method was performed for selecting the most important features affecting COVID-19 patients' intubation. Then, the different configurations of ANN were developed. Finally, the performance of ANN configurations was assessed using several evaluation metrics, and the best structure was determined for predicting intubation requirements among hospitalized COVID-19 patients. RESULTS The ANN models were developed based on 18 validated features. The results indicated that the best performance belongs to the 18-20-1 ANN configuration with positive predictive value (PPV) = 0.907, negative predictive value (NPV) = 0.941, sensitivity = 0.898, specificity = 0.951, and area under curve (AUC) = 0.906. CONCLUSIONS The results demonstrate the effectiveness of the ANN models for timely and reliable prediction of intubation risk in COVID-19 hospitalized patients. Our models can inform clinicians and those involved in policymaking and decision making for prioritizing restricted mechanical ventilation and other related resources for critically COVID-19 patients.
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Affiliation(s)
- Raoof Nopour
- Department of Health Information Management, Student Research Committee, School of Health Management and Information Sciences Branch, Iran University of Medical Sciences, Tehran, Iran
| | - Mostafa Shanbezadeh
- Department of Health Information Technology, School of Paramedical, Ilam University of Medical Sciences, Ilam, Iran
| | - Hadi Kazemi-Arpanahi
- Department of Health Information Technology, Abadan University of Medical Sciences, Abadan, Iran
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Blukacz A, Cabieses B, Obach A, Calderón AC, Álvarez MI, Madrid P, Rada I. Promoting the Participation of "Hard-to-Reach" Migrant Populations in Qualitative Public Health Research during the COVID-19 Pandemic in Chile. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1956. [PMID: 36767326 PMCID: PMC9916086 DOI: 10.3390/ijerph20031956] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 01/09/2023] [Accepted: 01/12/2023] [Indexed: 05/22/2023]
Abstract
The COVID-19 pandemic has further deepened socioeconomic and health inequities worldwide, especially among populations experiencing social vulnerability, such as international migrants. Sustained lockdowns and social distancing have raised challenges to conducting public health research with hard-to-reach populations. This study aims at exploring strategies to recruit "hard-to-reach" international migrants for qualitative public health research during the pandemic in Chile, based on the authors' experience. A retrospective qualitative evaluation process was carried out on the recruitment processes of three qualitative research projects focused on international migrants in Chile. All projects were implemented during the COVID-19 pandemic, demanding complementary and flexible strategies: (i) social media; (ii) snowball sampling; (iii) referrals from social workers and pro-migrant and migrant-led organizations; (iv) vaccination centers and healthcare centers; and (v) community-based recruitment. The strategies are qualitatively evaluated around seven emerging qualitative categories: (i) feasibility during lockdown periods; (ii) speed of recruitment; (iii) geographical coverage; (iv) sample diversity; (v) proportion of successful interviews; (vi) ethical considerations; and (vii) cost. Engaging hard-to-reach international migrants in public health research during the pandemic required constantly adapting recruitment strategies. Furthermore, relying on strategies that were not only Internet-based promoted the participation of populations with limited access to the Internet and low-digital literacy.
