Antenatal anxiety and depression: Frequency and correlates during the COVID-19 pandemic in Pakistan.

Context: Mental health ailments like anxiety and depression are common during the antenatal period. Uncertainty during COVID-19 pandemic has markedly increased its prevalence in the general population. Pregnancy, being emotionally and physically exhausting, makes mothers more susceptible to developing mental disorders like anxiety and depression. Aims: To investigate prevalence and associated risk factors of antenatal anxiety and depression among women in Karachi, Pakistan. Settings and Design: This cross-sectional study was conducted in the department of obstetrics and gynecology during May 2020 till May 2021. Methods and Material: The study explored anxiety, depression, and associated factors in pregnant women attending antenatal clinics at a tertiary care hospital located in Karachi, Pakistan, during the COVID-19 pandemic by using the hospital anxiety and depression scale (HADS) as a screening tool. Statistical Analysis: Data was entered in SPSS version 21 for statistical analysis. Results: A total of 390 patients were enrolled in the study with mean age of 28.06 ± 4.52 years. Mean week of pregnancy at the time of enrolment into the study was 32.7 ± 3.1. Prevalence of anxiety and depression was 46.7% and 33.1%, respectively. On multivariable analysis, polyhydramnios was a risk factor of anxiety, whereas low income and unplanned pregnancy were substantially linked to depression. Fear of visiting doctor was a common risk factor for both anxiety and depression. Conclusion: In a catastrophe like the COVID-19 pandemic, attempts to address heightened anxiety during antenatal visits will undoubtedly benefit maternal and fetal mental health. As a response, strategies to manage high anxiety symptoms should be taken into consideration.

Counselling and training of nutritional snacks making for immunity increasing during COVID 19 pandemic

Increasing body immunity is very necessary after the Covid-19 pandemic. One of the efforts that can be made to increase the body's immunity is to consume functional foods with immunostimulant activity, such as processed snakehead fish products in the form of nuggets, and "parkusel" juice made from a mixture of bitter melon, dates and celery. The purpose of community service is to provide knowledge and skills to housewives and the community at the Veteran ABRI Housing Complex in Medan Estate, Deli Serdang Regency, in making functional food products in the form of snakehead fish nuggets and Perkusel juice. The community service method used is the counseling method with leafet aids and training in making snakehead fish nuggets and perkusel juice. The results of the activity showed that there was an increase in the knowledge of the community participants in community service activities about nutritious snack products that can increase body immunity by 71% in the good value category.

Incidence and clinical characteristic of ocular surface manifestation: an evaluation of conjunctival swab results in Corona Virus 2019 (COVID-19) patients in Jakarta, Indonesia.

OBJECTIVES: This study aimed to investigate the spectrum of ocular characteristics and viral presence in the conjunctival swab of patients with COVID-19. METHODS: In this cross-sectional study, fifty-three patients were recruited from two COVID-19 referral hospitals in Jakarta (Cipto Mangunkusumo Hospital and Persahabatan Hospital) from July 2020 to March 2021. The inclusion criteria were patients who were suspected of or confirmed cases of COVID-19 with or without ocular symptoms. Demographic data, history of COVID-19 exposure, underlying medical condition, systemic symptoms, ocular symptoms, supporting laboratory results, reverse-transcriptase polymerase chain reaction (RT-PCR) of naso-oropharyngeal (NOP) swab and conjunctival swab were collected. RESULTS: Fifty-three patients who were suspected, probable or confirmed cases of Covid-19 were included. Forty-six out of 53 patients (86.79%) tested positive for either Covid-19 antibody rapid test or naso-oropharyngeal (NOP) swab. Forty-two patients tested positive for NOP swab. Fourteen out of 42 patients (33.33%) experienced symptoms of ocular infection including red eye, epiphora, itchy eyes, and eye discharge. None of these patients were tested positive for conjunctival swab. Two out of 42 patients (4.76%), who were tested positive for conjunctival swab, did not experience any ocular symptoms. CONCLUSIONS: Establishing the relationship between Covid-19 infection, ocular symptoms, and presence of SARS-CoV-2 virus on the ocular surface proves to be challenging. In Covid-19 patients, ocular symptoms did not warrant a positive conjunctival swab result. On the contrary, a patient without ocular symptoms can also have detectable presence of SARS-CoV-2 virus on the ocular surface.

