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Babikir IH, Alamri AM, Alraddadi AA, Alhajuj MN, Alnakhle MM, Alhajuj HA, Alfahal MS, Elmuttalut M. Bridging the Gaps: The Transformative Effect of Coronavirus Disease 2019 (COVID-19) on Preventive Measures Among Medical and Health Sciences College Students in Madinah, Saudi Arabia. Cureus 2024; 16:e55131. [PMID: 38558720 PMCID: PMC10979714 DOI: 10.7759/cureus.55131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/26/2024] [Indexed: 04/04/2024] Open
Abstract
Background The global impact of coronavirus disease 2019 (COVID-19) has disrupted the activities of medical and health profession education institutions. This study aimed to determine the impact of COVID-19 on medical and health profession education students' knowledge, attitudes, and practices toward preventive measures and their commitment to precautionary measures before, during, and after the pandemic. Materials and methods A cross-sectional study was carried out from January to March 2023 using an online, structured, validated questionnaire survey to gather information from medical and health sciences students from three universities, encompassing five colleges in Madinah, Saudi Arabia. The minimum required sample size was estimated using the Epi Info software as 380. The data was analyzed using IBM SPSS Statistics for Windows, Version 20.0 (Released 2011; IBM Corp., Armonk, New York, United States). Statistical tests including Student's t-test, chi-squared test, and analysis of variance (ANOVA) test were applied. Results The findings revealed that personal experiences with COVID-19 infection had a significant impact on students' attitudes and commitment to preventive measures (p<0.05). Among the participants, 172 students (45%) reported having contracted COVID-19. Students with clinical exposure showed a higher level of understanding and adherence to preventive measures (248 students, 68%), compared to pre-clinical students (198 students, 52%) (p<0.05). Positive attitudes were observed toward practices such as sneezing etiquette (289 students, 76%) and flu vaccination (314 students, 83%) (p<0.05). However, negative attitudes were observed toward mask-wearing (155 students, 41%) and social distancing (144 students, 38%), particularly among male students (p<0.05). Conclusion The study provided valuable insights into the impact of the COVID-19 pandemic on medical and health sciences students' knowledge, attitudes, and practices toward preventive measures and the importance of introducing COVID-19 prevention measures in the pre-clinical phase as well as mental health support to promote positive attitudes and enhance adherence to preventive measures.
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Affiliation(s)
- Ibrahim H Babikir
- Department of Microbiology, Al-Rayan National College of Medicine, Madinah, SAU
- Department of Microbiology, College of Laboratory Medicine, University of Khartoum, Khartoum, SDN
| | | | | | - Mohesn N Alhajuj
- Medical School, Al-Rayan National College of Medicine, Madinah, SAU
| | | | - Hassan A Alhajuj
- Medical School, Al-Rayan National College of Medicine, Madinah, SAU
| | - Mohammed S Alfahal
- Department of Psychiatry, Al-Rayan National College of Medicine, Madinah, SAU
| | - Mohammed Elmuttalut
- Department of Community Medicine, Al-Rayan National College of Medicine, Madinah, SAU
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Pandher R, Bilszta JLC. Novel COVID-19 vaccine hesitancy and acceptance, and associated factors, amongst medical students: a scoping review. MEDICAL EDUCATION ONLINE 2023; 28:2175620. [PMID: 36788502 PMCID: PMC9930839 DOI: 10.1080/10872981.2023.2175620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 01/29/2023] [Accepted: 01/30/2023] [Indexed: 06/18/2023]
Abstract
Medical students are likely to be exposed to COVID-19 patients so achieving high vaccination coverage rates for this group of healthcare workers is important, as is their potential as vaccination role models. The aim of this scoping review was to evaluate the current literature to determine the rates of COVID-19 vaccine hesitancy and acceptance, and associated factors, amongst medical students. Systematic searches of the Medline Ovid, Embase, PubMed, and Education Resources Information Centre (ERIC) online databases was conducted for relevant articles with keywords: 'COVID-19', 'vaccine hesitancy & acceptance' and 'medical students'. Articles were included for review if they reported the rates of vaccine hesitancy and acceptance, and associated factors, amongst medical students. Of the 258 articles identified, 52 met the inclusion criteria and underwent full-text review. Rates of vaccine hesitancy ranged from 5.4-86.7%, with generally positive attitudes towards COVID-19 vaccination. The main factors associated with vaccine hesitancy were concerns about the safety and efficacy of vaccines due to their accelerated development, being a pre-clinical medical student, and low perceived personal risk of COVID-19 infection. Inconsistencies were found for the influence of gender on attitudes towards vaccinations. Previous vaccination behaviours were predictive of willingness to receive the COVID-19 vaccine. Knowledge about COVID-19 vaccinations and their importance was found to be deficient amongst vaccine hesitant medical students. Generally, medical students express low levels of vaccine hesitancy. However, due to the variability in the factors associated with vaccine hesitancy across different populations and the dynamic and contextual nature of hesitancy, it is recommended that vaccination intent and associated attitudes are monitored on a longitudinal basis. It is important to map vaccine hesitancy at a local level to allow medical schools to develop strategies to encourage vaccination specific to their school's needs.