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Affiliation(s)
- Alice Blukacz
- Programa de Estudios Sociales en Salud, Instituto de Ciencias e Innovación en Medicina, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Avenida Plaza 680, Las Condes, Región Metropolitana, Santiago 7610658, Chile
| | - Báltica Cabieses
- Programa de Estudios Sociales en Salud, Instituto de Ciencias e Innovación en Medicina, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Avenida Plaza 680, Las Condes, Región Metropolitana, Santiago 7610658, Chile
- Department of Health Sciences, University of York, York YO10 5GH, UK
| | - Alexandra Obach
- Programa de Estudios Sociales en Salud, Instituto de Ciencias e Innovación en Medicina, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Avenida Plaza 680, Las Condes, Región Metropolitana, Santiago 7610658, Chile
| | - Alejandra Carreño Calderón
- Programa de Estudios Sociales en Salud, Instituto de Ciencias e Innovación en Medicina, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Avenida Plaza 680, Las Condes, Región Metropolitana, Santiago 7610658, Chile
| | - María Inés Álvarez
- Programa de Estudios Sociales en Salud, Instituto de Ciencias e Innovación en Medicina, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Avenida Plaza 680, Las Condes, Región Metropolitana, Santiago 7610658, Chile
| | - Paula Madrid
- Programa de Estudios Sociales en Salud, Instituto de Ciencias e Innovación en Medicina, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Avenida Plaza 680, Las Condes, Región Metropolitana, Santiago 7610658, Chile
| | - Isabel Rada
- Programa de Estudios Sociales en Salud, Instituto de Ciencias e Innovación en Medicina, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Avenida Plaza 680, Las Condes, Región Metropolitana, Santiago 7610658, Chile
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Mumin FI, Wesonga FD, Handuleh JIM, White RG, Mor SM. COVID-19 and its prevention in internally displaced person (IDP) camps in Somalia: impact on livelihood, food security and mental health. BMC Public Health 2022; 22:2414. [PMID: 36550473 PMCID: PMC9779940 DOI: 10.1186/s12889-022-14878-z] [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: 05/31/2022] [Accepted: 12/15/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Somalia has over 2.6 million internally displaced people (IDP) that depend on daily wages and humanitarian assistance for their livelihoods. This study investigated the impact of COVID-19 on livelihoods, food security and mental health of Somalia's IDPs. METHODS A questionnaire was conducted with "breadwinners" (n = 585) residing in 15 randomly selected IDP camps. Mental health was assessed using the 5-item World Health Organization Wellbeing Index (WHO-5) and the Patient Health Questionnaire-9 (PHQ-9). Multivariable regression was used to explore the effect of depressive symptoms on soap use and ability to pay for food/medicine/rent. RESULTS Knowledge of COVID-19 symptoms, transmission and prevention was relatively high, however only 55% reported using soap for hand washing. Around one third perceived that prohibition of public gatherings had negatively impacted weekly earnings. Participants reported difficulty buying food (85%), medicine (82%) and paying rent (51%) because of COVID-19. The majority were assessed as having low wellbeing and high depressive symptoms (mean WHO-5 = 44.2/100; mean PHQ-9 = 18.6/27), with most (74%) indicating that they felt worse than before the pandemic. Compared to people with low depressive symptoms, people with high depressive symptoms were less likely to use soap (aOR = 0.3, 95% CI = 0.2, 0.7; P < 0.001) and more likely to report difficulty buying food (aOR = 2.2; 95% CI = 1.1, 4.3; P = 0.02). CONCLUSION COVID-19 and associated restrictions have negatively impacted Somalia's internally displaced population. Livelihood and mental health support is urgently needed in the recovery phase of the pandemic and should be factored into future pandemic planning.
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Affiliation(s)
- Farah I. Mumin
- Faculty of Veterinary Medicine, Red Sea University, Bosaso, Somalia
| | - Fred D. Wesonga
- IGAD Sheikh Technical Veterinary School, Sheikh , Somaliland
| | - Jibril I. M. Handuleh
- Department of Psychiatry, Saint Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia ,grid.448938.a0000 0004 5984 8524School of Public Health, Amoud University, Borama, Somaliland
| | - Ross G. White
- grid.4777.30000 0004 0374 7521School of Psychology, Queen’s University Belfast, Belfast, UK
| | - Siobhan M. Mor
- grid.10025.360000 0004 1936 8470Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK ,grid.419369.00000 0000 9378 4481International Livestock Research Institute, Addis Ababa, Ethiopia
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Sakyi B, Amoako Johnson F. A cross-sectional study of the psychological impact of the COVID-19 pandemic on camped refugees in Ghana. PLoS One 2022; 17:e0277515. [PMID: 36449455 PMCID: PMC9710794 DOI: 10.1371/journal.pone.0277515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 10/28/2022] [Indexed: 12/05/2022] Open
Abstract
Vulnerable populations such as camped refugees are often exposed to spread of infectious diseases because of their living conditions, limited resources available to them and exclusion from social services. This study examined the psychological state of camped refugees in Ghana during the COVID-19 pandemic and how their background characteristics predict the severity of the pandemic's psychological impact. It covered 763 refugees aged 15 years and above resident in two (Krisan = 316 and Ampain = 447) camps. Nine COVID-19 Anxiety Scale indicators were used to examine the psychological state of camped refugees. A composite indicator was derived to examine the overall psychological impact. Logistic regression was used to examine the factors that were associated with severe psychological impact. The multivariate analysis revealed that sex of the respondent, marital status and age of head of household were the only socio-demographic factors associated with having a severe psychological impact of the pandemic. There was very strong evidence that respondents who had moderate (OR = 1.74, 95% CI = 1.12, 2.7) and high (OR = 1.66, 95% CI = 1.05, 2.63) knowledge of the disease had increased odds of severe psychological impact. Also, those with moderate (OR = 2.97, 95% CI = 1.78, 4.97) and high (OR = 12.98, 95% CI = 7.86, 21.42) adherence had increased odds of severe psychological impact. None of the pre-existing health conditions and challenges were not significantly associated with severe psychological impact. The limited number of significant socio-demographic covariates suggests that severe psychological impact of the pandemic was a problem in the general population, and thus interventions should target the general population of camped refugees. Also, health education should not only focus on enhancing knowledge and promoting preventive measures but also on managing psychological distress.