Flood 2022 in Pakistan: Managing medical flood relief camps in a developing country.

Floods are the most common natural disasters in the world. Currently Pakistan is in an acute emergency situation due to the recent flood that occurred as a result of the monsoon rains in July-August 2022. Unfortunately, the country was already under an economic crisis and was just recovering from the COVID pandemic when this devastating calamity struck. Almost one-third of the country's land was affected, with millions of houses damaged and property lost. As the victims are displaced and local health units are flooded, their medical needs are being met through medical flood relief camps arranged by public and private sector welfare organizations. Due to a lack of disaster preparedness and policies, most of the healthcare workers are untrained to manage medical flood relief camps and are hence learning from experience rather than following any standardized policy guidelines. We did not find any guidelines for organization and management of a flood relief camp in previous literature. As natural disasters continue to cause mass destruction every few years, there is a need to devise policies and procedures for disaster preparedness and hazard reduction. This paper is thus an effort to provide the best possible delivery of acute health services in a developing country during and after a flood in the transit phase, while the government and other non-governmental organizations (NGOs) help communities rebuild their health system.

Cabaran dan Implikasi Adaptasi Silang Budaya Pembantu Rumah Indonesia (PRI) di Malaysia

Pekerja asing yang bekerja di luar negara sering kali berhadapan dengan cabaran dan kesulitan kerana perbezaan dengan budaya asal mereka. Ini memberi kesan dan implikasi kepada mereka semasa bekerja terutama dalam aktiviti berinteraksi dengan silang budaya. Perbezaan budaya dalam aktiviti komunikasi adalah sukar dan boleh menghalang mesej serta pemahaman makna kepada dua budaya. Justeru makalah ini meneroka cabaran dan implikasi yang di hadapi oleh pembantu rumah Indonesia semasa bekerja di Malaysia. Kajian ini berpandukan pengalaman pekerja asing dalam bidang domestik berdasarkan dapatan kajian-kajian lepas yang menekankan proses penyesuaikan diri memerlukan jangka masa yang panjang terhadap sebuah budaya baharu. Mekanisme kajian melihat cabaran dan implikasi yang wujud semasa bekerja boleh mengganggu tahap prestasi kerja. Kaedah kualitatif menerusi temubual mendalam telah dilaksanakan ke atas tujuh informan terdiri daripada pembantu rumah Indonesia. Hasil kajian mendapati terdapat empat tema berkaitan cabaran dalam komunikasi silang budaya iaitu persepsi, stereotaip, ethnosentrisme dan diskriminasi. Kesemua cabaran ini dilihat menghalang kelancaran mengadaptasi budaya baharu sekaligus membentuk implikasi seperti keresahan, berprasangka dengan budaya baharu, menjadi rendah diri dan sekaligus sukar untuk menyesuaikan diri dengan budaya tersebut. Penulis berpendapat kaedah temubual mendalam ini sesuai untuk meneroka luas pengalaman pekerja asing yang berhadapan dengan cabaran dalam konteks silang budaya pada masa akan datang.Alternate abstract:The foreign worker who works overseas often faces challenges and obstacles because of their foreign cultures. This place an implication towards them when working, especially during cross-cultural integration. Different cultures in communication make it complicated and further conflict between the understanding of two cultures. Thus, this study explores challenges and implications faced by Indonesian maids working in Malaysia. This research built upon Indonesian maids' experiences working in the domestic sector based on past finding that focus on the adaptation process to a new culture which may take a long time. This mechanism finds that all the challenges and implication can affect one's work performance. The quantitative method carried out by interviewing seven participants of Indonesian maids. This research finding is four themes regarding intercultural communication: perception, stereotypes, ethnocentrism, and discrimination. All of these produce challenges in the smooth adaptation of new cultures that as a result, brought implications such as anxiety, prejudice towards new culture, low self-esteem and made the process of adapting to new culture harder. The researcher reckons that this thorough interview is suitable to deeply explore the foreign workers' experiences that will face the challenges in the intercultural context in the future.