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Affiliation(s)
- Robyn Pandher
- Department of Medical Education, Melbourne Medical School, University of Melbourne, Parkville, Australia
| | - Justin L C Bilszta
- Department of Medical Education, Melbourne Medical School, University of Melbourne, Parkville, Australia
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Qin Z, Ye X, Liu H, Tao Y, Zheng X, Zhong Y, Chen D, Ye W, Zhan C. Assessing the Knowledge, Attitudes, and Vaccination Practices Towards COVID-19 Vaccination Among Mainland Chinese Nursing Students and Interns: A Multicenter Cross-Sectional Study. Infect Drug Resist 2023; 16:4717-4728. [PMID: 37496694 PMCID: PMC10366673 DOI: 10.2147/idr.s415799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 07/12/2023] [Indexed: 07/28/2023] Open
Abstract
Objective This study investigated factors influencing the knowledge, attitudes, practice profiles, and vaccination intentions among Chinese nursing students and nursing interns toward the coronavirus disease (COVID-19) vaccination. Materials and Methods The multicenter cross-sectional study was based on a self-reported questionnaire collecting information among nursing students and nursing interns from three major geographic regions of China, and the sample was selected by consecutive sampling. The questionnaire was developed by knowledge, attitudes, and practice (KAP) theory. Univariate and multivariate logistic regression were used for statistical analysis. Results A total of 3180 nursing students and interns (effective rate: 99.8%) from six Chinese provinces were polled. The vaccine hesitation rate was 9.65% (307/3180), 2230 participants (70.1%) had gotten at least one dose of the vaccine, and 643 participants (67.7%) had indicated a readiness to be vaccinated. The results showed that older age, higher academic background, perfect vaccine management, others' recommendations, influenza vaccination history, epidemic under control, knowledge of vaccines or intervals, and vaccine knowledge training were associated with higher vaccination rates. Conversely, vaccine hesitancy was caused by a perceived lack of physical need, uncertainty about vaccination requirements, and fear of vaccination. Conclusion This study provided population-based estimates of COVID-19 vaccine uptake intention among mainland Chinese nursing students and interns. Factors such as age, education, vaccine knowledge, and attitudes influence COVID-19 vaccine behaviour. Relevant authorities should understand the barriers to COVID-19 vaccination from knowledge, attitude and practice, which is significant for formulating effective response strategies in future global public health crises.
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Affiliation(s)
- Zhuzhu Qin
- School of Nursing, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China
| | - Xinxin Ye
- Department of Sports and Exercise Science, College of Education, Zhejiang University, Hangzhou, Zhejiang, China
| | - Huanju Liu
- Women’s Hospital and Institute of Genetics, Zhejiang University School of Medicine, Hangzhou, China
| | - Yining Tao
- Department of Global Public Health, Karolinska Institute, Stockholm, Sweden
| | - Xutong Zheng
- School of Nursing, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China
| | - Yanxia Zhong
- Department of Nursing, Shijiazhuang Medical College, Shijiazhuang, China
| | - Danfeng Chen
- School of Nursing, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China
| | - Wan Ye
- Department of Nursing, Xiamen Medical College, Xiamen, Fujian, China
| | - Chenju Zhan
- Department of Nursing, Mindong Hospital Affiliated to Fujian Medical University, Ningde, China
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Su Y, Li S, Huang F, Xue J, Zhu T. Exploring the Influencing Factors of COVID-19 Vaccination Willingness among Young Adults in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3960. [PMID: 36900971 PMCID: PMC10001881 DOI: 10.3390/ijerph20053960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 02/10/2023] [Accepted: 02/20/2023] [Indexed: 06/18/2023]
Abstract
Vaccine uptake is considered as one of the most effective methods of defending against COVID-19 (coronavirus disease 2019). However, many young adults are hesitant regarding COVID-19 vaccines, and they actually play an important role in virus transmission. Based on a multi-theory model, this study aims to explore the influencing factors related to COVID-19 vaccine willingness among young adults in China. Using semi-structured interviews, this study explored the factors that would motivate young adults with vaccine hesitancy to get the COVID-19 vaccine. Thematic analysis was used to analyze the interview data with topic modeling as a complementarity method. After comparing the differences and similarities of results generated by thematic analysis and topic modeling, this study ultimately identified ten key factors related to COVID-19 vaccination intention, including the effectiveness and safety of vaccines, application range of vaccine, etc. This study combined thematic analysis with machine learning and provided a comprehensive and nuanced picture of facilitating factors for COVID-19 vaccine uptake among Chinese young adults. Results may be taken as potential themes for authorities and public health workers in vaccination campaigns.
