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Nuzhath T, Spiegelman A, Scobee J, Goidel K, Washburn D, Callaghan T. Primary care physicians' strategies for addressing COVID-19 vaccine hesitancy. Soc Sci Med 2023; 333:116150. [PMID: 37595423 DOI: 10.1016/j.socscimed.2023.116150] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 08/18/2022] [Revised: 08/02/2023] [Accepted: 08/04/2023] [Indexed: 08/20/2023]
Abstract
OBJECTIVE To explore the strategies that primary care physicians use to address patient COVID-19 vaccine hesitancy. METHOD We administered an online survey to 625 primary care physicians from May 14 to May 25, 2021, to assess the messages that primary care physicians use to encourage hesitant patients to get vaccinated against COVID-19.589 physicians from the total pool of 625 provided open-ended responses. We conducted thematic content analysis on the responses based on previous research and themes identified within the data. SETTING The survey was administered online using the survey research firm Dynata. RESULTS Eleven primary themes emerged from our analysis, which included, physicians addressing specific concerns about vaccine safety (including costs versus benefits), physicians helping patients understand what it means to remain unvaccinated, or whether physicians try to connect emotionally through the use of guilt, or personal experience, whether physicians use derisive language to communicate with unvaccinated patients. In addition, a small number of physicians indicated they would not attempt to persuade someone who is vaccine hesitant. CONCLUSIONS Our study shows that while some of the physicians used different strategies to address vaccine hesitancy, some of the physicians used harsh language or did not make any effort to reduce COVID-19 related vaccine hesitancy among their patients. Focused advocacy and training are needed to increase physician engagement in vaccine-related dialogues with their patients. Such efforts will ensure that critical opportunities for patient education and awareness-building are not missed and ensure high levels of vaccination uptake.
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Affiliation(s)
- Tasmiah Nuzhath
- Department of Global Health and Population, Harvard T. H. Chan School of Public Health. Huntington Ave, Boston, MA, 02115, USA; Department of Health Promotion and Community Health Sciences, School of Public Health, Texas A&M University. 212 Adriance Lab Rd. 1266 TAMU, College Station, TX, USA.
| | | | - Julia Scobee
- Department of Health Law, Policy and Management, School of Public Health, Boston University, 715 Albany Street, Boston, MA, USA
| | - Kirby Goidel
- Department of Political Science, Texas A&M University, 2935, Research Pkwy, College Station, TX, USA
| | - David Washburn
- Department of Health Policy and Management, School of Public Health and Tropical Medicine, Tulane University, 1440 Canal Street, New Orleans, LA, USA
| | - Timothy Callaghan
- Department of Health Law, Policy and Management, School of Public Health, Boston University, 715 Albany Street, Boston, MA, USA
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Goidel K, Callaghan T, Washburn DJ, Nuzhath T, Scobee J, Spiegelman A, Motta M. Physician Trust in the News Media and Attitudes toward COVID-19. J Health Polit Policy Law 2023; 48:317-350. [PMID: 36441631 DOI: 10.1215/03616878-10358696] [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] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
CONTEXT Previous research has established the importance of primary care physicians in communicating public health directives. The implicit assumption is that, because of their expertise, doctors provide accurate and up-to-date information to their patients independent of partisan affiliation or media trust. METHODS The authors conducted an online survey of 625 primary care physicians and used the results to test (1) whether physician trust in media outlets is consistent with their political partisanship, and (2) whether trust in media outlets influences (a) personal concern that someone in their family will get sick, (b) perceptions about the seriousness of the pandemic as portrayed in the media, and (c) trust in federal government agencies and scientists. FINDINGS Physicians are better positioned to critically evaluate health-related news, but they are subject to the same biases that influence public opinion. Physicians' partisan commitments influence media trust, and media trust influences concern that a family member will get sick, perceptions regarding the seriousness of the pandemic, and trust in federal government agencies and scientists. CONCLUSIONS Physician trust in specific media outlets shapes their understanding of the pandemic, and-to the extent that they trust conservative media outlets-it may limit their effectiveness as health policy messengers.
