ABSTRACT
ObjectivesIn addition to risking their physical well-being, frontline physicians are enduring significant emotional burden both at work and home during the COVID-19 pandemic. This study aims to investigate the levels of anxiety and depressive symptoms and to identify associated factors among Bangladeshi physicians during the COVID-19 outbreak. Methods and designA cross-sectional study using an online survey was conducted between April 21 and May 10, 2020. Outcomes assessed included demographic questions, COVID-19 related questions, and the Hospital Anxiety and Depression Scale (HADS). ResultsThe survey was completed by 412 Bangladeshi physicians. The findings revealed that, in terms of standardized HADS cut-off points, the prevalence of anxiety and depressive symptoms among physicians was 67.72% and 48.5% respectively. Risk factors for higher rates of anxiety or depressive symptoms were: being female, physicians who had experienced COVID-19 like symptoms during the pandemic, those who had not received incentives, those who used self-funded PPE, not received adequate training, lacking perceived self-efficacy to manage COVID -19 positive patients, greater perceived stress of being infected, fear of getting assaulted/humiliated, being more connected with social media, having lower income levels to support the family, feeling more agitated, less than 2 hours of leisure activity per day and short sleep duration. All these factors were found to be positively associated with anxiety and depression in unadjusted and adjusted statistical models. ConclusionsThis study identifies a real concern about the prevalence of anxiety and depressive symptoms among Bangladeshi physicians and identifies several associated factors during the COVID-19 pandemic. Given the vulnerability of the physicians in this extraordinary period whilst they are putting their own lives at risk to help people infected by COVID-19, health authorities should address the psychological needs of medical staff and formulate effective strategies to support vital frontline health workers. STHRENGHTS & LIMITATIONS OF THE STUDYO_LIThis study reports a novel and concerning findings on the prevalence of anxiety and depression symptoms with identification of several important associated factors among Bangladeshi physicians during the COVID-19 pandemic. C_LIO_LIThe cross-sectional nature of the study design could not establish causal relationship between the dependent and independent variables. C_LIO_LIThis study was carried out by conducting a web-based survey, which might generate sampling bias by excluding the physicians who do not have access to internet or inactive in social medias, and thus limit the generalizability of the findings. C_LI
Subject(s)
Anxiety Disorders , Depressive Disorder , COVID-19ABSTRACT
Effective pandemic management requires understanding the level of community knowledge, attitude of people and preparedness towards COVID-19. This study aimed to assess the knowledge, attitude and preparedness toward COVID-2019 among Bangladeshi general people. A cross sectional survey was conducted from 20th March 2020 to 20th April 2020 among 1007 Bangladeshi adult people. A convenience sampling strategy was utilized and the data was collected through a self-administered questionnaire. Chi-square test was used to identify the gender differences regarding knowledge, attitude and preparedness towards COVID-19. Respondents predominately used social media to inform themselves about COVID-19 (68.10%) and female used social media more than male (p<0.001). Female had more correct knowledge about staying home with sickness and/or symptoms to contain the COVID-19 transmission (p=.02). While male had more negative attitude about staying out during the pandemic than female (<0.001) and men were less likely to take preventative measures than female counterparts. A number of people were still believing the myths like “COVID-19 can transmit via mosquito” (9.14%) and male had more incorrect knowledge regarding this (p<0.001). Moreover, 17.81% of the respondents thought that COVID-19 can spread in warm weather. Some findings are directing us to a knowledge gap among general population in Bangladesh which calls for uncovering those aspects. Adequate and effective communication are necessary so that general people can stay alert with positive attitude and hygienic practices to fight against this ongoing crisis.