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Affiliation(s)
- Yue Su
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing 100101, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Sijia Li
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong
| | - Feng Huang
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing 100101, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Jia Xue
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON M5S 1A1, Canada
- Faculty of Information, University of Toronto, Toronto, ON M5S 1A1, Canada
| | - Tingshao Zhu
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing 100101, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing 100049, China
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Mudenda S, Ngalande N, Mukosha M, Hikaambo CN, Daka V, Matafwali SK, Banda M, Mfune RL, Mayoka G, Witika BA. Knowledge and practices toward COVID-19 among healthcare students: A cross-sectional study at the University of Zambia. Front Public Health 2022; 10:1028312. [PMID: 36530704 PMCID: PMC9748439 DOI: 10.3389/fpubh.2022.1028312] [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: 08/25/2022] [Accepted: 11/11/2022] [Indexed: 12/05/2022] Open
Abstract
Background The COVID-19 pandemic led to the disruption of physical classes for university students globally, as large gatherings fuelled the transmission of the virus. In the efforts to mitigate its transmission and return to normality, prevention measures, including vaccination, have been encouraged. Therefore, it is critical to understand the knowledge and practices of students regarding COVID-19. This study assessed the knowledge and practices toward COVID-19 among healthcare students at the University of Zambia. Materials and methods This questionnaire-based cross-sectional study was carried out from August 2021 to October 2021 among 478 healthcare students (pharmacy, physiotherapy, nursing, biomedical, medicine, and radiography). We used a previously validated questionnaire to measure knowledge and practice. The predictors of knowledge and practices were assessed using logistic regression with robust estimation of standard errors. Statistical analysis was conducted using Stata/BE version 17.0. Results Of the 478 respondents, 243 (50.8%) were females. A larger proportion, 175 (36.6%) were in Pharmacy training, and 156 (32.6%) were in their fifth year of study. The overall mean knowledge score of the participants was 87.9 (SD = 16.1), being higher at 89.6 (SD = 14.3) among medical students and the lowest at 86.7 (SD = 17.1) among Pharmacy students, although this was statistically non-significant (p = 0.488). The overall mean practice score was 60.0 (SD = 24.7), being significantly higher at 63.5 (23.4) among nursing, physiotherapy and environmental students compared to other students (p = 0.048). In multivariable analysis, the participant training program was non-significantly associated with knowledge and practice toward COVID-19. However, increased age (AOR = 1.09, 95% CI: 1.01-1.117) and residing in urban areas (AOR = 1.79, 95% CI: 1.07-3.01) than in rural areas were associated with higher odds of good practice toward COVID-19. Conclusion The healthcare students generally showed good knowledge levels and poor practices toward COVID-19. Further, there was no evidence of a difference in knowledge of COVID-19 among healthcare students. These findings suggest the need for implementation strategies to be centered on improving the practices of students toward COVID-19.