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Oloruntoba O, Aggad R, Nuzhath T, Fan Q, Smith ML. Meeting The Mentorship Needs Of International Students In The United States. Health Behavior Research 2022. [DOI: 10.4148/2572-1836.1169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
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Hossain MM, Saha N, Rodela TT, Tasnim S, Nuzhath T, Roy TJ, Burdine JN, Ahmed HU, McKyer ELJ, Basu BK, Ma P. Global research on syndemics: a meta-knowledge analysis (2001-2020). F1000Res 2022; 11:253. [PMID: 36936050 PMCID: PMC10015119 DOI: 10.12688/f1000research.74190.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/28/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Syndemics or synergies of cooccurring epidemics are widely studied across health and social sciences in recent years. METHODS We conducted a meta-knowledge analysis of articles published between 2001 to 2020 in this growing field of academic scholarship. RESULTS We found a total of 830 articles authored by 3025 authors, mostly from high-income countries. Publications on syndemics are gradually increasing since 2003, with rapid development in 2013. Each article was cited more than 15 times on average, and most (n = 604) articles were original studies. Syndemics research focused on several areas, including HIV/AIDS, substance abuse, mental health, gender minority stressors, racism, violence, chronic physical and mental disorders, food insecurity, social determinants of health, and coronavirus disease 2019. Moreover, biopsychosocial interactions between multiple health problems were studied across medical, anthropological, public health, and other disciplines of science. CONCLUSIONS The limited yet rapidly evolving literature on syndemics informs transdisciplinary interests to understand complex coexisting health challenges in the context of systematic exclusion and structural violence in vulnerable populations. The findings also suggest applications of syndemic theory to evaluate clinical and public health problems, examine the socioecological dynamics of factors influencing health and wellbeing, and use the insights to alleviate health inequities in the intersections of synergistic epidemics and persistent contextual challenges for population health.
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Affiliation(s)
- Md Mahbub Hossain
- EviSyn Health, Khulna, Bangladesh
- Department of Health Promotion and Community Health Sciences, Texas A&M Health Science Center, College Stataion, Texas, 77840, USA
| | - Nobonita Saha
- Institute of Nutrition and Food Science, University of Dhaka, Dhaka, Bangladesh
| | - Tahmina Tasnim Rodela
- Department of Economics, Mawlana Bhashani Science and Technology University, Tangail, Bangladesh
| | - Samia Tasnim
- EviSyn Health, Khulna, Bangladesh
- Department of Health Promotion and Community Health Sciences, Texas A&M Health Science Center, College Stataion, Texas, 77840, USA
| | - Tasmiah Nuzhath
- EviSyn Health, Khulna, Bangladesh
- Department of Health Promotion and Community Health Sciences, Texas A&M Health Science Center, College Stataion, Texas, 77840, USA
| | - Tamal Joyti Roy
- Institute of Information and Communication Technology, Khulna, Bangladesh
| | - James N. Burdine
- Department of Health Promotion and Community Health Sciences, Texas A&M Health Science Center, College Stataion, Texas, 77840, USA
| | | | - E. Lisako J. McKyer
- Department of Health Promotion and Community Health Sciences, Texas A&M Health Science Center, College Stataion, Texas, 77840, USA
| | | | - Ping Ma
- Department of Health Promotion and Community Health Sciences, Texas A&M Health Science Center, College Stataion, Texas, 77840, USA
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Hossain MM, Saha N, Rodela TT, Tasnim S, Nuzhath T, Roy TJ, Burdine JN, Ahmed HU, McKyer ELJ, Basu BK, Ma P. Global research on syndemics: a meta-knowledge analysis (2001-2020). F1000Res 2022; 11:253. [PMID: 36936050 PMCID: PMC10015119 DOI: 10.12688/f1000research.74190.2] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/26/2023] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Syndemics or synergies of cooccurring epidemics are widely studied across health and social sciences in recent years. METHODS We conducted a meta-knowledge analysis of articles published between 2001 to 2020 in this growing field of academic scholarship. RESULTS We found a total of 830 articles authored by 3025 authors, mostly from high-income countries. Publications on syndemics are gradually increasing since 2003, with rapid development in 2013. Each article was cited more than 15 times on average, and most (n = 604) articles were original studies. Syndemics research focused on several areas, including HIV/AIDS, substance abuse, mental health, gender minority stressors, racism, violence, chronic physical and mental disorders, food insecurity, social determinants of health, and coronavirus disease 2019. Moreover, biopsychosocial interactions between multiple health problems were studied across medical, anthropological, public health, and other disciplines of science. CONCLUSIONS The limited yet rapidly evolving literature on syndemics informs transdisciplinary interests to understand complex coexisting health challenges in the context of systematic exclusion and structural violence in vulnerable populations. The findings also suggest applications of syndemic theory to evaluate clinical and public health problems, examine the socioecological dynamics of factors influencing health and wellbeing, and use the insights to alleviate health inequities in the intersections of synergistic epidemics and persistent contextual challenges for population health.
