ABSTRACT
Background: Bangladesh with its large population is highly vulnerable to the devastating blows of coronavirus disease 2019 (COVID-19) and rural people are more at risks due to demographic characteristics and unequal health facilities. Currently, focuses are more on testing and clinical management of COVID-19 but initiatives or innovations on behavioural changes are almost unseen to prevent the spread of the disease which is more urgent until getting specific treatment or vaccine. Objective: The study was aimed to determine significant predictors in the preventive health practices during COVID-19 pandemic. Methods: The study was conducted among 810 rural adults of Bangladesh in 2020. Multistage sampling method was done and data were collected through face-to-face interview using a pretested questionnaire. Significant factors of COVID-19 prevention behaviour were determined through hierarchical regression and path relationships were explained through causal model. Results: Almost half of the rural adults showed poor COVID-19 prevention behaviour during the pandemic crisis. Poor knowledge and attitude regarding COVID-19 prevention were also common scenarios in rural areas. Majority of the rural adults were not well motivated and lack of seriousness made them more vulnerable for COVID-19. Socio-demographic and regional variation showed significance predicting health practices of rural adults regarding COVID-19 prevention. Information, attitude, motivation and intention were also found significant in hierarchical regression to predict the outcome. The causal model of preventive health behaviour was justified through all the significant direct and indirect path relationships (p<0.001). Conclusion: Socio-economic disparity should be reduced for behavioural changes of rural adults to ensure healthy practices during the pandemic. This study has great implications regarding designing health programs by emphasizing significant predictors to improve community behaviour to prevent the spread of coronavirus.
ABSTRACT
Purpose: To evaluate the incidence of large-bore hemodialysis catheter thrombosis in the setting of COVID-19. Materials and Methods: A retrospective review was performed of all patients who underwent placement of a temporary hemodialysis catheter after developing kidney injury after COVID 19 infection at our institution. Data collected included demographic information, procedure related information, and incidence of replacement due to lumen thrombosis. Groups were compared using students t-test for continuous variables and Fisher’s exact test for nominal variables. Results: 64 patients (43M, mean age 63.2 ± 13.3) underwent placement of temporary hemodialysis catheter placement for kidney injury related to COVID 19 infection. 31 (48.4%) of catheters were placed via an internal jugular vein (IJV) access and 33 (52.6%) of catheters were placed via a common femoral vein (CFV) access. Overall, 15 (23.4%) catheters required replacement due to lumen thrombosis despite heplock. There were no difference in age or sex in patients who required replacement to those who did not (P.0.05) [sic]. Of the replacements, 5/31 (16%) were placed via an IJV access and 10/33 (30.3%) were placed via a CVF access, although this difference was not statistically significant (P = 0.18). The average time to malfunction/replacement was 7.8 ± 4.8 days for catheters placed via an IJ access versus 3.4 ± 3.3 days for catheters placed via a CFV access (P = 0.055), trending toward significance. Conclusions: A high incidence of temporary dialysis catheter lumen thrombosis was present in patients with COVID-19 infection. This may be due to COVID related thrombosis versus decreased level of catheter care. Catheters placed via a femoral vein access had more frequent malfunction and with shorter indwelling time, although not significant, which may be due to small sample size.