Workplace Bullying and Violence on Burnout Among Bangladeshi Registered Nurses: A Survey Following a Year of the COVID-19 Pandemic.

Objectives: To investigate burnout among Bangladeshi nurses and the factors that influence it, particularly the association of workplace bullying (WPB) and workplace violence (WPV) with burnout. Methods: This cross-sectional study collected data from 1,264 Bangladeshi nurses. Mixed-effects Poisson regression models were fitted to find the adjusted association between WPB, WPV, and burnout. Results: Burnout was found to be prevalent in 54.19% of 1,264 nurses. 61.79% of nurses reported that they had been bullied, and 16.3% of nurses reported experience of "intermediate and high" levels of workplace violence in the previous year. Nurses who were exposed to "high risk bullying" (RR = 2.29, CI: 1.53-3.41) and "targeted bullying" (RR = 4.86, CI: 3.32-7.11) had a higher risk of burnout than those who were not. Similarly, WPV exposed groups at "intermediate and high" levels had a higher risk of burnout (RR = 3.65, CI: 2.40-5.56) than WPV non-exposed groups. Conclusion: Nurses' burnout could be decreased if issues like violence and bullying were addressed in the workplace. Hospital administrators, policymakers, and the government must all promote and implement an acceptable working environment.

Workplace violence against Bangladeshi registered nurses: A survey following a year of the COVID-19 pandemic.

AIMS: To investigate the prevalence of workplace violence and its associated factors among Bangladeshi registered nurses. BACKGROUND: Workplace violence is prevalent among nurses, particularly in developing countries. However, the issue has never been examined in Bangladeshi nurses. METHODS: Between February 26 and July 10, 2021, this cross-sectional survey involving 1264 registered nurses was conducted. Workplace violence was determined by the Workplace Violence Scale (WVS). A multivariable logistic regression model was fitted to find the factors associated with workplace violence. This study complies with the EQUATOR (STROBE) checklist. RESULTS: Of the 1264 nurses, 885 (70%) nurses reported being exposed to workplace violence in the previous year. Three hundred twenty-four (324; 25.6%) nurses reported physical violence, whereas 902 (71.4%) nurses reported nonphysical violence. According to the multivariable logistic regression model, male nurses, nurses in the Sylhet division, emergency department nurses, nurses working extended hours, and non trained nurses to tackle workplace violence were prone to physical violence. Furthermore, public hospital nurses and non trained nurses to tackle workplace violence were more likely to be exposed to nonphysical violence. Nurses who had not been exposed to workplace violence were satisfied with their current job, but those who had been exposed to workplace violence were dissatisfied and intended to leave their current job. CONCLUSIONS AND IMPLICATIONS FOR NURSING AND HEALTH POLICY: High prevalence of workplace violence underscores nurses' current working conditions, which are particularly poor in public hospitals and emergency departments. Moreover, the COVID-19 pandemic put unprecedented pressure on the whole healthcare system and caused various difficulties for healthcare workers. To develop a zero-violence practice environment, health authorities should implement policy-level interventions. Healthcare staff should be guided to deal more successfully with patients and coworkers to create a positive working environment.

Knowledge, Attitudes, and Practices Toward the Prevention of COVID-19 in Bangladesh: A Systematic Review and Meta-Analysis.