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Affiliation(s)
- Md Mahbub Hossain
- EviSyn Health, Khulna, Bangladesh
- Department of Health Promotion and Community Health Sciences, Texas A&M Health Science Center, College Stataion, Texas, 77840, USA
| | - Nobonita Saha
- Institute of Nutrition and Food Science, University of Dhaka, Dhaka, Bangladesh
| | - Tahmina Tasnim Rodela
- Department of Economics, Mawlana Bhashani Science and Technology University, Tangail, Bangladesh
| | - Samia Tasnim
- EviSyn Health, Khulna, Bangladesh
- Department of Health Promotion and Community Health Sciences, Texas A&M Health Science Center, College Stataion, Texas, 77840, USA
| | - Tasmiah Nuzhath
- EviSyn Health, Khulna, Bangladesh
- Department of Health Promotion and Community Health Sciences, Texas A&M Health Science Center, College Stataion, Texas, 77840, USA
| | - Tamal Joyti Roy
- Institute of Information and Communication Technology, Khulna, Bangladesh
| | - James N. Burdine
- Department of Health Promotion and Community Health Sciences, Texas A&M Health Science Center, College Stataion, Texas, 77840, USA
| | | | - E. Lisako J. McKyer
- Department of Health Promotion and Community Health Sciences, Texas A&M Health Science Center, College Stataion, Texas, 77840, USA
| | | | - Ping Ma
- Department of Health Promotion and Community Health Sciences, Texas A&M Health Science Center, College Stataion, Texas, 77840, USA
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Callaghan T, Washburn D, Goidel K, Nuzhath T, Spiegelman A, Scobee J, Moghtaderi A, Motta M. Imperfect messengers? An analysis of vaccine confidence among primary care physicians. Vaccine 2022; 40:2588-2603. [PMID: 35315324 PMCID: PMC8931689 DOI: 10.1016/j.vaccine.2022.03.025] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 03/08/2022] [Accepted: 03/10/2022] [Indexed: 12/13/2022]
Affiliation(s)
- Timothy Callaghan
- Department of Health Policy and Management, School of Public Health, Texas A&M University, 212 Adriance Lab Rd. 1266 TAMU, College Station, TX, United States.
| | - David Washburn
- Department of Health Policy and Management, School of Public Health, Texas A&M University, 212 Adriance Lab Rd. 1266 TAMU, College Station, TX, United States
| | - Kirby Goidel
- Department of Political Science, Texas A&M University, 2935 Research Pkwy, College Station, TX, United States
| | - Tasmiah Nuzhath
- Department of Health Promotion and Community Health Sciences, School of Public Health, Texas A&M University, 212 Adriance Lab Rd. 1266 TAMU, College Station, TX, United States
| | - Abigail Spiegelman
- USA Center for Rural Public Health Preparedness, School of Public Health, Texas A&M University, 212 Adriance Lab Rd. 1266 TAMU, College Station, TX, United States
| | - Julia Scobee
- Department of Health Policy and Management, School of Public Health, Texas A&M University, 212 Adriance Lab Rd. 1266 TAMU, College Station, TX, United States
| | - Ali Moghtaderi
- Department of Health Policy and Management, Milken School of Public Health, George Washington University, 950 New Hampshire Avenue, Washington, DC, United States
| | - Matthew Motta
- Department of Political Science, Oklahoma State University, 210 Social Sciences and Humanities Hall, Stillwater, OK, United States
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Callaghan T, McCord C, Washburn D, Goidel K, Schmit C, Nuzhath T, Spiegelman A, Scobee J. The Changing Nature of Telehealth Use by Primary Care Physicians in the United States. J Prim Care Community Health 2022; 13:21501319221110418. [PMID: 35795898 PMCID: PMC9274427 DOI: 10.1177/21501319221110418] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION Prior to the COVID-19 pandemic, telehealth utilization was growing slowly and steadily, although differentially across medical specialties in the United States. The pandemic dramatically expanded physician use of telehealth, but our understanding of how much telehealth use has changed in primary care in the United States, the correlates of physician telehealth uptake, and the frequency with which primary care physicians intend to use telehealth after the pandemic are unknown. This paper is designed to assess these important questions. METHODS Using data from an original national survey of 625 primary care physicians conducted from May 14 to May 25, 2021, we investigate the frequency of physician telehealth use before and during the pandemic and intended use after the pandemic. We also assess the correlates of changes in telehealth use by physicians, comparing telehealth use before the pandemic to use during and after the pandemic. RESULTS The proportion of primary care physicians using telehealth often, jumped from 5.3% (95% CI 3.5, 7.0) before the pandemic to 46.2% (95% CI 42.3, 50.2) during the pandemic. More importantly, over 70% of physicians intended to use telehealth at least occasionally after the pandemic compared to just 18.7% before, with younger physicians, physicians without telehealth training in medical school, and Asian physicians most likely to increase their telehealth use long-term. DISCUSSION The COVID-19 pandemic has spurred expansion in telehealth use by primary care physicians that will continue to shape care delivery well beyond the pandemic. Policy change could be needed to facilitate this growth of telehealth long-term.
