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Global fertility in 204 countries and territories, 1950-2021, with forecasts to 2100: a comprehensive demographic analysis for the Global Burden of Disease Study 2021. Lancet 2024; 403:2057-2099. [PMID: 38521087 DOI: 10.1016/s0140-6736(24)00550-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 12/28/2023] [Accepted: 03/15/2024] [Indexed: 03/25/2024]
Abstract
BACKGROUND Accurate assessments of current and future fertility-including overall trends and changing population age structures across countries and regions-are essential to help plan for the profound social, economic, environmental, and geopolitical challenges that these changes will bring. Estimates and projections of fertility are necessary to inform policies involving resource and health-care needs, labour supply, education, gender equality, and family planning and support. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 produced up-to-date and comprehensive demographic assessments of key fertility indicators at global, regional, and national levels from 1950 to 2021 and forecast fertility metrics to 2100 based on a reference scenario and key policy-dependent alternative scenarios. METHODS To estimate fertility indicators from 1950 to 2021, mixed-effects regression models and spatiotemporal Gaussian process regression were used to synthesise data from 8709 country-years of vital and sample registrations, 1455 surveys and censuses, and 150 other sources, and to generate age-specific fertility rates (ASFRs) for 5-year age groups from age 10 years to 54 years. ASFRs were summed across age groups to produce estimates of total fertility rate (TFR). Livebirths were calculated by multiplying ASFR and age-specific female population, then summing across ages 10-54 years. To forecast future fertility up to 2100, our Institute for Health Metrics and Evaluation (IHME) forecasting model was based on projections of completed cohort fertility at age 50 years (CCF50; the average number of children born over time to females from a specified birth cohort), which yields more stable and accurate measures of fertility than directly modelling TFR. CCF50 was modelled using an ensemble approach in which three sub-models (with two, three, and four covariates variously consisting of female educational attainment, contraceptive met need, population density in habitable areas, and under-5 mortality) were given equal weights, and analyses were conducted utilising the MR-BRT (meta-regression-Bayesian, regularised, trimmed) tool. To capture time-series trends in CCF50 not explained by these covariates, we used a first-order autoregressive model on the residual term. CCF50 as a proportion of each 5-year ASFR was predicted using a linear mixed-effects model with fixed-effects covariates (female educational attainment and contraceptive met need) and random intercepts for geographical regions. Projected TFRs were then computed for each calendar year as the sum of single-year ASFRs across age groups. The reference forecast is our estimate of the most likely fertility future given the model, past fertility, forecasts of covariates, and historical relationships between covariates and fertility. We additionally produced forecasts for multiple alternative scenarios in each location: the UN Sustainable Development Goal (SDG) for education is achieved by 2030; the contraceptive met need SDG is achieved by 2030; pro-natal policies are enacted to create supportive environments for those who give birth; and the previous three scenarios combined. Uncertainty from past data inputs and model estimation was propagated throughout analyses by taking 1000 draws for past and present fertility estimates and 500 draws for future forecasts from the estimated distribution for each metric, with 95% uncertainty intervals (UIs) given as the 2·5 and 97·5 percentiles of the draws. To evaluate the forecasting performance of our model and others, we computed skill values-a metric assessing gain in forecasting accuracy-by comparing predicted versus observed ASFRs from the past 15 years (2007-21). A positive skill metric indicates that the model being evaluated performs better than the baseline model (here, a simplified model holding 2007 values constant in the future), and a negative metric indicates that the evaluated model performs worse than baseline. FINDINGS During the period from 1950 to 2021, global TFR more than halved, from 4·84 (95% UI 4·63-5·06) to 2·23 (2·09-2·38). Global annual livebirths peaked in 2016 at 142 million (95% UI 137-147), declining to 129 million (121-138) in 2021. Fertility rates declined in all countries and territories since 1950, with TFR remaining above 2·1-canonically considered replacement-level fertility-in 94 (46·1%) countries and territories in 2021. This included 44 of 46 countries in sub-Saharan Africa, which was the super-region with the largest share of livebirths in 2021 (29·2% [28·7-29·6]). 47 countries and territories in which lowest estimated fertility between 1950 and 2021 was below replacement experienced one or more subsequent years with higher fertility; only three of these locations rebounded above replacement levels. Future fertility rates were projected to continue to decline worldwide, reaching a global TFR of 1·83 (1·59-2·08) in 2050 and 1·59 (1·25-1·96) in 2100 under the reference scenario. The number of countries and territories with fertility rates remaining above replacement was forecast to be 49 (24·0%) in 2050 and only six (2·9%) in 2100, with three of these six countries included in the 2021 World Bank-defined low-income group, all located in the GBD super-region of sub-Saharan Africa. The proportion of livebirths occurring in sub-Saharan Africa was forecast to increase to more than half of the world's livebirths in 2100, to 41·3% (39·6-43·1) in 2050 and 54·3% (47·1-59·5) in 2100. The share of livebirths was projected to decline between 2021 and 2100 in most of the six other super-regions-decreasing, for example, in south Asia from 24·8% (23·7-25·8) in 2021 to 16·7% (14·3-19·1) in 2050 and 7·1% (4·4-10·1) in 2100-but was forecast to increase modestly in the north Africa and Middle East and high-income super-regions. Forecast estimates for the alternative combined scenario suggest that meeting SDG targets for education and contraceptive met need, as well as implementing pro-natal policies, would result in global TFRs of 1·65 (1·40-1·92) in 2050 and 1·62 (1·35-1·95) in 2100. The forecasting skill metric values for the IHME model were positive across all age groups, indicating that the model is better than the constant prediction. INTERPRETATION Fertility is declining globally, with rates in more than half of all countries and territories in 2021 below replacement level. Trends since 2000 show considerable heterogeneity in the steepness of declines, and only a small number of countries experienced even a slight fertility rebound after their lowest observed rate, with none reaching replacement level. Additionally, the distribution of livebirths across the globe is shifting, with a greater proportion occurring in the lowest-income countries. Future fertility rates will continue to decline worldwide and will remain low even under successful implementation of pro-natal policies. These changes will have far-reaching economic and societal consequences due to ageing populations and declining workforces in higher-income countries, combined with an increasing share of livebirths among the already poorest regions of the world. FUNDING Bill & Melinda Gates Foundation.
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Global burden and strength of evidence for 88 risk factors in 204 countries and 811 subnational locations, 1990-2021: a systematic analysis for the Global Burden of Disease Study 2021. Lancet 2024; 403:2162-2203. [PMID: 38762324 DOI: 10.1016/s0140-6736(24)00933-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 03/11/2024] [Accepted: 05/02/2024] [Indexed: 05/20/2024]
Abstract
BACKGROUND Understanding the health consequences associated with exposure to risk factors is necessary to inform public health policy and practice. To systematically quantify the contributions of risk factor exposures to specific health outcomes, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 aims to provide comprehensive estimates of exposure levels, relative health risks, and attributable burden of disease for 88 risk factors in 204 countries and territories and 811 subnational locations, from 1990 to 2021. METHODS The GBD 2021 risk factor analysis used data from 54 561 total distinct sources to produce epidemiological estimates for 88 risk factors and their associated health outcomes for a total of 631 risk-outcome pairs. Pairs were included on the basis of data-driven determination of a risk-outcome association. Age-sex-location-year-specific estimates were generated at global, regional, and national levels. Our approach followed the comparative risk assessment framework predicated on a causal web of hierarchically organised, potentially combinative, modifiable risks. Relative risks (RRs) of a given outcome occurring as a function of risk factor exposure were estimated separately for each risk-outcome pair, and summary exposure values (SEVs), representing risk-weighted exposure prevalence, and theoretical minimum risk exposure levels (TMRELs) were estimated for each risk factor. These estimates were used to calculate the population attributable fraction (PAF; ie, the proportional change in health risk that would occur if exposure to a risk factor were reduced to the TMREL). The product of PAFs and disease burden associated with a given outcome, measured in disability-adjusted life-years (DALYs), yielded measures of attributable burden (ie, the proportion of total disease burden attributable to a particular risk factor or combination of risk factors). Adjustments for mediation were applied to account for relationships involving risk factors that act indirectly on outcomes via intermediate risks. Attributable burden estimates were stratified by Socio-demographic Index (SDI) quintile and presented as counts, age-standardised rates, and rankings. To complement estimates of RR and attributable burden, newly developed burden of proof risk function (BPRF) methods were applied to yield supplementary, conservative interpretations of risk-outcome associations based on the consistency of underlying evidence, accounting for unexplained heterogeneity between input data from different studies. Estimates reported represent the mean value across 500 draws from the estimate's distribution, with 95% uncertainty intervals (UIs) calculated as the 2·5th and 97·5th percentile values across the draws. FINDINGS Among the specific risk factors analysed for this study, particulate matter air pollution was the leading contributor to the global disease burden in 2021, contributing 8·0% (95% UI 6·7-9·4) of total DALYs, followed by high systolic blood pressure (SBP; 7·8% [6·4-9·2]), smoking (5·7% [4·7-6·8]), low birthweight and short gestation (5·6% [4·8-6·3]), and high fasting plasma glucose (FPG; 5·4% [4·8-6·0]). For younger demographics (ie, those aged 0-4 years and 5-14 years), risks such as low birthweight and short gestation and unsafe water, sanitation, and handwashing (WaSH) were among the leading risk factors, while for older age groups, metabolic risks such as high SBP, high body-mass index (BMI), high FPG, and high LDL cholesterol had a greater impact. From 2000 to 2021, there was an observable shift in global health challenges, marked by a decline in the number of all-age DALYs broadly attributable to behavioural risks (decrease of 20·7% [13·9-27·7]) and environmental and occupational risks (decrease of 22·0% [15·5-28·8]), coupled with a 49·4% (42·3-56·9) increase in DALYs attributable to metabolic risks, all reflecting ageing populations and changing lifestyles on a global scale. Age-standardised global DALY rates attributable to high BMI and high FPG rose considerably (15·7% [9·9-21·7] for high BMI and 7·9% [3·3-12·9] for high FPG) over this period, with exposure to these risks increasing annually at rates of 1·8% (1·6-1·9) for high BMI and 1·3% (1·1-1·5) for high FPG. By contrast, the global risk-attributable burden and exposure to many other risk factors declined, notably for risks such as child growth failure and unsafe water source, with age-standardised attributable DALYs decreasing by 71·5% (64·4-78·8) for child growth failure and 66·3% (60·2-72·0) for unsafe water source. We separated risk factors into three groups according to trajectory over time: those with a decreasing attributable burden, due largely to declining risk exposure (eg, diet high in trans-fat and household air pollution) but also to proportionally smaller child and youth populations (eg, child and maternal malnutrition); those for which the burden increased moderately in spite of declining risk exposure, due largely to population ageing (eg, smoking); and those for which the burden increased considerably due to both increasing risk exposure and population ageing (eg, ambient particulate matter air pollution, high BMI, high FPG, and high SBP). INTERPRETATION Substantial progress has been made in reducing the global disease burden attributable to a range of risk factors, particularly those related to maternal and child health, WaSH, and household air pollution. Maintaining efforts to minimise the impact of these risk factors, especially in low SDI locations, is necessary to sustain progress. Successes in moderating the smoking-related burden by reducing risk exposure highlight the need to advance policies that reduce exposure to other leading risk factors such as ambient particulate matter air pollution and high SBP. Troubling increases in high FPG, high BMI, and other risk factors related to obesity and metabolic syndrome indicate an urgent need to identify and implement interventions. FUNDING Bill & Melinda Gates Foundation.