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Affiliation(s)
- Barbara Sakyi
- Faculty of Social Sciences, Department of Population and Health, College of Humanities and Legal Studies, University of Cape Coast, Cape Coast, Ghana
| | - Fiifi Amoako Johnson
- Faculty of Social Sciences, Department of Population and Health, College of Humanities and Legal Studies, University of Cape Coast, Cape Coast, Ghana
- Faculty of Social Sciences, Centre for Mixed Migration and Diaspora Studies (CeMMiDS), College of Humanities and Legal Studies, University of Cape Coast, Cape Coast, Ghana
- * E-mail:
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Alhaffar M, Mkhallalati H, Alrashid Alhiraki O, Marzouk M, Khanshour A, Douedari Y, Howard N. "They cannot afford to feed their children and the advice is to stay home. How‥?": A qualitative study of community experiences of COVID-19 response efforts across Syria. PLoS One 2022; 17:e0277215. [PMID: 36331972 PMCID: PMC9635699 DOI: 10.1371/journal.pone.0277215] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 10/24/2022] [Indexed: 11/06/2022] Open
Abstract
Introduction COVID-19 highlighted the importance of meaningful engagement between communities and health authorities. This is particularly challenging in conflict-affected countries such as Syria, where social protection and food security needs can hinder adherence to non-pharmaceutical interventions (NPIs) and vaccine uptake. This study explored community perspectives of COVID-19 and health authority responses across the three main areas of control in Syria, i.e. Syrian government-controlled areas (GCA), autonomous administration-controlled areas (AACA), and opposition-controlled areas (OCA). Methods We conducted a qualitative study, interviewing 22 purposively-sampled Syrians accessing health services in AACA, GCA, or OCA in 2021 to provide approximately equal representation by governance area and gender. We analysed data thematically using deductive and inductive coding. Findings Interviewees in all areas described how their fears of COVID-19 and willingness to adhere to NPIs decreased as their local COVID-19 epidemics progressed and NPIs disrupted access to household essentials such as work and food. Community-level responses were minimal and ad hoc, so most people focused on personal or household protective efforts and many mentioned relying on their faith for comfort. Misinformation and vaccine hesitancy were common in all areas, linked to lack of transparency from and mistrust of local health authorities and information sources. Conclusions The COVID-19 pandemic has increased health actors’ need to engage with communities to control disease spread, yet most NPIs implemented in Syria were inappropriate and adherence decreased as the pandemic progressed. This was exemplified by lockdowns and requirements to self-isolate, despite precarious reliance on daily wages, no subsidies for lost income, individual self-reliance, and mistrust/weak communication between communities and health authorities. We found minimal community engagement efforts, consisting entirely of informing with no efforts to consult, involve, collaborate, or empower. This contributed to failures of health actors to contextualise interventions in ways that respected community understandings and needs.