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Fan Q, Roque M, Nuzhath T, Hossain MM, Jin X, Aggad R, Myint WW, Zhang G, McKyer ELJ, Ma P. Changes in Levels and Determinants of Maternal Health Service Utilization in Ethiopia: Comparative Analysis of Two Rounds Ethiopian Demographic and Health Surveys. Matern Child Health J 2021; 25:1595-1606. [PMID: 34117995 DOI: 10.1007/s10995-021-03182-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/09/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Antenatal care (ANC), delivery by skilled birth attendants, and postnatal care (PNC) are critical components of maternal health services for reducing maternal mortality. The study aimed to compare the utilization of maternal health services in the two most recent rounds of Ethiopia Demographic and Health Surveys (EDHS) and identify the factors influencing the utilization of these services using the 2016 EDHS. METHODS Two rounds of EDHS data in 2011 and 2016 were used to estimate the proportion of women who had ANC, delivered by skilled birth attendants, and had a postnatal checkup and other characteristics of the surveyed population. The most recent round of data-the 2016 EDHS-was used to examine the socio-cultural and reproductive health factors associated with the three maternal health services utilization. Chi-square tests and multivariate logistic regression analyses with adjusted Odds Ratios (AOR) were conducted using Stata 15.0. RESULTS The use of ANC services and skilled birth attendants increased significantly between 2011 and 2016 EDHS, utilization of ANC services increased from 34.0 to 65.5%, and use of skilled birth attendants increased from 11.7 to 35.9%, respectively. The use of postnatal care decreased from 9.3 to 6.9%. Utilization of maternal health service was significantly associated with urban residence, Protestant religion, Oromo ethnicity, more education, more household wealth, and less parity. Furthermore, women who had ANC visits during pregnancy were more likely to subsequently use skilled birth attendants (AOR 5.5, p < 0.001) and PNC (AOR 2.9, p < 0.001). CONCLUSION The study highlighted the inequalities in the utilization of maternal health services between rural and urban areas, and the need of addressing the social, economic, and physical barriers that prevent women from using these services. Further, programs should be targeted at promoting the use of professional birth and postnatal services in Ethiopia.
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Affiliation(s)
- Qiping Fan
- Department of Health Promotion and Community Health Sciences, School of Public Health, Texas A&M Health Science Center, Texas A&M University, College Station, TX, 77843-1266, USA. .,Duke Graduate School, Duke University, Durham, NC, 27705, USA. .,Global Health Research Center, Duke Kunshan University, Jiangsu, China.
