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There is limited seroepidemiological evidence on the magnitude and long-term durability of antibody titers of mRNA and non-mRNA vaccines in the Qatari population. This study was conducted to generate evidence on long-term anti-S IgG antibody titers and their dynamics in individuals who have completed a primary COVID-19 vaccination schedule. A total of 300 male participants who received any of the following vaccines BNT162b2/Comirnaty, mRNA-1273, ChAdOx1-S/Covishield, COVID-19 Vaccine Janssen/Johnson, or BBIBP-CorV or Covaxin were enrolled in our study. All sera samples were tested by chemiluminescent microparticle immunoassay (CMIA) for the quantitative determination of IgG antibodies to SARS-CoV-2, receptor-binding domain (RBD) of the S1 subunit of the spike protein of SARS-CoV-2. Antibodies against SARS-CoV-2 nucleocapsid (SARS-CoV-2 N-protein IgG) were also determined. Kaplan-Meier survival curves were used to compare the time from the last dose of the primary vaccination schedule to the time by which anti-S IgG antibody titers fell into the lowest quartile (range of values collected) for the mRNA and non-mRNA vaccines. Participants vaccinated with mRNA vaccines had higher median anti-S IgG antibody titers. Participants vaccinated with the mRNA-1273 vaccine had the highest median anti-S-antibody level of 13,720.9 AU/mL (IQR 6426.5 to 30,185.6 AU/mL) followed by BNT162b2 (median, 7570.9 AU/mL; IQR, 3757.9 to 16,577.4 AU/mL); while the median anti-S antibody titer for non-mRNA vaccinated participants was 3759.7 AU/mL (IQR, 2059.7-5693.5 AU/mL). The median time to reach the lowest quartile was 3.53 months (IQR, 2.2-4.5 months) and 7.63 months (IQR, 6.3-8.4 months) for the non-mRNA vaccine recipients and Pfizer vaccine recipients, respectively. However, more than 50% of the Moderna vaccine recipients did not reach the lowest quartile by the end of the follow-up period. This evidence on anti-S IgG antibody titers should be considered for informing decisions on the durability of the neutralizing activity and thus protection against infection after the full course of primary vaccination in individuals receiving different type (mRNA verus non-mRNA) vaccines and those with natural infection.
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BACKGROUND: COVID- 19 vaccines have been released, giving a major hope of getting rid of the dark pandemic crisis. Availability of vaccine does not necessarily mean that the mass vaccination program is a success. We aimed to investigate COVID-19 vaccination knowledge level, acceptance rate, and perception state among Egyptians. METHODS: An analytical cross-sectional online survey was carried out utilizing a self-administered adult questionnaire which assesses vaccination acceptance with related socio-demographic factors and perceptions based on health belief model perspectives. Predictors of vaccination acceptance were based on logistic regression analysis. RESULTS: We analyzed data for 957 participants, aged 18-78 years, 55.7% were females, and 66.9% were healthcare workers (HCWs). About one-fourth had history of confirmed COVID-19 infection and 56.5% would accept to have one of COVID-19 vaccines where "Pfizer" was the most preferable one (37.8%), while "AstraZeneca" was the most rejected vaccine (26.8%). The 1st vaccine dose was received by 273 (28.5%) of which 260 were intended to receive the 2nd dose. Vaccine efficacy, side effects, protection time, and administration route were essentially among factors that may influence their decision to accept COVID-19 vaccines. About 83.1% had good knowledge about vaccination which was significantly higher with increased age, among graduates/professionals, governmental workers, HCWs in addition to those able to save/invest money, had history of confirmed COVID-19 infection, and intending to have COVID-19 vaccine.. Perceptions that vaccination decreases chance of getting COVID-19 or its complications (OR=9.28; CI: 5.03-17.12), vaccination makes less worry about catching COVID-19 (OR=6.76; CI: 3.88-11.76), and being afraid of getting COVID-19 (OR=2.04; CI: 1.26-3.31) were strong significant predictors for vaccine acceptance. CONCLUSIONS: Vaccine campaigns should emphasize vaccine benefits and highlight severity of infection, while addressing barriers to vaccination in order to improve vaccine coverage among populations.
