ABSTRACT
Background:The COVID-19 pandemic has considerably impacted individuals' lives, extensively from mental and socioeconomic aspects, that requires someone to adapt. For postpartum mothers who also need to go through the maternal psychological adaptation phase, the pandemic could impose overwhelming emotional tension on them, increasing the risk of experiencing postpartum blues. This study aims to analyze the relationship between social factors that are affected during a pandemic with the incidence of postpartum blues on screening test results during the transition period of the COVID-19 pandemic in Banyumanik, Semarang. Subjects and Method: This was a cross-sectional study conducted in Banyumanik, Semarang, from November to December 2022.39 subjects were selected using a consecutive sampling technique. The dependent variable is postpartum blues. The independent variables include marital status, employment status of the mother, employment status of the spouse, and family income level. The study instrument was EPDS questionnaire. The data were analyzed used Chi-square. Results: Out of 39 subjects, 13 (33.3%) were experiencing postpartum blues, and 26 (66.7%) were not experiencing it. Mother's employment status associated with postpartum blues. Mothers who unemployed have a risk of experiencing postpartum blues 1.65 times compared to employed, but these were not statistically significant (OR= 1.65;95% CI= 0.40 to 6.77;p= 0.727). Family income level associated with postpartum blues. Mothers with low to moderate family income reduced postpartum blues by 0.73 times compared to mothers with high income levels, but these were not statistically significant (OR= 0.73;95%CI= 0.19 to 2.80;p= 0.908). Meanwhile, marital status and spouse employment status were not related to the incidence of postpartum blues. Conclusion: Mother's employment status and family income status associated with postpartum blues. Meanwhile, marital status and spouse employment status were not related to the incidence of postpartum blues.
ABSTRACT
Background: Stigma and poor linkage to care, amplified in the setting of the COVID-19 pandemic, are significant barriers for treating hepatitis C (HCV) in vulnerable patients, reducing our ability to implement a rapid test and treat (TnT) strategy with minimal monitoring within a simple patient cascade, as currently available HCV therapies would allow us to do This real-world analysis evaluates our ability to implement this approach in both general (GP) and vulnerable (VP) populations Methods: HCV-infected patients from 32 clinical cohorts in 8 countries treated with sofosbuvir/ velpatasvir without a history of decompensation or prior NS5A-inhibitor exposure were included in this analysis The VP included prisoners, homeless patients and patients with mental disorders Time to treatment (TT) between the most recent HCV RNA measurement and treatment initiation was estimated based on available data Results: A total of 2449 patients were included, 937 in GP (58% males), 1512 (72% males) in VP (59% with mental disorders, 31% homeless, 10% imprisoned) Mean age [standard deviation] was 55 [14] and 50 [14] years in GP and VP respectively Genotype 3 was observed in 35% and 33% respectively, compensated cirrhosis confirmed in 20% and 18% of GP versus VP. The median TT [MTT, interquartile range] was 55 days [23- 107] in GP and 60 days [27-132] in VP The longest MTT of 66 days [32-134] was observed in patients with mental disorders MTT was 63 days [29-149] in prisoners and 27 days [13-71] among the homeless Only 13% of GP and 8% of VP were treated the same day of diagnosis, and 70% of GP and 63% of VP were treated within 3 months In patients with mental disorders only 4% were treated the same day of diagnosis Cure rates were high and consistent with previously reported cure rates Conclusion: MTT varies across HCV patient groups, from over 6 months to 1 day This analysis shows that a quick treatment start is possible, both in general population and in vulnerable populations, supporting the feasibility of a TnT approach in all populations New strategies should be considered to engage patients with mental disorders in this model of care more effectively.