Subject(s)
COVID-19ABSTRACT
Background: The COVID-19 pandemic has impacted the physical, mental and financial health of many individuals. How substantially marginalized groups like impoverished urban-dwelling individuals are specifically impacted amid this pandemic is poorly understood. The present study aimed to investigate correlates of financial concerns and symptoms of depression and posttraumatic stress disorder (PTSD) during the COVID-19 pandemic among impoverished urban-dwelling individuals residing in Dhaka, Bangladesh. Methods: A cross-sectional survey was conducted between August and September 2020 using face-to-face interviews in six disadvantaged neighborhoods (“slums”) in Dhaka. Individuals were interviewed using a structured questionnaire consisting of questions assessing socio-demographics, lifestyle, financial well-being relating to the COVID-19 pandemic, depression, and PTSD. Results: A total of 435 individuals (male=54.7%; mean age=45.0±12.0 years; age range=18-85 years) participated. Most (96.3%) reported that their household income decreased due to the COVID-19 pandemic. Associated factors included female gender, primary education, jobless, food scarcity, and depression. Depression symptoms were linked to female gender, being jobless, being divorced, living in a joint family, excessive sleep, and smoking. Low incomes, excessive sleep, joblessness, and food scarcity were positively associated with PTSD symptoms. In contrast, less sleep appeared protective against PTSD. Limitations: Potential limitations included cross-sectional study design and limited sample size. Conclusions: Public health initiatives, in particular mental health services, should be introduced to mitigate against psychological and financial effects of the pandemic on impoverished urban-dwelling individuals in Bangladesh.
Subject(s)
COVID-19 , Intellectual Disability , Stress Disorders, Post-TraumaticABSTRACT
Background: As with countries worldwide, lockdown measures during the COVID-19 outbreak in Bangladesh were sudden and unexpected, and have the capacity to elicit serious psychological consequences. The present study examined the psychological consequences of COVID-19 in Bangladesh during the lockdown period. Methods: A nationwide online cross-sectional survey study recruited 10,067 individuals covering all 64 districts in Bangladesh via social media (April 1-10, 2020). The survey comprised questions concerning socio-demographics, knowledge of COVID-19, behavior towards COVID-19, fear of COVID-19, insomnia, depression, and suicidal ideation. Logistic regression and structural equation modeling (SEM) analyses were performed to identify the risk factors depression and suicidal ideation. Geographical information system (GIS)-based spatial analysis was used to identify district-wise susceptibility to depression and suicidal ideation. Findings: The prevalence rate of depression and suicidal ideation related to COVID-19 was 33% and 5%. Common risk factors for suicidal ideation and depression included being young, being female, being a cigarette smoker, having comorbid diseases, having high scores on the Fear COVID-19 Scale, and having insomnia symptoms. GIS-based maps detected high depression and suicidal ideation in the capital of Bangladesh and the districts near the capital as well as coastal areas where COVID-19 prevalence was high, as compared with districts with no reported cases. Interpretation: COVID-19 is associated with major psychological impact across Bangladesh, underlining the need of strategically located psychological support measures and improved access to mental health services, especially among women and younger people.Funding Statement: This study received no financial support from either government or non-government organizations.Declaration of Interests: The authors declare no completing interest to this work. Ethics Approval Statement: The ethical aspects were reviewed and approved by the Institute of Allergy and Clinical Immunology of Bangladesh ethics board, Bangladesh (IRBIACIB/CEC/03202005) and Biosafety, Biosecurity, and Ethical Committee of Jahangirnagar University, Bangladesh. Online informed consent was provided before survey participation.
Subject(s)
COVID-19ABSTRACT
Background: Healthcare workers (HCWs) who are in the frontline during the COVID-19 pandemic are often under significant pressures which may predispose them to mental ill-health. This study aimed to investigate the prevalence of anxiety and depression among HCWs and factors correlated with mental problems during the COVID-19 pandemic in Bangladesh. Methods: A cross-sectional survey was conducted between July and August 2020. A self-reported online questionnaire was utilized to collect data. The survey included questions concerning socio-demographic, lifestyle, and work setting and the Hospital Anxiety and Depression Scale (HADS). Results: Data from 803 HCWs (50.7% male; mean age: 27.3 [SD=6.9]; age range: 18-58 years) were included in analyses. Prevalence estimates of anxiety and depression were, respectively, 69.5% and 39.5% for at least borderline abnormal, 41.2% and 15.7% for at least abnormal symptoms. Regression analyses with HADS-score as dependent variable revealed significant (p<0.05) associations with female sex, moderate and poor health status, irregular physical exercising, smoking, having had regrets about their profession because of the pandemic and many unexpected experiences, not updating on the latest COVID-19-related research, experiencing discrimination in the workplace, and facing social problems due to working in a lab or hospital. Conclusions: Symptoms of mental ill-health are prevalent among HCWs during the COVID-19 pandemic in Bangladesh. The findings suggest a need for monitoring and early interventions to help these individuals.