Background: Numerous studies on knowledge, attitude, and practice (KAP) about the prevention of COVID-19 infections are available in Bangladeshi contexts, with results that vary significantly. However, no earlier attempt has been made to analyze the available COVID-19 KAP studies in Bangladesh, which is incorporated in this meta-analysis for the first time. Methods: Following the PRISMA guidelines, articles relevant to COVID-19 KAP that were conducted among the Bangladeshi population were found in databases such as PubMed, Scopus, CINAHL, Google Scholar, and ResearchGate. Random-effect meta-analysis was used to generate a pooled prevalence of knowledge, attitude, and practice level toward the prevention of COVID-19 infection. Results: This review included 18 articles that were published between March 2020 and November 2021. Overall, 89.87% (95% CI: 67.71-97.40) understood about COVID-19 symptoms, 92.09% (95% CI: 84.32-96.18) knew about how it spreads, and 79.51% (95% CI: 59.38-91.15) knew about how to treat it. The public's perception of controlling COVID-19 is mixed, with only 44.16% (95% CI: 35.74-52.93) and 60.28% (95% CI: 49.22-70.38) believing the country would win the struggle against the pandemic and the infection will be successfully controlled, respectively. Although overall COVID-19 preventative practice was good, subgroup analysis found that men had a poor practice toward controlling the infection. The practice of avoiding crowded places (70.15%) and maintaining social distance (77.17%) was found to be satisfactory in institution-based studies. Conclusion: The findings of this study revealed that the Bangladeshi population had a good awareness of COVID-19 symptoms, treatment, attitudes, and behaviors. The findings of this study are likely to aid Bangladeshi governments and policymakers in putting evidence into action by identifying gaps and emphasizing the importance of educating the less informed public about COVID-19 transmission.

Workplace Bullying and Violence on Burnout Among Bangladeshi Registered Nurses: A Survey Following a Year of the COVID-19 Pandemic

Objectives: To investigate burnout among Bangladeshi nurses and the factors that influence it, particularly the association of workplace bullying (WPB) and workplace violence (WPV) with burnout. Methods: This cross-sectional study collected data from 1,264 Bangladeshi nurses. Mixed-effects Poisson regression models were fitted to find the adjusted association between WPB, WPV, and burnout. Results: Burnout was found to be prevalent in 54.19% of 1,264 nurses. 61.79% of nurses reported that they had been bullied, and 16.3% of nurses reported experience of “intermediate and high” levels of workplace violence in the previous year. Nurses who were exposed to “high risk bullying” (RR = 2.29, CI: 1.53–3.41) and “targeted bullying” (RR = 4.86, CI: 3.32–7.11) had a higher risk of burnout than those who were not. Similarly, WPV exposed groups at “intermediate and high” levels had a higher risk of burnout (RR = 3.65, CI: 2.40–5.56) than WPV non-exposed groups. Conclusion: Nurses’ burnout could be decreased if issues like violence and bullying were addressed in the workplace. Hospital administrators, policymakers, and the government must all promote and implement an acceptable working environment.

Workplace violence, bullying, burnout, job satisfaction and their correlation with depression among Bangladeshi nurses: A cross-sectional survey during the COVID-19 pandemic.

BACKGROUND: Depression is one of the most serious yet understudied issues among Bangladeshi nurses, bringing health dangers to this workforce. This study aimed to investigate how workplace violence (WPV), bullying, burnout, and job satisfaction are correlated with depression and identify the factors associated with depression among Bangladeshi nurses. METHODS: For this cross-sectional study, data were collected between February 26, 2021, and July 10, 2021 from the Bangladeshi registered nurses. The Workplace Violence Scale (WPVS), the Short Negative Acts Questionnaire [S-NAQ], the Burnout Measure-Short version (BMS), the Short Index of Job Satisfaction (SIJS-5), and the Patient Health Questionnaire (PHQ-9) were used to measure WPV, bullying, burnout, job satisfaction, and depression, respectively. Inferential statistics include Pearson's correlation test, t-test, one-way ANOVA test, multiple linear regression, and multiple hierarchal regression analyses were performed. RESULTS: The study investigated 1,264 nurses (70.02% female) with an average age of 28.41 years (SD = 5.54). Depression was positively correlated with WPV, bullying, and burnout and negatively correlated with job satisfaction (p <0.001). According to the multiple linear regression model, depression was significantly lower among nurses with diploma degrees (ß = -1.323, 95% CI = -2.149 to -0.497) and bachelor's degrees (ß = -1.327, 95% CI = -2.131 to- 0.523) compared to the nurses with master's degree. The nurses who worked extended hours (>48 hours) had a significantly higher depression score (ß = 1.490, 95% CI = 0.511 to 2.470) than those who worked ≤ 36 hours. Depression was found to be significantly higher among those who did not receive a timely salary (ß = 2.136, 95% CI = 1.138 to 3.134), rewards for good works (ß = 1.862, 95% CI = 1.117 to 2.607), and who had no training on WPV (ß = 0.895, 95% CI = 0.092 to 1.698). CONCLUSIONS: Controlling burnout, bullying, and workplace violence, as well as improving the work environment for nurses and increasing job satisfaction, are the essential indicators of reducing depression. This can be accomplished with integrative support from hospital executives, policymakers, and government officials.