| | - Maria Roque
- Department of Health Promotion and Community Health Sciences, School of Public Health, Texas A&M Health Science Center, Texas A&M University, College Station, TX, 77843-1266, USA
| | - Tasmiah Nuzhath
- Department of Health Promotion and Community Health Sciences, School of Public Health, Texas A&M Health Science Center, Texas A&M University, College Station, TX, 77843-1266, USA
| | - Md Mahbub Hossain
- Department of Health Promotion and Community Health Sciences, School of Public Health, Texas A&M Health Science Center, Texas A&M University, College Station, TX, 77843-1266, USA
| | - Xurui Jin
- Duke Graduate School, Duke University, Durham, NC, 27705, USA.,Global Health Research Center, Duke Kunshan University, Jiangsu, China
| | - Roaa Aggad
- Department of Health Promotion and Community Health Sciences, School of Public Health, Texas A&M Health Science Center, Texas A&M University, College Station, TX, 77843-1266, USA
| | - Wah Wah Myint
- Department of Health Promotion and Community Health Sciences, School of Public Health, Texas A&M Health Science Center, Texas A&M University, College Station, TX, 77843-1266, USA
| | - Geng Zhang
- Department of Health Policy and Management, School of Public Health, Texas A&M University, College Station, TX, 77843, USA
| | - E Lisako Jones McKyer
- Department of Health Promotion and Community Health Sciences, School of Public Health, Texas A&M Health Science Center, Texas A&M University, College Station, TX, 77843-1266, USA
| | - Ping Ma
- Department of Health Promotion and Community Health Sciences, School of Public Health, Texas A&M Health Science Center, Texas A&M University, College Station, TX, 77843-1266, USA
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Abstract
In the coming months, most American adults will have the opportunity to receive at least one of up to five different COVID-19 vaccines produced by Operation Warp Speed and released through emergency use authorization by the U.S. Food and Drug Administration (FDA). A similar group of vaccines will also be released in Europe by the European Medicines Agency (EMA) and in the United Kingdom by the Medicines & Healthcare products Regulatory Agency (MHRA). Those living outside of North America and Europe may not have access to those particular vaccines, but they will benefit from receiving vaccines produced in Brazil, China, India, or Russia. These vaccines and some of their major features based on clinical trials and testing are listed in Table 1 [1-25]. As vaccine scientists and policy experts working in the area of coronavirus disease 2019 (COVID-19), we are frequently asked about potential choices regarding the available vaccines, both in the U.S. and globally. Provided here is a summary and informal decision-making tool kit for considering the different vaccine options at this time.
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Affiliation(s)
- Peter J Hotez
- Texas Children's Hospital Center for Vaccine Development and Center for Medical Ethics and Health Policy, Departments of Pediatrics and Molecular Virology & Microbiology, National School of Tropical Medicine, Baylor College of Medicine, Houston, TX, USA; Hagler Institute for Advanced Study at Texas A&M University, College Station, TX, USA; Scowcroft Institute of International Affairs, Bush School of Policy and Government, Texas A&M University, College Station, TX, USA; Department of Biology, Baylor University, Waco, TX, USA; James A Baker III Institute of Public Policy, Rice University Houston, Texas, USA.
| | - Tasmiah Nuzhath
- Department of Health Promotion and Community Health Sciences, Texas A&M School of Public Health, College Station, TX, USA
| | - Timothy Callaghan
- Department of Health Policy and Management, Texas A&M School of Public Health, College Station, TX, USA
| | - Brian Colwell
- Department of Health Promotion and Community Health Sciences, Texas A&M School of Public Health, College Station, TX, USA
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Nuzhath T, Ajayi KV, Fan Q, Hotez P, Colwell B, Callaghan T, Regan AK. Childhood immunization during the COVID-19 pandemic in Texas. Vaccine 2021; 39:3333-3337. [PMID: 34020814 PMCID: PMC8078904 DOI: 10.1016/j.vaccine.2021.04.050] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 04/09/2021] [Accepted: 04/23/2021] [Indexed: 12/02/2022]
Abstract
In 2020, the state of Texas implemented coronavirus disease 2019 (COVID-19) social distancing guidelines in order to prevent surges at Texas hospital emergency rooms and in intensive care units. As noted in other states, an unintended consequence of these activities was significant declines in childhood immunizations. After analyzing state-wide immunization register data for Texas, we observed a 47% relative decline in immunization rates between 2019 and 2020 among 5-month-olds and a 58% decline among 16-month-olds. We observed a small decline (5%) among 24-month-olds, and no decline in vaccines received at birth (Hepatitis B). Declines were larger in rural counties compared to urban. These declines are superimposed on increases in state vaccine exemptions over the last five years due to an aggressive anti-vaccine movement in Texas. There are concerns that continued declines in childhood immunization coverage due to COVID-19 could lead to co-endemics of measles and other vaccine preventable diseases.