Subject(s)
Anxiety Disorders , Intellectual Disability , COVID-19ABSTRACT
Background: The emergent COVID-19 has impacted unprecedentedly to all classes of people. Slum-dwellers' knowledge, attitudes and practices (KAP) towards COVID-19 are currently poorly understood. To investigate the KAP towards COVID-19 among slum dwellers resided in Dhaka City, Bangladesh. Methods: A cross-sectional offline survey was carried out enrolling 406 slum dwellers (53.2% male; mean age=44.9 years [SD=12.1]; age range=18-85 years) between August and September, 2020. The face to face interview was conducted to collect data from 6 selected slum areas in Dhaka City using convenience sampling. The questionnaire consisted of informed consent along with questions concerning observational checklists, socio-demographics, and KAP. Results: A sizeable minority were observed without wearing face masks during the survey periods (18.2%) and a vast portion (97.5%) without any hand protection. The mean scores of KAP were 6.1plus-or-minus sign2.6 (out of 17), 12.3plus-or-minus sign1.7 (out of 14), and 9.8plus-or-minus sign1.6 (out of 12), respectively. Moreover, the KAP were strongly and positively correlated with each other. Conclusions: The findings revealed that the majority of slum dwellers in Bangladesh have limited knowledge of COVID-19. Poor practices (i.e., face mask and hand protection) were directly observed during the survey. The findings suggest the immediate implementation of health education programs and adequate interventions.
Subject(s)
COVID-19ABSTRACT
Background:The ongoing COVID-19 pandemic has created several challenges including the financial burden which may result in mental health conditions. Aim: This study was undertaken to gauge the mental health difficulties during the COVID-19 pandemic to gain an insight into wage earners’ mental health as they are responsible for maintaining the finance of their families in this critical situation. Method: This cross-sectional study was conducted through an online survey, a total of 707 individual Bangladeshi wage earners were enrolled in between 20 May 2020 and 30 May 2020. The questionnaire had sections on sociodemographic information, COVID-19 related questions, PHQ-9 & GAD-7 scales to assess depressive symptoms & anxiety, respectively. STATA version 14.1 program was used to carry out all the analyses. Results: The study revealed that 58.6% and 55.9% of the respondents had moderate to severe anxiety and depressive symptoms, respectively. The total monthly income less than 30,000 BDT (353.73USD) displayed increased odds of suffering from depressive symptoms (OR=4.12; 95% CI: 2.68-6.34) and anxiety (OR=3.31; 95% CI: 2.17-5.03). Participants who didn’t get any salary, had no income source during lockdown, had financial problem, inadequate food supply were more likely to suffer from anxiety and depressive symptoms (p ≤ .01). Perceiving the upcoming financial crisis as a stressor was a potential risk factor for anxiety (OR=1.91; 95% CI:1.32-2.77) and depressive symptoms (OR=1.50; 95% CI:1.04-2.16). Conclusion: Wage-earners in a low resource setting like Bangladesh require mental health attention. Furthermore, financial consideration from the state or their workplace may help them to deal with mental health difficulties during this pandemic.
Subject(s)
COVID-19 , Anxiety Disorders , Intellectual DisabilityABSTRACT
Introduction:The economic vulnarability imposed by the COVID-19 pandemic induces stress on mental health of wage earnes in Bangladesh which is largely unexplored. This evidence gap was addressed in this study aiming to evaluate the mental health difficulties among Bangladeshi wage earners by assessing the associated factors influencing anxiety, depressive symptoms and sleep patterns. Methods: This cross-sectional study was conducted through online survey, a total of 707 individual Bangladeshi wage earners were enrolled in between 20 May 2020 and 30 May 2020. The questionnaire had sections on sociodemographic information, COVID-19 related information, & sleep duration; PHQ-9 & GAD-7 scales to assess depressive symptoms & anxiety, respectively. STATA version 14.1 program was used to carry out all the analyses. Results: The study revealed that anxiety and depressive symptoms among wage earners differed by gender, educational status, occupation, total monthly income (p ≤0.01). Fear of COVID-19 when working outside during the pandemic situation was inextricably linked with anxiety (AOR=2.08; 95% CI:1.42-3.04) and depressive symptoms (AOR=1.51; 95% CI= 1.04-2.20) among wage-earners. Participants who stayed at home for longer duration (>60 days) were more likely to have elevated anxiety and depressive symptoms (p≤ 0.05). Regarding sleep pattern, longer home stay during COVID-19 pandemic increased duration of sleep (β=0.70; 95% CI: 0.30 to 1.10) and respondents who were responsible to financially support their family experienced significantly decreased duration of sleep (β= -0.68; 95% CI: -1.18 to -0.20). Conclusions: The results of this study provided novel evidence on psychological difficulties among Bangladeshi wage earners which calls for an in-depth & longitudinal evaluation and immediate low intensity psychosocial interventions.