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N, Zakzuk J, Zamagni G, Zaman BA, Zaman SB, Zamora N, Zand R, Zandi M, Zandieh GGZ, Zanghì A, Zare I, Zastrozhin MS, Zeariya MGM, Zeng Y, Zhai C, Zhang C, Zhang H, Zhang H, Zhang Y, Zhang Z, Zhang Z, Zhao H, Zhao Y, Zhao Y, Zheng P, Zhong C, Zhou J, Zhu B, Zhu Z, Ziaeefar P, Zielińska M, Zou Z, Zumla A, Zweck E, Zyoud SH, Lim SS, Murray CJL. Global age-sex-specific mortality, life expectancy, and population estimates in 204 countries and territories and 811 subnational locations, 1950-2021, and the impact of the COVID-19 pandemic: a comprehensive demographic analysis for the Global Burden of Disease Study 2021. Lancet 2024; 403:1989-2056. [PMID: 38484753 DOI: 10.1016/s0140-6736(24)00476-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 12/08/2023] [Accepted: 03/06/2024] [Indexed: 04/13/2024]
Abstract
BACKGROUND Estimates of demographic metrics are crucial to assess levels and trends of population health outcomes. The profound impact of the COVID-19 pandemic on populations worldwide has underscored the need for timely estimates to understand this unprecedented event within the context of long-term population health trends. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 provides new demographic estimates for 204 countries and territories and 811 additional subnational locations from 1950 to 2021, with a particular emphasis on changes in mortality and life expectancy that occurred during the 2020-21 COVID-19 pandemic period. METHODS 22 223 data sources from vital registration, sample registration, surveys, censuses, and other sources were used to estimate mortality, with a subset of these sources used exclusively to estimate excess mortality due to the COVID-19 pandemic. 2026 data sources were used for population estimation. Additional sources were used to estimate migration; the effects of the HIV epidemic; and demographic discontinuities due to conflicts, famines, natural disasters, and pandemics, which are used as inputs for estimating mortality and population. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate under-5 mortality rates, which synthesised 30 763 location-years of vital registration and sample registration data, 1365 surveys and censuses, and 80 other sources. ST-GPR was also used to estimate adult mortality (between ages 15 and 59 years) based on information from 31 642 location-years of vital registration and sample registration data, 355 surveys and censuses, and 24 other sources. Estimates of child and adult mortality rates were then used to generate life tables with a relational model life table system. For countries with large HIV epidemics, life tables were adjusted using independent estimates of HIV-specific mortality generated via an epidemiological analysis of HIV prevalence surveys, antenatal clinic serosurveillance, and other data sources. Excess mortality due to the COVID-19 pandemic in 2020 and 2021 was determined by subtracting observed all-cause mortality (adjusted for late registration and mortality anomalies) from the mortality expected in the absence of the pandemic. Expected mortality was calculated based on historical trends using an ensemble of models. In location-years where all-cause mortality data were unavailable, we estimated excess mortality rates using a regression model with covariates pertaining to the pandemic. Population size was computed using a Bayesian hierarchical cohort component model. Life expectancy was calculated using age-specific mortality rates and standard demographic methods. Uncertainty intervals (UIs) were calculated for every metric using the 25th and 975th ordered values from a 1000-draw posterior distribution. FINDINGS Global all-cause mortality followed two distinct patterns over the study period: age-standardised mortality rates declined between 1950 and 2019 (a 62·8% [95% UI 60·5-65·1] decline), and increased during the COVID-19 pandemic period (2020-21; 5·1% [0·9-9·6] increase). In contrast with the overall reverse in mortality trends during the pandemic period, child mortality continued to decline, with 4·66 million (3·98-5·50) global deaths in children younger than 5 years in 2021 compared with 5·21 million (4·50-6·01) in 2019. An estimated 131 million (126-137) people died globally from all causes in 2020 and 2021 combined, of which 15·9 million (14·7-17·2) were due to the COVID-19 pandemic (measured by excess mortality, which includes deaths directly due to SARS-CoV-2 infection and those indirectly due to other social, economic, or behavioural changes associated with the pandemic). Excess mortality rates exceeded 150 deaths per 100 000 population during at least one year of the pandemic in 80 countries and territories, whereas 20 nations had a negative excess mortality rate in 2020 or 2021, indicating that all-cause mortality in these countries was lower during the pandemic than expected based on historical trends. Between 1950 and 2021, global life expectancy at birth increased by 22·7 years (20·8-24·8), from 49·0 years (46·7-51·3) to 71·7 years (70·9-72·5). Global life expectancy at birth declined by 1·6 years (1·0-2·2) between 2019 and 2021, reversing historical trends. An increase in life expectancy was only observed in 32 (15·7%) of 204 countries and territories between 2019 and 2021. The global population reached 7·89 billion (7·67-8·13) people in 2021, by which time 56 of 204 countries and territories had peaked and subsequently populations have declined. The largest proportion of population growth between 2020 and 2021 was in sub-Saharan Africa (39·5% [28·4-52·7]) and south Asia (26·3% [9·0-44·7]). From 2000 to 2021, the ratio of the population aged 65 years and older to the population aged younger than 15 years increased in 188 (92·2%) of 204 nations. INTERPRETATION Global adult mortality rates markedly increased during the COVID-19 pandemic in 2020 and 2021, reversing past decreasing trends, while child mortality rates continued to decline, albeit more slowly than in earlier years. Although COVID-19 had a substantial impact on many demographic indicators during the first 2 years of the pandemic, overall global health progress over the 72 years evaluated has been profound, with considerable improvements in mortality and life expectancy. Additionally, we observed a deceleration of global population growth since 2017, despite steady or increasing growth in lower-income countries, combined with a continued global shift of population age structures towards older ages. These demographic changes will likely present future challenges to health systems, economies, and societies. The comprehensive demographic estimates reported here will enable researchers, policy makers, health practitioners, and other key stakeholders to better understand and address the profound changes that have occurred in the global health landscape following the first 2 years of the COVID-19 pandemic, and longer-term trends beyond the pandemic. FUNDING Bill & Melinda Gates Foundation.
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Bender RG, Sirota SB, Swetschinski LR, Dominguez RMV, Novotney A, Wool EE, Ikuta KS, Vongpradith A, Rogowski ELB, Doxey M, Troeger CE, Albertson SB, Ma J, He J, Maass KL, A.F.Simões E, Abdoun M, Abdul Aziz JM, Abdulah DM, Abu Rumeileh S, Abualruz H, Aburuz S, Adepoju AV, Adha R, Adikusuma W, Adra S, Afraz A, Aghamiri S, Agodi A, Ahmadzade AM, Ahmed H, Ahmed A, Akinosoglou K, AL-Ahdal TMA, Al-amer RM, Albashtawy M, AlBataineh MT, Alemi H, Al-Gheethi AAS, Ali A, Ali SSS, Alqahtani JS, AlQudah M, Al-Tawfiq JA, Al-Worafi YM, Alzoubi KH, Amani R, Amegbor PM, Ameyaw EK, Amuasi JH, Anil A, Anyanwu PE, Arafat M, Areda D, Arefnezhad R, Atalell KA, Ayele F, Azzam AY, Babamohamadi H, Babin FX, Bahurupi Y, Baker S, Banik B, Barchitta M, Barqawi HJ, Basharat Z, Baskaran P, Batra K, Batra R, Bayileyegn NS, Beloukas A, Berkley JA, Beyene KA, Bhargava A, Bhattacharjee P, Bielicki JA, Bilalaga MM, Bitra VR, Brown CS, Burkart K, Bustanji Y, Carr S, Chahine Y, Chattu VK, Chichagi F, Chopra H, Chukwu IS, Chung E, Dadana S, Dai X, Dandona L, Dandona R, Darban I, Dash NR, Dashti M, Dashtkoohi M, Dekker DM, Delgado-Enciso I, Devanbu VGC, Dhama K, Diao N, Do THP, Dokova KG, Dolecek C, Dziedzic AM, Eckmanns T, Ed-Dra A, Efendi F, Eftekharimehrabad A, Eyre DW, Fahim A, Feizkhah A, Felton TW, Ferreira N, Flor LS, Gaihre S, Gebregergis MW, Gebrehiwot M, Geffers C, Gerema U, Ghaffari K, Goldust M, Goleij P, Guan SY, Gudeta MD, Guo C, Gupta VB, Gupta I, Habibzadeh F, Hadi NR, Haeuser E, Hailu WB, Hajibeygi R, Haj-Mirzaian A, Haller S, Hamiduzzaman M, Hanifi N, Hansel J, Hasnain MS, Haubold J, Hoan NQ, Huynh HH, Iregbu KC, Islam MR, Jafarzadeh A, Jairoun AA, Jalili M, Jomehzadeh N, Joshua CE, Kabir MA, Kamal Z, Kanmodi KK, Kantar RS, Karimi Behnagh A, Kaur N, Kaur H, Khamesipour F, Khan MN, Khan suheb MZ, Khanal V, Khatab K, Khatib MN, Kim G, Kim K, Kitila ATT, Komaki S, Krishan K, Krumkamp R, Kuddus MA, Kurniasari MD, Lahariya C, Latifinaibin K, Le NHH, Le TTT, Le TDT, Lee SW, LEPAPE A, Lerango TL, Li MC, Mahboobipour AA, Malhotra K, Mallhi TH, Manoharan A, Martinez-Guerra BA, Mathioudakis AG, Mattiello R, May J, McManigal B, McPhail SM, Mekene Meto T, Mendez-Lopez MAM, Meo SA, Merati M, Mestrovic T, Mhlanga L, Minh LHN, Misganaw A, Mishra V, Misra AK, Mohamed NS, Mohammadi E, Mohammed M, Mohammed M, Mokdad AH, Monasta L, Moore CE, Motappa R, Mougin V, Mousavi P, Mulita F, Mulu AA, Naghavi P, Naik GR, Nainu F, Nair TS, Nargus S, Negaresh M, Nguyen