Factors Associated With Nosocomial COVID-19 Infection Among Health Care Workers in an Urban-Setting Malaysia Hospital.

This single-center study aimed to explore the factors associated with coronavirus disease (COVID-19) transmission in a hospital. All laboratory-confirmed COVID-19 cases among health care workers (HCWs) in a tertiary hospital in Malaysia were analyzed cross-sectionally from January 25, 2020, to September 10, 2021. A total of 897 HCWs in the hospital had laboratory-confirmed COVID-19 infection during the study period. Around 37.4% of HCWs were suspected to acquire COVID-19 infection from the hospital workplace. Factors associated with lower odds of workplace COVID-19 transmission were being females, ≥30 years old, fully vaccinated, and working as clinical support staff. Involvement in COVID-19 patient care was significantly associated with higher odds (adjusted odds ratio = 3.53) of workplace COVID-19 transmission as compared with non-workplace transmission. Most HCWs in the tertiary hospital acquired COVID-19 infection from non-workplace settings. During a pandemic, it is important to communicate with HCWs about the risk of both workplace and non-workplace COVID-19 transmission and to implement measures to reduce both workplace and non-workplace COVID-19 transmission.

Frequency and predictors of depression among the elderly population of Karachi.

Context: Depression among the elderly is falsely considered as a normal part of aging and hence remains un-diagnosed in the majority. Elderly people are at a high risk of depression, which may produce a negative impact on their quality of life. Depression is a potentially treatable condition; hence, it is worthwhile to explore its burden in order to ensure its timely evaluation and management. Aims: To determine the frequency and predictors of depression among the elderly population of Karachi. Settings and Design: The current study was a cross-sectional study, conducted in out-patient clinics of a tertiary care hospital and its out-reach centers located in different areas of Karachi. Methods and Material: Patients aged 60 years and above were enrolled in the study. Demographic profiles and physical health conditions were investigated. Depression was assessed using Geriatric Depression Scale-15. Statistical Analysis: Data were entered in SPSS version 21 for statistical analysis. Results: A total of 232 participants were enrolled into the study with a median age of 65.8 [inter-quartile range = 61-69] years. Out of 232 participants, 186 (80.2%) were found to be depressed. In the multi-variable model, employment status, financial issues, and peer groups were left as independent predictors of depression. Conclusion: The current study found a significant burden of depression among elderly people in Karachi. Employment status, financial problems, and relationship with peers have been identified as risk factors of depression. There might be over-reporting of depression as the data collection was conducted during the coronavirus disease 2019 first wave. Hence, further community-based research is warranted to confirm the findings.

COVID-19 and Diagnosis Related Group In An Asian Middle-Income Country: Patient classifications and associated hospital costs (preprint)