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BackgroundEpidemics are a constant threat in the 21st century, particularly disease outbreaks following spillover of an animal virus to humans. Timeliness, a key metric in epidemic response, can be examined to identify critical steps and delays in public health action.AimTo examine timeliness, we analysed the response to the Middle East respiratory syndrome (MERS) epidemic, with a focus on the international and One Health response efforts.MethodsWe performed a historical review of the MERS epidemic between September 2012 and January 2019 in three steps: (i) the construction of a timeline identifying critical events in the global response, (ii) the performance of a critical path analysis to define outbreak milestones and (iii) a time gap analysis to measure timeliness in the execution of these milestones.ResultsWe proposed 14 MERS-specific milestones at different phases of the epidemic, assessing timeliness of the public health response as well as at the animal-human interface, where we identified the most significant delays.ConclusionsWhen comparing timeliness across three coronavirus epidemics, i.e. MERS (2012), SARS (2002) and COVID-19 (2019), we identified clear improvements over time for certain milestones including laboratory confirmation and diagnostics development, while this was not as apparent for others, as the identification of zoonotic hosts. To more efficiently respond to emerging threats, the global health community should widely assess and tackle specific delays in implementing response interventions by addressing challenges in the sharing of information, data and resources, as well as efficiency, quality, transparency and reliability of reporting events.
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COVID-19 , Epidemics , Middle East Respiratory Syndrome Coronavirus , Animals , Humans , Reproducibility of Results , Disease Outbreaks , Public HealthABSTRACT
BACKGROUND: The COVID-19 pandemic in Egypt triggered national preparedness, public engagement, and an integrated response that included social distancing measures, for example, staying at home. We aimed to investigate community awareness of and commitment to complying with the stay-at-home orders in Damietta Governorate, Egypt, during the COVID-19 pandemic. METHODS: A web-based cross-sectional survey was designed and completed by 500 adult participants from Damietta, Egypt, between April 10 and July 15, 2020. Participants were asked about their sociodemographics, sources of knowledge about COVID-19, awareness of COVID-19 prevention methods, commitment to stay-at-home orders, and their trust in governmental measures, community resources, and emergency services. The participants were classified as stay-at-home responders or nonresponders. RESULTS: Of the participants, 18.4% responded to stay-at-home orders; the main reasons for leaving home were buying essentials, especially food, and going to work. Compliance was significant among elderly individuals and those with a history of chronic illness. Nonresponse was significant among individuals who were married, working, or had low family income. More than one-third (39.2%) had good knowledge of effective methods of COVID-19 prevention, and the overall accepted knowledge was significantly higher among stay-at-home responders than nonresponders. Their trust in governmental measures, community resources, and emergency services to manage the pandemic was poor-84.6%, 71.8%, and 79%, respectively-with no significant differences between the groups. CONCLUSIONS: Participants' compliance with and engagement in stay-at-home orders in Damietta Governorate, Egypt, was poor. Public response to stay-at-home orders is affected by sociodemographics, and the public's trust in governmental measures, community resources, and emergency services was poor. Understanding how social distancing is perceived in Egypt is important to provide public support and improve pandemic disease containment.
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BACKGROUND: Public acceptance, trust, and actual uptake of COVID-19 vaccines are crucial to stem the pandemic. Although roll out of vaccines was high in KSA, the public response was not sufficiently studied. We aimed to investigate knowledge level, acceptance, and trust in COVID-19 vaccination and related predictors among adults in Makkah, KSA. METHODS: A web-based cross-sectional survey using a snowballing sample was carried on 507 adult Saudi population living in Makkah city. The survey was developed based on literature search. In the logistic analysis, the dependent variables included acceptance rate and trust in effectiveness and safety of COVID-19 vaccines, while the independent variables (predictors) were sociodemographics and level of knowledge. RESULTS: The survey included 507 participants, aged 18-78 years, 55.8% were females, and 36.7% had (or one of their family members) previously been exposed to COVID-19 infection. Their knowledge about COVID-19 vaccination was satisfactory (86.2%) with 71.2% intended to receive COVID-19 vaccination, and 56.4% was confident of the vaccine effectiveness. Vaccine efficacy, duration of protection, schedule of vaccination, and recommendation by authorities may favor their decision to accept or decline COVID-19 vaccines. Good knowledge about vaccines (OR = 2.07; CI: 1.24-3.48 for acceptance and OR = 2.67; CI: 1.58-4.51 for trust), higher educational level (OR = 1.80; CI: 1.07-3.40 for acceptance and OR = 3.59; CI: 2.08-6.21 for trust), previous seasonal flu vaccination (OR = 1.66; CI: 1.09-2.53 for acceptance and OR = 1.91; CI: 1.31-2.79 for trust), female sex (OR = 1.62; CI: 1.1-2.39 for acceptance and OR = 4.15; CI: 2.86-6.04 for trust), and history of COVID-19 infection (OR = 1.57; CI: 1.04-2.37 for acceptance and OR = 1.69; CI: 1.17-2.46 for trust) were among significant predictors for both vaccine acceptance and trust in vaccine effectiveness. CONCLUSIONS: Adult Saudi population in Makkah city showed satisfactory knowledge about COVID-19 vaccination with moderate rate of vaccine acceptance and a relatively low rate of confidence in vaccine effectiveness. Better understanding of public acceptance and trust in COVID-19 vaccines and addressing barriers to vaccination are recommended to improve vaccine coverage and to reinforce some communication characteristics of the current vaccination campaign.