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Affiliation(s)
- Mervat Alhaffar
- Syria Research Group (SyRG), Co-hosted by the London School of Hygiene and Tropical Medicine and Saw Swee Hock School of Public Health, London, United Kingdom
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, United Kingdom
- * E-mail:
| | - Hala Mkhallalati
- Syria Research Group (SyRG), Co-hosted by the London School of Hygiene and Tropical Medicine and Saw Swee Hock School of Public Health, London, United Kingdom
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Omar Alrashid Alhiraki
- Syria Research Group (SyRG), Co-hosted by the London School of Hygiene and Tropical Medicine and Saw Swee Hock School of Public Health, London, United Kingdom
| | - Manar Marzouk
- Syria Research Group (SyRG), Co-hosted by the London School of Hygiene and Tropical Medicine and Saw Swee Hock School of Public Health, London, United Kingdom
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Ahmad Khanshour
- Syria Research Group (SyRG), Co-hosted by the London School of Hygiene and Tropical Medicine and Saw Swee Hock School of Public Health, London, United Kingdom
| | - Yazan Douedari
- Syria Research Group (SyRG), Co-hosted by the London School of Hygiene and Tropical Medicine and Saw Swee Hock School of Public Health, London, United Kingdom
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Free Aleppo University, Aleppo, Syria
| | - Natasha Howard
- Syria Research Group (SyRG), Co-hosted by the London School of Hygiene and Tropical Medicine and Saw Swee Hock School of Public Health, London, United Kingdom
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
- Free Aleppo University, Aleppo, Syria
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Ghanbari Movahed R, Maleki Fard F, Gholamrezai S, Pakravan-Charvadeh MR. The Impact of COVID-19 Pandemic on Food Security and Food Diversity of Iranian Rural Households. Front Public Health 2022; 10:862043. [PMID: 35433601 PMCID: PMC9008508 DOI: 10.3389/fpubh.2022.862043] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 02/08/2022] [Indexed: 01/04/2023] Open
Abstract
With the onset of the coronavirus crisis, disruption of the domestic food supply chain, loss of revenue, and payments that affect food production have led to severe tensions and food security risks in many developing countries. The rural communities are more at risk of food insecurity due to less access to healthcare and social inequality. Therefore, this study aimed to assess the impact of the COVID-19 pandemic on food security and food diversity of rural households. The sample included 375 household heads living in the rural areas of Khorramabad county, which was determined using a three-stage cluster sampling method. Data were collected using standard Household Food Insecurity Access Scale (HFIAS) and Household Dietary Diversity Score (HDDS) questionnaires. The results showed that the food security situation of rural households has deteriorated, and consumption of some food groups changed during the COVID-19 pandemic. The results of the multinomial regression model showed that gender, level of education, monthly income, number of employed members, nutrition knowledge, employment status, livestock ownership, and access to credit were significantly associated with the food security of households during the COVID-19 pandemic. The household head's gender, level of education, monthly income, nutrition knowledge, employment status, livestock ownership, and access to credit were significantly associated with dietary diversity during the COVID-19 pandemic. Based on the findings, providing emergency food assistance and cash payments to food-insecure households can reduce the risk of food insecurity in rural households. It is suggested that government policies focus on identifying vulnerable households in rural areas, especially female-headed households, low-income households, and households without a wage income.
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Affiliation(s)
- Rezvan Ghanbari Movahed
- Department of Rural Development, Faculty of Agriculture, Lorestan University, Khorramabad, Iran
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Warsame A, Fuje M, Checchi F, Blanchet K, Palmer J. Evaluating COVID-19 decision-making in a humanitarian setting: The case study of Somalia. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000192. [PMID: 36962363 PMCID: PMC10021687 DOI: 10.1371/journal.pgph.0000192] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 02/01/2022] [Indexed: 06/18/2023]
Abstract
The global COVID-19 pandemic is unprecedented in its scope and impact. While a great deal of research has been directed towards the response in high-income countries, relatively little is known about the way in which decision-makers in low-income and crisis-affected countries have contended with the epidemic. Through use of an a priori decision framework, we aimed to evaluate the process of policy and operational decision-making in relation to the COVID-19 response in Somalia, a chronically fragile country, focusing particularly on the use of information and the role of transparency. We undertook a desk review, observed a number of key decision-making fora and conducted a series of key informant and focus group discussions with a range of decision-makers including state authority, civil society, humanitarian and development actors. We found that nearly all actors struggled to make sense of the scale of the epidemic and form an appropriate response. Decisions made during the early months had a large impact on the course of the epidemic response. Decision-makers relied heavily on international norms and were constrained by a number of factors within the political environment including resource limitations, political contestation and low population adherence to response measures. Important aspects of the response suffered from a transparency deficit and would have benefitted from more inclusive decision-making. Development of decision support tools appropriate for crisis-affected settings that explicitly deal with individual and environmental decision factors could lead to more effective and timely epidemic response.