A prospective longitudinal study with treated hypertensive patients in Northern Bangladesh (PREDIcT-HTN) to understand uncontrolled hypertension and adverse clinical events: A protocol for 5-years follow-up.

INTRODUCTION: Uncontrolled hypertension is the most common cause of major adverse clinical events (MACE), such as myocardial infarction, strokes, and death due to CVDs, in both developed and developing countries. Western-led studies found that treated hypertensive adults with uncontrolled hypertension were more at-risk of all-cause and CVD-specific mortality than normotensives. The PRospEctive longituDInal sTudy of Treated HyperTensive patients of Northern-Bangladesh (PREDIcT-HTN) study principally aims to estimate the incidence of MACE in treated hypertensive patients and identify the determinants of MACE. The secondary objective is to find the prevalence of uncontrolled hypertension in treated hypertensive patients and the associated risk factors. METHODS AND ANALYSIS: The treated hypertensive patients were obtained from the Hypertension and Research Center (H&RC), Rangpur, Bangladesh, from January to December 2020. Based on the eligibility criteria, 2643 patients were included to constitute the PREDIcT-HTN cohort. Baseline data was retrieved from the H&RC registry, and five follow-up waves are planned yearly (2021-2025). A questionnaire will be administered at each follow-up visit on hypertension control status, behavioral factors, quality of life, dietary adherence, and high blood pressure compliance-related variables. The participant will be right censored if the patient develops MACE, death due to any cause, loss to follow-up, or at the end of the study. A proportional hazard model will identify the risk factors of MACE. Multinomial logistic regression analyses will be performed to determine the predictors of the hypertension control status by medication and dietary adherence after adjusting confounders. ETHICS AND DISSEMINATION: The ethical approval for this study was obtained from the Institutional Review Board, North South University [Ref: 2019/OR-NSU/IRB-No.0902]. The participants will provide written consent to participate. The findings will be disseminated through manuscripts in clinical/academic journals and presentations at professional conferences and stakeholder communication.

Wastewater-based epidemiological surveillance to monitor the prevalence of SARS-CoV-2 in developing countries with onsite sanitation facilities.

Wastewater-based epidemiology (WBE) has emerged as a valuable approach for forecasting disease outbreaks in developed countries with a centralized sewage infrastructure. On the other hand, due to the absence of well-defined and systematic sewage networks, WBE is challenging to implement in developing countries like Bangladesh where most people live in rural areas. Identification of appropriate locations for rural Hotspot Based Sampling (HBS) and urban Drain Based Sampling (DBS) are critical to enable WBE based monitoring system. We investigated the best sampling locations from both urban and rural areas in Bangladesh after evaluating the sanitation infrastructure for forecasting COVID-19 prevalence. A total of 168 wastewater samples were collected from 14 districts of Bangladesh during each of the two peak pandemic seasons. RT-qPCR commercial kits were used to target ORF1ab and N genes. The presence of SARS-CoV-2 genetic materials was found in 98% (165/168) and 95% (160/168) wastewater samples in the first and second round sampling, respectively. Although wastewater effluents from both the marketplace and isolation center drains were found with the highest amount of genetic materials according to the mixed model, quantifiable SARS-CoV-2 RNAs were also identified in the other four sampling sites. Hence, wastewater samples of the marketplace in rural areas and isolation centers in urban areas can be considered the appropriate sampling sites to detect contagion hotspots. This is the first complete study to detect SARS-CoV-2 genetic components in wastewater samples collected from rural and urban areas for monitoring the COVID-19 pandemic. The results based on the study revealed a correlation between viral copy numbers in wastewater samples and SARS-CoV-2 positive cases reported by the Directorate General of Health Services (DGHS) as part of the national surveillance program for COVID-19 prevention. The findings of this study will help in setting strategies and guidelines for the selection of appropriate sampling sites, which will facilitate in development of comprehensive wastewater-based epidemiological systems for surveillance of rural and urban areas of low-income countries with inadequate sewage infrastructure.