HTH, Nguyen DH, Nguyen VT, Nikolouzakis TK, Noman EA, Nri-Ezedi CA, Odetokun IA, Okwute PG, Olana MD, Olanipekun TO, Olasupo OO, Olivas-Martinez A, Ordak M, Ortiz-Brizuela E, Ouyahia A, Padubidri JR, Pak A, Pandey A, Pantazopoulos I, Parija PP, Parikh RR, Park S, Parthasarathi A, Pashaei A, Peprah P, Pham HT, Poddighe D, Pollard A, Ponce-De-Leon A, Prakash PY, Prates EJS, Quan NK, Raee P, Rahim F, Rahman M, Rahmati M, Ramasamy SK, Ranjan S, Rao IR, Rashid AM, Rattanavong S, Ravikumar N, Reddy MMRK, Redwan EMM, Reiner RC, Reyes LF, Roberts T, Rodrigues M, Rosenthal VD, Roy P, Runghien T, Saeed U, Saghazadeh A, Saheb Sharif-Askari N, Saheb Sharif-Askari F, Sahoo SS, Sahu M, Sakshaug JW, Salami AA, Saleh MA, Salehi omran H, Sallam M, Samadzadeh S, Samodra YL, Sanjeev RK, Sarasmita MA, Saravanan A, Sartorius B, Saulam J, Schumacher AE, Seyedi SA, Shafie M, Shahid S, Sham S, Shamim MA, Shamshirgaran MA, Shastry RP, Sherchan SP, Shiferaw D, Shittu A, Siddig EE, Sinto R, Sood A, Sorensen RJD, Stergachis A, Stoeva TZ, Swain CK, Szarpak L, Tamuzi JL, Temsah MH, Tessema MBT, Thangaraju P, Tran NM, Tran NH, Tumurkhuu M, Ty SS, Udoakang AJ, Ulhaq I, Umar TP, Umer AA, Vahabi SM, Vaithinathan AG, Van den Eynde J, Walson JL, Waqas M, Xing Y, Yadav MK, Yahya G, Yon DK, Zahedi Bialvaei A, Zakham F, Zeleke AM, Zhai C, Zhang Z, Zhang H, Zielińska M, Zheng P, Aravkin AY, Vos T, Hay SI, Mosser JF, Lim SS, Naghavi M, Murray CJL, Kyu HH. Global, regional, and national incidence and mortality burden of non-COVID-19 lower respiratory infections and aetiologies, 1990-2021: a systematic analysis from the Global Burden of Disease Study 2021. Lancet Infect Dis 2024:S1473-3099(24)00176-2. [PMID: 38636536 DOI: 10.1016/s1473-3099(24)00176-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 02/19/2024] [Accepted: 03/07/2024] [Indexed: 04/20/2024]
Abstract
BACKGROUND Lower respiratory infections (LRIs) are a major global contributor to morbidity and mortality. In 2020-21, non-pharmaceutical interventions associated with the COVID-19 pandemic reduced not only the transmission of SARS-CoV-2, but also the transmission of other LRI pathogens. Tracking LRI incidence and mortality, as well as the pathogens responsible, can guide health-system responses and funding priorities to reduce future burden. We present estimates from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 of the burden of non-COVID-19 LRIs and corresponding aetiologies from 1990 to 2021, inclusive of pandemic effects on the incidence and mortality of select respiratory viruses, globally, regionally, and for 204 countries and territories. METHODS We estimated mortality, incidence, and aetiology attribution for LRI, defined by the GBD as pneumonia or bronchiolitis, not inclusive of COVID-19. We analysed 26 259 site-years of mortality data using the Cause of Death Ensemble model to estimate LRI mortality rates. We analysed all available age-specific and sex-specific data sources, including published literature identified by a systematic review, as well as household surveys, hospital admissions, health insurance claims, and LRI mortality estimates, to generate internally consistent estimates of incidence and prevalence using DisMod-MR 2.1. For aetiology estimation, we analysed multiple causes of death, vital registration, hospital discharge, microbial laboratory, and literature data using a network analysis model to produce the proportion of LRI deaths and episodes attributable to the following pathogens: Acinetobacter baumannii, Chlamydia spp, Enterobacter spp, Escherichia coli, fungi, group B streptococcus, Haemophilus influenzae, influenza viruses, Klebsiella pneumoniae, Legionella spp, Mycoplasma spp, polymicrobial infections, Pseudomonas aeruginosa, respiratory syncytial virus (RSV), Staphylococcus aureus, Streptococcus pneumoniae, and other viruses (ie, the aggregate of all viruses studied except influenza and RSV), as well as a residual category of other bacterial pathogens. FINDINGS Globally, in 2021, we estimated 344 million (95% uncertainty interval [UI] 325-364) incident episodes of LRI, or 4350 episodes (4120-4610) per 100 000 population, and 2·18 million deaths (1·98-2·36), or 27·7 deaths (25·1-29·9) per 100 000. 502 000 deaths (406 000-611 000) were in children younger than 5 years, among which 254 000 deaths (197 000-320 000) occurred in countries with a low Socio-demographic Index. Of the 18 modelled pathogen categories in 2021, S pneumoniae was responsible for the highest proportions of LRI episodes and deaths, with an estimated 97·9 million (92·1-104·0) episodes and 505 000 deaths (454 000-555 000) globally. The pathogens responsible for the second and third highest episode counts globally were other viral aetiologies (46·4 million [43·6-49·3] episodes) and Mycoplasma spp (25·3 million [23·5-27·2]), while those responsible for the second and third highest death counts were S aureus (424 000 [380 000-459 000]) and K pneumoniae (176 000 [158 000-194 000]). From 1990 to 2019, the global all-age non-COVID-19 LRI mortality rate declined by 41·7% (35·9-46·9), from 56·5 deaths (51·3-61·9) to 32·9 deaths (29·9-35·4) per 100 000. From 2019 to 2021, during the COVID-19 pandemic and implementation of associated non-pharmaceutical interventions, we estimated a 16·0% (13·1-18·6) decline in the global all-age non-COVID-19 LRI mortality rate, largely accounted for by a 71·8% (63·8-78·9) decline in the number of influenza deaths and a 66·7% (56·6-75·3) decline in the number of RSV deaths. INTERPRETATION Substantial progress has been made in reducing LRI mortality, but the burden remains high, especially in low-income and middle-income countries. During the COVID-19 pandemic, with its associated non-pharmaceutical interventions, global incident LRI cases and mortality attributable to influenza and RSV declined substantially. Expanding access to health-care services and vaccines, including S pneumoniae, H influenzae type B, and novel RSV vaccines, along with new low-cost interventions against S aureus, could mitigate the LRI burden and prevent transmission of LRI-causing pathogens. FUNDING Bill & Melinda Gates Foundation, Wellcome Trust, and Department of Health and Social Care (UK).
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Ledesma JR, Ma J, Zhang M, Basting AVL, Chu HT, Vongpradith A, Novotney A, LeGrand KE, Xu YY, Dai X, Nicholson SI, Stafford LK, Carter A, Ross JM, Abbastabar H, Abdoun M, Abdulah DM, Aboagye RG, Abolhassani H, Abrha WA, Abubaker Ali H, Abu-Gharbieh E, Aburuz S, Addo IY, Adepoju AV, Adhikari K, Adnani QES, Adra S, Afework A, Aghamiri S, Agyemang-Duah W, Ahinkorah BO, Ahmad D, Ahmad S, Ahmadzade AM, Ahmed H, Ahmed M, Ahmed A, Akinosoglou K, AL-Ahdal TMA, Alam N, Albashtawy M, AlBataineh MT, Al-Gheethi AAS, Ali A, Ali EA, Ali L, Ali Z, Ali SSS, Allel K, Altaf A, Al-Tawfiq JA, Alvis-Guzman N, Alvis-Zakzuk NJ, Amani R, Amusa GA, Amzat J, Andrews JR, Anil A, Anwer R, Aravkin AY, Areda D, Artamonov AA, Aruleba RT, Asemahagn MA, Atre SR, Aujayeb A, Azadi D, Azadnajafabad S, Azzam AY, Badar M, Badiye AD, Bagherieh S, Bahadorikhalili S, Baig AA, Banach M, Banik B, Bardhan M, Barqawi HJ, Basharat Z, Baskaran P, Basu S, Beiranvand M, Belete MA, Belew MA, Belgaumi UI, Beloukas A, Bettencourt PJG, Bhagavathula AS, Bhardwaj N, Bhardwaj P, Bhargava A, Bhat V, Bhatti JS, Bhatti GK, Bikbov B, Bitra VR, Bjegovic-Mikanovic V, Buonsenso D, Burkart K, Bustanji Y, Butt ZA, Camargos P, Cao Y, Carr S, Carvalho F, Cegolon L, Cenderadewi M, Cevik M, Chahine Y, Chattu VK, Ching PR, Chopra H, Chung E, Claassens MM, Coberly K, Cruz-Martins N, Dabo B, Dadana S, Dadras O, Darban I, Darega Gela J, Darwesh AM, Dashti M, Demessa BH, Demisse B, Demissie S, Derese AMA, Deribe K, Desai HD, Devanbu VGC, Dhali A, Dhama K, Dhingra S, Do THP, Dongarwar D, Dsouza HL, Dube J, Dziedzic AM, Ed-Dra A, Efendi F, Effendi DE, Eftekharimehrabad A, Ekadinata N, Ekundayo TC, Elhadi M, Elilo LT, Emeto TI, Engelbert Bain L, Fagbamigbe AF, Fahim A, Feizkhah A, Fetensa G, Fischer F, Gaipov A, Gandhi AP, Gautam RK, Gebregergis MW, Gebrehiwot M, Gebrekidan KG, Ghaffari K, Ghassemi F, Ghazy RM, Goodridge A, Goyal A, Guan SY, Gudeta MD, Guled RA, Gultom NB, Gupta VB, Gupta VK, Gupta S, Hagins H, Hailu SG, Hailu WB, Hamidi S, Hanif A, Harapan H, Hasan RS, Hassan S, Haubold J, Hezam K, Hong SH, Horita N, Hossain MB, Hosseinzadeh M, Hostiuc M, Hostiuc S, Huynh HH, Ibitoye SE, Ikuta KS, Ilic IM, Ilic MD, Islam MR, Ismail NE, Ismail F, Jafarzadeh A, Jakovljevic M, Jalili M, Janodia MD, Jomehzadeh N, Jonas JB, Joseph N, Joshua CE, Kabir Z, Kamble BD, Kanchan T, Kandel H, Kanmodi KK, Kantar RS, Karaye IM, Karimi Behnagh A, Kassa GG, Kaur RJ, Kaur N, Khajuria H, Khamesipour F, Khan YH, Khan MN, Khan Suheb MZ, Khatab K, Khatami F, Kim MS, Kosen S, Koul PA, Koulmane Laxminarayana SL, Krishan K, Kucuk Bicer B, Kuddus MA, Kulimbet M, Kumar N, Lal DK, Landires I, Latief K, Le TDT, Le TTT, Ledda C, Lee M, Lee SW, Lerango TL, Lim SS, Liu C, Liu X, Lopukhov PD, Luo H, Lv H, Mahajan PB, Mahboobipour AA, Majeed A, Malakan Rad E, Malhotra K, Malik MSA, Malinga LA, Mallhi TH, Manilal A, Martinez-Guerra BA, Martins-Melo FR, Marzo RR, Masoumi-Asl H, Mathur V, Maude RJ, Mehrotra R, Memish ZA, Mendoza W, Menezes RG, Merza MA, Mestrovic T, Mhlanga L, Misra S, Misra AK, Mithra P, Moazen B, Mohammed H, Mokdad AH, Monasta L, Moore CE, Mousavi P, Mulita F, Musaigwa F, Muthusamy R, Nagarajan AJ, Naghavi P, Naik GR, Naik G, Nair S, Nair TS, Natto ZS, Nayak BP, Negash H, Nguyen DH, Nguyen VT, Niazi