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Affiliation(s)
- Tasmiah Nuzhath
- Texas A&M School of Public Health, College Station, TX, USA; Hagler Institute for Advanced Study at Texas A&M University, College Station, TX, USA
| | - Kobi V Ajayi
- Department of Health and Kinesiology, Texas A&M University, College Station, TX, USA; Laboratory for Community Health Evaluation and Systems Science (CHESS), Texas A&M University, College Station, TX, USA
| | - Qiping Fan
- Texas A&M School of Public Health, College Station, TX, USA
| | - Peter Hotez
- Hagler Institute for Advanced Study at Texas A&M University, College Station, TX, USA; Texas Children's Hospital Center for Vaccine Development and Center for Medical Ethics and Health Policy, Departments of Pediatrics and Molecular Virology & Microbiology, National School of Tropical Medicine, Baylor College of Medicine, Houston, TX, USA; Scowcroft Institute of International Affairs, Bush School of Policy and Government, Texas A&M University, College Station, TX, USA; Department of Biology, Baylor University, Waco, TX, USA; James A Baker III Institute of Public Policy, Rice University Houston, TX, USA
| | - Brian Colwell
- Texas A&M School of Public Health, College Station, TX, USA
| | | | - Annette K Regan
- Texas A&M School of Public Health, College Station, TX, USA; School of Nursing and Health Professions, University of San Francisco, San Francisco, CA, USA; UCLA Fielding School of Public Health, Los Angeles, CA, USA.
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Hossain MM, Rahman M, Trisha NF, Tasnim S, Nuzhath T, Hasan NT, Clark H, Das A, McKyer ELJ, Ahmed HU, Ma P. Prevalence of anxiety and depression in South Asia during COVID-19: A systematic review and meta-analysis. Heliyon 2021; 7:e06677. [PMID: 33898819 PMCID: PMC8056240 DOI: 10.1016/j.heliyon.2021.e06677] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [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: 11/01/2020] [Revised: 03/08/2021] [Accepted: 03/29/2021] [Indexed: 12/20/2022] Open
Abstract
INTRODUCTION The COVID-19 pandemic has impacted biopsychosocial health and wellbeing globally. Pre-pandemic studies suggest a high prevalence of common mental disorders, including anxiety and depression in South Asian countries, which may aggravate during this pandemic. This systematic meta-analytic review was conducted to estimate the pooled prevalence of anxiety and depression in South Asian countries during the COVID-19 pandemic. METHOD We systematically searched for cross-sectional studies on eight major bibliographic databases and additional sources up to October 12, 2020, that reported the prevalence of anxiety or depression in any of the eight South Asian countries. A random-effects model was used to calculate the pooled proportion of anxiety and depression. RESULTS A total of 35 studies representing 41,402 participants were included in this review. The pooled prevalence of anxiety in 31 studies with a pooled sample of 28,877 was 41.3% (95% confidence interval [CI]: 34.7-48.1, I 2 = 99.18%). Moreover, the pooled prevalence of depression was 34.1% (95% CI: 28.9-39.4, I 2 = 99%) among 37,437 participants in 28 studies. Among the South Asian countries, India had a higher number of studies, whereas Bangladesh and Pakistan had a higher pooled prevalence of anxiety and depression. No studies were identified from Afghanistan, Bhutan, and Maldives. Studies in this review had high heterogeneity, high publication bias confirmed by Egger's test, and varying prevalence rates across sub-groups. CONCLUSION South Asian countries have high prevalence rates of anxiety and depression, suggesting a heavy psychosocial burden during this pandemic. Clinical and public mental health interventions should be prioritized alongside improving the social determinants of mental health in these countries. Lastly, a low number of studies with high heterogeneity requires further research exploring the psychosocial epidemiology during COVID-19, which may inform better mental health policymaking and practice in South Asia.