Knowledge, Attitudes, and Practices Toward the Prevention of COVID-19 in Bangladesh: A Systematic Review and Meta-Analysis

Background Numerous studies on knowledge, attitude, and practice (KAP) about the prevention of COVID-19 infections are available in Bangladeshi contexts, with results that vary significantly. However, no earlier attempt has been made to analyze the available COVID-19 KAP studies in Bangladesh, which is incorporated in this meta-analysis for the first time. Methods Following the PRISMA guidelines, articles relevant to COVID-19 KAP that were conducted among the Bangladeshi population were found in databases such as PubMed, Scopus, CINAHL, Google Scholar, and ResearchGate. Random-effect meta-analysis was used to generate a pooled prevalence of knowledge, attitude, and practice level toward the prevention of COVID-19 infection. Results This review included 18 articles that were published between March 2020 and November 2021. Overall, 89.87% (95% CI: 67.71–97.40) understood about COVID-19 symptoms, 92.09% (95% CI: 84.32–96.18) knew about how it spreads, and 79.51% (95% CI: 59.38–91.15) knew about how to treat it. The public's perception of controlling COVID-19 is mixed, with only 44.16% (95% CI: 35.74–52.93) and 60.28% (95% CI: 49.22–70.38) believing the country would win the struggle against the pandemic and the infection will be successfully controlled, respectively. Although overall COVID-19 preventative practice was good, subgroup analysis found that men had a poor practice toward controlling the infection. The practice of avoiding crowded places (70.15%) and maintaining social distance (77.17%) was found to be satisfactory in institution-based studies. Conclusion The findings of this study revealed that the Bangladeshi population had a good awareness of COVID-19 symptoms, treatment, attitudes, and behaviors. The findings of this study are likely to aid Bangladeshi governments and policymakers in putting evidence into action by identifying gaps and emphasizing the importance of educating the less informed public about COVID-19 transmission.

What is the extent of COVID-19 vaccine hesitancy in Bangladesh? A cross-sectional rapid national survey

ObjectivesTo assess COVID-19 vaccine hesitancy in Bangladesh and identify population subgroups with higher odds of vaccine hesitancy.DesignA nationally representative cross-sectional survey was used for this study. Descriptive analyses helped to compute vaccine hesitancy proportions and compare them across groups. Multiple logistic regression analyses were performed to compute the adjusted OR.SettingBangladesh.ParticipantsA total of 1134 participants from the general population, aged 18 years and above participated in this study.Outcome measuresPrevalence and predictors of vaccine hesitancy.ResultsOf the total participants, 32.5% showed COVID-19 vaccine hesitancy. Hesitancy was high among respondents who were men, over 60, unemployed, from low-income families, from central Bangladesh, including Dhaka, living in rented houses, tobacco users, politically affiliated, doubtful of the vaccine’s efficacy for Bangladeshis and those who did not have any physical illnesses in the past year. In the multiple logistic regression models, transgender respondents (adjusted OR, AOR=3.62), married individuals (AOR=1.49), tobacco users (AOR=1.33), those who had not experienced any physical illnesses in the past year (AOR=1.49), those with political affiliations with opposition parties (AOR=1.48), those who believed COVID-19 vaccines would not be effective for Bangladeshis (AOR=3.20), and those who were slightly concerned (AOR=2.87) or not concerned at all (AOR=7.45) about themselves or a family member getting infected with COVID-19 in the next year were significantly associated with vaccine hesitancy (p<0.05).ConclusionsGiven the high prevalence of COVID-19 vaccine hesitancy, in order to guarantee that COVID-19 vaccinations are widely distributed, the government and public health experts must be prepared to handle vaccine hesitancy and increase vaccine awareness among potential recipients. To address these issues and support COVID-19 immunisation programs, evidence-based educational and policy-level initiatives must be undertaken especially for the poor, older and chronically diseased individuals.