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Affiliation(s)
- Steward Mudenda
- Department of Pharmacy, School of Health Sciences, University of Zambia, Lusaka, Zambia
| | - Nelly Ngalande
- Department of Pharmacy, School of Health Sciences, University of Zambia, Lusaka, Zambia
| | - Moses Mukosha
- Department of Pharmacy, School of Health Sciences, University of Zambia, Lusaka, Zambia
| | | | - Victor Daka
- Department of Public Health, Michael Chilufya Sata School of Medicine, Copperbelt University, Ndola, Zambia
| | - Scott Kaba Matafwali
- Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Michelo Banda
- Department of Pharmacy, School of Health Sciences, University of Zambia, Lusaka, Zambia
| | - Ruth Lindizyani Mfune
- Department of Public Health, Michael Chilufya Sata School of Medicine, Copperbelt University, Ndola, Zambia
| | - Godfrey Mayoka
- Department of Pharmacology and Pharmacognosy, School of Pharmacy, Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya
| | - Bwalya Angel Witika
- Department of Pharmaceutical Sciences, School of Pharmacy, Sefako Makgatho Health Sciences University, Pretoria, South Africa
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Fajar JK, Sallam M, Soegiarto G, Sugiri YJ, Anshory M, Wulandari L, Kosasih SAP, Ilmawan M, Kusnaeni K, Fikri M, Putri F, Hamdi B, Pranatasari ID, Aina L, Maghfiroh L, Ikhriandanti FS, Endiaverni WO, Nugraha KW, Wiranudirja O, Edinov S, Hamdani U, Rosyidah L, Lubaba H, Ariwibowo R, Andistyani R, Fitriani R, Hasanah M, Nafis FAD, Tamara F, Latamu FO, Kusuma HI, Rabaan AA, Alhumaid S, Mutair AA, Garout M, Halwani MA, Alfaresi M, Al Azmi R, Alasiri NA, Alshukairi AN, Dhama K, Harapan H. Global Prevalence and Potential Influencing Factors of COVID-19 Vaccination Hesitancy: A Meta-Analysis. Vaccines (Basel) 2022; 10:vaccines10081356. [PMID: 36016242 PMCID: PMC9412456 DOI: 10.3390/vaccines10081356] [Citation(s) in RCA: 44] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 08/08/2022] [Accepted: 08/15/2022] [Indexed: 02/08/2023] Open
Abstract
Countries worldwide have deployed mass COVID-19 vaccination drives, but there are people who are hesitant to receive the vaccine. Studies assessing the factors associated with COVID-19 vaccination hesitancy are inconclusive. This study aimed to assess the global prevalence of COVID-19 vaccination hesitancy and determine the potential factors associated with such hesitancy. We performed an organized search for relevant articles in PubMed, Scopus, and Web of Science. Extraction of the required information was performed for each study. A single-arm meta-analysis was performed to determine the global prevalence of COVID-19 vaccination hesitancy; the potential factors related to vaccine hesitancy were analyzed using a Z-test. A total of 56 articles were included in our analysis. We found that the global prevalence of COVID-19 vaccination hesitancy was 25%. Being a woman, being a 50-year-old or younger, being single, being unemployed, living in a household with five or more individuals, having an educational attainment lower than an undergraduate degree, having a non-healthcare-related job and considering COVID-19 vaccines to be unsafe were associated with a higher risk of vaccination hesitancy. In contrast, living with children at home, maintaining physical distancing norms, having ever tested for COVID-19, and having a history of influenza vaccination in the past few years were associated with a lower risk of hesitancy to COVID-19 vaccination. Our study provides valuable information on COVID-19 vaccination hesitancy, and we recommend special interventions in the sub-populations with increased risk to reduce COVID-19 vaccine hesitancy.
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Affiliation(s)
- Jonny Karunia Fajar
- Brawijaya Internal Medicine Research Center, Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang 65145, Indonesia
| | - Malik Sallam
- Department of Pathology, Microbiology and Forensic Medicine, School of Medicine, The University of Jordan, Amman 11942, Jordan
- Department of Clinical Laboratories and Forensic Medicine, Jordan University Hospital, Amman 11942, Jordan
- Department of Translational Medicine, Faculty of Medicine, Lund University, 22184 Malmö, Sweden
- Correspondence: ; Tel.: +962-79-184-5186
| | - Gatot Soegiarto
- Division of Allergy and Immunology, Department of Internal Medicine, Faculty of Medicine, Universitas Airlangga, Surabaya 60286, Indonesia
| | - Yani Jane Sugiri
- Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Brawijaya, Malang 65145, Indonesia
| | - Muhammad Anshory
- Division of Allergy and Immunology, Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang 65145, Indonesia
| | - Laksmi Wulandari
- Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Airlangga, Surabaya 60286, Indonesia
| | | | - Muhammad Ilmawan
- Department of Urology, Faculty of Medicine, Universitas Brawijaya, Malang 65145, Indonesia
| | - Kusnaeni Kusnaeni
- Faculty of Matematics and Sciences, Institut Pertanian Bogor, Bogor 16680, Indonesia
| | - Muhammad Fikri
- Faculty of Matematics and Sciences, Institut Pertanian Bogor, Bogor 16680, Indonesia
| | - Frilianty Putri
- School of Veterinary Medicine and Biomedicine, Institut Pertanian Bogor, Bogor 16680, Indonesia
| | - Baitul Hamdi
- Faculty of Economy and Business, Universitas Airlangga, Surabaya 60286, Indonesia
| | | | - Lily Aina
- Faculty of Pharmacy, Universitas Airlangga, Surabaya 60286, Indonesia
| | - Lailatul Maghfiroh
- Faculty of Veterinary Medicine, Universitas Airlangga, Surabaya 60286, Indonesia
| | | | - Wa Ode Endiaverni
- Faculty of Economy and Business, Universitas Brawijaya, Malang 65145, Indonesia
| | | | - Ory Wiranudirja
- Faculty of Economy and Business, Universitas Brawijaya, Malang 65145, Indonesia
| | - Sally Edinov
- Faculty of Economics and Business, Riau University, Pekanbaru 28293, Indonesia
| | - Ujang Hamdani
- Faculty of Economy and Business, Universitas Brawijaya, Malang 65145, Indonesia
| | - Lathifatul Rosyidah
- Faculty of Economy and Business, Universitas Brawijaya, Malang 65145, Indonesia
| | - Hanny Lubaba
- Faculty of Economy and Business, Universitas Brawijaya, Malang 65145, Indonesia
| | - Rinto Ariwibowo
- Faculty of Economy and Business, Universitas Brawijaya, Malang 65145, Indonesia
| | - Riska Andistyani
- Faculty of Economy and Business, Universitas Brawijaya, Malang 65145, Indonesia
| | - Ria Fitriani
- Faculty of Administrative Science, Universitas Brawijaya, Malang 65145, Indonesia
| | - Miftahul Hasanah
- Faculty of Animal Science, Universitas Brawijaya, Malang 65145, Indonesia
| | | | - Fredo Tamara
- Brawijaya Internal Medicine Research Center, Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang 65145, Indonesia
| | - Fitri Olga Latamu
- Brawijaya Internal Medicine Research Center, Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang 65145, Indonesia
| | - Hendrix Indra Kusuma
- Medical Research Unit, School of Medicine, Universitas Syiah Kuala, Banda Aceh 23111, Indonesia
- Faculty of Mathematics and Natural Sciences, Universitas Syiah Kuala, Darussalam, Banda Aceh 23111, Indonesia
- Faculty of Tarbiyah and Teacher Training, Universitas Islam Negeri Ar-Raniry, Banda Aceh 23111, Indonesia
| | - Ali A. Rabaan
- Molecular Diagnostic Laboratory, Johns Hopkins Aramco Healthcare, Dhahran 31311, Saudi Arabia
- College of Medicine, Alfaisal University, Riyadh 11533, Saudi Arabia
- Department of Public Health and Nutrition, The University of Haripur, Haripur 22610, Pakistan
| | - Saad Alhumaid
- Administration of Pharmaceutical Care, Al-Ahsa Health Cluster, Ministry of Health, Al-Ahsa 31982, Saudi Arabia
| | - Abbas Al Mutair
- Research Center, Almoosa Specialist Hospital, Al Mubarrazs 36342, Saudi Arabia
- College of Nursing, Princess Norah Bint Abdulrahman University, Riyadh 11564, Saudi Arabia
- School of Nursing, Wollongong University, Wollongong, NSW 2522, Australia
- Nursing Department, Prince Sultan Military College of Health Sciences, Dhahran 33048, Saudi Arabia
| | - Mohammed Garout
- Department of Community Medicine and Health Care for Pilgrims, Faculty of Medicine, Umm Al-Qura University, Makkah 21955, Saudi Arabia
| | - Muhammad A. Halwani
- Department of Medical Microbiology, Faculty of Medicine, Al Baha University, Al Baha 4781, Saudi Arabia
| | - Mubarak Alfaresi
- Department of Pathology and Laboratory Medicine, Sheikh Khalifa General Hospital, Umm Al Quwain 499, United Arab Emirates
- Department of Pathology, College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai 505055, United Arab Emirates
| | - Reyouf Al Azmi
- Infection Prevention and Control, Eastern Health Cluster, Dammam 32253, Saudi Arabia
| | - Nada A. Alasiri
- Scientific Advisory Council, InsanCare Group for Scientific Studies and Specialized Business Solutions, Riyadh 13313, Saudi Arabia
| | - Abeer N. Alshukairi
- College of Medicine, Alfaisal University, Riyadh 11533, Saudi Arabia
- Department of Medicine, King Faisal Specialist Hospital and Research Center, Jeddah 12713, Saudi Arabia
| | - Kuldeep Dhama
- Division of Pathology, ICAR–Indian Veterinary Research Institute, Izatnagar, Bareilly 243122, India
| | - Harapan Harapan
- Medical Research Unit, School of Medicine, Universitas Syiah Kuala, Banda Aceh 23111, Indonesia
- Tropical Disease Centre, School of Medicine, Universitas Syiah Kuala, Banda Aceh 23111, Indonesia
- Department of Microbiology, School of Medicine, Universitas Syiah Kuala, Banda Aceh 23111, Indonesia
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