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Affiliation(s)
- Abdihamid Warsame
- Faculty of Epidemiology and Population Health, The London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Mohamed Fuje
- Office of the Chief Medical Officer, Federal Ministry of Health and Social Services, Mogadishu, Somalia
| | - Francesco Checchi
- Faculty of Epidemiology and Population Health, The London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Karl Blanchet
- Faculty of Medicine, Geneva Centre of Humanitarian Studies, University of Geneva, Geneva, Switzerland
| | - Jennifer Palmer
- Faculty of Public Health and Policy, The London School of Hygiene & Tropical Medicine, London, United Kingdom
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Ozer P, Dembele A, Yameogo SS, Hut E, de Longueville F. The impact of COVID-19 on the living and survival conditions of internally displaced persons in Burkina Faso. WORLD DEVELOPMENT PERSPECTIVES 2022; 25:100393. [PMID: 35036662 PMCID: PMC8743390 DOI: 10.1016/j.wdp.2022.100393] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 09/05/2021] [Accepted: 01/04/2022] [Indexed: 05/28/2023]
Abstract
In recent years, as in other parts of the Sahel, the threat of terrorism has escalated in Burkina Faso. In 2019, this country hosted the fourth highest number of new conflict-related internal displaced persons (IDPs) in the world. These people have to cope simultaneously with the full spectrum of environmental, social and health-related stresses in the long, medium and short term, respectively. We seek to compare the living conditions of IDPs before and during the lockdown implemented by the authorities (between 27 March and 5 May 2020) to contain the spread of the virus. Interviews were conducted with 106 IDPs in Kongoussi (Central-Northern region). Although no respondent reported having been directly affected by the virus, 84.9% of the IDPs surveyed had no income-generating activities during the lockdown and the remaining 15.1% who continued to work reported that their activities had been greatly scaled-down. For a large majority of them, their living conditions, already described as difficult under 'normal' circumstances (insufficient food, insignificant financial assistance, or difficult access to health care), further deteriorated. In addition, IDPs were unable to leave the camps or regions where they were located to search for better living conditions or to return home. Lastly, 96.2% of respondents believed that the COVID-19 pandemic would have a negative impact on their future. These IDPs, like many in the sub-region and around the world, therefore require urgent assistance from the authorities and humanitarian NGOs, as the slightest new stress is likely to considerably worsen their already vulnerable state.
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Affiliation(s)
- Pierre Ozer
- Department of Environmental Sciences and Management, UR SPHERES, University of Liège, Belgium
- The Hugo Observatory, UR SPHERES, University of Liège, Belgium
| | - Adama Dembele
- Department of Environmental Sciences and Management, UR SPHERES, University of Liège, Belgium
| | - Simplice S Yameogo
- Executive Secretariat of the National Council for Food Security, Ministry of Agriculture and Hydro Agricultural Development, Burkina Faso
| | - Elodie Hut
- The Hugo Observatory, UR SPHERES, University of Liège, Belgium
| | - Florence de Longueville
- Department of Geography, University of Namur, Belgium
- Institute of Life, Earth and Environment, University of Namur, Belgium
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Varzaneh ZA, Orooji A, Erfannia L, Shanbehzadeh M. A new COVID-19 intubation prediction strategy using an intelligent feature selection and K-NN method. INFORMATICS IN MEDICINE UNLOCKED 2022; 28:100825. [PMID: 34977330 PMCID: PMC8712462 DOI: 10.1016/j.imu.2021.100825] [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: 11/10/2021] [Revised: 12/13/2021] [Accepted: 12/14/2021] [Indexed: 12/14/2022] Open
Abstract
Background Predicting severe respiratory failure due to COVID-19 can help triage patients to higher levels of care, resource allocation and decrease morbidity and mortality. The need for this research derives from the increasing demand for innovative technologies to overcome complex data analysis and decision-making tasks in critical care units. Hence the aim of our paper is to present a new algorithm for selecting the best features from the dataset and developing Machine Learning(ML) based models to predict the intubation risk of hospitalized COVID-19 patients. Methods In this retrospective single-center study, the data of 1225 COVID-19 patients from February 9, 2020, to July 20, 2021, were analyzed by several ML algorithms which included, Decision Tree(DT), Support Vector Machine (SVM), Multilayer perceptron (MLP), and K-Nearest Neighbors(K-NN). First, the most important predictors were identified using the Horse herd Optimization Algorithm (HOA). Then, by comparing the ML algorithms' performance using some evaluation criteria, the best performing one was identified. Results Predictive models were trained using 12 validated features. Also, it found that proposed DT-based predictive model enables a reasonable level of accuracy (=93%) in predicting the risk of intubation among hospitalized COVID-19 patients. Conclusions The experimental results demonstrate the effectiveness of the proposed meta-heuristic feature selection technique in combining with DT model in predicting intubation risk for hospitalized patients with COVID-19. The proposed model have the potential to inform frontline clinicians with quantitative and non-invasive tool to assess illness severity and to identify high risk patients.