Background The COVID-19 pandemic impacted healthcare systems in many aspects, with the most immediate need being the increased healthcare burden and healthcare costs. This study aimed to determine the distribution of the disease and its costs of COVID-19 management in Malaysia.Methods Data on hospital admissions related to COVID-19 were coded with ICD-10 and ICD9-CM, and the combination generated DRG codes, which were A-4-13-I, A-4-13-II and A-4-13-III for mild, moderate and severe classification of COVID-19 respectively. Simultaneously, healthcare resource utilisation and costs were estimated for the codes through clinical pathways. The distribution of COVID-19 patients based on DRG was presented as frequencies and percentages while cost data were reported in US$ with the price year 2021.Results A total of 4889 patients with COVID-19 diagnosis were admitted to the hospital. Of that, 4813/4889(98%) had a primary diagnosis of COVID-19 while the remaining patients were admitted for other medical reasons, however, were found to be positive during the admission. 3909(81%) were admitted with mild COVID-19 (A-4-13-I), 630(13%) had moderate COVID-19 (A-4-13-II) and 274(6%) were admitted for severe COVID-19 (A-4-13-III). The cumulative hospital costs for mild COVID-19 (A-4-13-I) were estimated to be USD 1,543. While the cumulative hospital costs for both moderate COVID-19 (A-4-13-II) and severe COVID-19 (A-4-13-III) were estimated at USD 23,527 and USD 26,731 respectively.Conclusions The total costs incurred by the hospital for COVID-19 were estimated to be USD 19,259,153. COVID-19 resulted in significant economic implications for the healthcare system. This study provides local data and an assessment of the economic burden of Covid-19 infection in Malaysia.

Setting Up a Transfusion Laboratory for Covid-19 Samples: An Experience from a New Teaching Hospital

University Putra Malaysia (UPM) Teaching Hospital or Hospital Pengajar UPM (HPUPM) is a new 400-bed teaching hospital that started operations in 2019 and initially did not manage COVID-19 patients. However, due to a surge of COVID-19 patients in Malaysia in 2021, HPUPM needs to manage COVID-19 patients in various categories, including those needing intensive care. This paper explored the experience of setting up the transfusion laboratory for COVID-19 samples within a short notice, including the development of the protocol, challenges, and lessons learnt during the whole process. [ FROM AUTHOR]

Challenges in IPC training for non–healthcare workers

Background: In the last 2 years of the COVID-19 pandemic, Singapore has been forced to explore alternative sites to quarantine persons or manage infected cases during surge periods in a national effort not to overwhelm the public healthcare facilities. External quarantine facilities were created at the EXPO and further extended to D'Resort and other hotels in May 2020. Infection prevention (IP) practices were implemented at these external facilities, where training non–healthcare staff to quickly learn and understand these required practices has been challenging. A team of staff from different clinical disciplines was formed to manage the COVID-19 patients at these facilities. The Infection Prevention and Epidemiology (IPE) department was invited to train all staff, including the clinical team, management agency, and security staff, regarding IP measures. We have described the system and approach used in the rapid training of all staff in IP measures where the goal is zero transmission while providing care to COVID-19 patients. Methods: Training materials were developed to facilitate rapid learning by all staff;medical jargon was avoided. Curriculum included precautions to be taken while performing terminal cleaning of patient rooms, serving meals, disinfecting phones and thermometers, as well as donning and doffing personal protective equipment (PPE). "Green” and "red” zones were created to assist staff in remembering appropriate PPE to be used. PPE training was provided using slides and video. Posters were created as a guide for staff at donning and doffing stations. Additionally, the IPE training team utilized an online data collection tool to capture staff completion on IP training and PPE competency for record keeping. We used a ‘soft' approach because staff members were fearful of the unknown when caring for COVID-19 patients. Daily audits were conducted with immediate concurrent feedback to engage the relevant stakeholders. Infection prevention liaison officers (IPLOs) were appointed to assist in the daily audits. An electronic audit tool was used to facilitate audit and quick analysis. Conclusions: The experience gained in the last 2 years has been useful and may provide a template if new external sites are needed in the future because of the potential surge associated with the ο (omicron) variant.Funding: NoneDisclosures: None

An scFv-Based Impedimetric Immunosensor Using SPCE/AuNP for RBD of SARS-CoV-2 Detection

