Perceived social support and compliance on stay-at-home order during COVID-19 emergency in Nepal: an evidence from web-based cross-sectional study.

BACKGROUND: After COVID-19 was declared a Public Health Emergency of International Concern by WHO, several non-pharmaceutical interventions were adopted for containing the virus. Success to which largely depend upon citizens' compliance to these measures. There is growing body of evidence linking social support with health promoting behaviour. Hence, this research aimed to study the effects on compliance with stay-at-home order in relation to their perceived social support. METHODS: A web-based cross-sectional study was conducted among adult participants aged 18 years and above residing in Bagmati Province, Nepal. A convenient non-probability sampling method was adopted to select the required number of samples. The questionnaire was developed through an extensive review of literature, and consultations with the research advisor, subject experts, as well as peers and converted to online survey form using Google Forms. Perceived social support was measured using the Multidimensional Scale of Perceived Social Support (MSPSS) scale whereas compliance was assessed using a single screening question. Statistical analysis was performed using SPSS version 20 involving both the descriptive and inferential statistics. RESULTS: Two fifth (40.2%) of the participants reported poor compliance with stay-at-home order which was found higher among participants who were not vaccinated against COVID-19 compared to those vaccinated (p value < 0.05). A significant difference was observed between sex and perceived support (p value < 0.05) with higher proportion (80.8%) of female participants reporting perceived support from family, friends, and significant others in comparison to male participants. CONCLUSION: Overall, the results of this study suggest that the perceived support from family is higher compared to others. Further evidence might be helpful to understand contextual factors on compliance with public health measures. Tailoring behaviour change messages as per the community needs would help the response in such emergencies. The findings from this study might be useful as one of the evidence base for formulating plans and policy during emergencies of similar nature.

Experience of Treating COVID-19 With Remdesivir and Convalescent Plasma in a Resource-Limited Setting: A Prospective, Observational Study.

BACKGROUND: Convalescent plasma therapy (CPT) and remdesivir (REM) have been approved for investigational use to treat coronavirus disease 2019 (COVID-19) in Nepal. METHODS: In this prospective, multicentered study, we evaluated the safety and outcomes of treatment with CPT and/or REM in 1315 hospitalized COVID-19 patients over 18 years in 31 hospitals across Nepal. REM was administered to patients with moderate, severe, or life-threatening infection. CPT was administered to patients with severe to life-threatening infections who were at high risk for progression or clinical worsening despite REM. Clinical findings and outcomes were recorded until discharge or death. RESULTS: Patients were classified as having moderate (24.2%), severe (64%), or life-threatening (11.7%) COVID-19 infection. The majority of CPT and CPT + REM recipients had severe to life-threatening infections (CPT 98.3%; CPT + REM 92.1%) and were admitted to the intensive care unit (ICU; CPT 91.8%; CPT + REM 94.6%) compared with those who received REM alone (73.3% and 57.5%, respectively). Of 1083 patients with reported outcomes, 78.4% were discharged and 21.6% died. The discharge rate was 84% for REM (n = 910), 39% for CPT (n = 59), and 54.4% for CPT + REM (n = 114) recipients. In a logistic model comparing death vs discharge and adjusted for age, gender, steroid use, and severity, the predicted margin for discharge was higher for recipients of remdesivir alone (0.82; 95% CI, 0.79-0.84) compared with CPT (0.58; 95% CI, 0.47-0.70) and CPT + REM (0.67; 95% CI, 0.60-0.74) recipients. Adverse events of remdesivir and CPT were reported in <5% of patients. CONCLUSIONS: This study demonstrates a safe rollout of CPT and REM in a resource-limited setting. Remdesivir recipients had less severe infection and better outcomes.ClinicalTrials.gov identifier. NCT04570982.