Seroprevalence of SARS-CoV-2 IgG antibodies among health care workers prior to vaccine administration in Europe, the USA and East Asia: A systematic review and meta-analysis.

BACKGROUND: Knowing the seroprevalence of SARS-CoV-2 IgG antibodies across geographic regions before vaccine administration is one key piece of knowledge to achieve herd immunity. While people of all ages, occupations, and communities are at risk of getting infected with SARS-CoV-2, the health care workers (HCWs) are possibly at the highest risk. Most seroprevalence surveys with HCWs conducted worldwide have been limited to Europe, North America, and East Asia. We aimed to understand how the seroprevalence of SARS-CoV-2 IgG antibodies varied across these geographic regions among HCWs based on the available evidences. METHODS: By searching through PubMed, ScienceDirect, and Google Scholar databases, eligible studies published from January 1, 2020 to January 15, 2021 were included for the systematic review and meta-analysis. The random-effects model was used to estimate the pooled proportion of IgG seropositive HCWs. Publication bias was assessed by funnel plot and confirmed by Egger's test. Heterogeneity was quantified using I2 statistics. We performed sensitivity analyses based on sample size, diagnostic method and publication status. The study protocol was registered with PROSPERO (CRD42020219086). FINDINGS: A total of 53 peer-reviewed articles were selected, including 173,353 HCWs (32.7% male) from the United States, ten European, and three East Asian countries. The overall seropositive prevalence rate of IgG antibodies was 8.6% in these regions (95% CI= 7.2-9.9%). Pooled seroprevalence of IgG antibodies was higher in studies conducted in the USA (12.4%, 95% CI= 7.8-17%) than in Europe (7.7%, 95% CI=6.3-9.2%) and East Asia (4.8%, 95% CI=2.9-6.7%). The subgroup study also estimated that male HCWs had 9.4% (95% CI= 7.2-11.6%) IgG seroconversion, and female HCWs had 7.8% (95% CI=5.9-9.7%). The study exhibits a high prevalence of IgG antibodies among HCWs under 40 years in the USA, conversely, it was high in older HCWs (≥40 years of age) in Europe and East Asia. In the months February-April 2020, the estimated pooled seroprevalence was 5.7% (4.0-7.4%) that increased to 8·2% (6.2-10%) in April-May and further to 9.9% (6.9-12.9%) in the May-September time-period. INTERPRETATION: In the view of all evidence to date, a significant variation in the prevalence of SARS-CoV-2 antibodies in HCWs is observed in regions of Europe, the United States, and East Asia. The patterns of IgG antibodies by time, age, and gender suggest noticeable regional differences in transmission of the virus. Based on the insights driven from the analysis, priority is required for effective vaccination for older HCWs from Europe and East Asia. A considerable high seroprevalence of IgG among HCWs from the USA suggests a high rate of past infection that indicates the need to take adequate measures to prevent hospital spread. Moreover, the seroprevalence trend was not substantially changed after May 2020, suggesting a slow progression of long-term SARS-CoV-2 immunity. Routine testing of HCWs for SARS-CoV-2 should be considered even after the rollout of vaccination to identify the areas of increased transmission. FUNDING: None.

Prevalence of mental health symptoms and its effect on insomnia among healthcare workers who attended hospitals during COVID-19 pandemic: A survey in Dhaka city.