A single-chain variable fragment (scFv) is an antibody fragment composed of VH and VL linked by a hydrophilic linker that can be designed according to the shape of the target molecule and synthesized in prokaryotic or eukaryotic cells via biotechnology engineering. This study developed an electrochemical immunosensor that detects the RBD of SARS-CoV-2 using a screen-printed carbon electrode modified with gold nanoparticles, and scFv as a bioreceptor. Electrochemical impedance spectroscopy was employed to measure specific interactions of antigens with antibodies. The developed immunosensor had a limit of detection and a quantification limit of 4.86 ng mL(-1) and 16.20 ng mL(-1), respectively. The immunosensor was stable at room temperature for up to 30 days' storage. The immunosensor was assessed at biosafety level 3 using 33 nasopharyngeal swab specimens (clinical samples);the pieces of data were compared with quantitative Reverse Transcriptase-PCR. The agreement of the data, the low detection limit achieved, the rapid analysis (30 min), the miniaturization, and the portability of the instrument combined with the easiness to use has the potential to become Point of Care (POC) for diagnosing the COVID-19 disease.

Antenatal anxiety and depression: Frequency and correlates during the COVID-19 pandemic in Pakistan

Context: Mental health ailments like anxiety and depression are common during the antenatal period. Uncertainty during COVID-19 pandemic has markedly increased its prevalence in the general population. Pregnancy, being emotionally and physically exhausting, makes mothers more susceptible to developing mental disorders like anxiety and depression. Aims: To investigate prevalence and associated risk factors of antenatal anxiety and depression among women in Karachi, Pakistan. Settings and Design: This cross-sectional study was conducted in the department of obstetrics and gynecology during May 2020 till May 2021. Methods and Material: The study explored anxiety, depression, and associated factors in pregnant women attending antenatal clinics at a tertiary care hospital located in Karachi, Pakistan, during the COVID-19 pandemic by using the hospital anxiety and depression scale (HADS) as a screening tool. Statistical Analysis: Data was entered in SPSS version 21 for statistical analysis. Results: A total of 390 patients were enrolled in the study with mean age of 28.06 ± 4.52 years. Mean week of pregnancy at the time of enrolment into the study was 32.7 ± 3.1. Prevalence of anxiety and depression was 46.7% and 33.1%, respectively. On multivariable analysis, polyhydramnios was a risk factor of anxiety, whereas low income and unplanned pregnancy were substantially linked to depression. Fear of visiting doctor was a common risk factor for both anxiety and depression. Conclusion: In a catastrophe like the COVID-19 pandemic, attempts to address heightened anxiety during antenatal visits will undoubtedly benefit maternal and fetal mental health. As a response, strategies to manage high anxiety symptoms should be taken into consideration.

The effect of online learning on student satisfaction in nursing education during the COVID-19 pandemic

Introduction: Online learning is a global trend in higher education in the era of the COVID-19 pandemic. Online learning becomes one of the approaches available to most students and educators, as opposed to face-to-face learning. The aim of this research is to find out the correlation of online learning and satisfaction among nursing students during the COVID-19 pandemic. Methods: This study was a cross-sectional approach involving 177 second-year nursing students randomly selected resulting in 121 students. Students filled out an online learning questionnaire consisting of 14 items and a satisfaction questionnaire consisting of 21 items from Google Forms. Data were analysed using logistic regression with level of significance (p=0.000). Results: The online learning indicator that had the highest average value was relevance (3.12), while the highest average value of student satisfaction indicator was content (3.05). Logistic regression showed that the online learning indicator that greatly affected student satisfaction was attractiveness. Fair attractiveness for online learning increased satisfaction by 7.516 times compared to poor attractiveness (p = 0.000) and good attractiveness for online learning increased satisfaction by 55.538 times compared to poor attractiveness (p = 0.000). Conclusions: Student satisfaction depends heavily on student attractiveness to the online learning process. Lecturers can increase the attractiveness of students toward online learning, whether through the utilized media, learning methods, or the technology of delivering lecture materials. © 2022, Faculty of Nursing, Universitas Airlangga. All rights reserved.

Rhinovirus/enterovirus was the most common respiratory virus detected in adults with severe acute respiratory infections pre-COVID-19 in Kuala Lumpur, Malaysia.