RK, Nnaji CA, Nnyanzi LA, Noman EA, Nomura S, Oancea B, Obamiro KO, Odetokun IA, Odo DBO, Odukoya OO, Oh IH, Okereke CO, Okonji OC, Oren E, Ortiz-Brizuela E, Osuagwu UL, Ouyahia A, P A MP, Parija PP, Parikh RR, Park S, Parthasarathi A, Patil S, Pawar S, Peng M, Pepito VCF, Peprah P, Perdigão J, Perico N, Pham HT, Postma MJ, Prabhu ARA, Prasad M, Prashant A, Prates EJS, Rahim F, Rahman M, Rahman MA, Rahmati M, Rajaa S, Ramasamy SK, Rao IR, Rao SJ, Rapaka D, Rashid AM, Ratan ZA, Ravikumar N, Rawaf S, Reddy MMRK, Redwan EMM, Remuzzi G, Reyes LF, Rezaei N, Rezaeian M, Rezahosseini O, Rodrigues M, Roy P, Ruela GDA, Sabour S, Saddik B, Saeed U, Safi SZ, Saheb Sharif-Askari N, Saheb Sharif-Askari F, Sahebkar A, Sahiledengle B, Sahoo SS, Salam N, Salami AA, Saleem S, Saleh MA, Samadi Kafil H, Samadzadeh S, Samodra YL, Sanjeev RK, Saravanan A, Sawyer SM, Selvaraj S, Senapati S, Senthilkumaran S, Shah PA, Shahid S, Shaikh MA, Sham S, Shamshirgaran MA, Shanawaz M, Sharath M, Sherchan SP, Shetty RS, Shirzad-Aski H, Shittu A, Siddig EE, Silva JP, Singh S, Singh P, Singh H, Singh JA, Siraj MS, Siswanto S, Solanki R, Solomon Y, Soriano JB, Sreeramareddy CT, Srivastava VK, Steiropoulos P, Swain CK, Tabuchi T, Tampa M, Tamuzi JJLL, Tat NY, Tavakoli Oliaee R, Teklay G, Tesfaye EG, Tessema B, Thangaraju P, Thapar R, Thum CCC, Ticoalu JHV, Tleyjeh IM, Tobe-Gai R, Toma TM, Tram KH, Udoakang AJ, Umar TP, Umeokonkwo CD, Vahabi SM, Vaithinathan AG, van Boven JFM, Varthya SB, Wang Z, Warsame MSA, Westerman R, Wonde TE, Yaghoubi S, Yi S, Yiğit V, Yon DK, Yonemoto N, Yu C, Zakham F, Zangiabadian M, Zeukeng F, Zhang H, Zhao Y, Zheng P, Zielińska M, Salomon JA, Reiner Jr RC, Naghavi M, Vos T, Hay SI, Murray CJL, Kyu HH. Global, regional, and national age-specific progress towards the 2020 milestones of the WHO End TB Strategy: a systematic analysis for the Global Burden of Disease Study 2021. Lancet Infect Dis 2024:S1473-3099(24)00007-0. [PMID: 38518787 DOI: 10.1016/s1473-3099(24)00007-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Revised: 12/09/2023] [Accepted: 01/08/2024] [Indexed: 03/24/2024]
Abstract
BACKGROUND Global evaluations of the progress towards the WHO End TB Strategy 2020 interim milestones on mortality (35% reduction) and incidence (20% reduction) have not been age specific. We aimed to assess global, regional, and national-level burdens of and trends in tuberculosis and its risk factors across five separate age groups, from 1990 to 2021, and to report on age-specific progress between 2015 and 2020. METHODS We used the Global Burden of Diseases, Injuries, and Risk Factors Study 2021 (GBD 2021) analytical framework to compute age-specific tuberculosis mortality and incidence estimates for 204 countries and territories (1990-2021 inclusive). We quantified tuberculosis mortality among individuals without HIV co-infection using 22 603 site-years of vital registration data, 1718 site-years of verbal autopsy data, 825 site-years of sample-based vital registration data, 680 site-years of mortality surveillance data, and 9 site-years of minimally invasive tissue sample (MITS) diagnoses data as inputs into the Cause of Death Ensemble modelling platform. Age-specific HIV and tuberculosis deaths were established with a population attributable fraction approach. We analysed all available population-based data sources, including prevalence surveys, annual case notifications, tuberculin surveys, and tuberculosis mortality, in DisMod-MR 2.1 to produce internally consistent age-specific estimates of tuberculosis incidence, prevalence, and mortality. We also estimated age-specific tuberculosis mortality without HIV co-infection that is attributable to the independent and combined effects of three risk factors (smoking, alcohol use, and diabetes). As a secondary analysis, we examined the potential impact of the COVID-19 pandemic on tuberculosis mortality without HIV co-infection by comparing expected tuberculosis deaths, modelled with trends in tuberculosis deaths from 2015 to 2019 in vital registration data, with observed tuberculosis deaths in 2020 and 2021 for countries with available cause-specific mortality data. FINDINGS We estimated 9·40 million (95% uncertainty interval [UI] 8·36 to 10·5) tuberculosis incident cases and 1·35 million (1·23 to 1·52) deaths due to tuberculosis in 2021. At the global level, the all-age tuberculosis incidence rate declined by 6·26% (5·27 to 7·25) between 2015 and 2020 (the WHO End TB strategy evaluation period). 15 of 204 countries achieved a 20% decrease in all-age tuberculosis incidence between 2015 and 2020, eight of which were in western sub-Saharan Africa. When stratified by age, global tuberculosis incidence rates decreased by 16·5% (14·8 to 18·4) in children younger than 5 years, 16·2% (14·2 to 17·9) in those aged 5-14 years, 6·29% (5·05 to 7·70) in those aged 15-49 years, 5·72% (4·02 to 7·39) in those aged 50-69 years, and 8·48% (6·74 to 10·4) in those aged 70 years and older, from 2015 to 2020. Global tuberculosis deaths decreased by 11·9% (5·77 to 17·0) from 2015 to 2020. 17 countries attained a 35% reduction in deaths due to tuberculosis between 2015 and 2020, most of which were in eastern Europe (six countries) and central Europe (four countries). There was variable progress by age: a 35·3% (26·7 to 41·7) decrease in tuberculosis deaths in children younger than 5 years, a 29·5% (25·5 to 34·1) decrease in those aged 5-14 years, a 15·2% (10·0 to 20·2) decrease in those aged 15-49 years, a 7·97% (0·472 to 14·1) decrease in those aged 50-69 years, and a 3·29% (-5·56 to 9·07) decrease in those aged 70 years and older. Removing the combined effects of the three attributable risk factors would have reduced the number of all-age tuberculosis deaths from 1·39 million (1·28 to 1·54) to 1·00 million (0·703 to 1·23) in 2020, representing a 36·5% (21·5 to 54·8) reduction in tuberculosis deaths compared to those observed in 2015. 41 countries were included in our analysis of the impact of the COVID-19 pandemic on tuberculosis deaths without HIV co-infection in 2020, and 20 countries were included in the analysis for 2021. In 2020, 50 900 (95% CI 49 700 to 52 400) deaths were expected across all ages, compared to an observed 45 500 deaths, corresponding to 5340 (4070 to 6920) fewer deaths; in 2021, 39 600 (38 300 to 41 100) deaths were expected across all ages compared to an observed 39 000 deaths, corresponding to 657 (-713 to 2180) fewer deaths. INTERPRETATION Despite accelerated progress in reducing the global burden of tuberculosis in the past decade, the world did not attain the first interim milestones of the WHO End TB Strategy in 2020. The pace of decline has been unequal with respect to age, with older adults (ie, those aged >50 years) having the slowest progress. As countries refine their national tuberculosis programmes and recalibrate for achieving the 2035 targets, they could consider learning from the strategies of countries that achieved the 2020 milestones, as well as consider targeted interventions to improve outcomes in older age groups. FUNDING Bill & Melinda Gates Foundation.
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Browning M, Banik B, Bourke S, Abdelkader A, Anish L, Muduwa M. The impact of COVID 19 restrictions on Australian nurse academics attitudes to technology: A survey of Technology Readiness Index 2.0. Nurse Educ Pract 2023; 71:103719. [PMID: 37523997 DOI: 10.1016/j.nepr.2023.103719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 06/20/2023] [Accepted: 07/05/2023] [Indexed: 08/02/2023]
Abstract
AIM This study aimed to determine the attitude of Australian nursing lecturers to the use of technology applied to the teaching and learning of nursing students. BACKGROUND The use of technology in teaching was accelerated in reaction to the COVID-19 restrictions whereby measures, including social distancing and lockdowns, forced many higher education courses to transition online. Lecturers play a key role in the integration of technology in teaching, as it is the lecturer, not the technology, who facilitates the students' learning experience. DESIGN A cross sectional survey design was used for this study, distributed from April to June of 2022. The purpose of the survey was to gather technology readiness data (via the TRI 2 questions) and descriptive data representative of the nursing academic population in Australia. RESULTS There was no statistically significant differences between participants based on demographic data (such as gender or age). There was an association between TRI 2 score and: the sum of elearning technologies engaged with; the frequency of engagement with technology and self-rated confidence with elearning. Of note were statistically significant differences of TRI between states/territories. Finally, there was an inverse relationship between the impact of COVID-19 restrictions and TRI 2 score. CONCLUSION The study found that there was significant variation between states/territories and self-reported impact of TRI. Given that increased frequency and increased number of technologies engaged with are associated with technology readiness the variation between states/territories lockdowns which required engagement with technology, may have had an impact on the nursing academics attitude to technology. Importantly, this study found those who were highly technology ready found COVID-19 restrictions had less impact on them, suggesting that technology readiness may have assisted their transition to online learning.