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Background: COVID-19 is the first pandemic during which innovative technologies are being used to keep people connected, safe, and productive while being physically and socially apart. Aims: This study aimed to map health innovations in response to the pandemic in the Eastern Mediterranean Region. Methods: Health innovations are defined as novel methods, models, processes, products, services, or a combination that produce notable public health impact in people, families, and communities at large. We used two approaches: an online survey using a specially designed data collection tool and a review of publicly available literature using PubMed, IMEMR, Google Scholar, Google, and INSERM search engines. Data collection was conducted between September 2020 and February 2021. Results: We describe 80 innovations in this region, of which 13 were identified through the online survey and 76 via literature review. For the purposes of this paper, we subclassified two-thirds of these innovations (n = 52; 65%) as "digital health innovations", including telehealth and telemedicine, surveillance, and contact tracing. The rest were classified as "non-digital health innovations", including prevention and clinical management. Conclusion: This mapping exercise provides baseline information on response to the pandemic by the public and private sectors, innovation hubs within and outside the region, as well as by entrepreneurs and innovators. In-depth studies measuring the impact of health innovations will likely only become available when the pandemic is under better control and experts are able to assess the replicability, sustainability and scalability of the health innovations introduced.
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COVID-19 , Pandemics , Arabs , COVID-19/epidemiology , Humans , Mediterranean Region/epidemiology , Pandemics/prevention & control , Public HealthABSTRACT
Objectives: Manual and Craft Workers (MACWs), who constitute more than 80% of the population, were identified to be a vulnerable group to COVID-19 in Qatar. The goal of this study is to identify the limitations face MACWs in Qatar towards practicing the COVID-19 preventive measures and thereby designing behavioral change strategies. Methods: This is a qualitative research study in which individual interviews and focus group discussions were utilized for a deep understanding of the phenomenon from key informants. Four onlive individual interviews and four focus groups (n = 55) were conducted and transcribed verbatim. Inductive qualitative analysis was followed to discover the themes of the interviews. Data were analyzed using constant comparative techniques. Results: Major themes elicited from the analysis revealed that the barriers to following COVID-19 preventive behaviors among migrant workers in Qatar included barriers related to knowledge and risk perception;lifestyle and habits;nature of work and living conditions, and barriers related to health communication, diversified cultures, and languages. Conclusion: The findings would support constructing culturally sensitive health education messages and planning for effective health communication campaigns.
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Health research, innovation and knowledge management remain major priorities of the WHO's response to the COVID-19 pandemic. WHO's Eastern Mediterranean Regional Office (EMRO) supports priority research initiatives that address gaps in current knowledge regarding the COVID-19 pandemic. Through a specific call for proposals, 122 research proposals were received and reviewed in 2020, of which 17 were recommended for funding from eight countries. Ten countries in the region participated in the global solidarity trial to assess potential therapies for COVID-19. In addition, WHO advocated for early serological and epidemiological investigations ('COVID-19 Unity Studies') on the general population, healthcare workers, pregnant women and neonates, and extending technical, financial and material support for them.Starting in early 2020, scholarly articles on COVID-19 have been published in every issue of the Eastern Mediterranean Health Journal More than 6300 publications on COVID-19 were made available on the WHO knowledge management portal in the last year alone. WHO is also supporting countries in conducting studies to assess the field effectiveness of vaccines deployed nationally. To build and strengthen country capacities, regional webinars and intercountry meetings were conducted on research ethics, national health information systems and evidence-based health policy making. With support from WHO EMRO's new research and knowledge management pillar, countries in the region were well equipped to contribute to a global understanding of the novel virus's characteristics, as well as employ a national response based on informed evidence.