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Affiliation(s)
- Md Mahbub Hossain
- School of Public Health, Texas A&M University, College Station, TX 77843, United States
| | - Mariya Rahman
- School of Public Health, Texas A&M University, College Station, TX 77843, United States
| | - Nusrat Fahmida Trisha
- School of Public Health, Texas A&M University, College Station, TX 77843, United States
| | - Samia Tasnim
- School of Public Health, Texas A&M University, College Station, TX 77843, United States
| | - Tasmiah Nuzhath
- School of Public Health, Texas A&M University, College Station, TX 77843, United States
| | - Nishat Tasnim Hasan
- School of Public Health, Texas A&M University, College Station, TX 77843, United States
| | - Heather Clark
- School of Public Health, Texas A&M University, College Station, TX 77843, United States
| | - Arindam Das
- The IIHMR University, Jaipur, Rajasthan 302029, India
| | - E. Lisako J. McKyer
- School of Public Health, Texas A&M University, College Station, TX 77843, United States
| | - Helal Uddin Ahmed
- National Institute of Mental Health (NIMH), Sher-E-Bangla Nagar, Dhaka 1207, Bangladesh
| | - Ping Ma
- School of Public Health, Texas A&M University, College Station, TX 77843, United States
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Hossain MM, Mazumder H, Tasnim S, Nuzhath T, Sultana A. Geriatric Health in Bangladesh during COVID-19: Challenges and Recommendations. J Gerontol Soc Work 2020; 63:724-727. [PMID: 32501147 DOI: 10.1080/01634372.2020.1772932] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Accepted: 05/19/2020] [Indexed: 06/11/2023]
Abstract
The novel coronavirus disease (COVID-19) is impacting health globally, whereas older adults are highly susceptible and more likely to have adverse health outcomes. In Bangladesh, the elderly population has been increasing over the past few decades, who often live with poor socioeconomic conditions and inadequate access to healthcare services. These disparities are likely to increase amid COVID-19, which may result in high mortality and morbidity among Bangladeshi older adults. We recommend that multifaceted interventions should be adopted for strengthening social care and health systems approach to ensure wellbeing, promote preventive measures, and facilitate access to healthcare among older adults in Bangladesh. Such multipronged measures would require policy-level commitment and collaborative efforts of health and social care providers and institutions to protect health and wellbeing among this vulnerable population during the COVID-19 pandemic.
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Affiliation(s)
- Md Mahbub Hossain
- Department of Health Promotion and Community Health Sciences, Texas A&M School of Public Health, College Station , Texas, USA
| | | | - Samia Tasnim
- Department of Health Promotion and Community Health Sciences, Texas A&M School of Public Health, College Station , Texas, USA
| | - Tasmiah Nuzhath
- Department of Health Promotion and Community Health Sciences, Texas A&M School of Public Health, College Station , Texas, USA
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Hotez PJ, Nuzhath T, Colwell B. Combating vaccine hesitancy and other 21st century social determinants in the global fight against measles. Curr Opin Virol 2020; 41:1-7. [PMID: 32113136 DOI: 10.1016/j.coviro.2020.01.001] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 01/22/2020] [Accepted: 01/23/2020] [Indexed: 12/15/2022]
Abstract
The year 2019 marked the return of measles after almost two decades of unprecedented successes in global vaccination programs. Measles transmission due to sharp declines in measles-mumps-rubella (MMR) vaccination coverage is now widespread among nations that previously saw impressive public health gains including Philippines, DR Congo, Madagascar, Samoa, many in Europe, and the United States and Venezuela in the Americas. Key determinants include the interruption of vaccine health systems due to war, conflict, and political instability; food insecurity and urbanization; and an increasingly globalized vaccine hesitancy or antivaccine movement. Vaccine hesitancy is partly responsible for over 100000 measles cases in Europe in 2019, and the re-emergence of measles to the United States almost twenty years after it was eliminated. Three major elements currently comprise the American antivaccine movement, including a media empire, a political arm, and deliberate predatory behavior. New strategies will be required to counter these activities.
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Affiliation(s)
- Peter J Hotez
- Texas Children's Hospital Center for Vaccine Development and Center for Medical Ethics and Health Policy, Departments of Pediatrics and Molecular Virology & Microbiology, National School of Tropical Medicine, Baylor College of Medicine, Houston, Texas, USA; Hagler Institute for Advanced Study at Texas A&M University, College Station, Texas, USA; Scowcroft Institute of International Affairs, Bush School of Policy and Government, Texas A&M University, College Station, Texas, USA; Department of Biology, Baylor University, Waco, Texas, USA; James A Baker III Institute of Public Policy, Rice University Houston, Texas, USA.
| | - Tasmiah Nuzhath
- Department of Health Promotion & Community Health Sciences, Texas A&M School of Public Health, College Station, Texas, USA
| | - Brian Colwell
- Department of Health Promotion & Community Health Sciences, Texas A&M School of Public Health, College Station, Texas, USA.
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Affiliation(s)
| | - Tasmiah Nuzhath
- Department of Population Sciences, University of Dhaka, Dhaka, Bangladesh
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