BACKGROUND: During the COVID-19 pandemic, the high workload, risk of infection, and safety issues for family members may pose a threat to the mental health of healthcare workers (HCWs) working in hospital settings. The study aimed to find out the prevalence of anxiety, depression, and insomnia symptoms were among HCWs, as well as the factors related to these mental health issues. METHODS: We conducted an online survey of HCWs employed in Dhaka city from June 6 to July 6, 2020. Symptoms of anxiety, depression, and insomnia were measured using the Generalized Anxiety Disorder, the depression module of the Patient Health Questionnaire, and the Insomnia Severity Index, respectively. The related factors of anxiety, depression, and insomnia symptoms were identified using three regression models. RESULTS: This research included responses from 294 HCWs (mean ± standard deviation age: 28.86 ± 5.5 years; 43.5% were female). Anxiety, depression, and insomnia symptoms were found in 20.7%, 26.5%, and 44.2% of HCWs, respectively. The variable financial difficulties was commonly found as an associated factor for anxiety, depression, and insomnia symptoms. Female HCWs were more prone to mental health symptoms and insomnia compared to male HCWs (Adjusted odds ratio- AOR = 2.20, 95% CI = 1.27-3.79). The depression symptoms among HCWs were found to be a factor for insomnia (AOR = 6.321, 95% CI = 3.158-12.650). CONCLUSION: In the current pandemic, the high prevalence of mental health symptoms among HCWs indicates that this occupational group being associated with increased mental distress. Increasing financial support for HCWs and providing support to female workers in care facilities could help to alleviate the burden of mental illness. Supportive, training, and educational strategies, particularly through knowledge and communication platforms, could be recommended to the care facilities, which can reduce the burden of mental health symptoms among HCWs.

Willingness to vaccinate against COVID-19 among Bangladeshi adults: Understanding the strategies to optimize vaccination coverage.

BACKGROUND: Although the approved COVID-19 vaccine has been shown to be safe and effective, mass vaccination in Bangladeshi people remains a challenge. As a vaccination effort, the study provided an empirical evidence on willingness to vaccinate by sociodemographic, clinical and regional differences in Bangladeshi adults. METHODS: This cross-sectional analysis from a household survey of 3646 adults aged 18 years or older was conducted in 8 districts of Bangladesh, from December 12, 2020, to January 7, 2021. Multinomial regression examined the impact of socio-demographic, clinical and healthcare-releated factors on hesitancy and reluctance of vaccination for COVID-19. RESULTS: Of the 3646 respondents (2212 men [60.7%]; mean [sd] age, 37.4 [13.9] years), 74.6% reported their willingness to vaccinate against COVID-19 when a safe and effective vaccine is available without a fee, while 8.5% were reluctant to vaccinate. With a minimum fee, 46.5% of the respondents showed intent to vaccinate. Among the respondents, 16.8% reported adequate adherence to health safety regulations, and 35.5% reported high confidence in the country's healthcare system. The COVID-19 vaccine refusal was significantly high in elderly, rural, semi-urban, and slum communities, farmers, day-laborers, homemakers, low-educated group, and those who had low confidence in the country's healthcare system. Also, the prevalence of vaccine hesitancy was high in the elderly population, low-educated group, day-laborers, people with chronic diseases, and people with low confidence in the country's healthcare system. CONCLUSION: A high prevalence of vaccine refusal and hesitancy was observed in rural people and slum dwellers in Bangladesh. The rural community and slum dwellers had a low literacy level, low adherence to health safety regulations and low confidence in healthcare system. The ongoing app-based registration for vaccination increased hesitancy and reluctancy in low-educated group. For rural, semi-urban, and slum people, outreach centers for vaccination can be established to ensure the vaccine's nearby availability and limit associated travel costs. In rural areas, community health workers, valued community-leaders, and non-governmental organizations can be utilized to motivate and educate people for vaccination against COVID-19. Further, emphasis should be given to the elderly and diseased people with tailored health messages and assurance from healthcare professionals. The media may play a responsible role with the vaccine education program and eliminate the social stigma about the vaccination. Finally, vaccination should be continued without a fee and thus Bangladesh's COVID vaccination program can become a model for other low and middle-income countries.

Economic stressors and mental health symptoms among Bangladeshi rehabilitation professionals: A cross-sectional study amid COVID-19 pandemic.