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Affiliation(s)
- Mark Browning
- School of Nursing and Midwifery, Institute of Health and Wellbeing, Federation University, 100 Clyde Road, Berwick, VIC 3806, Australia.
| | - Biswajit Banik
- School of Public health, Institute of Health and Wellbeing, Federation University, 100 Clyde Road, Berwick, VIC 3806, Australia.
| | - Sharon Bourke
- School of Nursing & Midwifery, La Trobe University, The Alfred Centre, Level 4, 99 Commercial Rd, Melbourne 3004, Australia
| | - Amany Abdelkader
- School of Nursing and Midwifery, Institute of Health and Wellbeing, Federation University, 100 Clyde Road, Berwick, VIC 3806, Australia
| | - Ligi Anish
- School of Nursing and Midwifery, Institute of Health and Wellbeing, Federation University, 100 Clyde Road, Berwick, VIC 3806, Australia
| | - Miriam Muduwa
- School of Nursing and Midwifery, Institute of Health and Wellbeing, Federation University, 100 Clyde Road, Berwick, VIC 3806, Australia
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Alharbi TAF, Alqurashi AAB, Mahmud I, Alharbi RJ, Islam SMS, Almustanyir S, Maklad AE, AlSarraj A, Mughaiss LN, Al-Tawfiq JA, Ahmed AA, Barry M, Ghozy S, Alabdan LI, Alif SM, Sultana F, Salehin M, Banik B, Cross W, Rahman MA. COVID-19: Factors Associated with the Psychological Distress, Fear and Resilient Coping Strategies among Community Members in Saudi Arabia. Healthcare (Basel) 2023; 11:healthcare11081184. [PMID: 37108018 PMCID: PMC10138665 DOI: 10.3390/healthcare11081184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 03/31/2023] [Accepted: 04/07/2023] [Indexed: 04/29/2023] Open
Abstract
(1) Background: COVID-19 caused the worst international public health crisis, accompanied by major global economic downturns and mass-scale job losses, which impacted the psychosocial wellbeing of the worldwide population, including Saudi Arabia. Evidence of the high-risk groups impacted by the pandemic has been non-existent in Saudi Arabia. Therefore, this study examined factors associated with psychosocial distress, fear of COVID-19 and coping strategies among the general population in Saudi Arabia. (2) Methods: A cross-sectional study was conducted in healthcare and community settings in the Saudi Arabia using an anonymous online questionnaire. The Kessler Psychological Distress Scale (K-10), Fear of COVID-19 Scale (FCV-19S) and Brief Resilient Coping Scale (BRCS) were used to assess psychological distress, fear and coping strategies, respectively. Multivariate logistic regressions were used, and an Adjusted Odds Ratio (AOR) with 95% Confidence Intervals (CIs) was reported. (3) Results: Among 803 participants, 70% (n = 556) were females, and the median age was 27 years; 35% (n = 278) were frontline or essential service workers; and 24% (n = 195) reported comorbid conditions including mental health illness. Of the respondents, 175 (21.8%) and 207 (25.8%) reported high and very high psychological distress, respectively. Factors associated with moderate to high levels of psychological distress were: youth, females, non-Saudi nationals, those experiencing a change in employment or a negative financial impact, having comorbidities, and current smoking. A high level of fear was reported by 89 participants (11.1%), and this was associated with being ex-smokers (3.72, 1.14-12.14, 0.029) and changes in employment (3.42, 1.91-6.11, 0.000). A high resilience was reported by 115 participants (14.3%), and 333 participants (41.5%) had medium resilience. Financial impact and contact with known/suspected cases (1.63, 1.12-2.38, 0.011) were associated with low, medium, to high resilient coping. (4) Conclusions: People in Saudi Arabia were at a higher risk of psychosocial distress along with medium-high resilience during the COVID-19 pandemic, warranting urgent attention from healthcare providers and policymakers to provide specific mental health support strategies for their current wellbeing and to avoid a post-pandemic mental health crisis.
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Affiliation(s)
- Talal Ali F Alharbi
- Department of Community, Psychiatric and Mental Health Nursing, College of Nursing, Qassim University, Buraidah 51452, Saudi Arabia
| | - Alaa Ashraf Bagader Alqurashi
- Department of Epidemiology and Public Health, Riyadh Second Health Cluster, King Fahad Medical City, Riyadh 12271, Saudi Arabia
| | - Ilias Mahmud
- Department of Public Health, College of Public Health and Health Informatics, Qassim University, Al Bukairiyah 52741, Saudi Arabia
| | - Rayan Jafnan Alharbi
- Department of Emergency Medical Service, Jazan University, Jazan 45142, Saudi Arabia
- Central Clinical School, Faculty of Medicine Nursing and Health Sciences, Monash University, Melbourne, VIC 3004, Australia
| | - Sheikh Mohammed Shariful Islam
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, VIC 3125, Australia
| | - Sami Almustanyir
- Department of Medicine, Ministry of Health, Riyadh 3125, Saudi Arabia
- College of Medicine, Alfaisal University, Riyadh 50927, Saudi Arabia
| | | | - Ahmad AlSarraj
- College of Medicine, Alfaisal University, Riyadh 50927, Saudi Arabia
| | | | - Jaffar A Al-Tawfiq
- Specialty Internal Medicine and Quality Department, Johns Hopkins Aramco Healthcare, Dhahran 34465, Saudi Arabia
- Infectious Disease Division, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN 47405, USA
- Infectious Disease Division, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - Ahmed Ali Ahmed
- Faculty of Pharmacy, Alexandria University, Alexandria 21523, Egypt
| | - Mazin Barry
- Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, King Saud University, Riyadh 11421, Saudi Arabia
| | - Sherief Ghozy
- Radiology Department, Mayo Clinic, Rochester, MN 55902, USA
| | | | - Sheikh M Alif
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
| | | | - Masudus Salehin
- Institute of Health and Wellbeing, Federation University Australia, Berwick, VIC 3806, Australia
| | - Biswajit Banik
- Institute of Health and Wellbeing, Federation University Australia, Berwick, VIC 3806, Australia
- Manna Institute, Mental Health Research and Training for Regional Australia, Regional University Network (RUN), The University of New England, Armidale, NSW 2351, Australia
| | - Wendy Cross
- Institute of Health and Wellbeing, Federation University Australia, Berwick, VIC 3806, Australia
| | - Muhammad Aziz Rahman
- Institute of Health and Wellbeing, Federation University Australia, Berwick, VIC 3806, Australia
- Australian Institute for Primary Care & Ageing (AIPCA), La Trobe University, Melbourne, VIC 3086, Australia
- Department of Noncommunicable Diseases, Bangladesh University of Health Sciences (BUHS), Dhaka 1704, Bangladesh
- Faculty of Public Health, Universitas Airlangga, Surabaya 60115, Indonesia
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Radhamony R, Cross WM, Townsin L, Banik B. Perspectives of culturally and linguistically diverse (CALD) community members regarding mental health services: A qualitative analysis. J Psychiatr Ment Health Nurs 2023. [PMID: 36947100 DOI: 10.1111/jpm.12919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 02/14/2023] [Accepted: 02/28/2023] [Indexed: 03/23/2023]
Abstract
WHAT IS KNOWN ABOUT THE SUBJECT?: Immigrant, refugee and asylum seeker populations worldwide are at high risk of mental health issues National mental health policies call for recognising Australian society's multicultural characteristics to ensure adequate mental health services to CALD communities Several barriers exist for people from CALD communities in Victoria to access and utilise mental health services Improving mental health professionals' knowledge of mental health service provision and cultural responsiveness can enhance CALD community access to services. WHAT DOES THIS PAPER ADD TO EXISTING KNOWLEDGE?: We analysed the perspectives of people from CALD communities in Victoria regarding their needs and experiences with mental health services. Participants reported diverse perceptions and understanding of mental health issues and services Various challenges were identified regarding health service utilisation for the CALD community in Victoria, including language barriers, stigma towards mental health issues, mental health illiteracy, distrust and lack of familiarity with mainstream mental health services. These challenges were acknowledged by community members even after a long residence in Australia The data generated on the beliefs about mental health issues and consequent help-seeking behaviours highlight the importance of culturally sensitive targeted prevention and early intervention strategies and ongoing commitment to building mental health literacy in the wider community WHAT ARE THE IMPLICATIONS FOR PRACTICE?: The information from the study can be adapted for quality improvement and culturally responsive practices The strategies for effective service delivery drawn by this paper can be a comprehensive resource tool for mental health professionals, organisations and policymakers The findings imply that CALD mental health service users and their families will likely benefit from improved service assessment and quality of mental health care and equity when MHNs undertake cultural competence training and bring that into their practice. ABSTRACT INTRODUCTION: Victoria is one of the most multicultural states in Australia. Many CALD communities in Victoria may have encountered complicated migration journeys and complex life stressors during their initial settlement, leading to adverse mental health concerns. This diversity necessitates public policy settings to ensure equity and access in health services planning and delivery. While the MH policies and services take cultural diversity into account, there needs to be more implementation of those components of MH policies that relate to the particular needs of various CALD communities in Victoria. Even though mental health services prevent and address mental health issues, many barriers can impair CALD community access and utilisation of mental health services. Furthermore, the recent Royal Commission inquiry into the Victorian Mental Health system drives a renewed policy imperative to ensure meaningful engagement and cultural safety of all people accessing and utilising mental health services (Department of Health, 2023). AIM This study focused on the perspectives of people from CALD communities in Victoria regarding their mental health service needs, understandings of and experiences with mental health services to prepare an education package for mental health nurses as part of a larger multi-method research project. METHOD A qualitative descriptive design was used to collect and analyse the perspectives of 21 participants in Victoria, using telephone interviews, followed by thematic analysis. RESULTS The themes and sub-themes identified were: Settling issues; Perceptions of understanding of mental health issues (help-seeking attitudes toward mental health issues; the need for CALD community education); perceived barriers to accessing and utilising mental health services in Victoria (socio-cultural and language barriers; stigma, labelling and discrimination; knowledge and experience of accessing health facilities); experience with mental health services and professionals. DISCUSSION Community participation, mental health professional education and robust research regarding the mental health needs of CALD people are some of the recommended strategies to improve access and utilisation of mental health services in Victoria. IMPLICATIONS FOR PRACTICE The current study can contribute to the existing knowledge, understanding, practice and quality improvement as it vividly portrays the issues of various CALD communities in Victoria. The findings of this study imply that CALD MH service users and their families are likely to benefit in terms of improved service assessment and quality of MH care and equity when MHNs undertake CC training and bring that into their practice.
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Affiliation(s)
- Reshmy Radhamony
- Institute of Health and Wellbeing, Federation University, Berwick, Australia
| | | | - Louise Townsin
- Federation University, Berwick, Australia
- Torrens University, Adelaide, South Australia
| | - Biswajit Banik
- Institute of Health and Wellbeing, Federation University, Berwick, Australia
- Manna Institute, Regional Australia Mental Health Research and Training Institute, A project of Regional University Network (RUN), led by the University of New England, Armidale, NSW, Australia
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Banik B, Alam S, Chakraborty A. Comparative study between GRA and MEREC technique on an agricultural-based MCGDM problem in pentagonal neutrosophic environment. Int J Environ Sci Technol (Tehran) 2023; 20:1-16. [PMID: 36817165 PMCID: PMC9928147 DOI: 10.1007/s13762-023-04768-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 12/16/2022] [Accepted: 01/06/2023] [Indexed: 06/18/2023]
Abstract
In this research article, an improved Multi-criteria group decision-making (MCGDM) strategy has been developed in pentagonal neutrosophic environment incorporating grey relational analysis and method on the removal effects of criteria (MEREC) techniques to address the relative advantages and disadvantages of these aspects in MCGDM. The aim of the study is to improve MCGDM technique which can capture the underlying uncertainties in robust way and can produce consistent results in a more rigorous way. Here, the conception of Hamming distance between two pentagonal neutrosophic number (PNN)s is introduced and the weighted arithmetic and geometric averaging operators in PNN arena are deployed to craft our computational technique more progressive and robust. An agriculture-based numerical problem is illustrated to demonstrate the ranking results of the alternatives by both of the techniques. After evaluating the problem by two aggregation operators, it is found that "plantation crop" is the best alternative under certain circumstances. Lastly, the sensitivity investigation is performed which reveals that with the appliance of arithmetic and geometric aggregation operators the best ranked alternative preserves its position by both of the ranking methods, which definitely exhibit the consistency and robustness of our executed methodology.