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COVID-19 , Female , Humans , Infant, Newborn , Knowledge Management , Pandemics/prevention & control , Policy Making , Pregnancy , World Health OrganizationABSTRACT
Background Worldwide, millions of people got COVID-19 infection since the start of the pandemic with a large number of deaths. Re-infection with SARS-CoV-2 is possible, because it can mutate into new strains as it is an RNA virus. The main objective of our study is to correlate between CT severity score of the patients re-infected with COVID-19 during the first and second attack and its clinical impact. Results We performed a retrospective cohort study. It was carried out on fifty symptomatic patients (11 females and 39 males). Their ages ranged from 38 to 71 years. We included only patients who were re-infected after more than 6 months of the first infection and showed clinical symptoms with SARS-CoV-2 PCR-positive test. We found that CT severity score was decreased in the second infection in 47 (94%) of our patients associated with decreased respiratory distress as well as oxygen requirements, while the CT severity score was increased in two patients and only one patient showed no change in CT score severity between two infections. Conclusion The reduction in CT severity score in the majority of re-infected patients suggested the role of the immunity developed from first infection in protection against severe lung affection in case of repeated infection even after 6 months despite poor immunity against re-infection.
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The Eastern Mediterranean Region (EMR) faces massive challenges that threaten people's livelihood and health due to multiple factors, including socioeconomic disparities, conflicts and emergencies in many countries of the Region. The COVID-19 pandemic has further exacerbated these challenges and significantly disrupted access to essential health services. As highlighted in recent flagship reports, the region is unlikely to achieve health-related Sustainable Development Goals, unless crucial changes are made in the way the goals are pursued. Effective implementation of digital health technologies could provide opportunities to enhance the response to the pandemic, as well as improve the access to health services and develop stronger and more resilient health systems.
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COVID-19 , Pandemics , Humans , Mediterranean Region/epidemiology , SARS-CoV-2Subject(s)
COVID-19/diagnosis , Adolescent , COVID-19/epidemiology , COVID-19/physiopathology , Child , Child, Preschool , Cross-Sectional Studies , Female , Humans , Infant , Male , Prevalence , Qatar/epidemiologyABSTRACT
There is a paucity of evidence about the prevalence and risk factors for symptomatic infection among children. This study aimed to describe the prevalence of symptomatic coronavirus disease 2019 (COVID-19) and its risk factors in children and adolescents aged 0-18 years in Qatar. We conducted a cross-sectional study of all children aged 0-18 years diagnosed with COVID-19 using polymerase chain reaction in Qatar during the period 1st March to 31st July 2020. A generalised linear model with a binomial family and identity link was used to assess the association between selected factors and the prevalence of symptomatic infection. A total of 11 445 children with a median age of 8 years (interquartile range (IQR) 3-13 years) were included in this study. The prevalence of symptomatic COVID-19 was 36.6% (95% confidence interval (CI) 35.7-37.5), and it was similar between children aged <5 years (37.8%), 5-9 years (34.3%) and 10 + years (37.3%). The most frequently reported symptoms among the symptomatic group were fever (73.5%), cough (34.8%), headache (23.2%) and sore throat (23.2%). Fever (82.8%) was more common in symptomatic children aged <5 years, while cough (38.7%) was more prevalent in those aged 10 years or older, compared to other age groups. Variables associated with an increased risk of symptomatic infection were; contact with confirmed cases (RD 0.21; 95% CI 0.20-0.23; P = 0.001), having visited a health care facility (RD 0.54; 95% CI 0.45-0.62; P = 0.001), and children aged under 5 years (RD 0.05; 95% CI 0.02-0.07; P = 0.001) or aged 10 years or older (RD 0.04; 95% CI 0.02-0.06; P = 0.001). A third of the children with COVID-19 were symptomatic with a higher proportion of fever in very young children and a higher proportion of cough in those between 10 and 18 years of age.