Validity and reliability of the Generalized Anxiety Disorder-7 (GAD-7) among university students of Bangladesh.

This study investigated the reliability and factorial validity of General Anxiety Disorder-7 (GAD-7) in the context of university students in Bangladesh. The research aimed to assess whether the original one-dimensional model or a model containing both somatic and cognitive-emotional factors is appropriate. A repeated cross-sectional survey design based on convenience sampling was used to collect data from 677 university students. The factor structure of the GAD-7 was assessed by exploratory factor analysis (EFA) and confirmatory factor analysis (CFA), and its convergent validity was determined by investigating its correlations with Patient Health Questionnaire-9 (PHQ-9) and Patient Health Questionnaire Anxiety-Depression Scale (PHQ-ADS). Results showed excellent reliability of GAD-7 as measured by Cronbach's α. CFA suggested that a modified one-factor model is appropriate for the sample. This model provided high values of comparative fit index (CFI), goodness of fit index (GFI), and Tucker Lewis Index (TLI), low value of standardized root mean square residual (SRMR) and a non-significant root mean square error of approximation (RMSEA). Correlation between GAD-7 and PHQ-9 was 0.751 and 0.934 between GAD-7 and PHQ-ADS. Overall, the study provided support for modified unidimensional structure for GAD-7 and showed high internal consistency along with good convergent validity.

COVID-19 Vaccination in Lower-Middle Income Countries: National Stakeholder Views on Challenges, Barriers, and Potential Solutions.

The development of COVID-19 vaccines does not imply the end of the global pandemic as now countries have to purchase enough COVID-19 vaccine doses and work towards their successful rollout. Vaccination across the world has progressed slowly in all, but a few high-income countries (HICs) as governments learn how to vaccinate their entire populations amidst a pandemic. Most low- and middle-income countries (LMICs) have been relying on the COVID-19 Vaccines Global Access (COVAX) Facility to obtain vaccines. COVAX aims to provide these countries with enough doses to vaccinate 20% of their populations. LMICs will likely encounter additional barriers and challenges rolling out vaccines compared HICs despite their significant experience from the Expanded Programme on Immunisation (EPI). This study explores potential barriers that will arise during the COVID-19 vaccine rollout in lower-middle-income countries and how to overcome them. We conducted sixteen semi-structured interviews with national-level stakeholders from Ghana and Bangladesh (eight in each country). Stakeholders included policymakers and immunisation programme experts. Data were analysed using a Framework Analysis technique. Stakeholders believed their country could use existing EPI structures for the COVID-19 vaccine rollout despite existing challenges with the EPI and despite its focus on childhood immunisation rather than vaccinating the entire population over a short period of time. Stakeholders suggested increasing confidence in the vaccine through community influencers and by utilising local government accredited institutions such as the Drug Authorities for vaccine approval. Additional strategies they discussed included training more health providers and recruiting volunteers to increase vaccination speed, expanding government budgets for COVID-19 vaccine purchase and delivery, and exploring other financing opportunities to address in-country vaccine shortages. Stakeholders also believed that LMICs may encounter challenges complying with priority lists. Our findings suggest that COVID-19 vaccination is different from previous vaccination programs, and therefore, policymakers have to expand the EPI structure and also take a systematic and collaborative approach to plan and effectively rollout the vaccines.

Prevalence and socio-demographic correlates of depression, anxiety, and co-morbidity during COVID-19: A cross-sectional study among public and private university students of Bangladesh

Background COVID-19 has significantly affected the mental health of students. However, in the context of Bangladesh, no study has explored whether students from public and private universities have been affected differently. Therefore, the aim of the study is to focus on the prevalence of depression, anxiety, and co-morbidity among both types of university students and identify their potential correlates. Methods The study used convenience sampling to collect data from 333 university students. Patient Health Questionnaire-9 (PHQ-9) and General Anxiety Disorder-7 (GAD-7) were used to assess depression and anxiety respectively along with co-morbidity. Descriptive analysis and multivariate logistic regression were conducted to examine the association of variables. Results Among public university students, 59.16% had depression, 53.99% had anxiety and 46.95% had co-morbidity ranging from moderate to severe level. 30.83%, 33.33% and 24.17% of the private university students showed moderate to severe levels of depression, anxiety, and co-morbidity respectively. Overall, female students, students enrolled in third and fourth year, living in nuclear families, and students who spent less time with family reported having higher level of depression, anxiety, and co-morbidity. Limitations Due to the cross-sectional nature of the study, we were unable to make causal inferences. Also, data collected through snowball-sampling were prone to selection bias. Conclusions COVID-19 pandemic imposes a greater burden on mental health of students with different socioeconomic characteristics and university type. Therefore, psychological intervention designs should address these differences.