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Affiliation(s)
- B. Banik
- Department of Mathematics, Indian Institute of Engineering Science and Technology, Shibpur, Howrah, 711103 India
| | - S. Alam
- Department of Mathematics, Indian Institute of Engineering Science and Technology, Shibpur, Howrah, 711103 India
| | - A. Chakraborty
- Department of Engineering Science, Academy of Technology, Adisaptagram, West Bengal 712502 India
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Chair SY, Chien WT, Liu T, Lam L, Cross W, Banik B, Rahman MA. Psychological Distress, Fear and Coping Strategies among Hong Kong People During the COVID-19 Pandemic. Curr Psychol 2023; 42:2538-2557. [PMID: 34690470 PMCID: PMC8527280 DOI: 10.1007/s12144-021-02338-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/26/2021] [Indexed: 12/23/2022]
Abstract
The COVID-19 pandemic contributed to potential adverse effects on the mental health status of a wide range of people. This study aimed to identify factors associated with psychological distress, fear and coping strategies during the COVID-19 pandemic in Hong Kong. A cross-sectional online survey was conducted among general population in Hong Kong. Psychological distress was assessed using the Kessler Psychological Distress Scale; level of fear was evaluated using the Fear of COVID-19 scale; and coping strategies were assessed using the Brief Resilient Coping Scale. Multivariable logistic regression was used to identify key factors associated with these mental health variables. Of the 555 participants, 53.9% experienced moderate to very high levels of psychological distress, 31.2% experienced a high level of fear of COVID-19, and 58.6% showed moderate to high resilient coping. Multivariable logistic regression indicated that living with family members, current alcohol consumption, and higher level of fear were associated with higher levels of psychological distress; perceived stress due to a change in employment condition, being a frontline worker, experiencing 'moderate to very high' distress, and healthcare service use to overcome the COVID-19 related stress in past 6 months were associated with a higher level of fear; and perceived better mental health status was associated with a moderate to high resilient coping. This study identified key factors associated with distress, fear and coping strategies during the pandemic in Hong Kong. Mental health support strategies should be provided continuously to prevent the mental impact of the pandemic from turning into long-term illness. Supplementary Information The online version contains supplementary material available at 10.1007/s12144-021-02338-7.
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Affiliation(s)
- Sek Ying Chair
- grid.10784.3a0000 0004 1937 0482The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Room 725A, Esther Lee Building, Shatin, NT Hong Kong
| | - Wai Tong Chien
- grid.10784.3a0000 0004 1937 0482The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Room 725A, Esther Lee Building, Shatin, NT Hong Kong
| | - Ting Liu
- grid.10784.3a0000 0004 1937 0482The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Room 725A, Esther Lee Building, Shatin, NT Hong Kong
| | - Louisa Lam
- grid.1040.50000 0001 1091 4859School of Health, Federation University Australia, Berwick, VIC Australia
- grid.1002.30000 0004 1936 7857School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC Australia
| | - Wendy Cross
- grid.1040.50000 0001 1091 4859School of Health, Federation University Australia, Berwick, VIC Australia
| | - Biswajit Banik
- grid.1040.50000 0001 1091 4859School of Health, Federation University Australia, Berwick, VIC Australia
| | - Muhammad Aziz Rahman
- grid.1040.50000 0001 1091 4859School of Health, Federation University Australia, Berwick, VIC Australia
- grid.1018.80000 0001 2342 0938Australian Institute of Primary Care and Ageing, La Trobe University, Melbourne, VIC Australia
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11
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Elsayed M, Schönfeldt-Lecuona C, Welte XA, Dardeer KT, Kamal MA, Abdelnaby R, Rudek MA, Riedel E, Denkinger M, Gahr M, Connemann BJ, Alif SM, Banik B, Cross W, Rahman MA. Psychological Distress, Fear and Coping Strategies During the Second and Third Waves of the COVID-19 Pandemic in Southern Germany. Front Psychiatry 2022; 13:860683. [PMID: 35546957 PMCID: PMC9082598 DOI: 10.3389/fpsyt.2022.860683] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Accepted: 03/22/2022] [Indexed: 12/16/2022] Open
Abstract
Background The COVID-19 pandemic has imposed enormous psychological discomfort and fear across the globe, including Germany. Objectives To assess the levels of COVID-19 associated psychological distress and fear amongst Southern German population, and to identify their coping strategies. Methods A cross-sectional survey using an online questionnaire was conducted in healthcare and community settings in the region of Ulm, Southern Germany. Assessment inventories were the Kessler Psychological Distress Scale (K-10), the Brief Resilient Coping Scale (BRCS), and the Fear of COVID-19 Scale (FCV-19S), which were valid and reliable tools. Results A total of 474 Individuals participated in the study. The mean age was 33.6 years, and 327 (69%) were females. Most participants (n = 381, 80.4%) had high levels of psychological distress, whereas only 5.1% had high levels of fear, and two-thirds of participants showed higher levels of coping. Moderate to very high levels of psychological distress were associated with being female, living alone, distress due to employment changes, experiencing financial impact, having multiple co-morbidities, being a smoker, increased alcohol use over the previous 6 months, contact with COVID-19 cases and healthcare providers for COVID-19-related stress. Individuals who were ≥60 years, lived with non-family members, had co-morbidities and visited a healthcare provider had higher levels of fear. Higher levels of education and income showed better coping amongst participants. Conclusion Psychological distress was very high during the COVID-19 pandemic in Germany and associated with low levels of coping. This study identified vulnerable groups of people, who should be given priorities for addressing their health and wellbeing in future crisis periods.
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Affiliation(s)
- Mohamed Elsayed
- Department of Psychiatry and Psychotherapy III, University of Ulm, Ulm, Germany
| | - Carlos Schönfeldt-Lecuona
- Department of Psychiatry and Psychotherapy III, University of Ulm, Ulm, Germany
- Geriatric Center Ulm (GZU), Ulm, Germany
| | - Xenia Anna Welte
- Department of Psychiatry and Psychotherapy III, University of Ulm, Ulm, Germany
| | | | | | - Ramy Abdelnaby
- Department of Neurology, RWTH Aachen University, Aachen, Germany
| | - Markus A Rudek
- Division of Nephrology, University of Heidelberg, Heidelberg, Germany
| | | | - Michael Denkinger
- Geriatric Center Ulm (GZU), Ulm, Germany
- Agaplesion Bethesda Clinic, Geriatric Research Unit Ulm University, Ulm, Germany
| | - Maximilian Gahr
- Department of Psychiatry and Psychotherapy III, University of Ulm, Ulm, Germany
| | | | - Sheikh M Alif
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Biswajit Banik
- School of Health, Federation University Australia, Berwick, VIC, Australia
| | - Wendy Cross
- School of Health, Federation University Australia, Berwick, VIC, Australia
| | - Muhammad Aziz Rahman
- School of Health, Federation University Australia, Berwick, VIC, Australia
- Faculty of Public Health, Universitas Airlangga, Surabaya, Indonesia
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Yu S, Cross W, Lam LLY, Zhang K, Banik B, Li X, Wang H. Willingness, preferred ways and potential barriers to use pre-exposure prophylaxis for HIV prevention among men who have sex with men in China. BMJ Open 2021; 11:e053634. [PMID: 34716167 PMCID: PMC8559123 DOI: 10.1136/bmjopen-2021-053634] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
OBJECTIVE To explore willingness and preferred ways to use HIV pre-exposure prophylaxis (PrEP), factors associated with willingness, and potential barriers to PrEP use among men who have sex with men (MSM) in Changsha, China. DESIGN A cross-sectional survey was conducted from 25 June to 31 August 2019. Two hundred and fifty-five MSM were recruited from three community-based organisations (CBOs) in Changsha City. Willingness and potential barriers to use PrEP were examined using researcher-created scales. Univariate and multivariate logistic regression was used to analyse the factors associated with willingness to use PrEP. P values <0.05 were considered significant. SETTING Three MSM inclusive CBOs in Changsha, Hunan Province, China. PARTICIPANTS 255 HIV-negative MSM were recruited through their CBOs with snowball sampling. RESULTS Less than half of the participants (43.1%) had heard of PrEP and 15.3% were willing to use PrEP. The participants reported higher willingness to use event-driven PrEP (3.70±0.07) than daily PrEP (2.65±0.07). Higher self-rated risk and fear of contracting HIV (OR: 14.47, 95% CI 2.19 to 95.53), awareness of PrEP (OR: 4.20, 95% CI 1.64 to 10.73), sharing one's own sexual orientation with parents or siblings (OR: 2.52, 95% CI 1.54 to 7.20) and having a university education or above (OR:0.29, 95% CI 0.12 to 0.72) were associated with willingness to use PrEP. Only 12.2% of the sample was concerned about potential barriers to PrEP use. CONCLUSION Efforts to improve awareness and knowledge of PrEP, teach self-evaluation of HIV infection risk and provide social and emotional support for MSM are needed to scale up PrEP implementation in China.
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Affiliation(s)
- Simin Yu
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Wendy Cross
- School of Health, Federation University Australia, Melbourne, Victoria, Australia
| | - Louisa Lok Yi Lam
- School of Health, Federation University Australia, Melbourne, Victoria, Australia
| | - Kaili Zhang
- School of Nursing, Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Biswajit Banik
- School of Health, Federation University Australia, Melbourne, Victoria, Australia
| | - Xianhong Li
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Honghong Wang
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
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Alharbi TA, Alqurashi A, Mahmud I, Alharbi RJ, Islam SMS, Almustanyir S, Maklad AE, Alsarraj A, Mughaiss LN, Al-tawfiq JA, Ahmed AA, Barry M, Ghozy S, Alabdan LI, Alif SM, Sultana F, Salehin M, Banik B, Cross W, Rahman MA. Psychological Distress, Fear, and Coping Strategies among Citizens and Residents in Saudi Arabia During the COVID-19 Pandemic.. [DOI: 10.21203/rs.3.rs-887072/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
Abstract
Background: COVID-19 caused the worst international public health crisis, accompanied by major global economic downturns, mass-scale job losses, which impacted on the psychosocial wellbeing of the worldwide population. This study examined factors associated with psychosocial distress, fear of COVID-19 and coping strategies amongst the general population in Saudi Arabia.Methods: A cross-sectional study was conducted using an anonymous online questionnaire. Multivariate logistic regressions were used; Adjusted Odds Ratio (AOR) with 95% Confidence Intervals (CIs) was reported.Results: Among 803 participants, 70 %(n=556), were females and the median age was 27 years; 35% (n=278), were frontline or essential service workers; 24% (n=195), reported comorbid conditions including mental health illness. Factors associated with moderate to high levels of psychological distress were: youth (18 - 29 years) (AOR 3.35, 95% CIs 2.06 - 5.44), females (2.59, 1.60 - 4.19), non-Saudi nationals (2.17, 1.11 - 4.26), change in employment (2.9, 1.73 - 4.87), negative financial impact (2.14, 1.29-3.56), having comorbidities (2.67, 1.47 - 4.87), and current smoking (2.87, 1.55 - 5.33). Being ex-smokers (3.72, 1.14 - 12.14) and change in employment (3.42, 1.91 - 6.11) were associated with higher levels of fear of COVID-19. People whose financial situation was impacted and who had contact with known/suspected cases (1.63, 1.12-2.38) had low medium to high resilient coping.Conclusions: People in Saudi Arabia were at a higher risk of psychosocial distress and fear along with low resilience during the COVID-19 pandemic, warranting urgent attention from healthcare providers and policymakers, to provide specific mental health support strategies for their wellbeing currently and to avoid a post-pandemic mental health crisis.