BACKGROUND: Severe acute respiratory infections (SARI) pose a great global burden. The contribution of respiratory viruses to adult SARI is relatively understudied in Asia. We aimed to determine viral aetiology of adult SARI patients in Kuala Lumpur, Malaysia. METHODS: The prevalence of 20 common (mainly viral) respiratory pathogens, and MERS-CoV, SARS-CoV and 5 bacterial select agents was investigated from May 2017 to October 2019 in 489 SARI adult patients in Kuala Lumpur, Malaysia, using molecular assays (Luminex NxTAG-RPP kit and qPCR assays). Viral metagenomics analysis was performed on 105 negative samples. RESULTS: Viral respiratory pathogens were detected by PCR in 279 cases (57.1%), including 10 (2.0%) additional detections by metagenomics analysis. The most detected viruses were rhinovirus/enterovirus (RV/EV) (49.1%) and influenza virus (7.4%). Three melioidosis cases were detected but no SARS-CoV, MERS-CoV or other bacterial select agents. Bacterial/viral co-detections and viral co-detections were found in 44 (9.0%) and 27 (5.5%) cases respectively, mostly involving RV/EV. Independent predictors of critical disease were male gender, chronic lung disease, lack of runny nose and positive blood culture with a significant bacterial pathogen. Asthma and sore throat were associated with increased risk of RV/EV detection, while among RV/EV cases, males and those with neurological disease were at increased risk of critical disease. CONCLUSIONS: Prior to the COVID-19 pandemic, the high prevalence of respiratory viruses in adults with SARI was mainly attributed to RV/EV. Continued surveillance of respiratory virus trends contributes to effective diagnostic, prevention, and treatment strategies.

Barriers and Facilitators to Implementing Project ECHO in Malaysia During the COVID-19 Pandemic.

Objective: In Malaysia, HIV is concentrated among key populations who experience barriers to care due to stigma and healthcare discrimination. The COVID-19 pandemic has increased barriers to healthcare. Project ECHO (Extension for Community Healthcare Outcomes) is a transformative tele-education strategy that could improve HIV prevention and treatment. Methods: Practicing physicians who were aged 18 years or older and had internet access participated in asynchronous online focus groups. Results: Barriers to Project ECHO were conflicting priorities, time constraints, and technology. Facilitators included content and format, dedicated time, asynchronized flexible programming, incentives, and ensuring technology was available. Conclusion: Project ECHO is a promising intervention that can increase physicians' knowledge and skill set in specialty medicine during the COVID-19 pandemic. Interventionists in Malaysia in particular, but also in general, should consider these barriers and facilitators when developing Project ECHO as they may aid in developing a more robust program and increase participation.

Knowledge transfer of eLearning objects: Lessons learned from an intercontinental capacity building project.

BACKGROUND: Effective knowledge transfer of eLearning objects can hasten the adoption and dissemination of technology in teaching and learning. However, challenges exist which hinder inter-organisational knowledge transfer, particularly across continents. The ACoRD project aimed to transfer knowledge on digital learning development from UK/EU (provider) to Malaysian (receiver) higher education institutions (HEIs). This study explores the challenges encountered during the knowledge transfer process and lessons learned. METHODS: This is a qualitative study involving both the knowledge providers and receivers in focus group discussions (n = 25). Four focus group discussions were conducted in the early (n = 2) and mid-phase (n = 2) of the project by trained qualitative researchers using a topic guide designed to explore experiences and activities representing knowledge transfer in multi-institutional and multi-cultural settings. The interviews were audio-recorded, transcribed verbatim, and checked. The transcripts were analysed using thematic analysis. RESULTS: Five main themes emerged from this qualitative study: mismatched expectations between providers and receivers; acquiring new knowledge beyond the professional "comfort zone"; challenges in cascading newly acquired knowledge to colleagues and management; individual and organisational cultural differences; and disruption of knowledge transfer during the COVID-19 pandemic. CONCLUSION: This study highlights the need to create a conducive platform to facilitate continuous, timely and bi-directional needs assessment and feedback; this should be done in the early phase of the knowledge transfer process. The challenges and strategies identified in this study could guide more effective knowledge transfer between organisations and countries.