Subject(s)
Anxiety Disorders , COVID-19ABSTRACT
Background: The most recent global pandemic of COVID-19 has been creating multidimensional damages, including a detrimental impact on the mental health status of individuals. Medical students, a vulnerable cross-section of the population, may have perceived a myriad of psychological stressors during this crisis in the background of their prevailing stressful academic pressure and preexisting higher psychological and mental health issue. Objective: To determine the prevalence of anxiety and depressive symptoms and to elucidate the psychological impact of COVID-19 pandemic on Bangladeshi medical students. Method: A cross-sectional study design was utilized to conduct this survey. The online survey including demographic questions, COVID-19 related questions, and the Hospital Anxiety and Depression Scale (HADS; higher scores on the subscales indicate higher levels of depressive and anxiety symptoms), was completed by 425 Bangladeshi medical students. Collected data were statistically analyzed by using SPSS (version 25.0) software. Result: The HADS anxiety subscale revealed that 65.9% of the medical students had different levels of anxiety, ranging from mild (27.3%), moderate (26.8%), and severe (11.8%). As per HADS depression subscale, 49.9% of the medical students had varying degrees of depressive symptoms, with 3.3% of the participants had suffered from severely severe depressive symptoms. Female students had a relatively more anxiety and depressive symptoms, when compared with males. The students, who were severely tensed of getting infected by the virus, were at higher risk of suffering from anxiety (3.5-fold) and depressive (2.7-fold) symptoms, when compared with no/minimally stressed students. Besides, fear of getting assaulted or humiliated on the way to hospital or home, not to be able to give maximum concentration on study after COVID-19 pandemic, students’ present emotional status (agitation), had statistically significant higher risk of anxiety. Conclusion: A substantial proportion of Bangladeshi medical students are experiencing pandemic-related adverse psychological impact. The poor mental health conditions of these vulnerable medical students pose important threat to their potential contribution in future health care. Thus, medical colleges and health authorities should focus on addressing their psychological needs and formulate effective strategies to ameliorate medical students’ mental health status, particularly during any infectious disease outbreak.
Subject(s)
COVID-19 , Anxiety Disorders , Intellectual Disability , Communicable DiseasesABSTRACT
Background: COVID-19 is imposing threat both on physical and mental health since its outbreak. Bangladesh adopted lockdown strategy with potential consequences on day to day life, mental and physical health and this study aims to explore the impact of COVID-19 on mental health and wellbeing among Bangladeshi students. Methods: A cross-sectional study was conducted between 9th and 23th April 2020 among 505 college and university students. Data was collected by using online questionnaire including DASS 21 and IES. Descriptive analysis and bivariate linear regression were performed to examine the association of variables. Results: 28.5 % of the respondents had stress, 33.3% anxiety, 46.92% depression from mild to extremely severe, according to DASS 21 and 69.31% had event-specific distress from mild to severe in terms of severity according to IES. Perceiving physical symptoms as COVID-19 was significantly associated with DASS stress subscale (B=3.71, 95% CI: 1.01 to 6.40), DASS anxiety subscale (B= 3.95, 95% CI: 1.95 to 5.96), DASS depression subscale (B=3.82, 95% CI: 0.97 to 6.67) and IES scale (B=7.52, 95% CI: 3.58 to 11.45). Additionally, fear of infection, financial uncertainty, inadequate food supply, absence of physical exercise and limited or no recreational activity had significant association with stress, anxiety, depression and post-traumatic symptoms. Conclusion: This COVID-19 outbreak imposes psychological consequences on people to a great extent which requires attention from the concerned authorities to cope with this situation mentally. The perception about the outbreak can also play a big role in psychological impact.