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Rahman MA, Islam SMS, Tungpunkom P, Sultana F, Alif SM, Banik B, Salehin M, Joseph B, Lam L, Watts MC, Khan SJ, Ghozy S, Chair SY, Chien WT, Schönfeldt-Lecuona C, El-Khazragy N, Mahmud I, Al Mawali AH, Al Maskari TS, Alharbi RJ, Hamza A, Keblawi MA, Hammoud M, Elaidy AM, Susanto AD, Bahar Moni AS, AlQurashi AA, Ali A, Wazib A, Sanluang CS, Elsori DH, Yasmin F, Taufik FF, Al Kloub M, Ruiz MG, Elsayed M, Eltewacy NK, Al Laham N, Oli N, Abdelnaby R, Dweik R, Thongyu R, Almustanyir S, Rahman S, Nitayawan S, Al-Madhoun S, Inthong S, Alharbi TA, Bahar T, Ginting TT, Cross WM. COVID-19: Factors associated with psychological distress, fear, and coping strategies among community members across 17 countries. Global Health 2021; 17:117. [PMID: 34598720 PMCID: PMC8485312 DOI: 10.1186/s12992-021-00768-3] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 09/20/2021] [Indexed: 02/03/2023] Open
Abstract
Background The current pandemic of COVID-19 impacted the psychological wellbeing of populations globally. Objectives We aimed to examine the extent and identify factors associated with psychological distress, fear of COVID-19 and coping. Methods We conducted a cross-sectional study across 17 countries during Jun-2020 to Jan-2021. Levels of psychological distress (Kessler Psychological Distress Scale), fear of COVID-19 (Fear of COVID-19 Scale), and coping (Brief Resilient Coping Scale) were assessed. Results A total of 8,559 people participated; mean age (±SD) was 33(±13) years, 64% were females and 40% self-identified as frontline workers. More than two-thirds (69%) experienced moderate-to-very high levels of psychological distress, which was 46% in Thailand and 91% in Egypt. A quarter (24%) had high levels of fear of COVID-19, which was as low as 9% in Libya and as high as 38% in Bangladesh. More than half (57%) exhibited medium to high resilient coping; the lowest prevalence (3%) was reported in Australia and the highest (72%) in Syria. Being female (AOR 1.31 [95% CIs 1.09-1.57]), perceived distress due to change of employment status (1.56 [1.29-1.90]), comorbidity with mental health conditions (3.02 [1.20-7.60]) were associated with higher levels of psychological distress and fear. Doctors had higher psychological distress (1.43 [1.04-1.97]), but low levels of fear of COVID-19 (0.55 [0.41-0.76]); nurses had medium to high resilient coping (1.30 [1.03-1.65]). Conclusions The extent of psychological distress, fear of COVID-19 and coping varied by country; however, we identified few higher risk groups who were more vulnerable than others. There is an urgent need to prioritise health and well-being of those people through well-designed intervention that may need to be tailored to meet country specific requirements. Supplementary Information The online version contains supplementary material available at 10.1186/s12992-021-00768-3.
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Affiliation(s)
- Muhammad Aziz Rahman
- School of Health, Federation University Australia, Berwick, Victoria, Australia. .,Australia Institute for Primary Care and Ageing (AIPCA), La Trobe University, Melbourne, Victoria, Australia. .,Department of Noncommunicable Diseases, Bangladesh University of Health Sciences (BUHS), Dhaka, Bangladesh.
| | | | | | | | | | - Biswajit Banik
- School of Health, Federation University Australia, Berwick, Victoria, Australia
| | - Masudus Salehin
- School of Health, Federation University Australia, Berwick, Victoria, Australia
| | - Bindu Joseph
- School of Health, Federation University Australia, Berwick, Victoria, Australia
| | - Louisa Lam
- School of Health, Federation University Australia, Berwick, Victoria, Australia
| | | | | | - Sherief Ghozy
- Neurovascular Research Lab, Radiology Department, Mayo Clinic, Rochester, MN, USA
| | - Sek Ying Chair
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong
| | - Wai Tong Chien
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong
| | | | | | - Ilias Mahmud
- Department of Public Health, College of Public Health and Health Informatics, Qassim University, Al Bukairiyah, Kingdom of Saudi Arabia
| | | | | | - Rayan Jafnan Alharbi
- Department of Emergency Medical Service, Jazan University, Jazan, Kingdom of Saudi Arabia
| | - Amr Hamza
- Faculty of Medicine, University of Aleppo, Aleppo, Syria
| | | | - Majeda Hammoud
- Faculty of Medicine, Kuwait University, Kuwait City, Kuwait
| | - Asmaa M Elaidy
- Faculty of Medicine for Girls, Al-azhar University, Cairo, Egypt
| | - Agus Dwi Susanto
- Department of Pulmonology and Respiratory Medicine, Universitas Indonesia, Jakarta, Indonesia
| | | | | | | | - Amit Wazib
- Enam Medical College & Hospital, Dhaka, Bangladesh
| | | | | | | | - Feni Fitrani Taufik
- Department of Pulmonology and Respiratory Medicine, Universitas Indonesia, Jakarta, Indonesia
| | | | - Mara Gerbabe Ruiz
- Oman College of Health Sciences-South Sharquiya, Sur, Sultanate of Oman
| | - Mohamed Elsayed
- Department of Psychiatry and Psychotherapy, University of Ulm, Ulm, Germany
| | | | | | | | - Ramy Abdelnaby
- Department of Neurology, RWTH Aachen University, Aachen, Germany
| | - Rania Dweik
- Abu Dhabi University, Abu Dhabi, United Arab Emirates
| | | | | | | | | | | | - Suwit Inthong
- Faculty of Nursing, Chiang Mai University, Chiang Mai, Thailand
| | - Talal Ali Alharbi
- King Saud University Medical City, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Tamanna Bahar
- National Institute of Cancer Research and Hospital, Dhaka, Bangladesh
| | | | - Wendy M Cross
- School of Health, Federation University Australia, Berwick, Victoria, Australia
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Rahman MA, Islam SMS, Tungpunkom P, Sultana F, Alif SM, Banik B, Salehin M, Joseph B, Lam L, Watts MC, Khan SJ, Ghozy S, Chair SY, Chien WT, Schoenfeldt-lecuona C, El-khazragy N, Mahmud I, Mawali AHA, Maskari TSA, Alharbi RJ, Hamza A, Keblawi MA, Hammoud M, Elaidy AM, Susanto AD, Moni ASB, Alqurashi AA, Ali A, Wazib A, Sanluang CS, Elsori DH, Yasmin F, Taufik FF, Kloub MA, Ruiz MG, Elsayed M, Eltewacy NK, Laham NA, Oli N, Abdelnaby R, Dweik R, Thongyu R, Almustanyir S, Rahman S, Nitayawan S, Al-madhoun S, Inthong S, Alharbi TA, Bahar T, Ginting TT, Cross WM. COVID-19: Factors Associated with Psychological Distress, Fear, and Coping Strategies among Community Members Across 17 Countries.. [DOI: 10.21203/rs.3.rs-654989/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
Abstract
Background: The current pandemic of COVID-19 impacted the psychological wellbeing of populations globally. Objectives: We aimed to examine the extent and identify associated factors of psychological distress, fear of COVID-19, and coping.Methods: We conducted a cross-sectional study across 17 countries during Jun-2020 to Jan-2021. Levels of psychological distress (Kessler Psychological Distress Scale), fear of COVID-19 (Fear of COVID-19 Scale), and coping (Brief Resilient Coping Scale) were assessed. Results: A total of 8,559 people participated; mean age (±SD) was 33(±13) years, 64% were females and 40% self-identified as frontline workers. More than two-thirds (69%) experienced moderate-to-very high levels of psychological distress, which was 46% in Thailand and 91% in Egypt. A quarter (24%) had high levels of fear of COVID-19, which was as low as 9% in Libya and as high as 38% in Bangladesh. More than half (57%) exhibited medium to high resilient coping; the lowest prevalence (3%) was reported in Australia and the highest (72%) in Syria. Being female (AOR 1.31 [95% CIs 1.09-1.57]), perceived distress due to change of employment status (1.56 [1.29-1.90]), comorbidity with mental health conditions (3.02 [1.20-7.60]) were associated with higher levels of psychological distress and fear. Doctors had higher psychological distress (1.43 [1.04-1.97]), but low levels of fear of COVID-19 (0.55 [0.41-0.76]); nurses had medium to high resilient coping (1.30 [1.03-1.65]). Conclusions: The extent of psychological distress, fear of COVID and coping varied by country; however, some groups were more vulnerable than others. There is an urgent need to prioritise health and well-being of these people through well-designed intervention that may need to be tailored to meet country specific requirements.