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Affiliation(s)
- Zahra Asghari Varzaneh
- Department of Computer Science, Faculty of Mathematics and Computer, Shahid Bahonar University of Kerman, Kerman, Iran
| | - Azam Orooji
- Department of Advanced Technologies, School of Medicine, North Khorasan University of Medical Science (NKUMS), North Khorasan, Iran
| | - Leila Erfannia
- Department of Health Information Management, School of Management and Medical Informatics, Health Human Resources Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mostafa Shanbehzadeh
- Department of Health Information Technology, School of Paramedical, Ilam University of Medical Sciences, Ilam, Iran
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Ag Ahmed MA, Ly BA, Diarra NH, Traore FB, Diarra D, Kande IF, Dembele M, Doumbia S, Alami H. Challenges to the implementation and adoption of physical distancing measures against COVID-19 by internally displaced people in Mali: a qualitative study. Confl Health 2021; 15:88. [PMID: 34863236 PMCID: PMC8642860 DOI: 10.1186/s13031-021-00425-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 11/15/2021] [Indexed: 11/29/2022] Open
Abstract
Background For almost a decade now, Mali has been facing a security crisis that led to the displacement of thousands of people within the country. Since March 2020, a health crisis linked to the COVID-19 pandemic also surfaced. To overcome this health crisis, the government implemented some physical distancing measures but their adoption proved difficult, particularly among internally displaced people (IDPs). The objective of this study is to identify the challenges relating to the implementation and adoption of physical distancing measures and to determine the main mitigation measures taken by IDPs to adjust to these new policies.
Methods An exploratory qualitative research was conducted in Bamako and Ségou, two of the ten regions of Mali. The study counted 68 participants including 50 IDPs, seven administrative and health authorities, and 11 humanitarian actors. Sampling was guided by the principle of saturation and diversification, and data was collected through semi-structured individual interviews (n = 36) and focus groups (n = eight). Analysis was based on thematic content analysis through NVivo software.
Results The main challenges identified concerning the implementation and adoption of physical distancing measures include the proximity in which IDPs live, their beliefs and values, the lack of toilets and safe water on sites, IDPs habits and economic situation, humanitarian actors’ lack of financial resources and authority, and social pressure from religious leaders. Implemented mitigation measures include the building of new shelters or their compartmentalization, the creation of income-generating activities and food banks, psychosocial support, promoting awareness of IDPs, and nightly police patrols and surveillance to discourage IDPs from going out. Finally, a call for action is suggested for the actors involved in IDPs support and management. Conclusions The study demonstrates the difficulty for IDPs to follow most of the physical distancing measures and informs about the risk of disease spreading among IDPs with its potential consequences. It also shows the inability of mitigation measures to control the outbreak and suggests actions to be considered.
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Affiliation(s)
- Mohamed Ali Ag Ahmed
- Institute of Tropical Medicine, Antwerp, Belgium. .,Faculty of Medicine and Odontostomalogy, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali.
| | - Birama Apho Ly
- Faculty of Pharmacy, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - Niélé Hawa Diarra
- Faculty of Medicine and Odontostomalogy, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | | | - Djeneba Diarra
- Faculty of Medicine and Odontostomalogy, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | | | - Mahamadou Dembele
- Faculty of Medicine and Odontostomalogy, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - Seydou Doumbia
- Faculty of Medicine and Odontostomalogy, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
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