Mental health and parental factors among adolescents during the COVID pandemic in Malaysia

Purpose: The study aims to determine the prevalence of mental health problems among early adolescents and their associations with parental relationships.

Job insecurity and psychological distress during the COVID-19 outbreak: The moderating role of perceived supervisor support among hotel employees in Malaysia.

BACKGROUND: Millions of employees were laid off during the COVID-19 pandemic. The hospitality industry has been gravely hit by this crisis. OBJECTIVE: Drawing from the theory of conservation of resources (COR), our study aims to examine possible factors that influence turnover intention among hotel employees. METHODS: The hypotheses were tested on 141 hotel employees from Klang Valley, Malaysia. Data were collected by means of questionnaires, purposive sampling was employed, and PLS-SEM was used in performing the data analyses. RESULTS: Job insecurity and psychological distress were found to be the potent antecedent of turnover intention. In contrast, the role of perceived supervisor support did not significantly moderate the effects of both job insecurity and psychological distress on the quitting intention. CONCLUSION: Re-looking at existing policies and leadership styles may be fruitful in ensuring the sustainability path of an organization. This is pivotal in growing back the entire hospitality industry that has gravely affected by COVID-19.

Laboratory optimization of the production of guanidium-based inactivated transport media to support SARS-CoV-2 PCR testing in Indonesia

The availability of a viral transport medium (VTM) is often an obstacle to COVID-19 testing, especially for countries that are not VTM producers, including Indonesia. Therefore, the Parasitology Laboratory of Medicinal Faculty, Universitas Padjadjaran, Indonesia, developed an inactivation transport medium called “VITPAD®” that uses a guanidium-based buffer solution. This study evaluated VITPAD® as a transport medium for swab samples and scaled-up production from 2,000 tubes per month to 60,000 per month to support COVID-19 testing in Indonesia. VITPAD® has good stability and sterility, with a lifespan of over 2 years, and it performs well as a transport medium for COVID-19 samples. The production capacity was successfully scaled-up by implementing scheduling and capacity management, with the first large-scale production of VITPAD® distributed to 26 teaching hospitals in Indonesia. © 2022. Shabarni Gaffar et al. This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International License

Adverse events following immunization and psychological distress among cancer patients/survivors following vaccination against SARS-CoV-2 infection.

Purpose: This study aims to describe the adverse events following immunization (AEFIs) of SARS-CoV-2 vaccination in cancer patients/survivors associated with their psychological distress. Methods: A cross-sectional study was conducted to assess AEFIs after the receipt of SARS-CoV-2 vaccines in cancer patients/survivors attending a university hospital in Malaysia. Psychological distress was measured using the Hospital Anxiety and Depression Scale (HADS) before and after the first and second doses of COVID-19 vaccine. Results: A total of 217 complete responses were received. Compared with before vaccination, both HADS Anxiety (HADS-A) and HADS Depression (HADS-D) scores were significantly reduced after the first and second dose of the SARS-CoV-2 vaccine. Most of the participants had mild-or-moderate systemic and local AEFIs, with the most common being pain at the injection site, tiredness, and headache for both the first and second doses of the vaccine. Positive correlations between the total AEFI score and HADS-A (r = 0.309, p < 0.001) and HADS-D (r = 0.214, p = 0.001) scores were observed after the first dose of the SARS-CoV-2 vaccine. Similarly, positive associations were observed between the total AEFI score and HADS-A (r = 0.305, p < 0.001) and HADS-D (r = 0.235, p < 0.001) scores after the second dose of the SARS-CoV-2 vaccine. Conclusion: Mild-to-moderate AEFIs found in this study help address vaccine hesitancy in cancer patients/survivors. Receiving the SARS-CoV-2 vaccine had a positive effect on decreasing psychological distress in cancer patients/survivors. High severity of an AEFI was associated with higher anxiety and depressive symptoms.