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Affiliation(s)
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- RWTH Aachen University Medical Faculty: Rheinisch-Westfalische Technische Hochschule Aachen Medizinische Fakultat
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Sil A, Chandra A, Banik B, Biswas SK, Chakraborty U. Yellow nail syndrome. J R Coll Physicians Edinb 2021; 51:166-167. [PMID: 34131678 DOI: 10.4997/jrcpe.2021.217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Affiliation(s)
- Abheek Sil
- Department of Dermatology, Venereology and Leprosy, RG Kar Medical College, Kolkata, India
| | - Atanu Chandra
- Doctor's Quarters (RG Kar Medical College Campus), 1 Khudiram Bose Sarani, Kolkata-700004, West Bengal, India,
| | - Biswajit Banik
- Department of Gastroenterology, IPGMER and SSKM Hospital, Kolkata, India
| | - Surajit Kumar Biswas
- Department of Dermatology, Venereology and Leprosy, RG Kar Medical College, Kolkata
| | - Uddalak Chakraborty
- Department of Neurology, Bangur Institute of Neurosciences, IPGMER and SSKM Hospital, Kolkata, India
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Wang H, Yu S, Cross W, Lam L, Banik B, Zhang K. Condom Use Consistency and Associated Factors Among College Student Men Who Have Sex with Men from Seven Colleges in Changsha City: A Cross-Sectional Survey. HIV AIDS (Auckl) 2021; 13:557-569. [PMID: 34040452 PMCID: PMC8140883 DOI: 10.2147/hiv.s305932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 04/28/2021] [Indexed: 12/03/2022]
Abstract
Background College student men who have sex with men (MSM) are at high risk for HIV infection due to multiple social and behavioral factors. Consistent condom use is nationally advocated for HIV prevention. This study explored the sexual behaviors and factors associated with condom use consistency in the past six months among college student MSM from seven colleges in Hunan Province, China. Methods A cross-sectional survey was conducted from September 2017 to March 2018. Condom use consistency, sexual behaviors, HIV testing performance, substance use, and alcohol consumption were examined using researcher-created questionnaires. Condom use self-efficacy and HIV-related knowledge were assessed using the Condom Use Self-Efficacy Scale and the unified National AIDS Sentinel Surveillance Questionnaire. Univariate and multivariate logistic regressions were used. P <0.05 was considered significant. Results In the 214 respondents, the rate of consistent condom use was 56% (n = 119) during the past six months. Participants who were studying at first-tier universities (odds ratio [OR]: 2.522, 95% confidence interval [CI]: 1.255–5.067) and had higher scores for condom use self-efficacy (OR: 2.617, 95% CI: 1.462–4.685) were more likely to report consistent condom use than the others. The risk factor was having suspicious symptoms of sexually transmitted diseases (OR: 0.357, 95% CI: 0.163–0.780). Conclusion Numerous students were at high risk of HIV infection with inconsistent condom use. Comprehensive and specific topics about safe sex education from parents and peers should be offered on campuses in China.
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Affiliation(s)
- Honghong Wang
- Xiangya School of Nursing, Central South University, Changsha City, 410000, Hunan Province, People's Republic of China
| | - Simin Yu
- Xiangya School of Nursing, Central South University, Changsha City, 410000, Hunan Province, People's Republic of China
| | - Wendy Cross
- School of Health, Federation University, Berwick, 3806, Victoria, Australia
| | - Louisa Lam
- School of Health, Federation University, Berwick, 3806, Victoria, Australia
| | - Biswajit Banik
- School of Health, Federation University, Berwick, 3806, Victoria, Australia
| | - Kaili Zhang
- School of Nursing, Xuzhou Medical University, Xuzhou City, 221004, Jiangsu Province, People's Republic of China
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Rahman MA, Hoque N, Alif SM, Salehin M, Islam SMS, Banik B, Sharif A, Nazim NB, Sultana F, Cross W. Factors associated with psychological distress, fear and coping strategies during the COVID-19 pandemic in Australia. Global Health 2020; 16:95. [PMID: 33032629 PMCID: PMC7542573 DOI: 10.1186/s12992-020-00624-w] [Citation(s) in RCA: 145] [Impact Index Per Article: 36.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 09/29/2020] [Indexed: 01/08/2023] Open
Abstract
Background The COVID-19 pandemic disrupted the personal, professional and social life of Australians with some people more impacted than others. Objectives This study aimed to identify factors associated with psychological distress, fear and coping strategies during the COVID-19 pandemic in Australia. Methods A cross-sectional online survey was conducted among residents in Australia, including patients, frontline health and other essential service workers, and community members during June 2020. Psychological distress was assessed using the Kessler Psychological Distress Scale (K10); level of fear was assessed using the Fear of COVID-19 Scale (FCV-19S); and coping strategies were assessed using the Brief Resilient Coping Scale (BRCS). Logistic regression was used to identify factors associated with the extent of psychological distress, level of fear and coping strategies while adjusting for potential confounders. Results Among 587 participants, the majority (391, 73.2%) were 30–59 years old and female (363, 61.8%). More than half (349, 59.5%) were born outside Australia and two-third (418, 71.5%) completed at least a Bachelor’s degree. The majority (401, 71.5%) had a source of income, 243 (42.3%) self-identified as a frontline worker, and 335 (58.9%) reported financial impact due to COVID-19. Comorbidities such as pre-existing mental health conditions (AOR 3.13, 95% CIs 1.12–8.75), increased smoking (8.66, 1.08–69.1) and alcohol drinking (2.39, 1.05–5.47) over the last four weeks, high levels of fear (2.93, 1.83–4.67) and being female (1.74, 1.15–2.65) were associated with higher levels of psychological distress. Perceived distress due to change of employment status (4.14, 1.39–12.4), alcohol drinking (3.64, 1.54–8.58), providing care to known or suspected cases (3.64, 1.54–8.58), being female (1.56, 1.00–2.45), being 30–59 years old (2.29, 1.21–4.35) and having medium to high levels of psychological distress (2.90, 1.82–5.62) were associated with a higher level of fear; while healthcare service use in the last four weeks was associated with medium to high resilience. Conclusions This study identified individuals who were at higher risk of distress and fear during the COVID-19 pandemic specifically in the State of Victoria, Australia. Specific interventions to support the mental wellbeing of these individuals should be considered in addition to the existing resources within primary healthcare settings.
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Affiliation(s)
- Muhammad Aziz Rahman
- School of Health, Federation University Australia, 100 Clyde Road, Berwick, Victoria, 3806, Australia. .,Australian Institute of Primary Care and Ageing, La Trobe University, Plenty Road and Kingsbury Drive, Melbourne, Victoria, 3086, Australia. .,Bangladesh Medical Society of Victoria (BMSV), Melbourne, VIC, 3000, Australia.
| | - Nazmul Hoque
- Bangladesh Medical Society of Victoria (BMSV), Melbourne, VIC, 3000, Australia.,Emerald Medical Centre, 1 Murphys Way, Emerald, Victoria, 3782, Australia
| | - Sheikh M Alif
- Bangladesh Medical Society of Victoria (BMSV), Melbourne, VIC, 3000, Australia.,School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, Victoria, 3004, Australia
| | - Masudus Salehin
- School of Health, Federation University Australia, 100 Clyde Road, Berwick, Victoria, 3806, Australia
| | - Sheikh Mohammed Shariful Islam
- Institute for Physical Activity and Nutrition, Deakin University, 221 Burwood Highway, Burwood, Victoria, 3125, Australia
| | - Biswajit Banik
- School of Health, Federation University Australia, 100 Clyde Road, Berwick, Victoria, 3806, Australia
| | - Ahmed Sharif
- Bangladesh Medical Society of Victoria (BMSV), Melbourne, VIC, 3000, Australia.,Station Street Clinic, 34 Station Street, Pakenham, Burwood, Victoria, 3810, Australia.,Bangladesh Institute of Family Medicine and Research, University of Science & Technology Chittagong, Zakir Hossain Road, Foy's Lake, Khulshi, Chittagong, 4202, Bangladesh
| | - Nashrin Binte Nazim
- Bangladesh Medical Society of Victoria (BMSV), Melbourne, VIC, 3000, Australia.,Greenvale Medical Centre, 1/11 Greenvale Drive, Greenvale, Burwood, Victoria, 3059, Australia
| | - Farhana Sultana
- Telstra Health, 222 Lonsdale Street, Melbourne, Victoria, 3000, Australia
| | - Wendy Cross
- School of Health, Federation University Australia, 100 Clyde Road, Berwick, Victoria, 3806, Australia
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Banik B, Bhar D, Sil A. Terbinafine-induced Steven-Johnson syndrome and toxic epidermal necrolysis (SJS/TEN) overlap. Postgrad Med J 2020; 97:630-631. [PMID: 32665378 DOI: 10.1136/postgradmedj-2020-138326] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 06/13/2020] [Indexed: 11/04/2022]
Affiliation(s)
- Biswajit Banik
- Internal Medicine, R.G. Kar Medical College and Hospital, Kolkata, India
| | - Debarati Bhar
- Internal Medicine, R.G. Kar Medical College and Hospital, Kolkata, India
| | - Abheek Sil
- Dermatology, Venereology, and Leprosy, R.G. Kar Medical College and Hospital, Kolkata, India
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Chakraborty U, Banik B, Chandra A, Pal J. An atypical manifestation of lateral medullary syndrome. Oxf Med Case Reports 2020; 2019:527-529. [PMID: 31908829 PMCID: PMC6937448 DOI: 10.1093/omcr/omz139] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 10/07/2019] [Accepted: 11/17/2019] [Indexed: 11/13/2022] Open
Abstract
Lateral medullary syndrome is a common brainstem stroke associated with a classical triad of Horner's Syndrome, ipsilateral ataxia and hypalgesia and thermoanasthesia of ipsilateral face. We report a case of a 49-year-old diabetic, non-hypertensive, postmenopausal female who presented with symptoms involving the left dorsal medulla along with right sided hemiparesis and left UMN-type facial palsy. Contralateral hemiparesis was explained by caudal extension of infarct involving the pyramids before decussation at the medulla, known as Babinski-Nageotte Syndrome. UMN-type facial palsy was attributed to involvement of hypothetical supranuclear aberrant corticobulbar fibres of facial nerve which descend down in the contralateral ventromedial medulla, decussate at level of upper medulla and then ascend in the dorsolateral medulla to reach the facial nerve nucleus. Association of these two entities with Wallenberg's Syndrome have been reported separately in literature, but not together as in this case.
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Affiliation(s)
- Uddalak Chakraborty
- Department of General Medicine, R.G.Kar Medical College and Hospital, Kolkata 700004, West Bengal, India
| | - Biswajit Banik
- Department of General Medicine, R.G.Kar Medical College and Hospital, Kolkata 700004, West Bengal, India
| | - Atanu Chandra
- Department of General Medicine, R.G.Kar Medical College and Hospital, Kolkata 700004, West Bengal, India
| | - Jyotirmoy Pal
- Department of General Medicine, R.G.Kar Medical College and Hospital, Kolkata 700004, West Bengal, India
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Loo SCJ, Moore T, Banik B, Alexis F. Biomedical applications of hydroxyapatite nanoparticles. Curr Pharm Biotechnol 2011; 11:333-42. [PMID: 20199383 DOI: 10.2174/138920110791233343] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2009] [Accepted: 01/20/2010] [Indexed: 11/22/2022]
Abstract
Nanotechnologies have the potential to improve current disease diagnosis due to their ability to circulate in the blood and distribute in the body to image tissues and cells or therapeutical applications to deliver a payload. Among nanoparticles with different materials composition, inorganic nanoparticles composed of calcium phosphate have numerous advantages including ease of synthesis, control of physico-chemical properties, strong interactions with their payload, and biocompatibility. In this review we discuss the different routes of synthesis of calcium phosphate nanoparticles, novel systems, strategies to load agents, biostability and cytotoxicity, biodistribution and pharmacokinetics, bio-imaging and therapeutical applications.
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Affiliation(s)
- S C J Loo
- Department of Bioengineering,Rhodes Research Center, 203, Clemson University, Clemson, South Carolina 29634, USA
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