BACKGROUND: Mental health symptoms are considered a public health concern by many professionals and are frequently impacted by factors related to occupation, employment opportunities, and economic stressors. This study investigated the relationship between economic stressors and mental health symptoms among Bangladeshi rehabilitation professionals. METHODS: We conducted a cross-sectional survey of 420 rehabilitation professionals between July 2020 and October 2020. Economic stressors were measured using Economic Hardship Questionnaire, Financial Threat Scale, and Financial Well-Being Scale. Mental health symptoms were measured using the Depression, Anxiety, and Stress Scale (DASS-21). Multivariable logistic regression analysis was performed to find associated factors on mental health problems after adjusting confounders. RESULTS: Among 420 rehabilitation professionals 62.1% were male, 38.6% were post-graduated and 75% were in practice. The overall prevalence of depression, anxiety, and stress was 51.0%, 58.6%, and 33.6%, respectively. The multivariable regression analysis indicated that without a high professional degree, lack of opportunity to practice, and loss of income were the associated factors for mental health symptoms. The modelling of the structural equation showed that financial threat is significantly associated with mental health symptoms. CONCLUSION: During the era of COVID-19, a high prevalence of mental health symptoms was observed among rehabilitation professionals. To minimize the burden of mental health, we recommend that all rehabilitation organizations and the government come together to create equal opportunities to practice and enable individuals to obtain high professional degrees.

Machine Learning Approaches Reveal That the Number of Tests Do Not Matter to the Prediction of Global Confirmed COVID-19 Cases.

Coronavirus disease 2019 (COVID-19) has developed into a global pandemic, affecting every nation and territory in the world. Machine learning-based approaches are useful when trying to understand the complexity behind the spread of the disease and how to contain its spread effectively. The unsupervised learning method could be useful to evaluate the shortcomings of health facilities in areas of increased infection as well as what strategies are necessary to prevent disease spread within or outside of the country. To contribute toward the well-being of society, this paper focusses on the implementation of machine learning techniques for identifying common prevailing public health care facilities and concerns related to COVID-19 as well as attitudes to infection prevention strategies held by people from different countries concerning the current pandemic situation. Regression tree, random forest, cluster analysis and principal component machine learning techniques are used to analyze the global COVID-19 data of 133 countries obtained from the Worldometer website as of April 17, 2020. The analysis revealed that there are four major clusters among the countries. Eight countries having the highest cumulative infected cases and deaths, forming the first cluster. Seven countries, United States, Spain, Italy, France, Germany, United Kingdom, and Iran, play a vital role in explaining the 60% variation of the total variations by us of the first component characterized by all variables except for the rate variables. The remaining countries explain only 20% of the variation of the total variation by use of the second component characterized by only rate variables. Most strikingly, the analysis found that the variable number of tests by the country did not play a vital role in the prediction of the cumulative number of confirmed cases.

Immediate impact of stay-at-home orders to control COVID-19 transmission on mental well-being in Bangladeshi adults: Patterns, Explanations, and future directions.

OBJECTIVE: We aim to evaluate the immediate impacts of COVID-19 stay-at-home orders on the mental well-being of Bangladeshi adults. We recruited 1404 healthy adults following the Bangladesh government's lockdown announcement. A questionnaire comprising the Warwick Edinburgh Mental Well-being Scale was used to define mental health. RESULTS: The overall mean score for well-being was 42.4, indicating that 51.9% of adults suffered from poor mental health. And within that 48% of males and 57% of females were depressed. The mean scores for government workers, unemployed workers, and business employees were 45.1, 39.6, and 39.5, respectively. Confounding adjustments in multivariable linear regression models revealed that married women, unemployed and business communities, and individuals returning to villages were heavily depressed. Stay-at-home orders had significant repercussions on mental health and created a gender disparity in depression among adults. Suggestions include promoting mental health for women, unemployed, and business individuals. Married women need to be taken into special consideration as their mental well-being is worse. Older people (50 years of age and over) reported a high day-to-day variation in their mental health. These results should be factored in when discussing the mental health of adults and communities to cope with quarantine.